When Breath Becomes Air

Author: 
Kalanithi, Paul

A profoundly moving, exquisitely observed memoir by a young neurosurgeon faced with a terminal cancer diagnosis who attempts to answer the question—What makes a life worth living?

At the age of thirty-six, on the verge of completing a decade’s worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor treating the dying, and the next he was a patient struggling to live.

And just like that, the future he and his wife had imagined evaporated.

When Breath Becomes Air chronicles Kalanithi’s transformation from a naïve medical student "possessed," as he wrote, "by the question of what, given that all organisms die, makes a virtuous and meaningful life" into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality.

What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir.

Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all:

I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything. Seven words from Samuel Beckett began to repeat in my head: "I can’t go on. I’ll go on."

When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both. (From the publisher.)

Genre: 
Discussion Guide: 

1. How would you describe Dr. Paul Kalanithi? What kind of a person was he?

2. One of the most profound questions addressed in this book is what makes life worth living in the face of death. We all face death, but Paul Kalanithi knew his was imminent. What answers, or at least consolations, does he find?

3. Kalanithi quotes Samuel Beckett's seven words: I can't go on. I'll go on." Talk about what that means, not just for Paul Kalanithi but for all of us. In the face of dying, especially prolonged, how does one "go on" or, in popular parlance, "keep on keeping on"?

4. One of the ironies of Kalanithi's life is that he postponed learning how to live in order to learn how to be a doctor. But once he knew he had lung cancer, he had to learn how to die. What are the ways in which he learned to live...and learned to face his death? Would you be as brave and thoughtful as Katanithi was?

5. Describe Kalanithi's love-hate relationship with medicine. He saw it as a job that kept his cardiologist father away from home. But how else did he see it?

6. What kind of a doctor was Kalanithi? Why was he, even at a young age, able to understand the needs of his patients more than so many other young doctors?

7. Kalanithi said that he acted in caring for his patients as "death's ambassador." "Those burdens, he wrote, "are what makes medicine holy and wholly impossible." What does he mean?

8. Once Kalanithi and his wife learned that he had terminal cancer, why did they decide to have a child? Even Kalanithi wonders if having a child wouldn't make it harder to die. What would you do?

9. How would you (or will you) go about dying? How do you think of death—as something distant, something frightening or horrible, as part of the normal spectrum of life, as a closing of this chapter of your life and the opening of another? What comes to mind when you think of your own demise?

 10. Do you find When Breath Becomes Air enlightening, insightful, spiritual, maudlin? Would you describe it as an important book or merely interesting?

(Questions by LitLovers)