When Breath Becomes Air

This is a deeply moving, heart-breakingly beautiful book.

When Breath Becomes Air
Paul Kalanithi
Publisher: Bodley Head
Pages: 228; Price: Rs 599

One of the most moving documents is Randy Pausch’s “The Last Lecture”. Pausch was an assistant and associate professor in the Department of Computer Science at the University of Virginia’s School of Engineering and Applied Science from 1988 until 1997. In 1997, Pausch became Associate Professor of Computer Science, Human-Computer Interaction, and Design, at Carnegie Mellon University and taught for 10 years. In May 2008, Pausch was diagnosed with pancreatic cancer and after an unsuccessful attempt to halt it he was told in August 2007 to expect a remaining three to six months of good health. On July 25, 2008, Pausch died at his 47th year.

Pausch delivered his “The Last Lecture”, titled “Really Achieving Your Childhood Dreams” at CMU on September 18, 2007. This talk was modelled after an ongoing series of lectures where top academics are asked to think deeply about what matters to them, and then give a hypothetical “final talk”, that is, “what wisdom would you try to impart to the world if you knew it was your last chance?”

The book under review will remain a companion-piece to “The Last Lecture”. Paul Kalanithi died at the young age of 36, leaving behind his wife and daughter. He was a neurosurgeon and writer. He was a post-graduate in English Literature and a graduate in human biology from Stanford University. He acquired an M Phil in History and Philosophy of Science and medicine from the Cambridge University. He graduated from the Yale School of Medicine. He acquired a post-doctoral fellowship in neuroscience and bagged the highest award from the American Academy of Neurological Surgery.

After a decade of being a neuro-surgeon, he was diagnosed with advanced lung cancer. One day he was a doctor treating the dying and the next day he was a patient struggling to live. This book turns out to be the best book written by Paul for the simple reason that it is his only book and a posthumous book. It is bound to make us shed tears of sorrow and joy as it is the parting gift of a departing father to his young wife and eight month old daughter. Paul’s thinking is revolutionary as it combines several disciplines, science, medicine, philosophy and is so well written as to acquire status of high quality literature. It is at once soothing and uplifting.

When Breath Becomes Air

The volume is a chronicle of Paul’s growth from a raw medico to an accomplished neuro-surgeon specializing in brain. He came face to face with death. This testament is an unforgettable confirmation of faith in life and reflects on the challenge posed by imminent death. It is also a saga on the relationship between the doctor and the patient.

Paul’s distinguishing quality was much more than falling in love with the intricacies of the brain. More than the satisfaction of training his hands to accomplish amazing feats it was love and empathy for those who suffered, for what they endured and what he might bring to bear. Paul was a saint in a surgeon’s coat.

He recalls wistfully his college days in Stanford and how the Medical School sharpened his understanding of the relation between meaning, life and death. We have detailed accounts of operations which call for mastery of the doctor in several fields—neurosurgery, ICU medicine, neurology, radiology, Paul’s highest ideal was not saving lives but guiding a patient or a family to understanding death or illness.

Part Two of the book is about the author himself being afflicted by cancer of the lung. He returned to his favourite world of literature. He harked back to the central values of Christianity—sacrifice, redemption, forgiveness. He used to say, “Had I been more religious in my youth, I might have become a Pastor, for it was the pastoral role I sought.”

The Epilogue of the book is written by Paul’s wife Lucy Kalanithi. Paul died on March 9, 2015. His daughter was only 8 months old. This book was written during Paul’s decline and he wrote it relentlessly fuelled by a purpose. He confronted death—examined it, wrestled with it, accepted it as a physician and a patient. Relying on his own strength and the support of his family and community. Paul faced each stage of his illness with grace. This is a deeply moving, heart-breakingly beautiful book.

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