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When Breath Becomes Air
Cover of When Breath Becomes Air
When Breath Becomes Air
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#1 NEW YORK TIMES BESTSELLER • PULITZER PRIZE FINALIST • This inspiring, exquisitely observed memoir finds hope and beauty in the face of insurmountable odds as an idealistic young neurosurgeon attempts to answer the question, What makes a life worth living?

“Unmissable . . . Finishing this book and then forgetting about it is simply not an option.”—Janet Maslin, The New York Times
ONE OF THE BEST BOOKS OF THE YEAR: The New York Times Book Review, People, NPR, The Washington Post, Slate, Harper’s Bazaar, Time Out New York, Publishers Weekly, BookPage
At the age of thirty-six, on the verge of completing a decade’s worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi’s transformation from a naïve medical student “possessed,” as he wrote, “by the question of what, given that all organisms die, makes a virtuous and meaningful life” into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality.
What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir.
Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. “I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything,” he wrote. “Seven words from Samuel Beckett began to repeat in my head: ‘I can’t go on. I’ll go on.’” When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both.
 
Finalist for the PEN Center USA Literary Award in Creative Nonfiction and the Books for a Better Life Award in Inspirational Memoir
#1 NEW YORK TIMES BESTSELLER • PULITZER PRIZE FINALIST • This inspiring, exquisitely observed memoir finds hope and beauty in the face of insurmountable odds as an idealistic young neurosurgeon attempts to answer the question, What makes a life worth living?

“Unmissable . . . Finishing this book and then forgetting about it is simply not an option.”—Janet Maslin, The New York Times
ONE OF THE BEST BOOKS OF THE YEAR: The New York Times Book Review, People, NPR, The Washington Post, Slate, Harper’s Bazaar, Time Out New York, Publishers Weekly, BookPage
At the age of thirty-six, on the verge of completing a decade’s worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi’s transformation from a naïve medical student “possessed,” as he wrote, “by the question of what, given that all organisms die, makes a virtuous and meaningful life” into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality.
What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir.
Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. “I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything,” he wrote. “Seven words from Samuel Beckett began to repeat in my head: ‘I can’t go on. I’ll go on.’” When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both.
 
Finalist for the PEN Center USA Literary Award in Creative Nonfiction and the Books for a Better Life Award in Inspirational Memoir
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  • From the book Part I

    In Perfect Health I Begin

    The hand of the Lord was upon me, and carried me out in the spirit of the Lord, and set me down in the midst of the valley which was full of bones,

    And caused me to pass by them round about: and, behold, there were very many in the open valley; and, lo, they were very dry.

    And he said unto me, Son of man, can these bones live?

    —­Ezekiel 37:1–­3, King James translation

    I knew with certainty that I would never be a doctor. I stretched out in the sun, relaxing on a desert plateau just above our house. My uncle, a doctor, like so many of my relatives, had asked me earlier that day what I planned on doing for a career, now that I was heading off to college, and the question barely registered. If you had forced me to answer, I suppose I would have said a writer, but frankly, thoughts of any career at this point seemed absurd. I was leaving this small Arizona town in a few weeks, and I felt less like someone preparing to climb a career ladder than a buzzing electron about to achieve escape velocity, flinging out into a strange and sparkling universe.

    I lay there in the dirt, awash in sunlight and memory, feeling the shrinking size of this town of fifteen thousand, six hundred miles from my new college dormitory at Stanford and all its promise.

    I knew medicine only by its absence—­specifically, the absence of a father growing up, one who went to work before dawn and returned in the dark to a plate of reheated dinner. When I was ten, my father had moved us—­three boys, ages fourteen, ten, and eight—­from Bronxville, New York, a compact, affluent suburb just north of Manhattan, to Kingman, Arizona, in a desert valley ringed by two mountain ranges, known primarily to the outside world as a place to get gas en route to somewhere else. He was drawn by the sun, by the cost of living—­how else would he pay for his sons to attend the colleges he aspired to?—­and by the opportunity to establish a regional cardiology practice of his own. His unyielding dedication to his patients soon made him a respected member of the community. When we did see him, late at night or on weekends, he was an amalgam of sweet affections and austere diktats, hugs and kisses mixed with stony pronouncements: “It’s very easy to be number one: find the guy who is number one, and score one point higher than he does.” He had reached some compromise in his mind that fatherhood could be distilled; short, concentrated (but sincere) bursts of high intensity could equal . . . whatever it was that other fathers did. All I knew was, if that was the price of medicine, it was simply too high.

    From my desert plateau, I could see our house, just beyond the city limits, at the base of the Cerbat Mountains, amid red-­rock desert speckled with mesquite, tumbleweeds, and paddle-­shaped cacti. Out here, dust devils swirled up from nothing, blurring your vision, then disappeared. Spaces stretched on, then fell away into the distance. Our two dogs, Max and Nip, never grew tired of the freedom. Every day, they’d venture forth and bring home some new desert treasure: the leg of a deer, unfinished bits of jackrabbit to eat later, the sun-­bleached skull of a horse, the jawbone of a coyote.

    My friends and I loved the freedom, too, and we spent our afternoons exploring, walking, scavenging for bones and rare desert creeks. Having spent my previous years in a lightly forested suburb in the Northeast, with a tree-­lined main street and a candy store, I found the wild, windy desert alien and alluring. On my first trek alone,...
About the Author-
  • Paul Kalanithi was a neurosurgeon and writer. He grew up in Kingman, Arizona, and graduated from Stanford University with a BA and MA in English literature and a BA in human biology. He earned an MPhil in history and philosophy of science and medicine from the University of Cambridge and graduated cum laude from the Yale School of Medicine, where he was inducted into the Alpha Omega Alpha national medical honor society. He returned to Stanford to complete his residency training in neurological surgery and a postdoctoral fellowship in neuroscience, during which he received the American Academy of Neurological Surgery’s highest award for research. He died in March 2015. He is survived by his large, loving family, including his wife, Lucy, and their daughter, Elizabeth Acadia.
Reviews-
  • Publisher's Weekly

    November 2, 2015
    Author and physician Kalanithi had nearly completed his residency in neurosurgery at Stanford when he was diagnosed with Stage lV lung cancer at the age of 36. Despite the stubborn progression of his disease, Kalanithi was able to write, work, and delve into a number of profound issues before the end of his life, documented here (his wife provides the epilogue). As a youth in Arizona, Kalanithi was unsure whether he wanted to pursue medicine, as his father did, or if literature and writing were his calling. This inspiring memoir makes it clear that he excelled at both. Kalanithi shares his career struggles, bringing readers into his studies at Yale (including cadaver dissection), the relentless demands of neurosurgery, and the life-and-death decisions and medical puzzles that must be solved. After he begins cancer treatment, Kalanithi strives to define his dual role as physician and patient, and he weighs in on such topics as what makes life meaningful and how one determines what is most important when little time is left. He also shares the challenges of colleagues: an oncologist who walks a tightrope between hope and honest reality; a fellow doctor who commits suicide after losing a patient; Kalanithi’s wife, also a doctor, bearing witness to her husband’s decline even as she gives birth to their child. This deeply moving memoir reveals how much can be achieved through service and gratitude when a life is courageously and resiliently lived.

  • Kirkus

    Starred review from October 15, 2015
    A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer. Writing isn't brain surgery, but it's rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn't enter the field of medicine, in which his father and other members of his family excelled. "But I couldn't let go of the question," he writes, after realizing that his goals "didn't quite fit in an English department." "Where did biology, morality, literature and philosophy intersect?" So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which "would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay." The author's empathy undoubtedly made him an exceptional doctor, and the precision of his prose--as well as the moral purpose underscoring it--suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. "The fact of death is unsettling," he understates. "Yet there is no other way to live." A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.

    COPYRIGHT(2015) Kirkus Reviews, ALL RIGHTS RESERVED.

  • Booklist

    November 15, 2015
    Can life remain full and rewarding even while one is living under a death sentence? This is the question now-deceased neurosurgeon Kalanithi asked himself after receiving a late-stage lung cancer diagnosis. Newly married and almost ready to complete his residency, at 34 Kalanithi was faced with a momentous decision: Should he continue with a promising medical career, or fall back on his first love of writing while taking care of his health? Fortunately for the readers of this moving memoir, he decided to do both. Kalanithi describes his life-changing decision to set aside the pursuit of a doctorate in literature in favor of attending medical school and then recounts the discovery and progress of his illness, along with the inevitable upheaval in his personal life. A precious highlight here is the heartrending epilogue penned by his wife, Lucy, following Kalanithi's passing shortly after she became pregnant. This eloquent, heartfelt meditation on the choices that make life worth living, even as death looms, will prompt readers to contemplate their own values and mortality.(Reprinted with permission of Booklist, copyright 2015, American Library Association.)

  • Publisher's Weekly

    April 25, 2016
    Malhotra is a youthful actor who embodies the thoughtful, genial yet inquisitive and energetic mien that Kalanithi exhibits in his life and in his book. Malhotra seems to mature, like Kalanithi, from an exuberant college student seeking the meaning of life and death in literature, philosophy and science to a studious and ambitious medical student to a devoted and exhausted intern and resident. At the age of 36, already recognized as an eminent brain surgeon, Kalanithi suddenly finds himself on the other side of the bed—as a stage-four lung cancer patient. The shock and confusion—the struggle first to conquer the disease, then simply to survive, then to accept his imminent death—is the day-to-day reality Kalanithi and his wife face with the wise medical and personal counsel of his oncologist. In his last year he condenses all his experience as student, doctor, patient, husband, and father into this contemplative, profoundly moving and beautifully written memoir. After his death, Kalanithi’s wife, Lucy, completes the book with her own words of anguish and love. Audiobook veteran Campbell reads her section in a soft, sure voice that may bring the listener to tears. A Random hardcover.

  • Entertainment Weekly "I guarantee that finishing this book and then forgetting about it is simply not an option. . . . Part of this book's tremendous impact comes from the obvious fact that its author was such a brilliant polymath. And part comes from the way he conveys what happened to him--passionately working and striving, deferring gratification, waiting to live, learning to die--so well. None of it is maudlin. Nothing is exaggerated. As he wrote to a friend: 'It's just tragic enough and just imaginable enough.' And just important enough to be unmissable."--Janet Maslin, The New York Times "Paul Kalanithi's memoir, When Breath Becomes Air, written as he faced a terminal cancer diagnosis, is inherently sad. But it's an emotional investment well worth making: a moving and thoughtful memoir of family, medicine and literature. It is, despite its grim undertone, accidentally inspiring."--The Washington Post "Paul Kalanithi's posthumous memoir, When Breath Becomes Air, possesses the gravity and wisdom of an ancient Greek tragedy. . . . [Kalanithi] delivers his chronicle in austere, beautiful prose. The book brims with insightful reflections on mortality that are especially poignant coming from a trained physician familiar with what lies ahead. . . . The narrative voice is so assured and powerful that you almost expect him to survive his own death and carry on describing what happened to his friends and family after he is gone."--The Boston Globe "Devastating and spectacular . . . [Kalanithi] is so likeable, so relatable, and so humble, that you become immersed in his world and forget where it's all heading."--USA Today "It's [Kalanithi's] unsentimental approach that makes When Breath Becomes Air so original--and so devastating. . . . Its only fault is that the book, like his life, ends much too early."
  • Cheryl Strayed "[When Breath Becomes Air] split my head open with its beauty."
  • Atul Gawande "Rattling, heartbreaking, and ultimately beautiful, the too-young Dr. Kalanithi's memoir is proof that the dying are the ones who have the most to teach us about life."
  • Ann Patchett "Thanks to When Breath Becomes Air, those of us who never met Paul Kalanithi will both mourn his death and benefit from his life. This is one of a handful of books I consider to be a universal donor--I would recommend it to anyone, everyone."
  • Henry Marsh, author of Do No Harm: Stories of Life, Death, and Brain Surgery "Inspiring . . . Kalanithi strives to define his dual role as physician and patient, and he weighs in on such topics as what makes life meaningful and how one determines what is most important when little time is left. . . . This deeply moving memoir reveals how much can be achieved through service and gratitude when a life is courageously and resiliently lived."--Publishers Weekly "A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity . . . Writing isn't brain surgery, but it's rare when someone adept at the latter is also so accomplished at the former."--Kirkus Reviews (starred review) "[A] moving and penetrating memoir . . . This eloquent, heartfelt meditation on the choices that make live worth living, even as death looms, will prompt readers to contemplate their own values and mortality."--Booklist "Dr. Kalanithi describes, clearly and simply, and entirely without self-pity, his journey from innocent medical student to professionally detached and all-powerful neurosurgeon to helpless patient, dying from cancer. Every doctor should read this book--written by a member of our own tribe, it helps us understand and overcome the barriers we all erect between ourselves and our patients as soon as we are out of medical school."
  • Gavin Francis, author of Adventures in Human Being "A tremendous book, crackling with life, animated by wonder and by the question of how we should live. Paul Kalanithi lived and died in the pursuit o
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