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The Doctor Who Became a Patient

Amazon Book review: When Breath Becomes AirThere's a truism in the book publishing world that it's nearly impossible to "sell" a book to readers if the author isn't alive to publicize it. Especially now, in an era in in which success often depends on author "platforms" - an era in which an author's personality and presence is at least as important as the work itself – popular wisdom holds that publishers shouldn't try to release orphaned books. There's also another, related truisim: bluntly put, it's that books about serious diseases, even if the author has died of one yet, don't sell either.

Of course, there are plenty of exceptions to these "rules." Most famously, there was Randy Pausch's The Last Lecture, about a professor's last days and the lessons he learned from them; that book was a #1 bestseller almost from the start and remained there after its author died six months later. There was my friend Kathy Rich's prize-winning The Red Devil, about her valiant struggle with the cancer that didn't kill her for almost two more decades.

And now, there's the late Paul Kalanithi's sonorous and extremely moving When Breath Becomes Air, which is a very personal account by a doctor who became a patient. Kalanithi, a neurosurgery resident at Stanford, was diagnosed, in his mid 30s, with lung cancer and chronicled his last months processing this information. All of us who read it here knew it belonged on our Best of January list, which we put together a while back; its publication is today (Tuesday, Jan 12) and, obviously, many many people – from New York Times reviewer Janet Maslin to the dozens of five-star reviewers on Amazon – agree. As of this writing, two days before official publication, When Breath Becomes Air is our #1 bestseller.

If you pick it up, you'll likely see right away what all the fuss is about. Granted, it's a very sad story and for whatever reasons, sad stories appeal to readers. But what makes this particular sad story particularly strong is that it's emotional without being sentimental. That, and for all that Kalanithi is clearly a brilliant, superbly educated guy (Harvard, Yale, etc etc) – and a *doctor,* no less – he sounds like somebody anybody could know. He is somehow even more accessible than Atul Gawande – the doctor who wrote wonderfully about learning to talk about dying in Being Mortal and Abraham Verghese, the doctor who wrote about treating AIDS patients in My Own Country and who wrote the introduction to Kalanithi's. And they are both great doctors, writers, and thinkers.

There's just something about Kalanithi's voice, and maybe also about his time of life. Young and relatively newly married to another doctor, Kalanithi wrestles with the question of whether to have a child he knows he will not see grow up - and the passages about that decision, his relationship with his wife Lucy and the eventual birth of their daughter Cady are among the most moving in the book. In this way, When Breath Becomes Air reminds me of another, very different, book about identity and parenthood. Ta-Nehisi Coates's Between the World and Me is framed as a letter from the author to his teenage son; parts of Kalanithi's work is written to Cady, who was nine months old when her father died.

Kalanithi wrote:

When you come to one of the many moments in life when 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, a joy that does not hunger for more and more, but rests, satisfied. In this time, right now, that is an enormous thing.


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