When Words Become Breath

If you found out you were dying, would you write a book?

“If the unexamined life isn’t worth living, is the unlived life worth examining?”

This is the question that Paul Kalanithi asks in his memoir, When Breath Becomes Air, as he contemplates his mortality and reflects on what makes life meaningful. Paul is a 36 year-old neurosurgical resident who learns that he has terminal lung cancer in his final year of residency. Like Paul’s life, this book isn’t very long, but it will leave a lasting impression nonetheless. I call him by his first name, Paul, because Dr. Kalanithi sounds too formal. He writes about his life, his ambitions and his pain with such openness and vulnerability that I feel like I know him now. In this book, Paul recounts his childhood in an Indian immigrant household and describes in detail how his love of literature and lifelong fascination with the study of human nature evolved into a decade-long journey into medicine and a grueling neurosurgical training program. And finally, he shares with us his struggle with the cancer that would kill him within 22 months of his diagnosis.

Any story about a life tragically cut short stands as a reminder to the reader that life is, well, short. But if we don’t know how short our own life will be, what are we supposed to do with that information? After Paul is diagnosed with stage IV metastic lung cancer, he realizes that coming in such close contact with his own mortality had changed both nothing and everything. He always knew he was going to die, but he didn’t know when. After his diagnosis, he still didn’t know when he was going to die, he just knew the fact more acutely. He may live for 10 or 20 years or he may die within a year. So what should he do with the rest of his life? How should he spend each passing day? Should he continue his medical training or become a writer or maybe just retire? Should he and his wife have a child? In summation, what was it that made life worth living?

The thing is, these are not questions that are unique to a dying man. We all have to think about these things at some point or another.

But Paul suddenly had to consider them with far greater urgency and significance. That he chose to painstakingly write about his struggle to answer these deeply personal questions in his final months of life with such honesty is remarkable and telling. Paul did not simply enjoy writing — he found deep meaning in language, in its power to form human connections. Paul will never be a neurosurgeon but he has impacted the world in a different way — by examining his life and its meaning, and bravely sharing his thoughts and experiences through his words. He has inspired me to do the same.