Book Review: Paul Kalanithi’s When Breath Becomes Air – Dinesh Sapkota

Paul Kalanithi’s When Breath Becomes Air

Random House. 2016. Pages 288.

Death is certainly an unavoidable reality of living beings. But, it scares Homo sapiens most because preservation of physique becomes foremost act of its psychic functions. More than disdain feeling of extinction, the horror of pain before last breath and tragic moment of adieu make death more disgusting. Human beings seldom want to talk about it because it is simply a tragic incident not only for dead one but his/her nearest and dearest. For instance, there have been scant numbers of literature existed on death amid the piles of write-ups coming everyday on life. However, Paul Kalanithi is one among handful figures who dares to explain how it is like to be a sated man? How it feels to see proliferation of incurable cancer damaging cells inside one’s body? How rapid decline of human organism nullified the sense of gustatory delights and psychologically prepares for death? Kalanithi briefly talks about his remarkable success in career at the age of mid 30’s as a neurosurgeon and neuroscientist. He died at the age of 36. He prepared the manuscript of When Breath Becomes Air from his deathbed which later, in 2015, appeared as a, in Atul Gawande’s terms, ‘rattling, heartbreaking and beautiful memoir to teach about life to us.’

Kalanithi born and grew up in Arizona. He becomes ‘intoxicated’ by the volumes of poetry in his teenage. Reading literature and losing sense of self into the words of Eliot, Nabokov, Conrad and Beckett had remained his lifelong passion. Kalanithi was graduated with MA from Standford University in English Literature. He pens in the memoir, “Literature not only illuminated another’s experience, it provided, I believed, the richest material for moral reflection.” Later, he switched his interest to medical science. Most of the Kalanithi family members were doctors. That familial backdrop of medical science encouraged him to build career as doctor, indeed he had chosen to be a neurosurgeon. The magnificent functions of brain, which helps human to build relationship and understand the meaning of life, intrigued him towards neurology. The firm belief and commitment of his mentor in establishing inextricable relation between ‘science and morality’ had greatly influenced him.

When Breath Becomes Air lucidly explains the beautiful relation between medical science and philosophy. Philosophy talks of metaphysics but, like medical science, it concerns more on the themes of life and death. Kalanithi writes, “Medical school sharpened my understanding of the relationship between meaning; life and death.” Doctors cannot be mere doctors of patients. They bear the responsibility to save the precious life. Doctors should also learn the art to deal with value, meaning and identity of patient and the family of patient at critical time. The critical situation of the patient poses serious question about life where the philosophical and biological exercise becomes a necessary lesion for doctors. Kalanithi argued that, “at those critical junctures, the question is not simply whether to live or die but what kind of life is worth living.” He brings the components of virtuous life which are ‘moral, emotional, mental and physical excellence.’

Paul Kalanithi finds last seven words from Samuel Beckett’s The Unnamable meaningful to understand life and death. ‘I can’t go on. I’ll go on.’ Beckett’s monologue bears the meaning of life and death where things happen spontaneously rather than intentionality. On the one hand, Kalanithi seems hopeful about the moral life where responsibility and honesty matter most; on the other hand, he epitomizes absurdism. He synthesizes both aspects of life and said, “You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.” Religion makes a lot sense to Kalanithi. Science cannot explain the importance of metaphysical values of human life. He takes religion as the value of human beings which helps to set code of conduct in the society. He argued that “to make science the arbiter of metaphysics is to banish not only God from the world but also love, hate, meaning—to consider a world that is self-evidently not the world we live in.” He recognizes the significance of religion in terms of limitation of science to address the problems of human.

When Breath Becomes Air depicts two dichotomous but parallel realities of life. There is the contradiction in life between hope to live and fear of death. Human being knows that death is inevitable but tries to defer even for a while. Kalanithi provides his account in this regard. His unstoppably failing health clearly hinted his early death but to postpone death, he asked for chemotherapy and molecular therapy, Tarceva. Chemotherapy gradually weakens not only his digestive system but kidney also failed to function. The intolerable pain and intense fatigues had caused sudden weight lose. Kalanithi bravely explains his tragic condition from his deathbed which can break the heart of the reader at any time. He requested to be intubated to make the sense of limited strokes of the watch. His last desire to see his daughter, Candy, and overwhelm tears in the eyes can powerfully burst the heart of the reader.

The memoir, When Breath Becomes Air, is an incredible, unimaginable and thrilling account of human organism which is metaphysically smeared by cruelties and embellished with the ‘unscientific’ “aspects of human life: hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue.” Kalanithi, as a doctor turned patient, not only feels his profession erstwhile but also ‘loses the sense of tenses.’ His brave account of lat minutes interestingly hypnotizes the readers with the feeling of awe and fright whichever profession they might belong to. He explained the sated joy of dying man where no more remains to be satisfied hunger.

The memoir is beautifully written in terms of arrangement of sentences; selection of words and the flow of story. The Foreword by Abraham Verghese and Epilogue by his wife and witness Lucy add the splendid beginning and ending of the book. At the end, reader might get feeling of unquenched due to the unexpected ending of the book. In nutshell, the book is worth not only to read a once in library but to keep in the bookshelves where eyesight goes every day.

Dinesh Sapkota is a final year MA International Relations student at South Asian University.

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