When Breath Becomes Air

by

Paul Kalanithi

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Prologue Quotes

At age thirty-six, I had reached the mountaintop; I could see the Promised Land, from Gilead to Jericho to the Mediterranean Sea. I could see a nice catamaran on that sea that Lucy, our hypothetical children, and I would take out on weekends.

Related Characters: Paul Kalanithi (speaker), Lucy Kalanithi
Page Number: 7
Explanation and Analysis:

And with that, the future I had imagined, the one just about to be realized, the culmination of decades of striving, evaporated.

Related Characters: Paul Kalanithi (speaker)
Related Symbols: Breath
Page Number: 16
Explanation and Analysis:
Part 1 Quotes

I knew medicine only by its absence—specifically, the absence of a father growing up, one who went to work before dawn and returned in the dark to a plate of reheated dinner.

Related Characters: Paul Kalanithi (speaker), Lucy Kalanithi, Paul’s Father
Page Number: 20
Explanation and Analysis:

My mother, afraid the impoverished school system would hobble her children, acquired, from somewhere, a “college prep reading list.” […] She made me read 1984 when I was ten years old; I was scandalized by the sex, but it also instilled in me a deep love of, and care for, language.

Related Characters: Paul Kalanithi (speaker), Paul’s Mother
Page Number: 26
Explanation and Analysis:

Though we had free will, we were also biological organisms—the brain was an organ, subject to all the laws of physics, too! Literature provided a rich account of human meaning; the brain, then, was the machinery that somehow enabled it.

Related Characters: Paul Kalanithi (speaker)
Page Number: 30
Explanation and Analysis:

It was as if this were the moment God said, “Let there be light!" You could not help but feel your specklike existence against the immensity of the mountain, the earth, the universe, and yet still feel your own two feet on the talus, reaffirming your presence amid the grandeur.

Related Characters: Paul Kalanithi (speaker)
Page Number: 30
Explanation and Analysis:

Only later would I realize that our trip had added a new dimension to my understanding of the fact that brains give rise to our ability to form relationships and make life meaningful. Sometimes, they break.

Related Characters: Paul Kalanithi (speaker)
Page Number: 38
Explanation and Analysis:

Stepping back, I realized that I was merely confirming what I already knew: I wanted that direct experience. It was only in practicing medicine that I could pursue a serious biological philosophy.

Related Characters: Paul Kalanithi (speaker)
Page Number: 43
Explanation and Analysis:

How could I ever learn to make, and live with, such judgment calls? I still had a lot of practical medicine to learn, but would knowledge alone be enough, with life and death hanging in the balance? Surely intelligence wasn't enough; moral clarity was needed as well.

Related Characters: Paul Kalanithi (speaker), Melissa
Page Number: 66
Explanation and Analysis:

When there’s no place for the scalpel, words are the surgeon’s only tool.

Related Characters: Paul Kalanithi (speaker), Jeff
Related Symbols: Scalpel
Page Number: 87
Explanation and Analysis:

Being with patients in these moments certainly had its emotional cost, but it also had its rewards. I don't think I ever spent a minute of any day wondering why I did this work, or whether it was worth it.

Related Characters: Paul Kalanithi (speaker), Jeff
Page Number: 97-98
Explanation and Analysis:

If boredom is, as Heidegger argued, the awareness of time passing, then surgery felt like the opposite: the intense focus made the arms of the clock seem arbitrarily placed.

Related Characters: Paul Kalanithi (speaker)
Page Number: 104
Explanation and Analysis:

Good intentions were not enough, not when so much depended on my skills, when the difference between tragedy and triumph was defined by one or two millimeters.

Related Characters: Paul Kalanithi (speaker), Matthew
Related Symbols: Scalpel
Page Number: 105
Explanation and Analysis:

The secret is to know that the deck is stacked […] and yet still struggle to win for your patients. You can’t ever reach perfection, but you can believe in an asymptote toward which you are ceaselessly striving.

Related Characters: Paul Kalanithi (speaker), Jeff
Page Number: 115
Explanation and Analysis:
Part 2 Quotes

My life had been building potential, potential that would now go unrealized.

Related Characters: Paul Kalanithi (speaker), V, Jeevan
Page Number: 120
Explanation and Analysis:

The angst of facing mortality has no remedy in probability.

Related Characters: Paul Kalanithi (speaker), Emma Hayward
Page Number: 135
Explanation and Analysis:

“Will having a newborn distract from the time we have together?” she asked. “Don’t you think saying goodbye to your child will make your death more painful?”

Wouldn’t it be great if it did?” I said. Lucy and I both felt that life wasn’t about avoiding suffering.

Related Characters: Paul Kalanithi (speaker), Lucy Kalanithi (speaker), Cady Kalanithi
Page Number: 143
Explanation and Analysis:

I got out of bed and took a step forward, repeating the phrase over and over: “I can’t go on. I’ll go on.”

Related Characters: Paul Kalanithi (speaker)
Page Number: 149
Explanation and Analysis:

Maybe, in the absence of any certainty, we should just assume that we’re going to live a long time. Maybe that’s the only way forward.

Related Characters: Paul Kalanithi (speaker)
Page Number: 162
Explanation and Analysis:

The physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.

Related Characters: Paul Kalanithi (speaker), Emma Hayward
Page Number: 166
Explanation and Analysis:

Scientific knowledge [is] inapplicable to the existential, visceral nature of human life, which is unique and subjective and unpredictable.

Related Characters: Paul Kalanithi (speaker), Paul’s Father
Page Number: 170
Explanation and Analysis:

Feeling her weight in one arm, and gripping Lucy’s hand with the other, the possibilities of life emanated before us […] Looking out over the expanse ahead I saw not an empty wasteland but something simpler: a blank page on which I would go on.

Related Characters: Paul Kalanithi (speaker), Lucy Kalanithi, Cady Kalanithi
Page Number: 195-196
Explanation and Analysis:

Words have a longevity I do not.

Related Characters: Paul Kalanithi (speaker)
Page Number: 199
Explanation and Analysis:
Epilogue Quotes

This book carries the urgency of racing against time, of having important things to say. Paul confronted death—examined it, wrestled with it, accepted it—as a physician and a patient. He wanted to help people understand death and face their mortality.

Related Characters: Lucy Kalanithi (speaker), Paul Kalanithi
Page Number: 215
Explanation and Analysis:

Caring for our daughter, nurturing relationships with family, publishing this book, pursuing meaningful work, visiting Paul’s grave, grieving and honoring him, persisting…my love goes on—lives on—in a way I’d never expected.

Related Characters: Lucy Kalanithi (speaker), Paul Kalanithi, Cady Kalanithi
Page Number: 224
Explanation and Analysis:
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