Review: When Breath Becomes Air

When Breath Becomes Air When Breath Becomes Air by Paul Kalanithi
My rating: 5 of 5 stars

When I opened 'When Breath Becomes Air' once again, I wanted to read something entirely different from the first time. The first read was in the middle of a night, in my college dorm. It was a race against time and sleep deprivation. Once I had started it, I couldn't stop. I raced through the prologue, and immediately wanted to know the story of this man, one if you had told me orally, I would've dismissed as pseudo-motivating feel-good story of someone who never existed. (I'm stupid that way')

But after reading it for a second time, I feel even more inadequate than the first time. I wanted to see meanings in this book, of mortality, of death, of bravery, of love, of commitment, of hard work. And I found them all. Perhaps, it is my tendency to try to relate to my life, whatever I read, is the source of this feeling of inadequacy. This book is pregnant with emotions and hidden meanings, struggles in every page, and bravery in every word. There is also a lining of honesty that shines through everything else. This is the kind of honesty that can scare you, when you know what it takes to be that honest.

Paul Kalanithi, is so different from the doctors that India, or for that matter, TamilNadu generates. There is no ruthless memorizing and vomiting. There is no counseling. There is only an year of intense coursework and an 18 month cycle of application process. Paul, interestingly, or perhaps obviously, didn't seek out to become a doctor initially. He was aiming to become an English professor, if pressed to given an answer for the question- "What are you going to do with your life?". A double major in English and Biology, it was Walt Whitman, that finally pushed him to Medicine, to know the Physiological- self.

From there, Paul highlights little of the gruesome coursework that is needed. He only mentions them briefly. Throughout his life, he makes unconventional choices, and perhaps that is why he succeeded. Once he gets into Stanford, Paul highlights the transition from a medical student to being a Doctor - A surgeon, in words that make even a layman like me appreciate the gravity of the transition. His discussion of cadavers, and the exploration of the relation between a medical student and his cadaver, is spot on, says my friend who happens to be a Medical Student. Everyone can hack a bone, but then very few can write about it with an air of authority like Paul can.

Paul traces his life, like this, quoting anecdotes, cases and brings us to the point where he is diagnosed with Terminal Cancer. From then on, his decisions take a new dimension of meaning. They are the decisions of a man who is dying and who knows about it in uncomfortable levels of finitude and detail. He declares, at a point, "You can't ever reach perfection, but you can believe in an asymptote towards which you can ceaselessly strive". And I haven't read a more precise utterance about perfection and the struggle for it.

Paul was at the prime of his life. He was not an aging man, someone who had enjoyed at least a bit of what life had to offer. He was on the other extreme. Someone who put a stopper on all his pleasures, including having kids, so he could finish his internship of a decade, and finally become a Neurosurgeon-Scientist. And when you find suddenly that everything you have ever worked for, is no more than a mirage, everything that you ever hoped will enjoy in the not so distant future, is now non existent, it is VERY HARD to act like Paul did. The immediate acceptance of what lay in front of him, is something that many of us may not be capable of.

After treatment, with first regime of drugs, he goes back to the OR. He works once again, and fulfills his requirements for graduation. The intermediate time is peppered with so many truisms about mortality, and if you look carefully, love - for life and for the profession.

Paul had a debilitating pain, a strained marriage and a possibly futile decade with him. And when he died, he had the best of marriages, an integrity that rivals everything else in the face of death and a rich legacy, this book and another human being - his daughter Cady. Many of us aren't capable of achieving even one of these things in an entire lifetime, with stable health and a great circle of family and friends. Paul did, and he had Lucy with him, who in the last line, stated poignantly, "I was his wife and witness". Lucy has written the epilogue of this book and her wondrance at the ability to love Paul, in his absence, is one of the best lines about love I have read so far.

Rest in Peace, Paul. Thank you, for this book, for your life.

Old review below.

“You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.”

I got to this book after a confusing night. I had hours ago, skimme2d through the Bhagavat Gita, and was contemplating the idea that we were nothing but a mere instrument in God's hands. This God person has been a source of much head ache to me recently. I have tried to rationalize, and well, as you guessed, I got nowhere. But not really because God himself is irrational. It is just that there are so many conflicting versions of him, that the only way to believe in him with any degree certainty is to refuse to believe anything except one version. There are more tolerant versions and versions less so. But all of them somehow point to the idea that all we do and act on is just according to God's wish. No other way. And I refused to believe it.

Paul Kalanidhi seems to reaffirm my decision. Perhaps it is too arrogant that a man's struggle with matters beyond my comprehension is mentioned as just a reaffirmation of my decision. But that doesn't take us away from the fact that he fought a magnificent battle.

This book inspired awe, instilled sadness and sowed courage. It is not often you get to see someone fight. Paul fought and he did so magnificently that for a while, everything else is going to seem so trivial. The writing is like a gentle lullaby. Soothing, and it almost succeeds in hiding the pain latent in the words. To fail is something. To be denied the chance to win is something else. When faced with the second, Paul carved his way out. And for that, I think he deserves all the praise I can think of.

His theological musings, as well as the pages on mortality, are so elegant and touching. There is no pseudo parading from a moral high horse. He plays the game, and he isn't afraid to lose. Only if we all could play the game.

Rest in peace Paul. There are not many dead men that I respect like I do you. Rest in peace.

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