Guest writer, Baba Yogesh reviews Paul Kalanithi’s ‘When Breath becomes Air‘
We breathe. We inhale air, with gases in proportion to those in local atmosphere, and we exhale breath which is the inhaled air but with a little less oxygen, some more carbon dioxide, humidified, and cleansed of all particulate matter. This process of breathing results in a personalized change in the quality of air that we breathe out, our breath. From a medical point of view, at no point in one’s life can breath become air. Then does the title imply the breath under scrutiny belongs to a person whose life has ceased to be? But then, how can a person who isn’t alive breathe? This latter pedantic quandary notwithstanding, the original motive of the author, Paul Kalanithi, who wrote the book titled such, probably was to signify death. Death in general, and his impending one in particular.
Paul was a neurosurgeon-scientist. He studied medicine at Stanford, and his research involved electrical stimulation of brain regions with intracerebral electrodes. Paul started college with the question, ‘What makes life meaningful?’ a philosophical timeless Gordian knot we all have wrestled with. Quite unlike many, Paul sought answer to it with literature.
“I had come to see language as an almost supernatural force, existing between people, bringing our brains, shielded in centimeter-thick skulls, into communion.” He saw literature as a fertile source-material to study life. He felt that only the vague intricate complexity of classical writing can encompass the similarly qualified concept of life and its meaning. He majored in English and Biology. He further went on to do Masters in English literature on ‘Whitman and the medicalization of personality’. But after masters, he felt caught in a catch-22. In his words,“If the unexamined life was not worth living, was the unlived life worth examining? ”
Convinced that to truly answer what makes life meaningful, one needed to experience life at the crucial juncture where it could possibly be stripped of meaning, he turned to medicine. His transition into neurosurgery is well-reasoned and captured in,“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?”
In this book, Paul writes about his life as a surgeon and how he grappled with the complexities involved in patient-care, informed decision, long work-hours, and the unfortunate objectification of patients. And its written with a personal touch such that at no point does it get preachy or overtly verbose. And in the second half, Paul writes about his descent from a care-giver, to a patient diagnosed with stage-IV lung cancer, grappling with the reality of being struck down in his prime when he was at the peak of his surgical career, with life looking up bright ahead. Paul writes about how he dealt with it, accepted it, curiously went through the Kubler-Ross model for 5 stages of loss in reverse, and faced his own mortality and the question of the meaning of his life, up close.
The book ends abruptly. Paul died, in February, 2015. And in the end of the book is an epilogue by his wife, Lucy, who remained by his side all along. She writes how its possible to love a person, as deeply as before, even when the person is no more. Its a book thats personal, humane, and heartrendingly tragic. But then, so is life, often times. If you are a doctor, or anyone who was ever interested in what life and living is all about, here in this book is a perspective that will remain with you for a very long time.
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