When Breath Becomes Air was not the book Dr. Paul Kalanithi intended to write, one day, after he had practiced for decades as a neurosurgeon. He planned to write a book about what he learned when he cut people’s skulls open with saws, looked at their brains, fixed them, and sewed them shut again. But instead, Dr. Kalanithi wrote a book about what he experienced, dying of metastatic lung cancer, at the age of thirty-seven.
His widow finished the manuscript. Their daughter was not yet one.
I had read some of the late Dr. Kalanithi’s essays, and when his book came out, I wanted to read it immediately. But I rarely buy books in hardcover—I live in a single room already crowded with them, and money is always in short supply.
When I put When Breath Becomes Air on hold at the Berkeley Public Library, I was 108th in line. A few days later, I found the book sitting on the shelf, part of a display titled “Lucky Day.”
“The ‘Lucky Day’ collection,” explained a placard, “offers users the chance to find in-demand materials when they visit.” Like how Springsteen picks a few fans at every show and upgrades them from the cheap seats to the front row. (A few months later, I scored Springsteen’s autobiography off the “Lucky Day” display on the mobile library cart at the farmer’s market. Was a more blue-state sentence ever writ?)
So I ended up reading a book about dying with a sticker that said “Lucky Day” on its spine.
Every time I picked up the book, the first words I read were: “Lucky Day.” Each night as I fell asleep, the book splayed across my chest, the last words I read were: “Lucky Day.”
Lucky Day. Lucky Day. Lucky Day, the words on the outside of the book whispered, admonished, hoped, pled. Inside the book, a man told the story of his short life and early death.
“Words have a longevity I do not,” wrote Paul Kalanithi. We write to touch this illusion of immortaility, to connect with people we will never meet and make them feel less alone, to help them feel things, and know things, not only about ourselves, but about themselves. To enter their minds, and yet in a way that would be invisible, even if Dr. Kalanithi were looking right into the gray matter in their brain. To make sense of our experiences in the world, even if we are using words to say the world, and our experiences in it, do not always make sense.
So when Dr. Kalanithi wrote, about finding out he would die and then getting to work on his book:
“I was searching for a vocabulary to make sense of death, to find a way to begin defining myself and inching forward again. The privilege of direct experience had led me away from literary and academic work, yet now I felt that to understand my own direct experiences, I would have to translate them back into language.”
I felt, in the place beyond words, the truth of his.
My brother is a builder, a maker. Ever since he was very little, he has used his hands to make things. He had every building toy imaginable, and family albums show him carefully constructing when he could barely walk. He would make forts out of chairs, blankets, and pillows, and when we weren’t fighting, he would make a room in his fort just for me. “For reading,” he would say. I was always reading.
“Noah always built,” I said to my parents. “But what did I like to do?”
“Tawk,” they answered, in unison, in their New York accents.
Words—my first addiction, my sharpest tool, my greatest comfort. I can’t always do the right thing, I haven’t been able to find the right man, or even the right van, for that matter, but I can always find the right word.
They say, when I was little, before I learned to read, I had my books memorized. When my tired parents would skip ahead to hasten bedtime, I would smack the page and shout, “Read, read, READ!”
I put my iPhone to that task now. When I am falling asleep and can’t hold my head up, I can eke out a few more minutes of reading by setting the screen on portrait lock and reading a final page or two fully horizontal under the covers, with my head on the pillow, phone turned sideways. I just like the feeling of words coming into my brain.
As Paul Kalanithi lay—and occasionally operated–dying, he wrote a book. And as I slept and woke in the luxury of not feeling my days especially numbered, I savored every word, with the acute sadness of knowing that this slim, yet somehow encompassing, volume was all I would ever read from this author.
He had so much more to say, so much more to do. He had so many natural resources, and had so carefully stewarded them. He had two bachelor’s degrees (English and biology, double major at Stanford) and two masters, an English one from Stanford and an M.Phil in History of Philosophy of Medicine and Science from Cambridge, before he decided to become a doctor—a neurosurgeon/neuroscientist. He was perfectly prepared to be a philosopher of science, to write the narratives of medicine. He was already a very good writer. He could and would have been an even better one.
Kalanithi quotes Beckett, “I can’t go on. I’ll go on,” then, explaining his decision to return to the OR, “Why? Because I could. Because that’s who I was. Because 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.”
Sometimes it feels the opposite—as Dylan wrote, that “He not busy being born is busy dying.”
But it is not either/or, as it has become fashionable to say in California. It is both/and.
Paul Kalanithi was living, even as he was dying. And we are all dying, as we are living each one of our lucky, numbered days.