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When Breath Becomes Air summary

Name: When Breath Becomes Air
Rating: 4.2 (152 reviews)
Author: Paul Kalanithi

Paul Kalanithi

Finding hope in the face of insurmountable odds

4.2 (152 ratings)

19 mins

Brief summary

When Breath Becomes Air by Paul Kalanithi is a memoir that follows a neurosurgeon's journey upon receiving a terminal cancer diagnosis. It offers a touching and insightful reflection on life, death, and the importance of finding meaning in one's limited time.

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Memoirs

Table of Contents

When Breath Becomes Air
Summary of 9 key ideas

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What’s in it for me? Learn about the relationships between chance, life and death.

Has everything turned out exactly as you planned? Maybe you intended to study one thing but were pulled in another direction; maybe one choice completely changed the course of your life; or maybe you’re still in high school and think your career will follow a set path.

Of course, we all know that life is messy and unfolds in unpredictable ways – unexpected twists and turns are inevitable.

Paul Kalanithi’s life was no exception. What made his experience even more potent was his career in neurosurgery, where small decisions and unforeseen events can result in a matter of life and death, and his diagnosis with terminal cancer.

In these blinks, you’ll learn

how neuroscience might answer some of your most pressing existential questions;
why it’s difficult to say whether a surgery was a complete success or failure; and
how great power comes with great responsibility.

The author had two passions that persisted throughout his life: literature and neuroscience.

While he was growing up, the author, Paul Kalanithi, became obsessed with literary geniuses like Orwell, Camus, Sartre, Poe and Thoreau. It was this passion that informed his decision to study literature in college, but things turned out quite differently than he had planned. During the summer before college, he discovered another field that captivated him: human biology.

Kalanithi was getting ready to head off to Stanford when his then-girlfriend gave him a book by Jeremy Leven called Satan: His Psychotherapy and Cure by the Unfortunate Dr. Kassler, J.S.P.S. He was fascinated by Leven’s idea that the brain is just an organic machine that enables the human mind to exist, so he signed up for courses in biology and neuroscience.

Throughout his college career, Kalanithi continued to ponder big questions like, “what infuses life with meaning?”, looking to both literature and neuroscience for answers. Works of fiction remained powerful to him as he considered literature a manifestation of the mind’s life, and therefore of human meaning.

So, while meaning itself is certainly no simple concept, he drew inspiration from writers like T. S. Eliot and his work The Waste Land, which connects meaninglessness to isolation, and came to believe that true meaning lies in human relationships.

However, literature only offered one piece of the puzzle, and Kalanithi knew he had to keep studying neuroscience. He felt that, since the brain is the organ that enables the mind to exist, our ability to form relationships comes directly from our brains.

This perspective was informed by his experiences. While visiting a home for people with brain injuries, Kalanithi found that the patients weren’t entirely capable of forming relationships.

From there, neuroscience gave him a way to explain the laws of the brain, which were central to his understanding of meaning at large. Because of this fascination, he applied to medical school, but only through hands-on experience would he come to understand the true meanings of life and death.

Medical school gave Kalanithi a direct understanding of life, death and meaning.

After months of grueling medical school applications, Kalanithi finally landed a spot at the Yale School of Medicine. It was in the anatomy lab that he found himself confronted with the realities of life and death.

As a part of his course work, he spent innumerable hours dissecting cadavers, slicing through skin and tissue and sawing through bone. While the medical students would keep the faces of these dead bodies covered and remained unaware of their names, Kalanithi was still very much moved by their humanity. One day, while opening up the stomach of a cadaver, he found a couple of undigested pills – a sign to him of life even within the dead.

In residency, Kalanithi had more responsibility and even more direct experiences with death.

During his fourth year of medical school, Kalanithi made the decision to specialize in neurosurgery. He knew this choice was far from easy, but the field was beckoning him. So, following his graduation, he began a residency at Stanford, where he would train for the next seven years.

It wasn’t long before he found himself working under the pressure of real responsibility, a situation he had only gotten glimpses of during medical school. One day a young boy named Matthew came in with a headache. An examination showed he had a substantial brain tumor, and it was Kalanithi’s responsibility to decide on a course of action.

Amid increased responsibility and exhaustion, Kalanithi found himself neglecting the human side of his work.

During the second year of his residency Kalanithi was put on call, which meant that in an emergency, he would be the first to arrive. Luckily, the responsibility he was beginning to shoulder increased in proportion to his skill level. But now, more than ever, it was up to him to call the shots and to decide whether someone would or should be saved.

On one occasion a patient was rushed into the operating room with severe brain trauma. The team saved him, but the patient permanently lost the ability to speak or eat by himself. Nothing could be done to save his brain, and he would be forced to spend the rest of his life institutionalized. So, while the patient still had a pulse, Kalanithi wasn’t sure whether saving his life was the right thing to do.

Kalanithi worked in a neuroscience lab before returning to even more responsibility at the hospital.

While in his fourth year of residency, Kalanithi received training in a field outside his specialization. He began work in a neuroscience lab at Stanford where he began studying to be a neuroscientist – a specialist who studies the nervous system, including the anatomy and biochemistry of neurons and their networks.

As you might imagine, being both a neurosurgeon and neuroscientist was simultaneously highly prestigious and difficult. Kalanithi also took a different route to his peers; while many neuroscientists in the lab were studying technologies that could help, for instance, a paralyzed person operate a computer or robotic leg with her mind, Kalanithi wanted to study the reverse of this.

Just before his residency ended, Kalanithi made a grim discovery.

Kalanithi made mistakes, but he also excelled. Despite the incredible pressure he was under, his hard work paid off.

His residency was drawing to a close. He’d hurdled all the obstacles in his way and performed all the operations required of him. He’d even received prestigious awards and the respect of the senior doctors with whom he worked.

Kalanithi contemplated life as a patient and debated whether he and his wife should have children.

If you knew your time on earth was going to be cut dramatically short, how would you spend your remaining days?

It’s one of the toughest questions imaginable, and during his treatment, Kalanithi had no clue how to proceed with his life and career. In discussions with his doctor, Emma, to whom he felt very close, he talked about how disturbing it was not to know how much time he had left.

Although in a poor state, Kalanithi witnessed his daughter’s birth, and passed away shortly afterward.

On 4 July 2014, Kalanithi’s daughter, Elizabeth Acadia, also known as Cady, was born. While Kalanithi survived long enough to see her birth, he was in a severely weakened state.

When Lucy went into labor, Kalanithi was debilitated, having been in and out of the hospital. Despite a brief and temporary recovery, he weighed next to nothing and had to lie on a cot in the delivery room, unable to stand as Lucy gave birth.

After Kalanithi’s death, his wife Lucy reflected on their time together with both sadness and gratitude.

Eight months after Lucy gave birth to Cady, Kalanithi was rushed to the emergency room with breathing difficulties. He would never recover.

Once in the hospital, Kalanithi was put on breathing support, but knew this was a temporary solution only. After discussing treatment options, he asked to be taken off life support, aware that if he’d opted to go on a ventilator, he might never come off it. Kalanithi concluded that as the time he had left was losing its meaning, there was little point in keeping his heart beating.

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What is When Breath Becomes Air about?

When Breath Becomes Air (2016) tells the incredible story of Paul Kalanithi, a neurosurgeon and neuroscientist who was diagnosed with and died from cancer in his mid-thirties. These blinks detail his extraordinary journey in search of the meaning of life in the face of death.

Who should read When Breath Becomes Air?

Philosophers and thinkers
Medical students and those interested in the field
Anyone who has ever lost a loved one

About the Author

Paul Kalanithi was an Indian-American writer and award-winning surgeon. He attended the Yale School of Medicine and completed his residency at Stanford University.

Categories with When Breath Becomes Air

Motivation & Inspiration Biography & Memoir

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