“When Breath Becomes Air” by Paul Kalanithi

I recently read, “When Breath Becomes Air,” by Paul Kalanithi. This memoir is written by a chief neurosurgeon resident who was diagnosed with Stage 4 lung cancer before he finished his residency.when-breath-becomes-air

I’m not giving any spoilers, although the reviews and book descriptions don’t hide the fact that the memoir was published posthumously.

Some choice gems from Kalanithi include:

How little do doctors understand the hells through which we put patients.

Re going from his role as chief neurosurgery resident to that of a patient:

My life had been building potential, potential that would now go unrealized. I had planned to do so much, and I had come so close. I was physically debilitated, my imagined future and my personal identity collapsed, and I faced the same existential quandaries my patients faced.

Yes, how painful to have your life plans, along with your identity, thwarted by illness. If we aren’t that which we aspire towards, then who and what do we become?

Death, so familiar to me in my work, was now paying a personal visit.

I sat, staring at a photo of Lucy and me … It was so sad, those two, planning a life together, unaware, never suspecting their own fragility.

I would have to learn to live in a different way, seeing death as an imposing itinerant visitor but knowing that even if I’m dying, until I actually die, I am still living.

Kalanithi’s oncologist talked to him on numerous occasions about “setting your values.” She encouraged him to identify what mattered most and then focus on those things in the time that remained. He writes:

The tricky part of illness is that, as you go through it, your values are constantly changing.

Grand illnesses are supposed to be life-clarifying. Instead, I knew I was going to die — but I’d known that before. My state of knowledge was the same, but my ability to make lunch plans had been shot to hell.  The way forward would seem obvious, if only I knew how many months or years I had left. Tell me three months, I’d spend time with family. Tell me one year, I’d write a book. Give me ten years, I’d get back to treating diseases. The truth that you live one day at a time didn’t help: What was I supposed to do with that day?

Severe illness wasn’t life altering, it was life shattering. It felt less like an epiphany, a piercing burst of light illuminating what really matters, and more like someone had just firebombed the path forward. Now I would have to work around it.

His wife, Lucy, writes in the Epilogue:

Relying on his own strength and the support of his family and community, Paul faced each state of his illness with grace–not with bravado or a misguided faith that he would “overcome” or “beat” cancer but with an authenticity that allowed him to grieve the loss of the future he had planned and forge a new one.

In Paul Kalanithi’s short time on earth, he made lasting contributions, not the least of which was writing, “When Breath Becomes Air.”


  1. A very good book that gives one much to think about. From #CancerBookClub: https://anticancerclub.com/club-activities/cancerbookclub/replays/

  2. Dana Stone Goldberg says

    It was s beautifully written and powerful book.

  3. Thank you for this post. I will be reading this very soon. xx

  4. This one has been on my list for some time and I will be moving it up. It sounds like he has some very thought provoking insights. Thanks for the review!

  5. Loved it, in a love/hate kind of way. same with ‘Being Mortal.’

  6. I love this book!

  7. Thank you for reminding me of some of the little nuggets of profound wisdom that were written in that book. It is a book that can be read over and over again as something new is learned each time.

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