When Breath Becomes Air Summary

The memoir When Breath Becomes Air recounts neurosurgeon Paul Kalanithi’s fight against Stage IV lung cancer.

  • Kalanithi is raised in Kingman, Arizona; attends Stanford to study literature; and ultimately enrolls at Yale Medical School.
  • Kalanithi meets his wife, Lucy, while in medical school, and they move to California to begin their residencies soon after. While chief resident of neurosurgery at Stanford, Kalanithi is diagnosed with Stage IV lung cancer.
  • Following his diagnosis, Kalanithi and Lucy decide to have a child, whom they name Cady.
  • Kalanithi dies in March 2015.


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Last Updated on February 7, 2020, by eNotes Editorial. Word Count: 1044


When Breath Becomes Air is neurosurgeon Paul Kalanithi’s heartbreaking memoir of life and death. Written in the last year of the author’s life, while he was dying of Stage IV lung cancer, the memoir recounts Kalanithi’s story: beginning with the onset of his symptoms, the book then takes readers back in time to trace his development from a bookish teenager and inquisitive student to a talented and well-trained resident with a bright future in neurosurgery ahead of him. Kalanithi’s cancer diagnosis derailed his career but gave him time to write his memoir, which ruminates on life, death, and what it means to be human when a debilitating illness alters one’s identity.

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Plot Summary

Paul begins having symptoms while a resident in neurosurgery. His back begins to spasm, and in a period of six months, he loses enough weight to cinch his belt two notches tighter. He suspects that he has cancer even before he sees a doctor. His X-rays look fine to the physician covering for his usual doctor, and he relaxes a bit, chalking up his fatigue and pain to the long hours and stress of being a medical student; soon, though, he begins experiencing chest pain. He and his wife, Lucy, are supposed to fly to New York to visit friends. Lucy decides to stay back in California while she considers their marriage; she feels alone and unsupported, particularly given how busy Paul is. Before Paul leaves, he has a series of tests done, including a chest X-ray, but when he arrives at his friend’s house, he is so exhausted and in pain that he decides to go home early. His primary care doctor calls the moment he gets off the plane in San Francisco: his X-rays are blurry.

Here, the memoir jumps to Paul’s childhood. When he is just ten, his family moves from Bronxville, New York, to Kingman, Arizona. His father establishes his own cardiology practice in Kingman, and Paul and his two brothers come to love the desert; the public schools in Kingman, however, are the worst in the nation, and his mother worries that her children won’t receive a proper education. She joins the PTA, lobbies for the school to offer AP classes, and gives her three sons books recommended on college reading lists. This sparks Paul’s lifelong love of literature, which leads him to study literature and literary theory at Stanford. At some point, however, he begins to question whether literature has all the answers he seeks about the meaning of life and human identity. His interest in psychology and neuroscience increases, and he begins taking classes to fulfill the prerequisites for medical school.

Paul spends a year studying medical history at Cambridge before he enrolls in medical school at Yale. He meets Lucy, who is also a medical student, there. Paul’s first two years are spent studying anatomy and pathology, building the base of knowledge he will need to become an effective surgeon. His medical training includes dissections of human cadavers, which give him the opportunity to practice his skills and help anesthetize him to the more gruesome aspects of surgery. He begins his practical training in the third year of medical school, starting off in obstetrics and gynecology, where he works in the...

(The entire section contains 1044 words.)

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