When Breath Becomes Air - Living Courageously Without Closure

I have been very sick over the last few weeks. My body and my mind are in conflict, the former is in pain, exhausted and limited, the latter is ravenous and eager. I have taken some of this time to read not only for education but also for pleasure - an activity that is too rare nowadays.


Paul Kanalithi's When Breath Becomes Air is a short read, stirring, visceral. Here are the reflections of a neurosurgeon-philospher, a man with a promising career, a life cut short by cancer. His writing is from a unique perspective as Doctor and Patient, Surgeon and Poet, a man bent on living as he turns his mind to an early death. Seeking completion and meaning well into the middle of a life.

I found Lucy Kalanithi's epilogue to be the most moving part of this book, perhaps because I relate to her perspective as a wife, and I wanted to hear more from her (see Further Reading below). My love for my husband has brought me into a close encounter with the mortality of the beloved, a loss that I fear more than my own death. And that Is something I sit with from time to time.

Even in the midst of being surrounded by love, I am aware that everything is impermanent. Even as love washes over and through me I am grasping for it. This is one of the reasons why literature is so important - it not only grows our empathy by putting us in touch with the experience of another, it can put us in more immediate contact with our own Selves, our experiences and fears. 

bereavement is not the truncation of married love
— C.S. Lewis

In my work, I am interested in bravery, in speaking authentically. The writing of this book, the sharing of this book with the public, is a brave act, it explores some of our greatest taboos, sickness, physical deterioration, death. The writing of this book was abridged by the author's death, but its publication was his dying wish. In that sense, it is unsettling. In a desire for an easy narrative arch into denouement, we will not find that here. Kalanithi's legacy is his daughter, his wife's love of him, and his writing. We so rarely get closure but we can always choose courage.

I decided to share some of the gems that stood out for me in this book.

"Even if I'm dying, until I actually die, I'm still living"

“I️ had passed from the subject to the direct object of every sentence of my life. In fourteenth-century philosophy, the word patient meant “the object of an action,’ and I️ felt like one.”

“I can’t go on, I thought, and immediately, it’s antiphon responded, completing Samuel Beckett’s seven words, words I had learned long ago as an undergraduate: I'll go on. I got out of bed and took a step forward, repeating the same phrase over and over: ‘i can’t go on. I’ll go on’ “ 

“The main message of Jesus, I believed, is that mercy trumps justice every time” 


“Struggle toward the capital-T Truth, but recognize that the task is impossible - or that if a correct answer is possible, verification is impossible. 
In the end, it cannot be doubted that each of us can only see part of the picture. The doctor sees one, the patient another, the engineer a third, the economist a fourth, the pearl diver a fifth, the alcoholic a sixth, the cable guy a seventh, the sheep farmer an eighth, the Indian beggar a ninth, the pastor a tenth. Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and is still never complete. And Truth comes somewhere above all of them” 

"When you come to one of the many movements in life where you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man's days with a sated joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests, satisfied."


YOU left me, sweet, two legacies,—    
A legacy of love    
A Heavenly Father would content,    
Had He the offer of;    
You left me boundaries of pain            
Capacious as the sea,    
Between eternity and time,    
Your consciousness and me. - Emily Dickinson

From Lucy Kalanithi's Epilogue:

"I was his wife and a witness"

"I expected to feel only empty and heartbroken after Paul died. It never occurred to me that you could love someone the same way after he was gone, that I would continue to feel such love and gratitude alongside the terrible sorrow"




Further Reading:

Inside A Doctor's Mind At The End Of His Life - Interview with Lucy Kalanithi

Emily Dickinson Biography and Poetry

The New York Times - interview with Lucy Kalanithi


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