The Catholic Book Club reads ‘When Breath Becomes Air’ by Paul Kalanithi

I have heard it once said that the trajectory of our human lives resembles the cycle of the liturgical year. There are times filled with expectation, joy and hope (Christmas); there are times filled with hyper-awareness of our shortcomings (Lent); there are times of outright sorrow and pain (Holy Week); times of exaltation and lightness of being (Easter); and then there is the ordinary time in which we live the majority of our lives. For Christians, ordinary time remains infused with the memory of Christ’s suffering and the lasting joy of his resurrection. Our daily lives can resemble seasons within the liturgical year—seasons of grinding suffering or restorative joy.

On February 10 the church began its celebration of Lent—its 40-day self-examination of its own authenticity in witnessing to the gospel of Jesus Christ. Christians examine the quality, the honesty of their discipleship, and, in the midst of such examination, they recognize God’s mercy and their own mortality. We even mark our mortality with an ashen cross traced on our foreheads. Human beings recall that they are created and loved by God, yet they fail often in loving. Sometimes we hurt others. We cause tears in others. Sometimes we isolate ourselves in an intricate world of pride and self-absorption.


Quite aware of dishonesty, mortality and a season of sorrow, I began reading the memoir When Breath Becomes Air by Paul Kalanithi. It is the story of the life, illness and death of a 37 year-old neurosurgeon—a 37 year-old husband and father. I have chosen this memoir for the February selection of the Catholic Book Club among the many recently published works that deal with death and dying.

I have chosen it because I want to think about the concepts of weight and meaning. I also want members of the Book Club to respond to the memoir as people of faith—particularly the Catholic faith. Dr. Kalanithi writes that he cultivated a mature Christian faith as he grew into his professional expertise and was confronted with illness:

About God, I could say nothing definitive, of course, but the basic reality of human life stands compellingly against blind determinism. Moreover, no one, myself included, credits revelation with any epistemic authority. We are all reasonable people—revelation is not good enough. Even if God spoke to us, we’d discount it as delusional.
So what, I wonder, is the aspiring metaphysician to do?
Give up?
Struggle toward the capital-T Truth, but recognize that the task is impossible—or that if a correct answer is possible, verification certainly is impossible.
In the end, it cannot be doubted that each of us can only see part of the picture. The doctor sees one, the patient another, the engineer a third, the economist a fourth, the pearl diver a fifth, the alcoholic a sixth, the cable guy a seventh, the sheep farmer an eighth, the Indian beggar a ninth, the pastor a tenth. Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete. And truth comes somewhere above all of them, where, as at the end of that Sunday’s reading: the sower and reaper can rejoice together. For here the saying is verified that “One sows and another reaps.” I sent you to reap what you have not worked for; others have done the work, and you are sharing the fruits of that work (172-173).

This book is first and foremost an elegant account of one person’s search for value and meaning. It is a gentle account, striving to be authentic, and it is authentic. Dr. Kalanithi strove and strove his entire life for Truth, for meaning that he could extend to himself and to others. He strove to be good, an excellent and compassionate surgeon. I utterly respect his account. I especially admire Dr. Kalanithi’s striving to leave his daughter some honest account of himself, and, at the same time, some honest account of the nature of human truth that a man once charged with caring for those seriously ill wrung out of his own confrontation with death.

I ask members of the Book Club to respond to Kalanithi’s account of his suffering and his quest for truth. Does being Catholic alter, at all, one’s conception or recognition of truth in the midst suffering and death? Is there truth in the liturgical cycle that anchors itself in the life, death and resurrection of Jesus Christ? Do all Catholics strive in such a way toward Truth? Can they? Or is Truth caught up in one’s authenticity, one’s conformity to the authenticity of Jesus Christ?

Lastly, I want to think about “weight” and weightiness. Kalanithi describes his own weight loss as a marker of illness, as a symptom of his cancer. He also describes his life-long striving toward weightiness or meaningfulness. Implicitly, that which has the most meaning in our lives carries a weight with it. Dr. Kalanithi sought out weightiness in ideas, but eventually strove to feel the “messiness and weight of real human life” (31). Real human life is embodied, and our embodied organs can break or fail (38). Kalanthi sought the palpable weight of the responsibility of trying to heal or put such bodily brokenness back together as a neurosurgeon (78). Such weight would lend weight to his own existence. But, in the pursuit of such personal meaingfulness, he also encountered human weight directly.

Kalanithi writes of the first time he helped in delivering a baby: “I held the baby a moment longer, feeling her weight and substance, and then passed her to the nurse, who brought her to her mother” (64). In the midst of his illness, he felt the weight of his mortality in his relationship with his wife (138). He also felt a need to return to conducting surgeries when his cancer was in remission: “Moral duty has weight, things that have weight have gravity, and so the duty to bear mortal responsibility pulled me back into the operating room” (151). Kalanithi even describes this moral/mortal weight in with a Christian image: “Those burdens [successes and failures in treating patients] are what make medicine holy and wholly possible: in taking up another’s cross, one must sometimes get crushed by the weight” (98).

This is a weighty Christian image. We may seek weightiness for our lives, the burden of responsibility and the weight of meaningfulness, but what really gives weight and meaning to our lives is the weight of others—tears of joy or grief, an embodied intimacy. Toward the end of his account, Kalanithi feels the weight of his new born daughter: “They wrapped her in blankets and handed her to me. Feeling her weight in one arm, and gripping Lucy’s hand with the other, the possibilities of life emanated before us” (195). Life’s meaning grew exponentially for Kalanithi as he felt the weight of his newborn daughter. Finally, there is the weight that Kalanithi leaves behind—a burden of grief that also testifies to Kalanithi’s goodness and meaningfulness. Lucy, his widow, writes the following in the epilogue: “It never occurred to me that you could love someone the same way after he was gone, that I would continue to feel such love and gratitude alongside such sorrow, the grief so heavy that at times I shiver and moan under the weight of it” (223). Our weightiness, our meaningfulness is extended to us by others.

I ask the Book Club to read and respond to Kalanithi’s memoir. It enriches, I think, our contemplation of mortality, meaning, and honesty during the season of Lent, knowing always that it is the Risen Christ, ultimately, from which our meaning—even in our direst suffering—emanates...even as our breath turns to air.

  • The month ahead: I intend to read Helen Castor’s book, Joan of Arc: A History, for March. I postponed it because of how much press Dr. Kalanithi’s book is receiving.
  • If you get a chance, I encourage you to read a classic: Robert Stone’s A Flag for Sunrise. It is at once a political thriller and a meditation on Catholicism, God, violence and human suffering.


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Beth Cioffoletti
2 years 11 months ago
I read this book. It was good, but left me feeling that Paul Kalanithi didn't quite get what he was reaching for in writing it. Perhaps I missed something, or was looking in the wrong direction.


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