When Breath becomes Air by Paul Kalanithi: Short Summary

When Breath Becomes Air is a memoir by Paul Kalanithi. A neurosurgeon at Stanford University when he got the news that he was going to die of stage four Lung cancer in his mid-thirties, he wanted to make sure he left his piece of wisdom in writing. In this Book, Paul confronts the question of what makes life meaningful in the face of death. Here are some key takeaways from the book “when breath becomes air by paul kalanithi”.

Key Takeaways from the book

  • You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.
  • Most ambitions are either achieved or abandoned; either way, they belong to the past.
  • Life isn’t about avoiding suffering – After being diagnosed with cancer paul and lucy decided to have a kid but then lucy asked:

“Will having a newborn distract from the time we have together?” she asked. “Don’t you think saying goodbye to your child will make your death more painful?”

“Wouldn’t it be great if it did?” I said. Lucy and I both felt that life wasn’t about avoiding suffering.”

  • It’s up to us to make meaning out of life. Suffering is inevitable but even some suffering can bring you joy.
  • Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete.
  • Most of us question ourselves about Life, death, and meaning only when there is a medical context.
  • In the depths of your pain and suffering, it might seem as though you cannot go on. It might feel like the end of you. But the moment you recognize you can’t go on also might be the moment you realize that you can go on. No matter how painful or difficult what you’re facing may be, you can go on. The brain mediates our experience of the world. What makes life to go on living?
  • Learning to judge whose lives could be saved, whose couldn’t be, and whose shouldn’t be requires an unattainable prognostic ability.

“I made mistakes. Rushing a patient to the OR to save only enough brain that his heart beats but he can never speak, he eats through a tube, and he is condemned to an existence he would never want… I came to see this as a more egregious failure than the patient dying.”

As a resident, my highest ideal was not saving lives—everyone dies eventually—but guiding a patient or family to an understanding of death or illness.

  • But getting clarity when learning about one’s own mortality can be hard, but if you are clear, you can leave something behind which can be a joy.

“I began to realize that coming in such close contact with my own mortality had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn’t know when. After the diagnosis, I knew that someday I would die, but I didn’t know when. But now I knew it acutely. The problem wasn’t really a scientific one. The fact of death is unsettling. Yet there is no other way to live.”

  • You can still fail even if you know and have everything. Sometimes the margins of failure are a few millimeters. But you can still live with it.

“The pain of failure had led me to understand that in neurosurgery technical excellence was a moral requirement. Good intentions were not enough, not when so much depended on my skills, when the difference between tragedy and triumph was defined by one or two millimeters.”

  • Death is a one time event, but living through pain, illness is a process.

“The tricky part of illness is that, as you go through it, your values are constantly changing. You try to figure out what matters to you, and then you keep figuring it out. It felt like someone had taken away my credit card and I was having to learn how to budget. You may decide you want to spend your time working as a neurosurgeon, but two months later, you may feel differently. Two months after that, you may want to learn to play the saxophone or devote yourself to the church. Death may be a one-time event, but living with terminal illness is a process.”

  • How do you decide what to do with your life when you’re not sure how much life you have left? Maybe in the absence of certainty we should just assume we’re going to live a long time. Maybe that’s the only way forward.

Eventually, he became too weak to finish the book. Lucy wrote the epilogue, describing him facing death with integrity.

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