You can imagine the young Paul Kalanithi. An ambitious achiever at an elite university, a vigorous allrounder with a plan. His love of English literature points to a writing career, until he discovers his calling: neurology. To be one of the world’s great neurologists becomes his life’s goal. By his mid-30s, Kalanithi is within grasping distance of everything he has worked for. Then he gets cancer and everything changes. If you were told tomorrow you had 18 months or so to live and they would be a time of rapid, painful and irreversible physical decline, what would you do? From his wheelchair, Kalanithi decides to write his memoir.
He died last March and 10 months later When Breath Becomes Air was published in the US, where it has been No 1 on The New York Times’ bestseller list since.
“A dying doctor writes” is always likely to capture the reading public’s imagination, especially when the doctor in question is already a rising star in neurosurgery, probably the world’s most competitive field. Kalanithi, one detects, knew this more than anybody; there’s still in his writing something of the clever boy at school desperate to prove himself.
So how is a highly competitive, goal-orientated man whose identity is wrapped up in his career accomplishments going to cope with being told by his doctors that he is too sick to work? By working, of course. Memoir writing is a sideline. Kalanithi — his body a wreck — resumes his career at full speed.
The first symptoms come in the form of back spasms. That was in 2013. Ignoring them, and also his wife Lucy’s repeated requests for greater intimacy in their marriage, he travels alone to see friends in New York state. Halfway through the journey, he collapses on a bench with pain — and is mistaken for a vagrant by a policeman.
“I knew about back pain but I didn’t know what it felt like,” he writes. It won’t be the last time that the Yale and Stanford-educated neurologist finds himself in a horrifyingly educational role reversal; learning about medicine as a patient. He spends the rest of his holiday bedridden. Back home in California in May 2013, a chest X-ray reveals that “my lungs, instead of being clear, looked blurry, as if the camera aperture had been left open too long. The doctor said she wasn’t sure what that meant. She likely knew what it meant. I knew.” Stage IV metastatic lung cancer.
“My life had been building potential, potential that would now go unrealised. I had planned to do so much, and I had come so close. I was physically debilitated, my imagined future and my personal identity collapsed, and I faced the same existential questions my patients faced.” Almost everything — his health, his marriage, his career path — changes. With the exception of that burning, desperate ambition of his. His ambition is what this memoir is really about.
Kalanithi’s cancer is a stealthy and aggressive creature. It will soon reduce him to a sapless, bone-thin, balding shadow, too weak to lift a When Breath Becomes Air By Paul Kalanithi Bodley Head, 228pp, $32.99
Paul Kalanithi decided to write his memoir after a terminal cancer diagnosis