A surgeon’s struggle and trauma in a book

By Baraah Al-Mujaini

When Breath Becomes Air is an autobiographical non-fiction book by Paul Kalanithi. Paul was so immersed and intoxicated by neurosurgery. Although he has studied English literature and human biology at Stanford University, and completed his master’s degree in the history and philosophy of science at Cambridge. Ultimately, he has trained as a neurosurgeon. At the time he was about to graduate, he was diagnosed with incurable stage-4 lung cancer.

The book is divided into two chapters. The first deal with Paul’s residency as a neurosurgeon when he was 35 years old while the second chapter narrates how he and his wife were dealing with his diagnosis and the idea of mortality.

Paul had to cope with his uncertain future, a future that is completely different from what he has always imagined being, as a physician. Throughout his book, he addresses the turmoil and traumas that doctors go through.

One of the main themes that was addressed by Paul is the controversy of hope and accepting the idea of certain-dead. It was a very emotional and complicated task for him to complete his training passionately, yet recognise the idea that he will not be able to do as a fully qualified neurosurgeon.

His symptoms started with backbone severe pain, and neglect it assuming that it was a consequence of his hard work and dedication. And his diagnosis was a complete shock for him, his wife, and the on-way baby. After the diagnosis of another tumour, Paul decided to spend the rest of his life writing and being around his family. He said he joined neurosurgery because he wanted to seek an answer to “what really matters in life”.

The flow of the ideas and events, the way of writing and addressing the nuanced details, and describing what exactly happens in the head of doctors and how they really deal with their patients are incredibly written and well organised. The book celebrates the idea that we cannot always stick to our plans, sometimes should be changed and we have to cope with it. We never know when our death is we can approach how we want to behave before we end.

He died at the age of 37, in March 2015 and his book was published posthumously, 10 months after he passed away. His wife ended the book with a breaking-heart letter. The book was nominated for several awards and was the most-selling book for 51 weeks and was a 2017 Pulitzer Prize Finalist. I highly recommend reading this piece of art.

These quotations are from his wife’s letter at the end of his book:

“His strength was defined by ambition and effort, but also by softness, the opposite of bitterness”.

“We were inseparable as we had been as medical students when we would hold our hands during lectures”.

“Even while terminally ill, Paul was fully alive; despite physical collapse, he remained vigorous, open, full of hope not for an unlikely cure but for days that were full of purpose and meaning”.