When Breath Becomes Air by Paul Kalanithi

Books have the unspoken power to connect people from different parts of the globe.  Words have an undeniable ability to start a conversation with ourselves internally or with others; a conversation that either heals, entertains or gives perspective. When Breath Becomes Air is a memoir written by Paul Kalanithi, an American Neurosurgeon who penned his story while confronting metastatic lung cancer up to the year 2015 when he passed away. Maurice Oniang’o is an award winning Kenyan Freelance Journalist, a Documentary Filmmaker and Writer who has produced content for television and notably National Geographic. Maurice has read the book twice, first on an eight hour flight from Nairobi to Amsterdam in 2017 and the second time early this year. While the book is still fresh in my memory, I thought to engage with Maurice on his experience with it.

Q: How did you meet the book for the first time?

A: I met a friend the day before I travelled and she gave me two books; The Alchemist and When Breathe Becomes Air to keep me company during the flight. 

Q: For me as a medical doctor, I read the book half expecting a glimpse into a colleague’s experiences in the profession. I hoped to be enriched as a professional at the end of it, but found the book far more personal than just that. What were your expectations, or impression of the book prior to reading it? 

A: The first time I didn’t have any expectations. I didn’t know about the book prior and my friend did not tell me much about it. She just said I have to books that you need to read, so when I dived in I hoped that the story would end with Paul beating the cancer and the ending was very disturbing. I was not prepared at all for the book to end with him gone, that was a sad moment for me.  Second time I read wanted to understand Paul’s point of view about life and death and just compare that with my own personal experiences.  

Q: An extracts I found distinctive is on page 70 [Vintage 2017] where the author writes “I had watched the parents’ face – at first wan, dull, almost otherworldly- sharpen and focus. And as I sat there, I realized that the questions intersecting life, death, and meaning, questions that all people face at some point, usually arise in a medical context.” What are your thoughts on the author’s observation?

A: I concur with Paul’s observation. Many life changing decisions and ways of life are made inside the doctor’s consulting room and wards. When a doctor sends you to do a test and you are back with the results, a million things run through your mind, sometimes you already know what to expect and sometimes you don’t but the feeling is always almost the same. Personally the questions that run in my mind in such a scenario include; what if it is something terminal? Have I lived my life to the fullest? Have I been careless? Have I treated my loved ones the way I ought to?  And if it is not something serious, how am I going to live my life moving on? So whether it is serious or not serious major decisions about life are made at that particular moment

Q: Is there an extract, or a scene, that particularly stood out for you?

A: Yes just at the beginning of part two on Page 120-121 Vintage 2017 when Paul speaks about the future he had worked so hard to achieve but now he had come to a realization that it was not going to happen. 

“My brother Jeevan had arrived at my bedside. “You’ve accomplished so much,” he said. “You know that, don’t you?”

I sighed. He meant well, but the words rang hollow. My life had been building potential, potential that would now go unrealized. I had planned to do so much, and I had come so close. I was physically debilitated, my imagined future and my personal identity collapsed, and I faced the same existential quandaries my patients faced. The lung cancer was confirmed. My carefully planned and hard-won future no longer existed.”

Q: I’m curious to know how you engaged with the medical concepts in the book and how you would rate its readability?

A: I found the book easy to understand because Paul did that by giving explanations to medical jargon.  Also I always challenge myself to read widely (even if it means reading a book with a science dictionary next to me haha!). Now can I recommend another book by a medical doctor? I take that as a YES! ‘This is Going To Hurt by Adam Kay’ quite different from When Breathe Becomes Air.

Q: A friend asked if I cried at the end of the book. I did not, however I certainly felt varied emotions at different points of the book. Can you recall what emotions the book evoked in you?

A: I also did not cry but I was heartbroken and angry at times. Paul was at the peak of his career life and then just like that everything fizzles out!  

Q: You’ve read the book twice. Did you experience it the same both times? Would you read it a third time?

A: No I did not get the same feeling because the first time I was hoping that somehow Paul is going to make it. Despite all the indicators that he won’t, I still did not want to believe that he would die. The second time I wanted to understand what was going through his mind after the diagnosis and I knew how the book will end, so it felt sad but not like the first time. I will definitely read it again and again. It is one of the books that I always recommend to friends and family 

Q: I took quite a few points from the book, one being that life, as the author says, is not about avoiding suffering. Are you able to summarize what the take home message for you was?

A: Yes I did. Eventually we all die (obvious though) and what matters is how you choose to live your life and how you choose to face your challenges. Are you going to brood and live in despair about it or will you try and find meaning about the challenges you are facing. It’s also important to note that throughout the book there was Paul does not show self-pity about his situation that was powerful to me. 

Q. Favorite quote from the book?

A. “Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete.” page 172 [Vintage 2017]

Q: As a last question, being the avid reader that you are, which other books have you read more than once?

A: Things Fall Apart by Chinua Achebe, The Alchemist by Paulo Coelho, Gifted Hands by Ben Carson and A Thousand Splendid Suns by Khaled Hosseini