When Breath Becomes Air Summary

1-Sentence-Summary: When Breath Becomes Air helps you see what’s really important by diving into Paul Kalanithi’s life of loving neuroscience, literature, meaning, and his family that ended from cancer in his mid-thirties.

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Life is short. But we go about most days not thinking about our inevitable death. It might not be a pleasant thing to dwell on, but maybe if we did we would try to live more meaningful lives. Maybe we would spend less time working and more time with family or helping others. Maybe we would leave some sort of wisdom for those who come after us

When neurosurgeon Paul Kalanithi got the news that he was going to die of cancer in his mid-thirties, he wanted to make sure he left his piece of wisdom in writing. Writing a friend about his diagnosis he said, “The good news is that I’ve already outlived two Brontës, Keats and Stephen Crane. The bad news is that I haven’t written anything.” 

Writing it wouldn’t be easy because of his fragile and worsening health. In When Breath Becomes Air, Kalanithi shares his feelings on being diagnosed with terminal cancer at the peak of his life and career with so much potential in front of him. 

Here are the 3 most interesting things I learned about this man’s life:

  1. Kalanithi was passionate about neuroscience and literature. 
  2. A career in the medical field proved difficult and taught him much about the intricacies of life and death right from the start. 
  3. Terminal cancer made Kanaithi’s think a lot about his career, life, and the future of his family. 

Let’s see what we can learn from the life and philosophy of this amazing man!

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Lesson 1: Neuroscience and writing were Kalanithi’s two passions.

Growing up, Paul Kalanithi fell in love with literature. He decided he would study literature, but in the summer before college, he found something else captivated him: human biology. On his way to Stanford, he got a book that explored the idea that the brain is a machine that allows the human mind to exist. His fascination led to him taking neuroscience courses. 

Kalanithi liked to ponder big questions like what life’s meaning was, and looked to both neuroscience and literature to find answers. He felt literature, and particularly fiction was a manifestation of the mind’s life. He drew from works that connected meaninglessness and isolation, concluding that true meaning comes from human relationships. 

But he understood that literature wouldn’t give him the whole answer. He needed to keep studying neuroscience to understand human meaning. Kalanithi believed that because the brain allows our mind to exist, the ability we have to build relationships comes directly from the brain. He also knew if he wanted to understand life, he needed to understand the most unavoidable part of it all: death. What better way to do this than practice medicine?

Lesson 2: He learned much about life and death during his time in medical school and later as a doctor.

During his time in medical school, Kalanithi spent a lot of time with cadavers. Most students covered the faces of the cadavers and didn’t learn their names, but he was moved by their humanity.

His first experience with a birth was also about death. A woman went into premature labor and lost both of her twins. Because of this experience, Kalanithi was left with the image of life one day, death the next. 

When he specialized in neurosurgery, he realized how much responsibility he would have in life or death decisions. He struggled with the expectation to be able to judge who could be saved, who couldn’t, and who shouldn’t be saved. If he rushed a patient to the OR to save their life but they were left to live unable to speak and eat, was this really the life they wanted?

He witnessed many deaths, both from patients and even people who worked at the hospital. When he got deeper into his practice, he tells of his regrets that his exhaustion and stress from his responsibility sometimes made him neglect his patients’ humanity.

Lesson 3: Kalanithi’s life ended in his mid-thirties from cancer, but his reflections on the illness can teach us much about life.

By the time his residency was ending, he had earned awards and the respect of senior doctors. He even had a great job lined up. But after months of back pain, he found out that he had malignant lung cancer that was spreading across his body.

Following the terrible news, he contemplated what to do. He talked with his doctor about how disturbing it felt not to know how long he had left. If he had many years, he wanted to continue his practice. If he had only a couple, he wanted to be with his family and write. His doctor advised him to do what really mattered.

He also had a hard time being both doctor and patient. As a doctor, he was a force of action. But as a patient, things happened to him. He gained empathy for patients with chronic and terminal illness that he wouldn’t be able to understand by any other way. 

He and his wife decided after much deliberation they would have the child they always wanted. Lucy gave birth to a daughter Cady, and Kalanithi was able to be there for the birth though he was weak. He ends the book with a message to Cady, saying she has given him the greatest joy of his life. 

In the last months of his life, he focused on being with family. He and Lucy grew closer at this time and spent time with friends and playing with baby Cady. He lived what life he had in the best way he could, saying, “Even if I’m dying, until I actually die, I’m still living.” 

Eventually, he became too weak to finish the book. Lucy wrote the epilogue, describing him facing death with integrity. It’s unfinished, but perhaps that’s what makes this book about confronting the uncertainty of death most realistic. But we are thankful to Dr. Kalanithi for sharing such beautiful thoughts about what gives life meaning.

When Breath Becomes Air Summary Review

When Breath Becomes Air is both inspiring and tragic at the same time. It was fascinating to hear about death from the perspective of both a doctor and a patient. This book will help you understand what is truly important in life and helps you confront the inevitability of death.

Who would I recommend the When Breath Becomes Air summary to?

The 57-year-old who just lost their spouse to cancer, the 31-year-old medical school student who’s feeling burnt out and like they don’t get enough time with their family, and anyone who thinks often about what’s really important in life.

Last Updated on October 10, 2022

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Luke Rowley

With over 450 summaries that he contributed to Four Minute Books, first as a part-time writer, then as our full-time Managing Editor until late 2021, Luke is our second-most prolific writer. He's also a professional, licensed engineer, working in the solar industry. Next to his day job, he also runs Goal Engineering, a website dedicated to achieving your goals with a unique, 4-4-4 system. Luke is also a husband, father, 75 Hard finisher, and lover of the outdoors. He lives in Utah with his wife and 3 kids.