When Breath Becomes Air by Dr. Paul Kalanithi (2016)

In my continued fascination with cancer books, I easily read this small book in one41jFVZL72YL._SX336_BO1,204,203,200_ sitting.  It’s hard not to.  From the outset, we know the author is doomed by a cancer diagnosis at a young age, and we cannot help but be heartbroken by his unfortunate circumstances.  A neurosurgical resident in his mid thirties, Kalanithi worked at breakneck speed for years on end trying to become the best doctor he could be.  This entailed never-ending shifts, personal sacrifices, and seemingly little attention to his marriage.  And just as he sees this pace of life nearing its end, he notices something is awry with his body.  How and why it took him several months to realize his symptoms were a sign of something far worse than fatigue is rather confusing and seemingly unrealistic, but apparently he was able to justify  pain, weight loss and other discomforts as merely the strain of his work. That struck me as rather out of touch for a doctor dealing with cancer patients on a regular basis, but much like teenagers who feel invincible, a successful surgeon in the most difficult specialty probably lives in that same false state of security.

Kalanithi write this book as he is undergoing treatment–and literally as he’s dying.  We get detailed accounts of daily appointments, his attempts to continue to work, and his conversations with his wife and his friends.  And yet, somehow, the raw emotion of this journey doesn’t come through the way it should.  Perhaps because the book is essentially a first draft or perhaps because his attempts at humility feel forced or perhaps because he simply does not know how to express himself, it feels like there is a gap between the writer and us. His story is emotional, but I still felt like he was holding back his true self.  Whereas the last 20-ish pages of the book written by his wife after his death seem to hit the reader with much more power and genuineness.  I guess I just liked her better than him and felt connected with her loss more than his.

Still, it’s a book that cannot help but ask us to reflect, to consider what it means to live and to die, to hang on and to let go.  It does not have the power of Atul Gawande’s Being Mortal, but it does move us to consider who we are, what we value, and how we’re living our lives.

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