Book Review: When Breath Becomes Air by Paul Kalanithi


I had the pleasure of being on a shadow panel for Wellcome Book Prize 2017 and was invited to participate in the official blog tour.

thumbnail_WBP 2017_Blog tour twitter bannerv3

My choice was this wonderful non-fiction novel which I am pleased to say the shadow panel agree should be the winner of the prize! The prize is announced tomorrow – I will be attending the ceremony and will be tweeting away! Come find me on Twitter if you are interested.

Here is my original review:

Shortlisted for the Waterstones Book of the Year 2016 and both a New York Times and Sunday Times bestseller this autobiographical non-fiction novel is heart breakingly powerful.

Paul Kalanithi was a highly successful resident neurosurgeon with a passion for literature intrigued with understanding the “particularities of death” diagnosed with inoperable lung cancer.  His considerations regarding better acquainting himself with death “face-to-face” ironically became too real.

The book is split into two parts: Kalanithi’s training and rise to a well-regarded resident neurosurgeon and his decline following his diagnosis.  At all times, you are aware that Kalanithi’s time is limited.  You know he is going to die. It is a strange thing to read this book willing for Kalanithi to get better for the sake of his family and his little daughter knowing that won’t happen.

What struck me throughout this book was how there was not a word of self-pity. Kalanithi does not linger over the question of: ‘why me’.  He just deals with the ‘how’ of getting better.  This is best summed up by his wife who notes in the in the epilogue: “This book carried the urgency of racing against time, of having important things to say.  Paul confronted death – examined it, wrestled with it, accepted it – as a physician and as a patient.”  It seems Kalanithi embraced and understood the particularities of death after all.

This book looks death right in the eye and doesn’t seek to rationalise it, explain it, avoid it.  It deals with it head on.  Perhaps we could all do with acknowledging that the only certain thing in life is death – that way we may appreciate there here and now with more vigour.

Here is an exclusive extract from this book courtesy of The Bodley Head, Penguin Random House:

Before leaving for New York, I snuck in a few medical appointments to rule out some common cancers in the young. (Testicular? No. Melanoma? No. Leukemia? No.) The neurosurgical service was busy, as always. Thurs- day night slipped into Friday morning as I was caught in the operating room for thirty-six hours straight, in a series of deeply complex cases: giant aneurysms, intra-cerebral arterial bypasses, arteriovenous malformations. I breathed a silent thanks when the attending came in, allowing me a few minutes to ease my back against a wall. The only time to get a chest X-ray was as I was leaving the hospital, on the way home before heading to the airport. I figured either I had cancer, in which case this might be the last time I would see my friends, or I didn’t, in which case there was no reason to cancel the trip.

I rushed home to grab my bags. Lucy drove me to the airport and told me she had scheduled us into couples therapy.

From the gate, I sent her a text message: “I wish you were here.”

A few minutes later, the response came back: “I love you. I will be here when you get back.”

My back stiffened terribly during the night, and by the time I made it to Grand Central to catch a train to my friends’ place upstate, my body was rippling with pain. Over the past few months, I’d had back spasms of varying ferocity, from simple ignorable pain, to pain that made me forsake speech to grind my teeth, to pain so severe I curled up on the floor, screaming. This pain was toward the more severe end of the spectrum. I lay down on a hard bench in the waiting area, feeling my back muscles contort, breathing to control the pain – the ibuprofen wasn’t touching this – and naming each muscle as it spasmed to stave off tears: erector spinae, rhomboid, latissimus, piriformis…

A security guard approached. “Sir, you can’t lie down here.”

“I’m sorry,” I said, gasping out the words.

“Bad_. . . back_. . . spasms.” “You still can’t lie down here.”

I’m sorry, but I’m dying from cancer.

The words lingered on my tongue— but what if I wasn’t? Maybe this was just what people with back pain live with. I knew a lot about back pain— its anatomy, its physiology, the different words patients used to describe different kinds of pain— but I didn’t know what it felt like. Maybe that’s all this was. Maybe. Or maybe I didn’t want the jinx. Maybe I just didn’t want to say the word cancer out loud.

The Chairman of Judges for the Wellcome Book Prize had this to say about this book:

Val McDermid on When Breath Becomes Air by Paul Kalanithi:

Mortality faces us all, and its contemplation is a key part of our humanity; few books pack in as many diverse insights as this. First comes the gripping dissection of the demands and satisfactions of a career in neurosurgery. Then the disastrous diagnosis of terminal lung cancer. Intensely moving but remarkably unsentimental, this is an intellectually, revelatory and emotionally devastating read.”

I hope this is enough to convince you this should be the winner of the prize and if anything to pick this up and give it a read.  Trust me it will stay with you long after you put it down!

Published by The Bodley Head: you can buy a copy here

Recommended for: anyone!

Rating: 5/5

Favourite quote: When recalling how he felt after his first patient’s death: “Like a premature lung, i felt unready for the responsibility for sustaining life.” When surmising the effects of cancer: “Part of the cruelty of cancer, though, is not only that it limits your time, it also limits your energy, vastly reducing the amount you can squeeze into a day.

Thank you to Rebecca for organising the shadow panel (you can follow her wonderful blog here).

Thanks for reading – I hope you enjoyed it.

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