Dying

I caught a mention of Paul Kalanithi's book When breath becomes air recently on the radio. It was very well reviewed, not least because it had recently been shortlisted for the Wellcome Book Prize. The Wellcome Book Prize is one of the more unusual book awards concentrating on fiction or non-fiction that celebrates medicine or health. This year's shortlist included a novel about sudden death, the story of a heart and its donation, the history behind genetics, and Paul Kalanithi's memoir When breath becomes air. 

When breath becomes air is particularly poignant in that the author died before his book was ready for publication. Entirely appropriate, in a rather grim way, as the book is about the process of dying, focusing particularly on the author's own path to death. This doesn't sound the most cheery of reads but in fact the resulting book is a curiously life affirming read.
Paul Kalanithi with a colleague at the Stanford hospital and clinics, California.
Paul died just 13 months later.

Kalanithi was about to qualify as a neurosurgeon. A stunningly clever man, he had abandoned the world of literature for medicine, but struggled throughout his time as a doctor with the eternal questions, especially "What makes life worth living in the face of death?" Ultimately he was to provide his own answers when on the verge of qualifying, in his mid-thirties, he was diagnosed with inoperable lung cancer. The book is about Paul's journey towards his own death, but it is above all about a life that was lived to the full before his departure.

Paul wasn't afraid to embrace life even in the face of death; and that's not always as easy as it may sound. Married to Lucy, another doctor, the marriage had its usual ups and downs, but Paul's diagnosis meant another huge change to their lives, not least when they decided to try for a baby. The decision was not easy: as Lucy says, in the book, "Won't it make dying harder?" Paul's reply was "Wouldn't it be great if it did?" This joyful attitude to life in the face of death permeates the book making it an unexpectedly happy read.

His philosophy of life, the moral conflicts of life and death, and the struggle to find a good life in the shadow of death permeate this book. As I said in my last post, I had been musing on life and death with the events of the novel Do not say we have nothing taking me back to a pivotal moment in my own life. I wish I had been able to read Paul Kalanithi's book at that time. Paul may be gone, but the book is a candle lit for a life well lived, and encourages us all to live it to the full.

More than the story of one individual's engagement with a modern taboo (the Victorians would never have understood our reluctance to speak, or even think, about death), this also provides much for anyone involved in health care to ponder on. What is important in the face of death? What makes life worth living in the worst of times? And is the technology that means you can keep life suspended indefinitely truly a good thing?

An amazing book by an equally amazing author that asks as many questions as it answers. It's a slim read; thankfully, as it's sometimes heavy going. This is not through any fault of the author, who writes beautifully. His language is eloquent - one wonders what Paul Kalanithi's poetry would have been like? But this is the sort of book that encases its reader, and the subject matter sometimes means that this is an emotionally difficult read. It's a book that demands reading though for the beauty of its language, the bravery of its author, and the joy of life despite the threat of death.


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