Book review: When Breath Becomes Air by Dr. Paul Kalanithi

16 March 2017 - inspiration

"Do any human beings ever realise life while they live it?" — Thornton Wilder, Our Town

One of our favourite books is Dr. Paul Kalanithi’s posthumous memoir, When Breath Becomes Air, which chronicles his life as a neurosurgeon and terminal cancer patient. It is a profoundly moving love letter to his young daughter Cady who was born 8 months before his death, and a tale of hope for anyone trying to find meaning in life, death and suffering.

Dr. Kalanithi died at age 37 on 9 March 2015, 2 years after being diagnosed with stage IV lung cancer and just as he had completed a decade’s worth of training as a neurosurgeon. After learning of his diagnosis, he began writing this memoir to document what gave his life purpose and meaning. His wife recounts that the writing process was arduous, but it was “an act that allowed him to live with hope”.

In the foreword, American physician-author Abraham Verghese writes, “In the silences between [Paul’s] words, listen to what you have to say back. Therein lies his message.”

If a book resonates with you, it reveals something about yourself—what you’re seeking and what encouragement you're hoping for at this time of your life. So we’re sure that many, like us, who picked up this book were hoping to find specific answers to the quintessential question: What gives life meaning?

Dr. Kalanithi, in writing about his quest for meaning, doesn’t give us our answers (after all, the question with regards to life’s meaning is yours and only yours to answer). However, by bearing witness to his courage, we are reminded to confront and re-examine our own lives and mortality.

The pursuit of meaning is a courageous act and we were moved by two such acts of his: first, his capacity for empathy as a doctor and patient, and second, his confrontation and acceptance of death and suffering. Both gave his life, and the lives of those around him, meaning.

His relentless pursuit of human connection with his patients (when he could have easily settled for what he calls ‘empty formalism’, a reference to Tolstoy’s stereotype of a doctor) elucidates what makes life meaningful: the ability to feel another’s pain (and joy).

“In taking up another’s cross,” he writes, “one must sometimes get crushed by the weight.” His grave acceptance of the inevitable pain that comes with empathy is a tremendous act of courage and love. That same empathy allows him to remain so generous within his pain as he battled cancer.

Dr. Kalanithi pursues the topic of death intimately in this book—at the start of the second chapter (‘Cease Not till Death’), he quotes Michel de Montaigne: “If I were a writer of books, I would compile a register, with a comment, of the various deaths of men: he who should teach men to die would at the same time teach them how to live.”

He recounts numerous encounters with terminal patients as a doctor and his days as a patient himself, revealing that accepting death is as much a part of life as is searching for life’s meaning and how to live it. “The fact of death is unsettling,” he writes, “yet there is no other way to live. […] Like my own patients, I had to face my mortality and try to understand what made my life worth living. […] I struggled, while facing my own death, to rebuild my old life—or perhaps find a new one.”

In accepting the inextricable connection between life and death, he discovers that meaning is found in the present (“the future, instead of the ladder toward the goals of life, flattens out into a perpetual present”), and can be created or re-created. “You can’t ever reach perfection,” he writes, “but you can believe in an asymptote toward which you are ceaselessly striving.” Perhaps life isn’t always about having found meaning or being sure of it at all times, but having the capacity to create and re-create meaning continually.

Dr. Kalanithi concludes that “life [isn’t] about avoiding suffering”. This line beautifully reminds us that when we make peace with death and suffering we are then able to devote ourselves to the precious act of living; gratefully knowing that the present is all we have.

Have you read When Breath Becomes Air? We’d love to hear your thoughts. Write to us at

- The Mindful Company Team

When Breath Becomes Air By Paul Kalanithi. 228 pages. Random House. 

Photo credit to The Guardian.