When Breath Becomes Air

When Breath Becomes AirWhen Breath Becomes Air by Paul Kalanithi

My rating: 5 of 5 stars

 

Summary (adapted from Goodreads)

At the age of thirty-six, on the verge of completing a decade’s worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer.  Just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi’s transformation from a naïve medical student, into a young neurosurgeon at Stanford, and finally into a patient and a new father to a baby girl, confronting his own mortality.

What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir.

Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing mortality and on the relationship between doctor and patient, from a gifted writer who became both.

My Review

This is one of those books that is so hard to review because there is just no way that you can do it justice. The author says it all absolutely perfectly, precisely, and poetically, so any words on my part are like fluorescent lights compared to the perfect gold of autumn sunshine. However, there is so much Truth and beauty to process and internalize from the pages of this book that I must attempt a review regardless of the inadequacy of my words. There were several passages though, that resounded with such power that I will quote them directly.

It seems almost an oxymoron to say that a memoir written by a dying cancer patient is one of the most powerful, positive, uplifting, and hopeful records of life that I have ever read, but it is the truth. Paul Kalanithi’s grasp of the meaning of life and death is so full, nuanced, and inspiring; he so eloquently describes his life journey as a son, reader, student, friend, philosopher, doctor, husband, and finally patient and father. All of it motivated by his desire to live a meaningful life and to discover what makes a life meaningful.

His interest in and search for meaning was sparked by literature. He felt like a bosom friend when I read, “I had come to see language as an almost supernatural force, existing between people, bringing our brains, shielded in centimeter-thick skulls, into communion. A word meant something only between people, and life’s meaning, its virtue, has something to do with the depth of the relationships we form. It was the relational aspect of humans that undergirded meaning…Literature not only illuminated another’s experience, it provided, I believed, the riches material for moral reflection.”

But Paul Kalanithi didn’t just stop at reflection. He wrote, ““If the unexamined life was not worth living, was the unlived life worth examining?” And so he lived. He challenged his mind and body, he formed relationships, he worked hard and played hard.

His reading also introduced him to an idea that stuck with him through many years and that ultimately led him to choose neurosurgery as his career path over literature and writing:

“The mind was simply the operation of the brain, an idea that struck me with force…Of course it must be true – what were our brains doing, otherwise? Though we had free will, we were also biological organisms – the brain was an organ, subject to the laws of physics, too! Literature provided a rich account of human meaning; the brain, then, was the machinery that somehow enabled it. It seemed like magic…I began to see all disciplines as creating a vocabulary, a set of tools for understanding human life in a particular way. Great literary works provided their own set of tools, compelling the reader to use that vocabulary….I couldn’t quite let go of the question: Where did biology, morality, literature, and philosophy intersect? [Medical school] would mean setting aside literature. But it would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.”

I was completely fascinated by his experiences and descriptions of medical school. He illuminates the ironies and conflicts in balancing science and sensitivity in the practice of medicine. One of my favorite descriptions related to working on cadavers: “You would think that the first time you cut up a dead person, you’d feel a bit funny about it. Strangely, though, everything feels normal. The bright lights, stainless steel tables, and bow-tied professors lend an air of propriety. Even so, that first cut, running from the nape of the neck down to the small of the back, is unforgettable.”

I would describe Paul Kalanithi as a hero, but that’s certainly not what he was going for. However, his integrity and sincerity are truly bold and valiant in today’s world of instant gratification and self-interest. His words give the best sense of his convictions:

“Words began to feel as weightless as the breath that carried them…Moral speculation was puny compared to moral action.”

“I was pursuing medicine to bear witness to the twinned mysteries of death, its experiential and biological manifestations: at once deeply personal and utterly impersonal.”

“The heroic spirit of responsibility amid blood and failure. This struck me as the true image of a doctor.”

“In my life, had I ever made a decision harder than choosing between a French dip and a Reuben? I still had a a lot of practical medicine to learn, but would knowledge alone be enough, with life and death hanging in the balance? Surely intelligence wasn’t enough; moral clarity was needed as well.”

“The cost of my dedication to succeed was high, and the ineluctable failures brought me nearly unbearable guilt. Those burdens are what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.”

I went back to teaching this year after 10 years as a stay-at-home mom. There have been feelings of doubt, guilt, euphoria, and everything in between. I have had to make decisions and judgment calls regarding how to prioritize my time, how to balance my family and my students, how to keep and strengthen relationships with my children while also being effective as a teacher – both situations in which I can impact lives for good or ill. It was cathartic to read and relate to Kalanithi’s struggle to find the same balance in his life between medical school, family, research, and then ultimately illness and death. He wrote, “Putting lifestyle first is how you find a job – not a calling.” Both Motherhood and Teaching are my callings; this book has inspired me and strengthened my resolve that I can bring meaning to my life and to others through doing what it takes to fulfill my callings, no matter the sacrifice and inconvenience to myself.

Most powerful was the feeling of kinship Kalanithi inspires not just between him and his readers, but between the human race as a whole: “…it cannot be doubted that each of us can see only a part of the picture. The doctor sees one, the patient another, the engineer a third, the economist a fourth, the pearl diver a fifth, the alcoholic a sixth, the cable guy a seventh, the sheep farmer and eighth, the Indian beggar a ninth, the pastor a tenth. 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. And Truth comes somewhere above all of them.”

All of this wisdom and Truth Paul Kalanithi shares as his body and mind are attacked and destroyed by cancer. It brings such an urgency to his message, while at the same time his words are full of peace and dignity even in the face of death. He is honest and open about his struggles in each stage of his life, including at the end, but that just makes his message and decisions to put others above himself more inspiring. The epilogue written by his wife solidifies the beauty of the love that they shared as a family and that they now share with the world.

Please read this book. No matter your life circumstance or experience there is something in these words for you.

Age Recommendation: This book deals with the theme of death beautifully, respectfully, and with reverence; however, some of the facts may be too emotional for younger readers. For that reason, I would recommend this book for 17 and older.

Appropriateness: There is some swearing in the book, but not a distracting or disturbing amount. Some vague, mild, reference to sex, but nothing graphic or disturbing. There is some medical procedures and description, but it’s all scientific so even when described in some detail the intent is not to be disgusting.  There are emotional themes which ought to push us out of our comfort zones a little, but the intent is pure and good.  If any of these aspects would deter you from reading the book, please don’t let them. This is a “must-read.”

Book Club Discussion: There are so many topics and questions that could be discussed in relation to When Breath Becomes Air including the importance of literature, doctor and patient responsibilities, terminal illness, dealing with death, sacrifice for goals, and finding balance.

Other book recommendations: If you are interested in When Breath Becomes Air then I think you would also likeThe Alchemist by Paul Coelho, The Perfect Mile by Neal Bascomb, The Guernsey Literary and Potato Peel Pie Society by Mary Ann Shaffer, Unbroken: A World War II Story of Survival, Resilience, and Redemption by Laura Hillenbrand, Everything on a Waffle by Polly Horvath, Anne of Green Gables by L.M. Montgomery, The Little Prince by Antoine de Saint-Exupery, and A Tree Grows in Brooklyn by Betty Smith.

 

 

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The Perfect Mile

The Perfect Mile: Three Athletes, One Goal, and Less Than Four Minutes to Achieve ItThe Perfect Mile: Three Athletes, One Goal, and Less Than Four Minutes to Achieve It by Neal Bascomb

My rating: 5 of 5 stars

 

Summary (adapted from Goodreads)

There was a time when running the mile in four minutes was believed to be beyond the limits of human foot speed, and in all of sport it was the elusive holy grail. In 1952, after suffering defeat at the Helsinki Olympics, three world-class runners each set out to break this barrier.

Roger Bannister was a young English medical student who epitomized the ideal of the amateur — still driven not just by winning but by the nobility of the pursuit. John Landy an Australian who trained relentlessly in an almost spiritual attempt to shape his body to this singular task. Then there was Wes Santee, the swaggering American, a Kansas farm boy and natural athlete.

Spanning three continents and defying the odds, their collective quest captivated the world and competed with headlines from the Korean War, the atomic race, and such legendary figures as Edmund Hillary, Willie Mays, Native Dancer, and Ben Hogan. Neal Bascomb delivers a breathtaking story of unlikely heroes and leaves us with a lasting portrait of the twilight years of the golden age of sport.

My Review

I am a runner and I love it. (Though that hasn’t always been the case. You can read more about my conversion to running here.) So I was naturally interested in this book since it’s all about runners. But there is also historical significance in learning more about this event along with what was going on in the world at the time it took place. I was fascinated by the view of amateur and professional athletics in the 1950’s, and how much athletics have changed since then.

This book also introduced me to true heroes and role models of our day, and the writing is superb. The author paints pictures with words of people and events so that they come alive and are so relatable. I was just as nervous and engaged reading about the races in this book as I was while reading the Hunger Games.

And when it comes down to it, this book is less about running and more about working hard with what life has given us to make something of ourselves and to contribute to the world in which we live. The 3 main running figures in the book sum it up best:

John Landy: “Running gave me discipline and self-expression…It has all the disappointments, frustrations, lack of success, and unexpected success, which all reproduce themselves in the bigger play of life. It teaches you the ability to present under pressure. It teaches you the importance of being enthusiastic, dedicated, focused. All of these are trite statements, but if you actually have to go through these things as a young man, it’s very, very important.”

Wes Santee: “Hard work pays off. You have to be just as disciplined to run a business as you do to train for an athletic event. You have to eat right, still have to get up early and work more than others.”

Roger Bannister: “Sport is about not being wrapped up in cotton wool. Sport is about adapting to the unexpected and being able to modify plans at the last minute. Sport, like all life, is about taking your chances.”

All of these factors make this a book that everyone, runner or non-runner, athlete or completely lacking in coordination, should read.

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Age Recommendation: All ages will be interested in this story, particularly those with experience truly sacrificing and working hard toward a goal. The writing is probably best for 16 and older though younger readers with a high reading level would do just fine.

Appropriateness: Clean as a whistle on this one.  Clean language, no violence, no immorality.

This would provide great book club discussion material.  Comparing the  different approaches to running from each of the main runners as well as from their coaches would be interesting.  The different approaches to running could also be discussed in how they relate to the characters view of life.  This book provides great material for discussion on themes such as

1) the merits of athletics

2) the pros and cons to amateur vs. professional athletics

3) what does it take (physically and mentally) to push past barriers? Which is more important – physical or mental?

4) How do circumstances affect our performance in sport and in life? How do we keep our confidence and determination when circumstances all seem to be against us?

5) Why do sporting events and athletes bring out such pride in a country or school?

For more discussion material and for some of my favorite quotes and inspirations from the book see my previous post titled Full of Running.

Other Book Recommendations: If you like the sound of this book you might also enjoy Born to Run by Christopher McDougall, Unbroken by Laura Hillenbrand, Eat and Run by Scott Jurek, A Tree Grows in Brooklyn by Betty Smith, Maniac Magee by Jerry Spinelli, Shipwreck at the Bottom of the World by Jennifer Armstrong, and The Guernsey Literary and Potato Peel Pie Society by Mary Ann Shaffer.

Full of Running

Revel

“If you can force your heart and nerve and sinew

To serve your turn long after they are gone,

And so hold on when there is nothing in you

Except the Will which says to them: ‘Hold On!’ “

-Rudyard Kipling (as quoted in the Prologue of The Perfect Mile)

I have been reading The Perfect Mile by Neal Bascomb which is about 3 runners in 1952 who set out to be the first to run a mile in under 4 minutes.  FANTASTIC book!  You can find my review of the book from a “literary” standpoint here, but I also wanted to share some of the inspiration I have received through this book.

“The essential thing in life is not so much conquering as fighting well.” 

-Baron de Coubertin, founder of the modern Olympic Games (as quoted in chapter 2 of The Perfect Mile)

The drive and hard work of the athletes and coaches in this book to achieve a seemingly unachievable goal is unbelievable and motivating. Their personal histories and the historical events of the time really drive home how dedicated and disciplined these people were. Full-time med student and training as an olympian with no financial backing so you can keep your amateur athlete status sounds beyond impossible. But they did it.

“To be great, one does not have to be mad, but definitely it helps.”

-Percy Cerutty (as quoted in chapter 3)

Some of my favorite parts of the book are the headings at the beginning of each chapter. I am a runner and they capture so well my feelings about that part of my life, but they apply to more than just running.  The quotes are insights into the joys and sacrifices that come from complete dedication to a goal or idea.

“Whatever you can do,

Or think you can, begin it.

Boldness has power, and genius,

And magic in it.

-Goethe (as quoted in chapter 9)

When I finished reading about the race in which the 4 minute barrier was broken for the first time, I had to get on YouTube and see if I could find video footage of the actual race.  Sure enough, I could watch the whole thing. The video has commentary from the runner (I won’t tell you who it is so as to not spoil the outcome) and he says he “felt so full of running” through the first 3 laps. I immediately loved and related to that phrase – “full of running.”

Running (and life) can be hard work. Some days it can feel like pulling your feet through thick sludge. But then there are those days when the timing, weather, diet, and rest align perfectly and breathe new life and energy into your legs and soul. I love that feeling of beginning a run and just feeling strong, fast, connected, and alive – full of running.

When that feeling transfers to life in general, it makes for a pretty great day.

Relay 224

John Landy was one of the runners trying to break the 4 minute mile barrier.  He is quoted in the book as saying, “In any running event, you are absolutely alone. Nobody can help you. But short races are run without thought. In very long races you must go a great distance simply to be present in the laps that really count. But almost every part of the mile is important – you can never let down, never stop thinking, and you can be beaten at almost any point. I suppose you could say it is like life. I had wanted to master it.”

I love running because of the ways it teaches me about life and myself, and how much stronger I have become because of it – physically, emotionally, mentally, and spiritually. So Landy’s comparison of the mile to life resounds with me. Though, I have never felt alone in a running event as he describes.  In a race or even just in training runs I have always felt the support and faith of my family.  They cheer me on and make sure that they make it a priority for me to get out on those runs so I can keep my soul healthy. I love the feeling of camaraderie in a race between runners as well. And most of all, I feel my Heavenly Father and my Savior as I connect with the earth and my inner self in a unique and powerful way as I run. It is these same influences that reassure me that I am never alone in life either.

“If you can meet with Triumph and Disaster

And treat those two impostors just the same…

If you can fill the unforgiving minute

With sixty seconds’ worth of distance run –

Yours is the Earth and everything that’s in it,

And – which is more – you’ll be a Man, my son!

-Rudyard Kipling (as quoted in chapter 4)

Everything on a Waffle

Everything on a Waffle (Coal Harbour #1)Everything on a Waffle by Polly Horvath
My rating: 4 of 5 stars

Summary

When Primrose’s parents both disappear at sea in the middle of a vicious storm, she is forced into a new life which includes a new home, new friends, new conflicts and adventures, new insights, and new recipes. It really does take a village in this case to take care of 11-year old Primrose. Some of the townspeople think they know best, like the snobbish and socially awkward school counselor Miss Honeycut. While others truly are just what Primrose needs to keep her hope alive, like her impulsive Uncle Jack, and Kate Bowzer, the owner of the local restaurant where all the food is served on a waffle. But the true joy in this story is how Primrose and her hope is just what the town, and all of us, need to approach the world and all of its challenges with courage, wit, kindness, fun, and love.

My Review

This is the kind of book I would want to write, but the genius to do so hasn’t hit me yet. I am inspired by the unique and accurate way in which life and people are depicted. I love the vibrant and varied characters and how each of them reveals wisdom to Primrose and to us as readers through both their follies and their successes.

I also love the humor! Parents disappearing at sea and a child wading through the foster system certainly doesn’t seem like the setup for a comedy, but that just makes it all the more impressive when you find yourself smiling all the way through. It’s not a silly humor or irreverent either. It’s a look at the bad things that can come in life through the eyes of a girl who is open to the good in everyone and in everything. But she also calls things like she sees them with the innocence and directness of childhood. She’s wades through major change with youthful adaptability and so perfectly communicates what she learns without ever letting go of the hope and knowledge that anchors her. I loved the recipes that were included as well and how they reveal Primrose’s state of mind. And there is humor and wit found even in the recipes.

Everything on a Waffle makes it into my top 20 list of favorite children’s books for sure.

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Age Recommendation: 10 years and older, though if you had a mature reader 8 years old would probably love it too.  Some of the wit and experience would be better understood at 10, however. And obviously despite it’s children’s book genre I would absolutely recommend it for adults as well.

Appropriateness: I found nothing offensive or questionable at all. There are some traumatic events for sure, but because of the approach to them I don’t think a child would be impacted negatively.  Instead, I think children can learn about hope, attitude, and faith through Primrose’s example. They can also learn how to better understand the adults in their life as well.

This would be a great book club discussion book! Scroll down for a list of discussion questions.

Other Book Recommendations: If you like Everything on a Waffle then you should read A Little Princess and The Secret Garden both by Frances Hodgson Burnett,  Ella Enchanted by Gail Carson Levine, Tuck Everlasting by Natalie Babbitt, The Chronicles of Narnia by C.S. Lewis, Princess Academy by Shannon Hale, Matilda by Roald Dahl, Frindle by Andrew Clements, Mr. Popper’s Penguins by Richard Atwater, Stargirl by Jerry Spinelli, and Charlotte’s Web by E.B. White.

Favorite Quotes

“Sometimes you get tempted to make something wonderful even better but in doing so you lose what was so wonderful to begin with.”

“You can be sunk low or as a skunk and still have a joy in your heart. Joy lives like one of those spinning things—a gyroscope in your heart. It doesn’t seem to have any connection to circumstance, good or bad.”

“All my life I had wanted to travel but what I discovered that year was that the things that you find out become the places that you go and sometimes you find them out by being jettisoned off alone and other times it is the people who choose to stand by your side who give you the clues. But the important things that happen to you will happen to you even in the smallest places…”

“The only really interesting thing about someone that makes you want to explore them further is their heart.”

“There’s something about sports. You can be setting fire to cats and burying them in your backyard, but as long as you’re playing team sports, people think you’re okay.”

“I want someone who puts the whole ball of wax at risk. I want the kind of marriage where we would follow each other out into the stormy fatal sea or I’m not marrying at all.”

“You can’t replace one dog with another any more than you can replace one person with another, but that’s not to say you shouldn’t get more dogs and people in your life.”

Discussion Questions

  1. Primrose never doubts that her parents are alive. Did you agree with her throughout the story? Did your opinion change?
  2. Primrose keeps a positive attitude throughout the book even when not so positive things happen.  How does she do it? Why does she do it? Do you think this is wisdom or just naivety?
  3. Which of the adult characters were your favorite? Why? What were their follies? How did they help Primrose?
  4. Miss Honeycut was certainly the least helpful adult to Primrose. How did you feel about her?
  5. Despite Miss Honeycut’s misguided intentions, Primrose seems to keep patience and understanding for her. How does she do this?
  6. Primrose says, “Miss Honeycut didn’t tell anecdotes because she was interesting; she told them because she wasn’t”. Have you ever known someone like that?
  7. Does seeing Miss Honeycut  and the other adults in the story through Primrose’s eyes change your opinion about any of the people you have known in your life?
  8. Was Miss Perfidy “good” or “bad” for Primrose? Do you think they cared about each other?
  9. Do you think Uncle Jack and Kate Bowzer will ever become romantically involved? What evidence did you see to support your opinion?
  10. Have you ever felt changed by traveling to a new place? Have you ever found big changes in even the “smallest places?”
  11. Primrose seems to relate better to the adults in Coal Harbor than to the children her age. Can you relate to that? Is this healthy for her?