Paul’s attempts to live a meaningful life in the face of terminal cancer make him intent on living in the present, but his reckoning with death also makes him consider how to leave behind a legacy through which he can positively impact the world once he is gone. As such, Paul spends the majority of his remaining time nurturing a new daughter and writing When Breath Becomes Air. He chooses to put his time into writing and fatherhood because he realizes that the way to make his remaining time most meaningful is to put effort into the things that will outlast him and will make a positive impact on the world.
When Paul learns that he has terminal cancer, he and his wife Lucy decide to have a child together. In a way, Paul sees their daughter Cady as an essential part of his legacy: she is a person whom he created who will remain in the world once he is gone. This is particularly important to Paul because of Lucy, as Paul worries that when he dies he will leave Lucy without love and family. Cady, then, is a way to make sure that Lucy is not alone and that she has someone in whom she can see Paul and with whom she can share Paul’s importance. Paul also argues that even though having to say goodbye to a child might add to the pain of his death, life isn’t about avoiding suffering, but rather about appreciating what one is able to leave behind. When his daughter Cady is born, Paul describes how he no longer looks at his future as “an empty wasteland,” but rather as “a blank page on which he would go on.” Whereas before he worried that he had not made an impact on the world, his daughter’s birth gives him hope for an unknown future that he had a part in creating. At the end of Paul’s writing, he thanks his daughter for providing him with happiness, and notes that the joy she gives to him and to the rest of the family will add to her own legacy in the world.
Paul doesn’t comment much on the book that he is writing, but in the epilogue, Lucy explains Paul’s desire to finish When Breath Becomes Air. The book was important for Paul to write, even in the face of immense emotional and physical distress, because it is an essential part of his legacy: it documents his life and helps others by sharing the insights that Paul gained throughout his career and his struggle with cancer. Throughout the early part of the book, Paul hints at the fact that he always imagined he would return to writing. Paul tells the reader that if someone had asked him just before he left for college what career path he might choose, he would have said a writer, because he had been so inspired by other writers grappling with human existence. When Paul is diagnosed with cancer, writing returns to the forefront of his mind as something he always wanted to do, saying that if knew he only had two years left, writing would be the way he would choose to spend his last days. In the final passages of the memoir, Lucy provides more of a backstory for Paul’s tirelessness in writing When Breath Becomes Air. She describes how he wrote while his cancer was in remission, while in chemotherapy, and even when it was painful to type, fueled by the desire to help others understand death and face mortality. Ultimately, Lucy writes, Paul’s book becomes not only a way of making sense of his own life, but also a narrative from which others could seek guidance, just as Paul himself seeks guidance from other writers when he is initially diagnosed.
In the face of impending death, Paul must identify his values to discover how to make his remaining time meaningful. Rather than making an explicit argument about what he cherishes, Paul’s actions reveal what he finds truly important: creating a legacy that will outlive himself. For proof of this legacy, readers need look no further than the book in their hands, as Paul’s words have been read by over one million people in thirty-nine different languages.
Legacy Quotes in When Breath Becomes Air
“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.
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.
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.