The meaning of life and of memoir writing: Review of Paul Kalanithi’s memoir ‘When Breath Becomes Air’

by Chandra Ganguly

“We cannot change the cards we are dealt, just how we play the hand.”

— Randy Pausch

paul-kalanithi-book-cover-when-breath-becomes-airIn Paul Kalanithi’s memoir When Breath Becomes Air, we are faced immediately with the bane and challenge of any memoirist – how much do you give away of what you know and how soon? The question gathers a new grave importance when the outcome is a certain death, which in Paul’s story comes about with his diagnosis of terminal lung cancer early in the narrative. Paul, a neurosurgeon, is faced with the question of what he wants to do with his remaining days and he decides to write, to have a baby. He tries to practice medicine too for a while and must accede defeat to his fading body. What does a dying memoirist write about? About death, surely but more importantly what emerges is how a book about dying becomes a book about life and living and meaning. And isn’t that what we are all looking for? Isn’t that the purpose of our every day? Isn’t that our raison d’etre? A search for meaning?

Paul grappled early with meaning in his adolescence. He sought it out in literature and then channeled that search in medicine. Paul quotes Graham Greene, “Graham Greene once said that life was lived in the first twenty years and the remainder was just reflection.” (p.197) Paul spends his remaining time through the pain and treatments of his disease reflecting, trying to reflect even when his body and mind slowly gave way. These reflections at the center of his work is what makes this memoir so valuable to the readers he has left behind. Other than the insight he provides into the life of medical students and residents, which is engaging, what we as the reader are left with is a heightened awareness of our mortality and also an urgent sense of our need to give it meaning. “You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.” (p. 155) What does Paul find at the end of his search? These are his final words in the book, addressed to his daughter, to a future he does not have, “When you come to one of the many moments in life where you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years…”(p.200)

855This meaning is what we memoirists are seeking, this purging of the self from one’s past so we can go forward and continue to live, casting off shackles of the wounds, efforts, experiences of the past that hold us almost against our will to what we were, sometimes becoming impediments to the person we are striving to become. For Paul, who searched for meaning in his studies of literature and then medicine, in his practice as a neurologist, it is finally here with his daughter in his lap, at the end of his time, that he finds meaning. And sometimes that is what it is, the truth. Not found in the books we peruse, the careers we deem necessary for us to succeed in, the ambitions and the mountains set to be climbed, but in truly living in a moment and finding that that elusive meaning was all along right there in the moment. The past and all the experiences in life and the writing become a means to reach that moment. Paul found that meaning, he shared his version of his search and discovery with us – as generous a gift as any man can give. This is what we writers are seeking and hoping to find—our meanings encased ever so delicately under the veil of the lives we lead. Paul found it and I can only hope so will we all.

Chandra Ganguly lives in Palo Alto, California.She writes about the clash of cultures, loss of identities and the search for meaning.She is a pursuing her MFA in writing at Bennington College.