When Breath Becomes Air

By some minor miracle, the interruptions that had been plaguing me yesterday finally settled down at around 9.30pm and I was able to return to the book I had started the day before and finish it.

I had been waiting for a while to get hold of When Breath Becomes Air by Paul Kalanithi. As is the usual case with things, it was released in the US and the UK well ahead of Australia, and I didn’t want to pre order it in case it arrived when I was away and birds ate it. So I waited and it arrived this week, with a couple of others – one a birthday present for my mum in May, which I ended up giving her wrapped last night. To be fair she waited a whole fifteen minutes before deciding life was too short and she would have her present immediately. Having now read my book, I have to say I agree with her.

The book is stunning. It is only about 200 pages, because the author wrote it while facing the physical and emotional trauma of cancer that had spread throughout his body. He was 36 when diagnosed, 37 when he died and first saw his own cancer on a scan shortly before finishing his residency as a neurosurgeon. Before training in medicine though, he had completed a degree in Literature and the book is suffused with what drove him, despite both his father and brother being doctors, to temporarily reject the expected route to the medical profession and seek answers in the writings of artists and philosophers, before deciding that where the answers to his questions lay was at the true point of metaphysics: the brain.

The brain is the organ which transitions the physical into the experience that is consciousness. Intelligence, perception, memory – all these intangibles which work together to form an identity, which are the core of our being, and the light that goes out when the physical stops working and we transition from being alive back to the physical reality of death.

His voice is striking and makes for compelling reading, even while he veers off on his account of his early metaphysical search during university for meaning. He is able to take the terrible irony of his situation and create from it a vivid account of someone, who understands the medical system  – indeed hospital, into which he must now enter as a patient where once he was a doctor. Some of the decisions which I might have thought would be difficult that he and his wife face – such as starting a family –  seem to be handled with suprisingly little or no anguish, at least none than is documented, whereas the question, Who am I now? How he handles is identity – I am a neurosurgeon, but I can’t work as one, so I was one, though might still be one again – which tense do I choose? Provide the platforms for the work in hand, facing the awful fact that we all do one day: that it is not forever, even if we all like to pretend it is until officially told otherwise.

His wife, too writes eloquently in the epilogue of the book, paying tribute to her husband. She is also a doctor. Notable in the book, is the lack of the language of war that is so often associated with facing such a grave diagnosis. He did not ‘fight’, there was no ‘battle’. Cancer is a disease and the medical approaches allowed him a small extension, to make peace with his fate and make the most of the short time he had with his baby daughter. She writes eloquently of his dignity on the last day of his life and both her last chapter and his own eloquent account of his experience are  moving testaments to him.

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