“When Breath Becomes Air” by Paul Kalanithi

I picked up this book in between readings, mostly because it was available immediately on Libby. It sort of sucks, it is a cool book, but it just made me realize that I have to stop reading these medical books. Just completely, they are not my thing. And therefore this post will be a little biased.

The book follows the author, Paul, through his life including medical school and residency. He gets diagnosed with lung cancer in the middle of his training to become a neurosurgeon, and he talks about his treatments and conversations that he has with his wife, how their marriage was struggling and their decision to have a kid. It drops off eventually when he has to go back for third-line treatment, and from their his wife picks it up in the epilogue. Paul ended up not recovering with that and dying shortly after graduation, he got to see maybe the first year of his daughter’s life and was unable to finish the manuscript before succumbing.

There’s a lot of cool things about this book. First is that Paul has degrees in English literature so he clearly knows what he is doing with his writing. It really makes it a joy to read. And second, or similarly, he talks a lot about how he wanted to understand the human experience and particularly what it means to die. He starts by talking about death in literature, and from there goes to the doctor’s view of it, and finally death as a patient. He struggles with his diagnosis and the fact that he doesn’t want to die, even though he knows that he must. The book therefore holds a very interesting perspective for anyone who has thought about death and what it means to face it on a practical level.

I’m so done with these books though. A lot of the book talks about how horrible it is to be in residency and to be a neurosurgeon. Paul repeatedly says that it is a calling because if it was a job then it’d be the worst job in the world. But there is absolutely no momentum to change that. Whatsoever. And that frustrates me so much about medical training and medical school. People look down on those that pick “lifestyle specialties” where you get to have humane hours and a work-life balance instead of burning out. Paul shares a classmate of his even commits suicide after losing a patient. Why on earth aren’t we changing things instead of leaving everyone to get burnt out? It’s part of the reason why I didn’t pursue medical school in the end, there is a deep attachment to tradition just because and breaking you down just because. I couldn’t do it and take it seriously. I’m not sure I take most doctors seriously as a result.

Anyways so I have to stop reading them. I know too much and this veneer about how doctors are such good, brave people feels false and rings hollow to me. Even someone like Paul who I’m sure was a good person seems fake when taking into context the fact that doctors just don’t have the time and capacity to get sleep and care for people. It’s ridiculous. But also if you aren’t jaded like me, it is an interesting read. I just hate the taste that these memoirs leave in my mouth now.