"When Breath Becomes Air" Book Review

Paul Kalanithi accounts in his book When Breath Becomes Air that, as he approached the end of his residency for neurosurgery, he became ill, and he knew the symptoms and their potential severity before anyone else. As the one who usually delivered the news to patients, he was now in their shoes. He could not run his own CT scans or perfom checkups on himself, but as the results turned up, they were directly handed over to him to assess; his previous coworkers and classmates knew he might be better informed about the situation than they were. As a neurosurgery resident, he had been working tirelessly in the OR treating patients and delivering news that you would see in sad movies, but now he was on the receiving end. 

Paul had returned to Stanford to complete his residency training in neurosurgery, which lasted for seven years after he graduated from medical school. He worked over twelve hours a day, with little time to see his wife or do anything outside of the OR. He said of the experience, “Don’t think I ever spent a minute of any day wondering why I did this work, or whether it was worth it. The call to protect life—and not merely life but another’s identity; it is perhaps not too much to say another’s soul—was obvious in its sacredness.” As the brain is so complicated, he noted his logic and thought processes on what was ethical and “right” for the patients. For example, is it always better for a patient to keep them hanging on by a thread if they are distant from their true self and only have a life of misery ahead of them?

His commitment to his work made the time he dedicated to it a very minor sacrifice in comparison to the result. However, it was only a matter of time before his body would ache and the lack of rest would leave a painful aftermath; this was an easy way to explain away his fatal symptoms. Although he attempted to sympathize with his patients and their families, it wasn’t until he experienced it firsthand that he fully understood what they were going through. Talking about the process he went through to make sense and understand the implications of his condition, he said, “As a doctor, I knew not to declare 'Cancer is a battle I’m going to win!' or ask 'Why me?' (Answer: Why not me?)” He understood that he could not be an exception to the “cancer rule”, but his neurosurgery career/calling was just about to launch. 

Paul was only in his thirties when his spine started collapsing and tumors emerged on his lungs, just when the end of his years of residency was so close in sight. Paul had dedicated the last fourteen or so years of his life to his practice, knowing that putting in the time and effort put something of great value in the cards for the people that would inevitably need his knowledge. The entire concept is ironic, and Paul acknowledged this in his book, “Shouldn’t terminal illness, then, be the perfect gift to that young man who had wanted to understand death?” By reading about the reversal of roles in this scenario, where the doctor became the patient, he teaches you to step out of everything you have come to know, to prioritize the essentials, and to make life meaningful with the opportunities you have.

 

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