When Breath Becomes Air

Part I

In Perfect Health I Begin

The hand of the Lord was upon me, and carried me out in the spirit of the Lord, and set me down in the midst of the valley which was full of bones,

And caused me to pass by them round about: and, behold, there were very many in the open valley; and, lo, they were very dry.

And he said unto me, Son of man, can these bones live?

­Ezekiel 37:1 ­3, King James translation

I knew with certainty that I would never be a doctor. I stretched out in the sun, relaxing on a desert plateau just above our house. My uncle, a doctor, like so many of my relatives, had asked me earlier that day what I planned on doing for a career, now that I was heading off to college, and the question barely registered. If you had forced me to answer, I suppose I would have said a writer, but frankly, thoughts of any career at this point seemed absurd. I was leaving this small Arizona town in a few weeks, and I felt less like someone preparing to climb a career ladder than a buzzing electron about to achieve escape velocity, flinging out into a strange and sparkling universe.

I lay there in the dirt, awash in sunlight and memory, feeling the shrinking size of this town of fifteen thousand, six hundred miles from my new college dormitory at Stanford and all its promise.

I knew medicine only by its absence ­specifically, the absence of a father growing up, one who went to work before dawn and returned in the dark to a plate of reheated dinner. When I was ten, my father had moved us ­three boys, ages fourteen, ten, and eight ­from Bronxville, New York, a compact, affluent suburb just north of Manhattan, to Kingman, Arizona, in a desert valley ringed by two mountain ranges, known primarily to the outside world as a place to get gas en route to somewhere else. He was drawn by the sun, by the cost of living ­how else would he pay for his sons to attend the colleges he aspired to? ­and by the opportunity to establish a regional cardiology practice

Paul Kalanithi was a neurosurgeon and writer. He grew up in Kingman, Arizona, and graduated from Stanford University with a BA and MA in English literature and a BA in human biology. He earned an MPhil in history and philosophy of science and medicine from the University of Cambridge and graduated cum laude from the Yale School of Medicine, where he was inducted into the Alpha Omega Alpha national medical honor society. He returned to Stanford to complete his residency training in neurological surgery and a postdoctoral fellowship in neuroscience, during which he received the American Academy of Neurological Surgery’s highest award for research. He died in March 2015. He is survived by his large, loving family, including his wife, Lucy, and their daughter, Elizabeth Acadia.

I guarantee that finishing this book and then forgetting about it is simply not an option. . . . Part of this book s tremendous impact comes from the obvious fact that its author was such a brilliant polymath. None of it is maudlin. Nothing is exaggerated. As he wrote to a friend: It s just tragic enough and just imaginable enough. And just important enough to be unmissable. Janet Maslin, The New York Times

Paul Kalanithi s memoir, When Breath Becomes Air, written as he faced a terminal cancer diagnosis, is inherently sad. But it s an emotional investment well worth making: a moving and thoughtful memoir of family, medicine and literature. It is, despite its grim undertone, accidentally inspiring. The Washington Post

Kalanithi uses the pages in this book to not only tell his story, but also share his ideas on how to approach death with grace and what it means to be fully alive. James Clear, #1 New York Times bestselling author of Atomic Habits

Paul Kalanithi s posthumous memoir, When Breath Becomes Air, possesses the gravity and wisdom of an ancient Greek tragedy. . . . The book brims with insightful reflections on mortality that are especially poignant coming from a trained physician familiar with what lies ahead. . . . The Boston Globe

Devastating and spectacular . . . [Kalanithi] is so likeable, so relatable, and so humble, that you become immersed in his world and forget where it s all heading. USA Today

It s [Kalanithi s] unsentimental approach that makes When Breath Becomes Air so original and so devastating. . . . Its only fault is that the book, like his life, ends much too early. Entertainment Weekly

[When Breath Becomes Air] split my head open with its beauty. Cheryl Strayed

Rattling, heartbreaking, and ultimately beautiful, the too-young Dr. Kalanithi s memoir is proof that the dying are the ones who have the most to teach us about life.