“Lucid and wise and affecting” – When Breath Becomes Air by Paul Kalanithi

wbbapkIt may be that you’ve heard about this book already. Hell, given it’s bestseller status, it’s possible you’ve already read this. You might be glancing at this review just to see if we agreed with you. We’ve all done that, right? Read reviews just to see if we’re simpatico with the reviewer. We’re going to try and talk about this book, though, as if you haven’t heard about it. As if you are among what we like to call the uninitiated.

The thing you should probably know first, before the fact that the author was a medical professional (which puts the book in Do Not Harm territory, Henry Marsh’s surgical memoir), before the fact that this is a book in which an individual does battle with a terrible illness, is: Paul Kalanithi is no longer with us. Paul Kalanithi is no longer with us and When Breath Becomes Air isn’t (or wasn’t) strictly speaking finished. Paul Kalanithi didn’t win his fight. What we have here is a book by a man who was very interested in books, who considered being a writer as a younger man, who thought he would possibly go back to writing after his medical career, who had started to publish articles in the likes of the New Yorker and had garnered some repute, who then became ill and wrote this as he was dying.

As such, then, in some ways this puts it on the same shelf as Kent Haruf’s Our Souls at Night, because here is someone who chose to spend a portion of the hours that he knew were among his last committing something to paper. Unlike Haruf’s book, though (which, as a result of being fiction demands that you try to understand it – what did Haruf think it was so important to impart? I think the answer, if you can say such a thing, to the question is: Love endures), Kalanithi’s book is a mite more straightforward (in that here is a man talking about his situation, and the situation at a slightly lesser remove, of his wife and imminent family). But that isn’t to say that the book is not without surprises. One of the surprises is Kalanithi himself. The man can write.

His career as a surgeon also imbued him with wisdom, and it is a wisdom that will stop you in your tracks and, no doubt, dwell upon your own mortality. Here he is talking about his role in talking to families in which someone has suffered a catastrophic brain incident:

“In these moments, I acted not as I most often did, as death’s enemy, but as its ambassador. I had to help those families understand that the person they knew – the full, vital independent human – now lived only in the past and that I needed their input to understand what sort of future he or she would want: an easy death or to be strung between bags of fluids going in, others coming out, to persist despite being able to struggle.”

Although the writing is never anything less than lucid, you can feel him grappling with meaning (and it’s the biggest question there is):

“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.”

When he learns the outcome of his struggle, his equanimity is inspiring and this is very definitely something you take from the book:

“I was neither angry nor scared. It simply was. It was a fact about the world, like the distance from the sun to the earth.”

You’d expect a book written by a man as he was dying to leave you depressed and acutely aware of the finite number of days we all have round the sun but When Breath Becomes Air actually has the opposite effect – which probably strikes you as banal. Of course, you are probably saying. There is a reason this is a bestseller after all. Sometimes good books sell.

And just as with Ali Eskandarian’s Golden Years , another book that showed us a talented writer who will only ever give us one book, yes, there is a sense of if only. If only he had decided to write as a younger man. But here that if only is couched in a much more personal sense of the people Kalanithi leaves behind, that this is a testament for his daughter to see the man he was as much as it is a book for all of us to read, a book that we imagine has given and will go on to give solace to lots and lots of people.

Any Cop?: It’s quite an achievement. Sombre, of course, and spiritual (but spiritual in a way that is we think unlikely to put off anyone who doesn’t go in for all that mumbo jumbo), but most importantly lucid and wise and affecting. We’d recommend.



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