When Breath Becomes Air: Book Summary and Reflection


“There is a moment, a cusp, when the sum of gathered experience is worn down by the details of living. We are never so wise as when we live in this moment.”

– Paul Kalanithi, When Breath Becomes Air

What is the meaning of life? This is perhaps the most asked yet least answered philosophical question known to man. To me, it does not do much good to fixate on the need for a “correct” answer. Yet the process of contemplating the answer, and the path to knowing it, is undoubtedly useful.

I find this question intriguing in that it has a different answer for everyone. And it is ultimately important for each of us to ponder this question as it pertains to our own life. In my opinion, then, the better questions are the following:

What gives meaning to my life? What should I spend my time doing to search for meaningful experience, understanding, and happiness?

These are the things we can control and what can truly impact our existence. Therefore, I think these questions are crucial to contemplate.

Dr. Kalanithi’s Story

One intelligent way to approach such a question, or any question for that matter, is to observe how others have answered it. Dr. Paul Kalanithi’s When Breath Becomes Air is an amazing opportunity for insight into a very unique individual’s quest to answer this all-important question.

Dr. Kalanithi was a talented neurosurgery resident at Stanford University who was diagnosed with metastatic lung cancer just prior to completing his residency. After a valiant battle for his life, he ultimately succumbed to the disease at the age of 37. This is a tragic story no doubt. But much more than that, the book is a fascinating view into the mind of a man who was desperate to find the source of meaning in his life, most fervently in his dying days.

Dr. Kalanithi was a unique individual far prior to the events that led to his death. From his youth, he studied humanities with a particular interest in literature and philosophy. His chief goal was to answer the question, what is the meaning of life?

In pursuit of this goal he developed an interest in medicine, which led him down the path of becoming a surgeon. In order to gain the deepest understanding of life, he felt he needed to interface with one of its only absolutes: death. Thus he ended up pursuing neurosurgery, a field in which patients suffer from diseases that often claim their lives despite any and all efforts of medicine. If that is not a unique path to becoming a doctor, I don’t know what is. I found this fascinating.


When Doctor Becomes Patient

What makes the book all the more powerful is that Dr. Kalanithi himself was thrust suddenly into the position his patients were in, opposite to his usual vantage point. He was given a diagnosis of metastatic cancer with a prognosis surely less than a few years. It was at this point that he began to question how he wanted to spend the remainder of his days. Was it surgery, literature, or simply time with family that would provide him the most lasting happiness and the deepest meaning?


Pursuing True Meaning in Life

I found this quest for meaning to be the central theme of the book. Although Dr. Kalanithi was forced to answer this question much sooner than most of us, the question is one we all must face at one point or another. What provides true meaning in our lives?

I have found myself struggling with this question when making difficult decisions about personal and professional life. Do I want to become a doctor? Do I want to move across the country to start residency? Do I want to continue my training and specialize, or start practice as a physician sooner?

All these questions have been immense personal challenges for me. As I pondered them, I realized that it always came down to determining what was most important to me, what provided true meaning to my life. If we can answer this, we will know how to spend our time. Instead of the conventional method of striving toward a destination for gratification, the journey itself will provide the meaning and purpose we seek.

As I mentioned before, answering this question can be extremely challenging, but learning from the example of others is one way to improve the process. This is what I love about readingjust by opening a book, you can delve into the mind of someone else, someone who shares their deepest and most meaningful thoughts, those worthy of making it on paper. There is so much to learn from understanding the perspective of others.


Live for the Present Moment

One of the best pearls Dr. Kalanithi shares with us is illustrated by the quote at the opening of this post:

“There is a moment, a cusp, when the sum of gathered experience is worn down by the details of living. We are never so wise as when we live in this moment.

In the pursuit of that which is best for us, we can be worn down by the process. We can often become consumed by worries of the future and regrets of the past, so much that we do not appreciate or even notice the present. As Dr. Kalanithi states, living in true appreciation, and even simply observation, of the present moment is the wisest way.

I have tried to heed this advice in my own life. Even as I strive to answer the question of what provides meaning in my life, I try not to be consumed by stresses, worries or doubts of an inadequate or incomplete answer. This is much easier said than done, but it is a worthwhile goal. Because as the Roman Philosopher Seneca the Younger once said, “we suffer more often in imagination than in reality.”

Fear of the unknown can be crippling. We have all experienced this when worrying about the future. Conversely, true immersion in the present moment can be liberating. This is one of the basic tenets of mindfulness. Dr. Kalanithi and Seneca the Younger both remind us to live as much as possible in the present moment.

“We suffer more often in imagination than in reality.”

– Roman Philosopher Seneca the Younger


When Breath Becomes Air is a uniquely powerful look at one man’s pursuit of meaning in life. Dr. Kalanithi’s profoundly honest account of his inner thoughts through this tremendously challenging experience is a blessing to the reader. I am grateful to have read and learned from this book, and I’m sure you will be too.


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