When Breath Becomes Air

When Breath Becomes Air by Paul Kalanithi

So there’s a new book you may have heard about: When Breath Becomes Air, by the late Paul Kalanithi, a neurosurgeon who died of lung cancer last March. In the last year of his life he published several essays on facing cancer, the irony of being a doctor with a terminal illness, and the sadness of not being able to see his daughter grow up. And Paul worked on a book, shepherded to completion and publication by his wife Lucy. But I don’t think of him as Paul – I think of him as Pubby (his nickname). Because that’s how he was introduced to me twenty years ago.

Pubby and I had a lot of things in common. We were English majors, active members of the Stanford Band, wrote scripts for the Band’s field shows, and served terms as public relations director for the Band. This is an understatement, but he had a great sense of humor – it worked on levels from subtle and dry to completely over-the-top and crazy. We liked each other’s writing, and shared stories about crazy hate mail we responded to. I remember when he tried to bleach his hair, and the closest he could get was orange. I’ve heard he always wore fake mustaches for ID photos, and was known to randomly show up to events wearing a gorilla suit.

He had another side, it turns out. Besides majoring in English, he also majored in human biology, and like many of my band friends, eventually became a doctor (by the way, majoring in Hum Bio alone is tough, without a reading-heavy major like English on top of it). He returned to the Bay Area, working as a neurosurgeon at the Stanford hospital. And the rest you know, or you will when you read his book. We weren’t close friends, and I hadn’t seen him in person in about ten years, but the news of his illness hit me harder than I expected. Reading his moving words made it a little easier to think of his impending death, if only because I could see how his various and disparate talents had melded in this perfect, tragic, way. 

One thing that will really get you is when Pubby writes about his and Lucy’s daughter, who was born in the last year of his life. He knew he wouldn’t have much time with her, but he was determined to enjoy all the time he had. I look at my children and wonder if I have made the most of my time with them – how they would remember me if they were suddenly to lose me. Pubby was the third person from my era of the LSJUMB to pass away in a span of about a year (all from cancer), prompting me (and many of my friends, I’m sure) to dwell on my own mortality. But Pubby’s writing, I think, will not cause us to become obsessed with our deaths, but our lives: is what we’re doing worth doing? What is the best use we can make of the time we have left, however much time that is? What are the things that are really most important to us? I hope his book will help you find the answers to these questions. Snowden’s secret in Catch-22 is that man is matter, that we are fragile machines prone to destruction. Pubby’s secret is that despite that fragility, man can matter – we can choose to make a difference in this world before our own fragile machines break down, and our breath becomes air.

– Joe