What do you do when life is interrupted? What does it mean to have your life fade away, for you, for your family and for your friends? What makes life worth living?

Essential Book Information

Paul Kalanithi was a neurosurgeon and writer. He had degrees in English literature, biology and history and philosophy of science and medicine from Stanford and Cambridge university before completing medicine at Yale School of Medicine. He gives a unique perspective as a neurosurgeon who was diagnosed with terminal lung cancer.

Basic Plot Summary

When Breath Becomes Air follows Kalanithi’s journey from medical student, deciding what would provide a meaningful life, to neurosurgeon, who operates in the very centre of the human identity: the brain, before finally a patient with terminal cancer, as a new father.

The very pinnacle of the plot is described by Kalanithi as being at the neurosurgical training mountaintop and seeing the Promised Land, from Gilead to Jericho, to the Mediterranean Sea. He could see himself as finally becoming the husband he had promised to be, but then the night sweats, weight loss, cough and back pain started. He knew he had cancer. It was just a matter of time before he was told it was lung cancer and he faced his own mortality.


The book begins with a trainee surgeon interpreting a set of CT scans. His eye picking up that the tumour had dispersed across the lungs and spread to the spine and the liver. The simple diagnosis was: cancer that had metastasised. The thing that changed the perspective of the interpretation was that these were scans from his own body.

The surgeon that the book follows is Paul Kalanithi who was found to have cancer that had metastasized at age 36. He was on the verge of becoming a fully qualified neurosurgeon and starting a family with his wife, Lucy. Instead he was confronting a terminal illness and an identity crisis as he switched from doctor to patient. The book was written in the year before his death.

Before he was diagnosed, Paul’s life was exceptional. He was a doctor’s son in the desert, offered a place at Stanford University and completed a postgraduate degree in English literature. He then enrolled in medicine as he wanted action and “answers that are not in books.” It was never just a job, it was an approach to metaphysical questions that he had during his English degree. He ended up deciding neurosurgery, as he was interested in the “unforgiving call to perfection.”

As cancer weakened his body, he continued to write. When Breath Becomes Air is an eloquent articulation of the fact that we all face our mortality each and every day, whether we are conscious of it or not. The real question is not, how long, but rather, how we live.


When Breath Becomes Air is an insightful read and asks us to question what makes life worth living in the face of death. It is an incredibly profound read and I would recommend it to all.



Kalanithi was an exceptional neurosurgeon and writer who profoundly articulates his journey. It is a very well written story and an impactful read that makes you feel as though you are there in the room with him.

His lyrical language offers clarity around living a meaningful life in the time that we have as we never know when our time will be up.

Review compiled by Grace Borchert, Australia, 2021 Chapter Lead: Oceania