BOOK REVIEW
WHEN BREATH
BECOMES AIR
Paul Kalanithi, MD
Random House, New York, 2016
Reviewed by
M. Saleem Seyal, MD, FACC, FACP
You that seek what life is in death,
Now find it air that once was breath.
New names unknown, old names gone:
Till time end bodies, but souls none.
Reader! then make time, while you be,
But steps to your eternity
- Baron Brooke Fulke Greville
(1554-1628), “Caelica 83”
P
aul Kalanithi was a writer and neurosurgeon who died prematurely at the age of 37. His courageous and eloquent
autobiography “When Breath Becomes Air” was published
posthumously. It’s a tour-de-force which describes his life and particularly the travails and trials of being diagnosed with metastatic
lung cancer and facing mortality at a very young age. Inherently
and devastatingly sad, but ultimately an uplifting book, it has been
on the New York Times Best Sellers list.
Highly reminiscent of the late Dr. Oliver Sack’s Opinion piece,
“My Own Life” in The New York Times (February 19, 2015) when
he faced terminal illness, Paul Kalanithi wrote two moving essays,
“How Long Have I Got Left” in The New York Times (January 14,
2014) and “Before I Go” in Stanford Medicine (Spring 2015), offering
his heartfelt insights as a wounded healer facing his own death. He
died peacefully with tremendous poise and bravery two years after
being diagnosed with his terminal ailment, surrounded by family,
16
LOUISVILLE MEDICINE
on March 9, 2015.
One of three sons of an immigrant Indian-American cardiologist, Paul Kalanathi was born in New York, moving at age 10 to
Kingman, Arizona. His father is still a practicing interventional
cardiologist (a Tamil Christian with a Hindu wife) in Kingman. Paul
had a lifelong love affair with books and writing and was planning
to become a writer. He talked about his bibliophilia as “….Books
became my closest confidants, finely ground lenses providing new
views of the world.” He earned enviable scholastic achievements
including a BA in Human Biology and Masters in English Literature
from Stanford. He next studied at the University of Cambridge
and earned the MPhil in History and Philosophy of Science and
Medicine. He next changed his focus to studying medicine: “It was
only in practicing medicine that I could pursue a serious biological
philosophy.” He went to Yale and earned his MD degree cum laude
in 2007. He returned to Stanford for his residency in neurosurgery
and a postdoctoral fellowship in neuroscience, and progressed
to the coveted position of Chief Resident. Near the tail-end of a
relentless and grueling training, and destined for an academic
position as a neuroscientist and a practicing neurosurgeon, he
was being wooed by excellent academic outfits in the country. A
bright future was within grasp, “…At age thirty-six, I had reached
the mountaintop; I could see the Promised Land, from Gilead to
Jericho to the Mediterranean Sea.” His dreams, however, came
crashing down after the grim diagnosis of metastatic lung cancer