When Breath Becomes Air centers primarily on Paul’s career as a neurosurgeon and his battle with lung cancer. But on the periphery of these two narratives, Paul relays stories of his childhood and the importance of his family. In the memoir, Paul demonstrates that family helps him determine his values in his youth and keep him grounded throughout his early career, but eventually family itself becomes one of his most important values, as he chooses to spend his limited time becoming a father.
When Paul is growing up, his family determines much of what he will come to value later in life, particularly in education and religion. Paul’s mother values education highly, and one of the greatest gift she gives him is a college prep reading list, which would become foundational for his love of literature. This is a value she had gained from her own father, who championed her right to an education in 1960s rural India, demonstrating how values are often passed down from parents to children. Paul’s father, a devout Christian, also gives him his religious beliefs. Paul describes how prayer and Scripture readings were a nightly ritual in his home as a child. Though he moves away from religion at times, he returns to Scripture because of the values within it that he finds so compelling throughout his life: sacrifice, redemption, and forgiveness.
Even though Paul is initially hesitant to follow in his father’s footsteps and pursue a career in medicine, he comes to realize that his father is someone whose characteristics he wants to emulate, demonstrating what personal and professional qualities Paul aims to have as an adult. As a child, Paul had decided that he didn’t want to be a doctor, because his father, a cardiologist, was so often absent from his life. But when Paul decides that he does in fact want to study medicine, he also realizes how caring his father is toward his patients. Paul recounts a story in which his father jokes with a woman about getting her lobster and steak for dinner—which might look more like a turkey sandwich. Paul’s father’s compassion and genuine care inspire Paul to earn the trust of his own patients.
When Paul is diagnosed with cancer, the value that he places on his family becomes immediately clear, and he realizes how vital family is to his future. Due to his long hours in residency and constant absence, Paul and his wife Lucy had been having marital issues just before he was diagnosed with cancer. But when he is diagnosed, their values are thrown into stark relief, and their love rekindles as they fight Paul’s cancer together. Paul and Lucy make the decision to have a child, although they know that Paul may not survive very long into the child’s life. Paul not only wants to have a child because of the joy it would bring him; he also wants to leave Lucy with a remnant of himself and of their relationship. The fact that Paul wants to spend much of his remaining time as a new father demonstrates that having a family is a high priority for him, and having his daughter Cady becomes a source of immense joy in his last months.
Though it is clear in the memoir that Paul’s career is integral to his identity, his family is no less important. Paul’s parents provide him with a foundation from which Paul inherits his own set of values. But even more importantly than that, the newest members of Paul’s family—his wife and infant daughter—bring him a lot of joy and purpose in the final months of his life. Thus, for Paul, family transitions from shaping the ideas that give his life meaning to giving his life meaning in itself.
Family Quotes in When Breath Becomes Air
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.
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.
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.
My life had been building potential, potential that would now go unrealized.
“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.
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.
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.