I’m of the mind that books—like people, come into our lives when we are oven-ready to receive them.
It doesn’t always happen this way, sometimes a book is just a book, but more often than not I find myself reading something that feels tailor-made for all I need to learn in a particular time frame.
When Breath Becomes Air by Paul Kalanithi was one such read.
Originally published on January 12th, 2016, I recall seeing a slow trickle of cover photos splashed across many a social media posts, building to what felt like a synchronistic crescendo.
I knew nothing about the actual story arc, I just picked up on whispers that it was a transcendent and powerful read, and I liked the cover. I’m not sure about you—but covers are a big draw for me. It’s what leads me to pick up the book in the first place and read the back cover and/or flip through some pages. Not having had the recent luxury of visiting a book store, I didn’t have that tactile experience of going through my touchy-feely process and finding out more—just a visual intuition via online optics that I needed to read this book.
It was finally delivered to me by my good friends at Chapters Indigo on March 1st, despite having made a request for it in early February. This is not to highlight any fault on Chapter Indigo’s part, they are always sending me books well in advance for review. This is more about my belief in receiving knowledge right when we need it and how the universe conspires on our behalf. In this case it was due to my late request and promotional back orders, that I received it when I did.
I read, nay, drank in When Breath Becomes Air in 8 straight hours. I experienced a flash flooding of memories and parallels that this book brought forth concerning my own mothers death, some painful, many of them comforting—more on this later.
When Breath Becomes Air, is about author Paul Kalanithi’s decade worth of training towards becoming a neurosurgeon—only to find out that he has terminal lung cancer in his last year of residency. The book details the many transformations and rebirths that Kalanithi experiences as he bravely and humanely comes to terms with his impending death sentence. Or does he? Can we ever really be ready?
Paul Kalanithi Photo: © Norbert von der Groeben
While it’s certainly not the first memoir to be written by someone describing their terminal illness as they were actually cycling through it, it was unique in that Kalanithi had a previous interest in the emotional response to death and dying and how to parlay that to his patients before he was ever diagnosed with terminal cancer. His young age (he was 36 when diagnosed), his wake of incredible accomplishments, coupled with his exceptional facility for writing, all added a unique dimension to this memoir for me. The-doctor-who-becomes-the patient narrative is also poignant as we see him go through the various Kübler Ross stages of grief—albeit, he humorously notes, backwards! It also gives readers a window into how Kalanithi, with his ambitious nature decided to spend his remaining time. Time becomes a precious commodity and the present moment takes center stage.
“Everyone succumbs to finitude. I suspect I am not the only one who reaches this pluperfect state. Most ambitious are either achieved or abandoned; either way they belong to the past. The future instead of the ladder towards the goals of life, flattens into a perpetual present. Money, status, all the vanities the preacher of Ecclestiasties described hold so little interest; a chasing of the wind indeed.”
In Kalanithi’s case, he and his wife decide to go ahead and have a baby through IVF before his cancer treatment starts. This was one of many passages that turned me into a human puddle from weeping my face off.
“Will having a newborn distract from the time we have left together?” she asked. Don’t you think saying goodbye to your child will make your death more painful?”
“Wouldn’t it be great if it did.”
My mother passed away from breast and uterine cancer that ultimately spread to her brain almost 3 years ago this April 1st. The spread to her brain was a surprise—as a family we collectively thought she was on the mend after she had her breast removed and went through chemotherapy and radiation. Her hair fully grew back, and while the toxicity of these poisonous medications altered her emotionally and physically, we were hopeful that she was going to recover. She then took a turn for the worse, complaining of migraines and began to fall. We thought it was possibly a stroke, and were not prepared for the shocking emergency room diagnosis that the cancer had spread to her brain and that she had days, maybe weeks to live.
She thought she possibly had the flu, and it was utterly heartbreaking having to tell her the diagnosis, after learning of it privately. How do you tell your own mother in so many words that she will never leave the hospital? We were in utter shock. It took us 48 hours of consulting with doctors on how to do just that, whilst unbeknownst to her we began a regimen of treatment to contain the growth of her tumours. I had never lied to my mother in my entire life, and those 48 hours before we told her were an absolute exercise in inner resolve and digging deep deep deep into the ‘soul well’ for every ounce of strength I could muster. I had to pretend that tests were still being done, making sure to never cry in front of her or lead her to believe anything was awry. It was gut wrenching.
When she was told, she accepted the news bravely and with grace. And although the doctors gave her an option to attempt a surgery, she knew it could be fatal or barely stave off the inevitable. The first night that she was moved out of emergency and into a temporary room, I spent the night sleeping with her in her bed, clutching on to her and kissing her, not knowing how much time she had left. I honestly felt g-ds presence with me in that room, in a way I had never felt before in my entire life.
Luckily she lasted 5+ weeks in palliative and did not lose her mental capacities, in the ways we had all feared in those last days. She was most definitely over compensating, but she always knew who her family was, and this was the biggest blessing to all of us. The month of March brings with it bittersweet memories for me, each day marked with a visceral flashback tied to the weather, scent and certain music that I can barely get through listening now without falling apart. The frisson of winters thaw and impending spring is one that will be forever tied to saying goodbye to her. I recall the sunshine pouring through my mothers hospital window in mid March, with part of me wishing it would stay dark, and winter-like so she wouldn’t feel badly that she would be missing spring.
All of my senses were extraordinarily heightened during that time. I had bionic hearing. All smells were that much more potent. I was a veritable skin covered satellite dish. To say that the spiritual and cosmic dots were aligning and unfolding on a daily basis would be a criminal understatement. Words really don’t do those last synchronistic weeks justice, so I’m going to stop trying for now.
So many parts of this book reminded me of that long stretch of time, watching my mother slowly pass. The book describes the various brain surgeries Dr. Kalanithi worked on during his residency (so gruesome were the details that many times I actually gagged or looked away from the copy as if it were a television screen.) Despite the squirming, I did glean valuable information that reminded me of my mothers case, the various places where tumours can exist and how they can affect different emotions, memory and language.
It brought the memory of those first 24 hours of my mother in the emergency room into focus, as looking back— after months of experiencing depression—she was actually smiling while we were taking various tests to see what was wrong with her. Her memory was also exceptional, that I’m convinced her tumours were pressing on some sort of happy centres at that point. Her relatively good mood, despite the diagnosis was ever-present for her first full week in palliative. It was an absolute blessing to see. It was also a comfort to be reminded through the book of the close relationship between Dr. Kalanithi and his oncologist. One of the issues that clenched my heart in my mothers last days were that she never discussed that she was going to die with me. I realise this was her protective nature, and was reminded through the book that there were doctors, nurses, and other friends and relatives available for her to discuss these issues if she wanted to.
In the books epilogue Paul Kalanithi’s wife Lucy, writes a posthumous update through loving reflections on her husbands last days. She explains that Paul passed away one year ago this coming March 9th, and again I wept as if I had just lost a very special friend.
He was only 37 years young.
Among her many passages that resonated with me;
“Paul napped comfortably in the afternoon, but he was gravely ill. I started to cry as I watched him sleep, then crept out into the living room, where his fathers tears joined mine. I already missed him.”
This lodged an enormous peach pit in my throat upon reading it. It still does, just writing these words. So many times upon leaving my mother’s room, I felt the exact same way. I missed her already. So many times I longed to cry to my mother about LOSING MY MOTHER, but that was obviously impossible. I missed her before I physically lost her, and especially in those last days, the world of the dying becomes that much insular and they slowly pull away from the living.
But not before I got repeated I LOVE YOU’s that I hold in my heart forever. She passed in the early morning of April, 1st, at 7:45 am lovingly surrounded by her sister, her daughters and grandchildren.
Paul Kalanithi’s knowledge of literature and poetry were awe-inspiring and an ongoing theme in When Breath Becomes Air. A compelling standout was how he repeatedly used writer Samuel Beckett’s seven words to help him get through some of his toughest days.
They read: “I can’t go on. I’ll go on.”
Simple—yet potent, reminding me of a quote that helped me absorb my own personal grief.
I thought I could not
go any closer to grief
I went closer,
and I did not die.
To my dear readers,
I realise this is an off-brand post filled with the uncommon spillage of my own emotional graffiti and not the usual pop culture brilliance, yet frivolity that I normally employ in this space. It was what had to pour out of me after reading this book and I hope you can cull some sort of meaningful takeaway for yourselves. While I read this book quickly, it took some time for me to get through writing of this post, as it was quite painful to relive the loss of my mother as it is every year at this time. This post went through various incarnations, rewrites, and many tears.
However, I don’t see it as a coincidence that it is ready to be published on the eve of Paul Kalanithi’s one year anniversary of his passing, and on International Womens Day.
So with that in mind, I dedicate this post to the strongest, most selfless, and loving woman I have ever known.
My beloved mother Evelyn, who I miss every day—but especially every year in March.
P.S. …And now back to our regular programming → *Makes fart noises with my armpit.