At each stage of his life — from English student to philosopher and neurosurgeon — Paul Kalanithi has searched for what makes life worth living in the face of human mortality.
“When Breath Becomes Air,” the autobiographical book which he details this search, is nothing like the traditional coming-of-age novel. And yet, it’s exactly that. Except, the ‘coming-of-age’ happens right before death, as the book provides a firsthand account of Kalanithi’s transformation from a curious student at Stanford University to a neurosurgeon-turned-cancer patient.
This is where his pursuit for meaning becomes ironic. Despite sorting through literary works, philosophical pieces, and even interacting with those face-to-face with death in a medical context, he only came close to an inexplicable understanding and embracing of his question when he himself became the patient upon his cancer diagnosis.
Throughout his development as an adolescent and doctoral student, Kalanithi was consumed “by the question of what, given that all organisms die, makes a virtuous and meaningful life,” which he believed was encapsulated in the intersection between body and psyche.
Guided by this obsession, he decided to pursue degrees in English, history, and philosophy in order to satisfy his intellectual cravings.
Despite his incessant search for answers in the humanities, Kalanithi realized “that the questions intersecting life, death, and meaning, questions that all people face at some point, usually arise in a medical context.”
Therefore, he decided to concentrate in neurosurgery, as the brain most directly reconciles one’s sense of identity through a comprehension of one’s experiences, ultimately enabling one to answer the question: “What makes life meaningful enough to go on living?”
This rumination on what makes life worth living might be the most fundamental principle underlying the newfound comfort of “wearing one’s matured skin,” which accompanies a coming-of-age novel. The pursuit of an identity into adulthood requires an evaluation of what life means in that moment to an individual, based on their developed values and beliefs.
“The tricky thing about terminal illness (and life, probably) is our values are constantly changing. You try to figure out what matters to you and then you keep figuring it out.”
Kalanithi is forced to confront his very question on life’s meaning during his dealings with terminal illness. He ages mentally as his figurative ‘coming of age’ quite literally accelerates the maturation that usually accompanies one’s dealings with questions of immortality.
But, he also ages physically upon diagnosis, struggling to repress the dulling pain in his back, and the physical transformation of his body leads to his positional transformation from neurosurgeon to patient.
Written from a view that is not short of pure empathy, solicitude, and grave thought, we hear from a medical member who goes beyond repairing what is physically broken. Seeking life’s worth, he concerns himself and his patients with hope and an understanding of life’s vibrancy during its ensuing end.
Though Kalanithi’s writing doesn’t linguistically measure up to some of his revered greats like Charlotte Brontë and Samuel Beckett, it does fully embody his voice. The way in which Kalanithi communicates his story punctures the pages with intense rumination and emotion. It is in his written philosophical ideas that he relates to the transformational trajectory of his own life that we are able to glean his discussion on immortality — something he ironically struggles to find earlier in literature.
Approaching death summons one to appreciate the life they’ve lived up till that point — an obvious thought that we have all heard in one context or another. However, Kalanithi conveys this thought with such beauty that despite the incomparable condition that both he and his readers experience, readers feel the communal purging of emotions that shadow a coming-of-age tale. In fact, Kalanithi’s story encourages us to evaluate the states of our lives at this very moment.
This book literally defines ‘coming of age’ as a proceeding toward death. Embracing death, a difficult feat to conquer, can only be achieved in knowing one’s life has been worthwhile. Kalanithi’s beautifully tragic tale jolts us into finding the beauty embedded in our individual lives. It both spreads and swells the flash of warmth that accompanies a traditional coming-of-age tale, which tells us we are not alone.