‘When Breath Becomes Air’ Book Club Discussion Recap

July 18, 2024

The Margs & Memoirs book club met to discuss ‘When Breath Becomes Air’ by Paul Kalanithi, a powerful memoir that takes the reader through a neurosurgeon’s own battle with cancer after treating dying patients throughout his own career. Prior to pursuing the medical field, Paul earned a Master’s Degree from Stanford in English literature. As of today, the book has a 4.4 on Goodreads and the average rating from our group was 4.33, so pretty well aligned! To guide the discussion, we used questions from Penguin Random House.

How did you come away feeling, after reading this book? Upset? Inspired? Anxious? Less afraid?

Readers in our group found Paul’s account of dying to be inspiring, comforting and made them less afraid. It was mentioned that it made some readers think of their parents and that they might be close to end of their lives.

What did you think of Paul’s exploration of the relationship between science and faith? As Paul wrote, “Science may provide the most useful way to organize empirical, reproducible data, but its power to do so is predicated on its inability to grasp the most central aspects of human life: hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue. Between these core passions and scientific theory, there will always be a gap. No system of thought can contain the fullness of human experience.” Do you agree? 

We discussed that it was refreshing that he had a diverse perspective because so many doctors can be so black and white/scientific. Having a balance in beliefs in science and faith is important so that one is not fully reliant on one or the other. They can coexist and work together.

How do you think the years Paul spent, tending to patients and training to be a neurosurgeon, affected the outlook he had on his own illness? When Paul wrote that the question he asked himself was not “why me,” but “why not me,” how did that strike you? Could you relate to it?

He had a more realistic view and that allowed him to plan better for his prognoses and his remaining time. He has already seen throughout his career that illness and injury don’t discriminate and can happen to anyone.

Paul had a strong background in the humanities, and read widely throughout his life. Only after getting a Master’s in English Literature did he decide that medicine was the right path for him. Do you think this made him a better doctor? A different kind of doctor? If so, how? How has reading influenced your life? 

We definitely believed that his background in humanities made Paul a better and different kind of doctor. He was likely more empathetic because he had a more colorful worldview. Reading has influenced all of our lives; as an escape in different stages of life, as a way to get out of the house and make friends and to learn.

5. What did you think of Paul and Lucy’s decision to have a child, in the face of his illness? When Lucy asked him if he worried that having a child would make his death more painful, and Paul responded, “Wouldn’t it be great if it did,” how did that strike you? Do you agree that life should not be about avoiding suffering, but about creating meaning?

I thought that this was one of the most beautiful and profound notions of this book and of Paul’s life. Luckily, Paul’s story isn’t too common or relatable, so we compared this to the love of dogs. Dogs don’t live as long as humans and your heart is shattered when they leave us, but would we ever trade it? No. We relish in the fact that we were lucky to love and be loved for as long as we were able to.

Creating meaning is another beautiful way to live your life. Paul knew he was going to die but he created meaning through this book and through the life that his daughter would live; not to mention the patients he treated that now continue to live on after him.

Some say that suffering is inevitable, so you should enjoy life as much as you are blessed to be able to do so.

We agreed that it would be interesting to know the daughter’s perspective and how she felt about the decision to be brought into the world knowing that her father was dying. It was noted that it could be considered selfish to procreate knowing you are potentially passing on the genes for that type of cancer.

Were there passages or sentences that struck you as particularly profound or moving?

Other than the ones already mentioned in this post, readers commented that some of the medical descriptions were very graphic invoking intense visuals that they are not likely to forget anytime soon; especially for those of us who don’t work in the medical field.

Given that Paul died before the book was finished, what are some of the questions you would have wanted to ask him if he were still here today? 

Are you happy that you spent the time going back to work?

Did you regret all of the training/schooling?

Paul was determined to face death with integrity, and through his book, demystify it for people. Do you think he succeeded? 

Absolutely, but we are wondering what happened between the time he stopped writing and his death.

In Lucy’s epilogue, she writes that “what happened to Paul was tragic, but he was not a tragedy.” Did you come away feeling the same way?

For sure, Paul’s life was beautiful and meaningful. Many of us commented on how much we enjoyed Lucy’s epilogue as well.           

How did this book impact your thoughts about medical care? The patient-physician relationship? End of life care?  

It is important to note that 50% of our group during this discussion works in the medical field. It was noted that it made someone more aware of communication with patients and inspired her to strive to be a better listener and allow patients more autonomy in guiding their treatment plans. The doctor/patient relationships in this book were awesome but also not entirely realistic because most patients aren’t coming into that relationship with as much knowledge as Paul did and aren’t able to advocate for themselves as clearly.

Is this a book you will continue thinking about, now that you are done? Do you find it having an impact on the way you go about your days?

Two of us in this group read the book ten years ago and agreed that it had a lasting impact. Some say they will remember it and it will continue to inspire them to live in the moment and make the most of their lives. One did not find the book to be impactful because she said it felt like reading medical records which she does all day for work and has already moved on from this book.          

Lucy also writes that, in some ways, Paul’s illness brought them closer – that she FELL feel even more deeply in love with the “beautiful , focused man” he became in the last year of his life. Did you find yourself seeing how that could happen? 

100%. His cancer diagnosis likely allowed them to see that whatever they had been struggling with beforehand was trivial and it allowed Paul to only pursue things that he was passionate about since he knew that his life was coming to an end.

Were you surprised that he could live on a curve from six months to ten years?

Yes, 10 years seemed high for someone with lung cancer and it seemed like Paul also knew that 10 years was unrealistic and if he were to live 10 more years, the quality of life probably wouldn’t be great.

Overall, I am so excited to start the blog series with this book. ‘When Breath Becomes Air’ is my favorite non-fiction book of all time and it meant a lot to me to inspire others to read it through this book club. I recommend that everyone read this book even if they missed the book club!

Our next meeting for the Margs & Memoirs book club is Monday, September 16, 2024 at 7pm discussing ‘Did I Ever Tell You?: A Memoir’ by Genevieve Kingston. The full meeting will take place at Los Tres Magueyes in Rolesville. Please make sure to RSVP to the Facebook event so we know how big of a table to get!

Link to purchase ‘When Breath Becomes Air’:

https://amzn.to/3WdV64N

Link to purchase ‘Did I Ever Tell You?: A Memoir’:

https://amzn.to/3y88u2b

Questions sourced from: When Breath Becomes Air by Paul Kalanithi - Reading Guide: 9780812988406 - PenguinRandomHouse.com: Books

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