This is a book which you cannot forget about after reading Initially, I was a little reticent about reading it, due to the subject matter, but after many personal recommendations and assurances it was not all doom and gloom, I gave it a go I m glad I did.Paul Kalanithi was a brilliant brain surgeon when he was diagnosed with an aggressive lung cancer, which despite treatment, continued to spread and ultimately caused his premature death Paul was also a brilliant and very gifted writer, who, in his long terms plans prior to a diagnosis was going to spend twenty years of his life post medical career, dedicated to writing His ability to write shines through in this book He uses language beautifully and has an almost poetic turn of phrase while remaining brutally honest to the situation he is facing.Ironically, I found this book to be about life than death Paul talks about his journey into medicine and the privilege of being allowed to change the course of a person s life through surgery His own cancer journey is shown as something he deals with rather than being ruled by He continues to work and plans to start a family with his wife, Lucy He charts the difficult transition he needs to make from being the doctor to being the patient and how he is not always successful in doing this. I enjoyed this book and found it easy to read despite the weighty subject matter However, the book is unfinished well, sort of Towards the end of his life he became too ill to complete it and the final chapter is left to his widow in the form of an epilogue describing his final moments and the events leading up to them This book is thought provoking, interesting and well written, but in all that it tackles the issue of dying head on I felt there was still much left unsaid He spoke several times about the uncomfortable relationship of a former doctor become patient and the machinations of privileged access to the best health care available But he rarely allows us in to share his private fears as the end of his life draws close.I m glad I read it and would encourage others to read it also, but it wasn t the book I was expecting I wanted to look death fully in the face, accept its inevitability and learn a little about that process Instead Paul s illness appears as an inconvenience limiting his ability to work and restricting the degree to which he can come to know his daughter Like many Americans Paul is religious which seems to deprive death of its finality, appearing only in occasional glimpses As an atheist I view death very differently but I admire him none the less. When I first finished this book, I was ready to award it only 3 stars.I had absolutely loved Part 1 Everything Paul talked about enthralled me His love for literature, his constant philosophical questioning as to what made life meaningful, his insights into the paradoxes of studying life to understand it vs experiencing it and building the relationships that gave it meaning, and his drive and fascination with biology and specifically neurology He felt so alive in Part 1 as I read, his drive, his yearning to master this thing called life, his success mindset, I loved him I felt so sad that he was dead and that I would never get to meet him What a loss to the world And it seemed so horribly unfair that a man who did so much to save the lives of others, should be deprived of life himself Horribly unfair Was that how we got rewarded in life for good deeds I gave myself a break before Part 2 A breather because I knew it was going to get heavy Paul hadn t survived despite the upbeat voice of Part I He had died Others had warned me this was a book that would leave me in torrents of tears, so I gave myself some time to prepare for the emotional upheaval and brace myself.Yet during that break, something nagged at me A small voice at the back of my head told me something didn t sit quite right Paul seemed too brilliant from the first part Was that how he really was Maybe he was saying some of things that so impressed me, because they came to light after he knew he was facing death Maybe he was making himself sound better than he was I made the mistake of googling the book so I could read some about him It was odd, I wasn t ready to face Part 2 yet, but I still wanted to stay connected to Paul and the book, so I found myself reading about him and his wife on the internet.I discovered they d had a baby That shocked me Why would he have a child when he knew he wasn t going to be around to bring it up And I read about his wife finding new love a couple of years after his death Ironically, with a widower whose dead wife had also written and had a memoir published about her impending death.I know it s totally wrong of me to feel this and judge, but I felt cross with her I was still at the part in the book where Paul was alive, and here she was already with someone else I lost love for her and my opinion of her became a little jaded I know, totally dumb and unfair What can I say When I finally got back to Part 2 then, I was already in lower spirits, but not because I knew Paul was going to die Because I felt lost and didn t understand the decisions that he or his wife were making I started to feel cross with him for having a baby when we wouldn t be there for her as she grew up And when he returned to work full gusto after the first successful treatment, I was beyond flabbergasted How could he do that Knowing how ill he d been In fact, worse, how could he ignore all the pain that was returning and just use painkillers to mask it and go on Why Why would he do that Why would anyone do that In my vanity and arrogance, I was so mad with Paul He d had a chance to live and he d thrown it away in my opinion He d gone back to a job that had killed him That s what it felt like for me.And that oncologist Why did she keep pushing him back to such a stressful unhealthy job There was no way in the world that a personality like Paul was going to go back to it part time A return to it was always going to almost certainly put critical strain on his body.And emulating her question, he kept asking several times in the book, what do you value What gives your life meaning Except, he never explicitly answered In my arrogance, I judged the meaning of his actions and assumed that they revealed what gave him meaning his job, achievement, becoming a high flying consultant who was respected and adored by all.I thought he was selfish His marriage was on the rocks before his diagnosis, precisely because they weren t spending time together my assumption and there he was, having been given another chance, and he returned to the same crazy lifestyle He valued success He didn t value relationships or other people.That was my original opinion Harsh, judgmental and assuming.It took a whole evening of discussion at Bookclub to really unlock this book and Paul Kalanithi s last days for me, and turn my opinion completely around One of the members asked repeatedly, why did we think Paul wrote the book We didn t come to a common consensus right away I felt he had wanted to leave a legacy For selfish reasons But others thought that the book was a way of him coming to terms with what was happening to him.I now think that this is true, the book did give him opportunity to try to make some sense of his life and his impending early death I think that anyone facing an early demise would find themselves trying to understand what was the point of it all.I think he did also want to leave a legacy, but not truly for selfish reasons Literature was a passion of his and he had always wanted to write It was a dream, an ambition and he wanted to fulfil it before he died There s even something noble in this To leave something of value behind for others so that they might benefit from his sorrow and suffering.When we noted that Paul never explicitly answered what he valued and what made his life meaningful, we considered that maybe he didn t actually know the answer to that question And there was a searching for it in the book as he wrote it to some extent.Someone noted that he d repeatedly asked and needed to know, how long did he have Because how long he had would impact how he chose to spend his remaining time Did he have time to finish his training and graduate Or was it less If it was less, he would write his book The same dilemma appeared again and again.And he noted finally at one stage, the irony of his position Before his diagnosis, he hadn t known how long he d got left And after, he hadn t known how long he d got left.My friends helped me to realise that Paul was a man that was really struggling even though he doesn t express it in emotional terms through his writing What a horrible position to find yourself in You ve got cancer, you re definitely going to die What do you do with your remaining days What would you do For Paul, it made sense if he had time to go back to work and complete the training he had invested virtually his whole life in He was so close to the finish line So close It made sense to just go back and finish it and maybe even reclaim the future he had worked so hard and relentlessly to attain.When the returning cancer started to make itself known through the excruciating back pains he started to experience again, he dumbed it down, ignored it, buried his head in the sand a little, or accurately perhaps, stayed laser focused on his goal You don t become a neurosurgeon by being swayed or distracted by obstacles when they appear That was not his way, and I can only assume that he was helpless to change this in himself.I realised that for all the good that Paul Kalanithi did for others, how many lives he saved and how many people he redirected on the road back to health and self care, ultimately he did not do the same for himself.Did he realise this That he had failed in his own self care He makes a point midway through Part 1 how some students had rallied to try and change the Hippocratic Oath equivalent that they were to swear to in the US, caveating that they should not put their own welfare behind their patients Of course this was meant in a different context, but the irony strikes me hard in the face I wish fervently that Paul Kalanithi had cared about his own health and well being, maybe then, maybe, he might even be here still to save lives and see his wife smile and his little girl grow up.Of course death comes to us all It is our final master The curtain that gives our performance meaning ultimately And yet what I learnt from this book is that having Focus without Balance is a fatal mistake Fatal to all projects, but in this case it feels like it may have been a key factor that claimed a life.If Paul had not been so single mindedly driven, would he have spotted those shadows in the scans before they became irreversible Would he have chosen to make better choices about his hours punishing 5am starts and such late finishes it was all he could do to collapse , about the food that he ate a quick lunch of an ice cream sandwich and coke was never going to be conducive to promoting good health in the body , about the emotions that he felt there was such a desperate need requirement to perform unreasonably consistently at an exceptionally high level for him I feel so sad for Paul now This was a man who struggled desperately to do the right thing in the only way he was taught to and the only way he knew how But he was not rewarded for it ultimately.I think now, that what Paul maybe valued most of all, was maybe trifold relationships in conjunction with giving value to others and achievement When he returned to neurosurgery and he was only doing the surgeries, he had said that the job had started to feel empty and he d stopped enjoying it And that it was only when he returned to consulting with patients that it became meaningful again.And at the very end of the book, his final letter to his daughter, he tells her that when she questions if her life has had meaning, to know that she gave a dying man joy such that all his desires were sated Finally in death, he had stopped the chasing that had been set up in his childhood and persisted in this crazy world we live in permeating a job that he loved and had tremendous value Finally he found value and found himself being valued by a child who was till a baby and asked nothing of him other than to love and adore him and be loved and adored back in return No chasing, nothing about his past or his future, all she wanted and needed from him was his attention now, here, in the present.I ve realised that this book was actually his real gift to his daughter In it she can learn everything that her father was, what he stood for and believed in, what he loved and what he struggled with Within the pages if she looks closely enough, she will find a guiding compass as to what kind of questions to ask yourself in life so you can be proactive in making your life meaningful and valuable.For me, Paul and our bookclub members have given me an immeasurable gift I have realised that like Paul, I myself need to actively prioritise my health Maybe that is why I was so mad with Paul, because he did what I do myself so regularly Sacrifice longevity for quick wins in the scheme of things.And perhaps equally importantly, I ve recalled that none of us know how long we have truly And that if we live our life without prioritising what s really the most important thing in the world for us, regardless of how long we have left, then we can only win ultimately We must find a way to balance the scenario where we might live for several decades and yet today might be our last day too.I think this is actually possible and achievable But it requires us to stop and take a step back every now and then, so that we look deeply into how we our lives now And consider what it would be like if everything was to phase out to black in the next moments, as death stole us away What would be the urgent need in these final moments Paul s sweet wife, Lucy, says in the afterword that Paul s hope was that the book might prompt readers to walk in his shoes a moment and feel what it s like to facing a difficulty such as his, before stepping out of them again It s definitely done this for me What a tremendous profound gift.I don t know what the book might have been if Paul had had an opportunity to complete it But I feel that paradoxically, not achieving completion was his greatest achievement of all He perfectly demonstrates the future that awaits us all, and gives a profoundly valuable opportunity to breathe life into our remaining days and years as a result. there s one phrase i love the best in this book No philosopher can explain the sublime better than this, standing between day and night It was as if this were the moment God said, Let there be light You could not help but feel your specklike existence against the immensity of the mountain, the earth, the universe, and yet still feel your own two feet on the talus, reaffirming your presence amid the grandeur Paul Kalanithi, When Breath Becomes AirHe really writes very well.. It s the narration of a neurosurgeon of his entire life how it gets upside down when he discovers that he is suffering from grade 4 cancer This book depicted his struggle till the end Also he tells us how much life we take for granted and how we should live our life to the fullest with the time we got Must read not only by Doctors but also everyone out there to know the real meaning of life. At the touch of love, everyone becomes a poet , it is said But one cannot say the same about Death When Death arrives calling, not everyone stays brave or becomes a philosopher Not all of us remain the proud humans that we are during our lifetimes, but go begging for another lease of life, no matter however brief that might be Very few of us have the courage and composure to meet Death face to face, contemplate their life so far, take stock of their purpose and progress, and then, finally, do something that would fill them with the satisfaction of leaving behind something worthwhile, something that could set apart their sojourn on this planet from the billions of others Paul Kalanithi s was, fortunately or unfortunately, one such life that acquired a glowing purpose and meaning, sadly during his final phase of life.Paul Kalanithi was the second of three sons of an Indian couple settled in America He had everything going for him A comfortable life with family, marrying the love of his life, pursuing a career as special and as advanced as neurosurgery, reputation that could have landed him a plump career as soon as his training ended But he also had something else too lung cancer of an advanced stage All his plans for the future suddenly vanished like mirage With a life now cut short due to illness, Paul launched deeply into questions of existential nature, questions he had felt even while he was riding the crest of the tide.This book is the answer to his questions about the meaning and purpose of human life And, what an eloquent and poetic answer this has turned out to be Published posthumously, this memoir recounts Paul s early life in detail, telling us about what led to his decision to pursue a career in neuroscience, his early days as a resident surgeon and his ascent to glory Then come the details of his illness, the various stages of cure that were tried and his frantic, determined quest to find the meaning for his life, whatever little was left of it His wife Lucy s epilogue is as fitting an end to the book as it could have been beautiful, full of love and written in a matter of fact manner than in a mawkish tone, just the same way in which Paul had written the whole book.Life is a continuum and Death is a part of it, whether we like it or not Death is in fact the only absolute certainty in the lives of everything, from the tiny sapling to the mightiest of stars Just like the eyes ignore the nose that is in front of them, in order to give us an unhindered view of the world, our minds push that ineluctable reality behind so that we can plot our plans for decades until, of course, Death arrives calling, putting to waste our best laid plans The we contemplate the meaning of our lives, the we acknowledge what awaits us all in the end, and the we chart the course of our lives accordingly, the easier it becomes for us to leave our mortal shells behind with dignity Just the way Paul did.Going through the book, I was often reminded of Viktor Frankl s Meaning Triangle According to him, a human being can add meaning to his her life in one of these three ways by creating something beautiful a work of art, literature or something else similar, by being a beacon of love, filling the lives of others with love and joyful experiences or, finally, by showing a courageous attitude towards the travails that Life places on one s path According to me, Paul has done all the three and has really added a glowing meaning to his beautiful life, no matter however short it had been.Done reading, I am leaving this book on my shelf, nestled between Viktor Frankl s magnum opus Man s Search for Meaning and Anne Frank s The Diary of A Young Girl , because I really feel that this book deserves its place up there Tackling the agonizing transition from skilled surgeon to bewildered patient, When Breath Becomes Air is an unflinching account of what it means to be betrayed by the body you devoted your life to understanding The New York Times number one best seller At the age of , on the verge of completing a decade s training as a neurosurgeon, Paul Kalanithi was diagnosed with inoperable lung cancer One day he was a doctor treating the dying, the next he was a patient struggling to live When Breath Becomes Air chronicles Kalanithi s transformation from a medical student asking what makes a virtuous and meaningful life into a neurosurgeon working in the core of human identity the brain and finally into a patient and a new father What makes life worth living in the face of death What do you do when life is catastrophically interrupted What does it mean to have a child as your own life fades away Paul Kalanithi died while working on this profoundly moving book, yet his words live on as a guide to us all When Breath Becomes Air is a life affirming reflection on facing our mortality and on the relationship between doctor and patient, from a gifted writer who became both