'When Breath Becomes Air' by Paul Kalanithi: EW review

Many memoirs about terminal illness are meant to inspire readers who have the luxury of pondering what it means to be alive. Paul Kalanithi could have written that kind of book when he was diagnosed with lung cancer at 36, just as he was about to complete a decade’s worth of training as a neurosurgeon. Instead, he ended up with a very different kind of memoir. In When Breath Becomes Air, he writes about the philosophical implications of death—his popular New York Times op-ed “How Long Have I Got Left?” was a clear-eyed meditation on the nature of time—but he refuses to offer any overarching message about what makes life worth living. “I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything,” he writes. “Seven words from Samuel Beckett began to repeat in my head: ‘I can’t go on. I’ll go on.”

It’s this unsentimental approach that makes When Breath Becomes Air so original—and so devastating. There’s no redemption here. Kalanithi died before he finished the book, leaving his wife Lucy to write a beautiful but painful epilogue. In the few hundred pages he completed, he chronicles his transition from doctor to patient with an acute clinical eye. He carefully considers the matter-of-fact way he dealt with death as a professional—there’s a good story about him going back to finish a half-eaten lunch after losing someone during an operation—before focusing on the day-to-day decisions his sickness requires. He makes poetic connections between literature and his own feelings about mortality, but the most profound questions he asks are more pragmatic: When should he stop practicing medicine? Would it be practical to have a child? His struggle to live a normal life makes his experience all the more immediate for the reader. As Lucy writes in the epilogue, “Dying in one’s fourth decade is unusual now, but dying is not.”

If that’s true, you might imagine asking Samuel Beckett, then why go on? “The secret,” Kalanithi says, “is to know that the deck is stacked, that you will lose, that your hands or judgment will slip, and yet still struggle to win…You can’t ever reach perfection, but you can believe in an asymptote toward which are ceaselessly striving.” When Breath Becomes Air is an elegant attempt to capture that struggle. Its only fault is that the book, like his life, ends much too early. A–