When Breath Becomes Air

At the beginning of Paul Kalanithi’s memoir, When Breath Becomes Air, he appears to be a health practitioner at work, scrolling via CT scan pictures on a sanatorium computer: “the diagnosis was obvious: the lungs have been matted with innumerable tumors, the spine deformed, a full lobe of the liver obliterated”. The story takes a surprising flip when he adds, “This scan used to be different: it used to be my own”. 15 months earlier than the quit of his neurosurgery residency, Kalanithi was diagnosed with lung cancer. He died much less than 2 years later. When Breath Becomes Air is Kalanithi’s first and solely book. So many books and essays have been written about the shock doctors experience upon becoming patients, and about sufferers who learn to live when they face death, that it may appear there is nothing extra to say. Kalanithi’s memoir is special, however, because it offers a portrait not solely of a younger health practitioner facing tragic circumstances, but additionally of a deeply reflective man who wants to understand what its ability to be a doctor, a father, and a mortal being.

In the first 1/2 of the book, in which Kalanithi describes his education and residency, it turns into clear that his dependency of reflection lengthy preceded his diagnosis. Even earlier than medical school, he studied literature and philosophy. As a scientific student, he meditated the relationship of the intelligence and idea and asked questions about the best of life versus its quantity. Later as a young neurosurgeon, he described his work as “a manipulation of the substance of our selves”. He desired his patients to understand that they would possibly emerge from surgical treatment with modified capacities, so he spent time discussing what kind of lives they felt have been really worth living. Since Kalanithi was once so reflective about identification and scientific practice.

Before he realized he had cancer, his insights into illness and mortality are richer than those offered in many illness memoirs. Being a patient unmoored him from his planned future and altered his ride of time. His reflections on time are some of the most placing passages in his book. Medical training, he observes, is “relentlessly future oriented”, a decade of delayed gratification. But after his diagnosis, long-term plans no longer matter. Because no one could say how lengthy he might live, Kalanithi used to be unsure how to make the best use of his remaining days: “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 returned to treating diseases.” Time for him became “a perpetual present”. Kalanithi back quickly to his work as a medical professional and, due to his changed relationship to time and its consequences on his experience of self, he gained a new grasp of the sort of health practitioner he wished he had been. Illness led him to an understanding of exercise “not found in Hippocrates, Maimonides, or Osler”:

“The physician’s obligation is not to stave off loss of life or return patients to their historic lives, but to take into our arms an affected person and a family whose lives have disintegrated and work till they can stand back up and face, and make experience of, their own existence.” Treating a physical ailment is a physician’s first priority, but that is no longer the place the job ends. Morbidities remain, emotional as well as physical, Kalanithi argues, and medicine’s dedication should extend to supporting an affected person and family build new and meaningful lives and identities. He is an idealist, certainly, but an idealist who understands very real unmet needs. Although some of Kalanithi’s insights about medicine and living in the present can also appear familiar, the price of studying this e-book is in seeing how he handles suffering and death with such elegant notion and writing. Among the many insights Kalanithi’s memoir affords is how much the practice of reflection can enrich one’s work and one’s life. Taking the time to be thoughtful is, for him, a necessary section of caring for himself. This element of Kalanithi’s story can be viewed as a task to the medical profession. If the young doctor’s training in literature and philosophy and his reflective habits of idea prepared him to be such a perceptive and astute physician and writer, how may the profession seek to domesticate such reflectiveness in its ranks—for the sake of both patients and doctors?