Monday, May 30, 2016

When Breath Becomes Air

When Breath Becomes Air by Paul Kalanithi is one of the best books I’ve read about the experience of life, cancer and mortality.  The author had degrees in English literature and biology and chose to go to medical school.  He was diagnosed with lung cancer during his residency in neurosurgery at Stanford.  He came to my attention after I read an editorial he wrote in The New York Times that I shared on my blog here:

This is my definite “best book” pick of 2016, even though it is only May. 

Below are some quotes from the book.  I would definitely recommend reading the book as one can’t get the whole amazing experience from a few quotes.

On dissecting a cadaver in medical school:  “Cadaver dissection epitomizes, for many, the transformation of the somber, respectful student into the callous, arrogant doctor.”

On being diagnosed with cancer:  "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 know it acutely.”

“The word hope first appeared in English about a thousand years ago, denoting some combination of confidence and desire…Medical statistics not only describe numbers such as mean survival, they measure our confidence in our numbers, with tools like confidence levels, confidence intervals and confidence bounds…Could we divide the curve into existential sections from ’defeated’ to ‘pessimistic’ to ‘realistic’ to ‘hopeful’ to ‘delusional’?  It occurred to me that my relationship with statistics changed as soon as I became one.”

“While being trained as a physician and scientist had helped me process the data and accept the limits of what that data could reveal about my prognosis, it didn’t help me as a patient.  It didn’t tell Lucy and me whether we should go ahead and have a child, or what it meant to nurture a new life while mine faded.  Nor did it tell me whether to fight for my career, to reclaim the ambitions I had single-mindedly pursued for so long, but without the surety of the time to complete them.  Like my own patients, I had to face my mortality and try to understand what made my life worth living.”

“I would have to learn to live in a different way, seeing death as an imposing itinerant visitor, but knowing that even if I’m dying, until I actually die, I am still living.”

“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. You may decide that you want to spend your time working as a neurosurgeon but two months later, you may feel differently.  Death may be a one-time event, but living with terminal illness is a process.”

“Time for me now is double edged.  There are, I imagine, two responses to that realization.  The most obvious might be an impulse to frantic activity: to ‘live life to its fullest’, to travel, to dine, to achieve a host of neglected ambitions.  Part of the cruelty of cancer, though, it’s not only that it limits your time; it also limits your energy, vastly reducing the amount you can squeeze into a day.”

Enjoy the book and honor our fallen soldiers on this Memorial Day.


  1. Thanks for the heads up Beth. I had read that original article as well. It came out not long after I was diagnosed and I was fascinated. I'm excited that he was able to write his book and I look forward to reading it. When do you have scans to see if the PRRT worked?

    1. I'm scheduled for my second round of PRRT on 6/22. I think I will have a scan the week before to see what's happened since the first round. I'll probably report the results in my next blog post. Hope you are doing well.

  2. Beth, I see you are having your second round of PRRT today! I hope it goes off without a hitch. Please let us know how you are doing and if you did see any results yet. I know it can take more than 1 treatment.

    1. The PRRT didn't work for me at all, which surprised me. My tumors progressed and I am out the trial. I am looking at a liver embolization now. See my most recent post. I hope you are doing well.

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