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Paul Kalanithi, When Breath Becomes Air (New York: Random, 2016), 228pp.Paul Kalanithi, When Breath Becomes Air (New York: Random, 2016), 228pp.

Paul Kalanithi had finished some twelve years of training — medical school (Yale), a degree in the history and philosophy of science and medicine (Cambridge), and then neurosurgery training and a post-doc in neuroscience (Stanford), when, at the age of thirty-six in 2013, he was diagnosed with stage IV metastatic lung cancer — a terminal diagnosis that was extremely rare for someone his age (.0012% of the population).

This eloquent memoir, which he worked on right up to his death in March of 2015, describes how he and his wife Lucy, an internist at Stanford, struggled to find meaning in this dramatic role reversal — from being a young neurosurgeon who had won prestigious national awards to becoming a patient in a hospital gown sitting in the very same examine rooms where he had treated hundreds of his own patients.

Kalanithi was an obvious superstar, but what makes his story compelling is that he was always "driven less by achievement than by trying to understand, in earnest: What makes human life meaningful?" (30).  As an undergraduate at Stanford, he double-majored in human biology and English Literature.  Although he muses that he might have even become a pastor (88), he concluded that neurosurgery "seemed to present the most challenging and direct confrontation with meaning, identity, and death." (72).  What he calls "human relationality" became paramount for him.  He worked hard to see his patients as persons, rather than as problems to solve (as he himself later experienced at the hands of a Stanford physician).

The physician-writer Abraham Verghese contributes an eloquent foreword to the book, and his wife Lucy finishes Kalanithi's story in an Epilogue about their experiences of life, death, love, and the meaning of life.  This book has been eagerly anticipated for over a year, with excerpts published in the Washington Post, the Paris Review, the New Yorker and The New York Times.  I couldn't put it down, and finished it in a day.



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