When Breath Becomes Air

When Breath Becomes Air

When my sister’s husband, Paul, died last spring of lung cancer, our family was devastated. He had been diagnosed less than two years earlier, at age 36; he was a neurosurgery chief resident at Stanford, nearly done with his training.

During his last year of life, he wrote about facing death. His memoir, When Breath Becomes Air, comes out this Tuesday, January 12th.

I’ve read the book twice now — once as a manuscript, and again over the holidays as a hardcover. Both times, I devoured his story in almost one sitting; I couldn’t put it down. Although I knew how it ended, the book felt almost suspenseful in its gripping, race-against-the-clock questions about life, love, meaning and death.

Paul himself was an introvert. He was smart and lovely. He had a deep kindness and laughed at every joke. But since he was often quiet (and uncomplaining), I wondered — as I hung out in their living room across from him — what was going on in his mind as he grew sicker. I knew he was brave, but was he sad? Was he scared?

Reading the memoir was like hearing his inner monologue after all this time. I couldn’t believe the fascinating things he did as a neurosurgery resident (he once said it was like operating on pudding, yet a millimeter can cost someone’s life), which he rarely opened up about. He described what it felt like to transform from a doctor to a patient (“how little do doctors understand the hells through which we put patients”). I was gripped by his thoughts on accepting death when your life feels like it’s just beginning (“the fact of death is unsettling; yet there is no other way to live”); and how to create a meaningful life, even if you have only months left.

My favorite passage of the book comes at the end, when Paul writes directly to his daughter, Cady:

There is perhaps only one thing to say to this infant, who is all future, overlapping briefly with me, whose life, barring the improbable, is all but past. That message is simple: When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing.

Needless to say, I would recommend the book wholeheartedly.

People often asked how my twin sister is doing. Lucy has shared a few thoughts on Cup of Jo over the months, and today she wrote a moving essay about her experience:

At first I could scarcely grasp what widowhood meant; I was too busy looking for ways to comfort Paul even after he died. When the funeral home asked me to bring a set of clothes for Paul to be buried in, I wore them first, thinking I will make these clothes warm and redolent of us. I put a pair of our daughter’s socks in his pants pocket. On the day of the burial, I stepped out from the procession and moved ahead of the pallbearers, compelled to lead his coffin down the hill. I can’t take your hand, but I will guide you; you will not go alone. For several months, I slept with my head on the pillow he had died on, left his medications in their drawer, wore his clothes to bed. Still today, months after his death, I go and sit at his grave, absent-mindedly stroking the grass as if it were his hair, talking to him using nicknames only he would understand.

You can find When Breath Becomes Air here, if you’d like. Thank you so much for all your kind words over the years. My heart goes out to anyone who is missing someone today. xoxo

Lucy and Paul Kalanithi

P.S. Two essays by Paul, published before he died: How Long Have I Got Left and Before I Go.

(Top photo by Stella Blackmon. Photo of Paul and Lucy by Ryan Padrez. Family photo by Team Draft.)