The poetry of “When Breath Becomes Air” by Paul Kalanithi

“They should have sent a poet.”

Ask me to quote any other line from 1997’s Contact and I’ll remain silent, but that memorable moment is seared in my brain.

It’s the line that came to mind when I finished reading Paul Kalanithi’s When Breath Becomes Air.

Except the tense changed: they did send a poet.

Let me be clear: Kalanithi’s prose is not poetry, but it swims.

I rarely read full books in a day or two—even comparatively short ones like When Breath Becomes Air—but the current of his words swept me for two straight days. And his advanced knowledge in medicine, in literature, and ultimately in life makes for a compelling author.

When Breath is not a poem, but it is an ode to meaningful living.

Despite the heartbreaking subject matter—a young neurosurgeon is diagnosed with Stage IV lung cancer—Kalanithi offers an accessible and honest reflection on dealing with death.

Kalanithi went into neurosurgery because he wanted answers to the central question of humanity:

“Because the brain mediates our experience of the world, any neurosurgical problem forces a patient and family, ideally with a doctor as a guide, to answer this question: What makes life meaningful enough to go on living?”

On “the ineluctable failures” of neurosurgery:

“Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.”

On the stark difference between being a doctor and being a patient:

“Death, so familiar to me in my work, was now paying a personal visit. Here we were, finally face-to-face, and yet nothing about it seemed recognizable.”

Also:

“It occurred to me that my relationship with statistics changed as soon as I became one.”

I could go on, but this section, for the prose-writers and the poets, spoke to me:

“Lost in a featureless wasteland of my own mortality, and finding no traction in the reams of scientific studies, intracellular molecular pathways, and endless curves of survival statistics, I began reading literature again: Solzhenitsyn’s Cancer Ward, B. S. Johnson’s The Unfortunates, Tolstoy’s Ivan Ilyich, Nagel’s Mind and Cosmos, Woolf, Kafka, Montaigne, Frost, Greville, memoirs of cancer patients—anything by anyone who had ever written about mortality. I was searching for a vocabulary with which to make sense of death, to find a way to begin defining myself and inching forward again. The privilege of direct experience had led me away from literary and academic work, yet now I felt that to understand my own direct experiences, I would have to translate them back into language. Hemingway described his process in similar terms: acquiring rich experiences, then retreating to cogitate and write about them. I needed words to go forward.

“And so it was literature that brought me back to life during this time.”

When Breath Becomes Air has sold millions for many good reasons.

  • Kalanithi asks the questions we all wonder about but are afraid to speak.
  • He endures the most difficult challenges of life face on.
  • And he writes with humble confidence on the meaning of our mortality.

Cancer memoirs and terminal-disease memoirs proliferate because the experiences are so intense to the author, and sharing those experiences can and do help people enduring the same struggle.

But the best memoirs in this genre reach wide audiences for their searing, insightful, unflinching writing.

Because what we need when we try to peer into the infinite is a poet.

P.S. Thank you to Jaymi the OCBook Girl and her Let’s Read Nonfiction Substack newsletter in which she announced the Nonfiction Book Party. It’s a free virtual book club unlike any other I’ve seen: instead of everyone reading the same book each month, Jaymi offered a genre per month. I’ve long felt the pull to read more widely, so I signed up as quickly as I could. I read When Breath Becomes Air for the January prompt of “Health & Wellness.” If you need to read more widely, I highly recommend the club.


If you enjoyed this review, I also write a weekly newsletter for nonfiction authors called Better Writing with Blake Atwood. Subscribe for free at Substack.

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