I heard about this book when it was published in 2016. But what struck me when I finally read the book was that Paul – the author – was a surgeon with a literary flair. I'm not saying surgeons can't be closet poets, but the sheer amount of time and energy that surgical training (in fact, almost all medical training) takes might not leave one much time for the humanities. Therefore, Paul's account of medical school and residency has a certain heightened awareness and sensitivity that he was able to call forth and display.
The visage of death hovers throughout the entire book; it was present in the author's description of the cadaver dissection during anatomy class, in his quotation of the Scripture, and in seeing his own patients die before him. The book was also a touching and brief recollection of his journey to medicine, through medical school and residency. And it was when he was on the cusp of completing his residency (on the very day of graduation), that he was hospitalised following a massive chemotherapy-related infection. Paul alluded the experience to climbing to the top of the proverbial mountain and seeing the Promised Land. But what is tragic is that the reader never knows whether he thought he'll ever reach it, and what it meant to him.
Paul's relationship with his oncologist, Emma, is to be admired. She encouraged him to find meaning in his life, refused to discuss Kaplan-Meier survival curves, and also offered to "just be his doctor". My oncology colleagues, no doubt, grapple with such issues on a daily basis. In fact, at one point or another, we will face such situations: the patient seated before us is a fellow physician, or that we become patients ourselves. How much do you let this doctor-patient of yours make treatment decisions? Where does the balance of control lie?
The book concludes with Paul's heartbreaking account of his final day of residency, his prolonged hospitalisation, and his struggle with what to do with the time he had left. The latter is made all the more poignant because at the time of his writing, he truly had no idea how much time he had remaining.
This book is a must-read for medical students and those of us who have "seen too much". If I could paraphrase this book into a sentence, it'd be: "When a doctor with a literature degree becomes a patient". Of course, given the prominent absence of a literature background in my case, my paraphrasing destroys the poetic title. But hopefully, it doesn't take away from the meaning of the book – how each of us face death and what we make of the time that is given to us.
Title: When Breath Becomes Air
Author: Paul Kalanithi
Number of pages: 228
ISBN: 978-0812988406
Type of book: Hardcover
Publisher: Random House
Year of Publication: 2016