For those of you that haven't or couldn't attend book club lately, we'll be publishing the previous months' discussion questions here. I hope eventually to post discussion questions for all of the books we've covered since I took over a couple of years ago and beyond, all the way to the beginning over a decade and a half ago. It will take a while. Until then, we will be posting discussion questions on a weekly basis. Here are the questions from our February title, When Breath Becomes Air. We hope these questions spark discussions of your own.
When Breath Becomes Air
by Paul Kalanithi
Summary:
#1 NEW YORK TIMES BESTSELLER • PULITZER PRIZE FINALIST • This inspiring, exquisitely observed memoir finds hope and beauty in the face of insurmountable odds as an idealistic young neurosurgeon attempts to answer the questionWhat makes a life worth living?
NAMED ONE OF PASTE’S BEST MEMOIRS OF THE DECADE • NAMED ONE OF THE BEST BOOKS OF THE YEAR BYThe New York Times Book Review • People • NPR • The Washington Post • Slate • Harper’s Bazaar • Time Out New York • Publishers Weekly • BookPage
Finalist for the PEN Center USA Literary Award in Creative Nonfiction and the Books for a Better Life Award in Inspirational Memoir
At the age of thirty-six, on the verge of completing a decade’s worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi’s transformation from a naïve medical student “possessed,” as he wrote, “by the question of what, given that all organisms die, makes a virtuous and meaningful life” into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality.
What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir.
Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. “I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything,” he wrote. “Seven words from Samuel Beckett began to repeat in my head: ‘I can’t go on. I’ll go on.’” When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both.
Discussion Questions
Official Discussion Questions
How did you come away feeling, after reading this book? Upset? Inspired? Anxious? Less afraid?
What did you think of Paul’s exploration of the relationship between science and faith? As Paul wrote, “Science may provide the most useful way to organize empirical, reproducible data, but its power to do so is predicated on its inability to grasp the most central aspects of human life: hope, fear, love, hate, beauty, envy, honor, weakness, striving, suffering, virtue. Between these core passions and scientific theory, there will always be a gap. No system of thought can contain the fullness of human experience.” Do you agree?
How do you think the years Paul spent, tending to patients and training to be a neurosurgeon, affected the outlook he had on his own illness? When Paul wrote that the question he asked himself was not “why me,” but “why not me,” how did that strike you? Could you relate to it?
Paul had a strong background in the humanities, and read widely throughout his life. Only after getting a Master’s in English Literature did he decide that medicine was the right path for him. Do you think this made him a better doctor? A different kind of doctor? If so, how? How has reading influenced your life?
What did you think of Paul and Lucy’s decision to have a child, in the face of his illness? When Lucy asked him if he worried that having a child would make his death more painful, and Paul responded, “Wouldn’t it be great if it did,” how did that strike you? Do you agree that life should not be about avoiding suffering, but about creating meaning?
Were there passages or sentences that struck you as particularly profound or moving?
Given that Paul died before the book was finished, what are some of the questions you would have wanted to ask him if he were still here today?
Paul was determined to face death with integrity, and through his book, demystify it for people. Do you think he succeeded?
In Lucy’s epilogue, she writes that “what happened to Paul was tragic, but he was not a tragedy.” Did you come away feeling the same way?
How did this book impact your thoughts about medical care? The patient-physician relationship? End of life care?
Is this a book you will continue thinking about, now that you are done? Do you find it having an impact on the way you go about your days?
Lucy also writes that, in some ways, Paul’s illness brought them closer – that she fell even more deeply in love with the “beautiful , focused man” he became in the last year of his life. Did you find yourself seeing how that could happen?
Unofficial Questions
Because the brain mediates our experience of the world, any neurosurgical problem forces a patient and family, ideally with a doctor as a guide, to answer this question: What makes life meaningful enough to go on living?
What do you think was meant when Kalanithi wrote “As a doctor, I was an object, a cause. As a patient, I was merely something to which things happened”?
Kalanithi has some profound statements. At one point, he states: “Even if I’m dying, until I actually die, I’m still living.” Do you agree? If diagnosed with a similarly fatal illness or injury, do you think you could live with that mindset?
What did you make of Kalanithi’s occasional quotes? Did they add to your experience? Did you have a favorite or one that spoke to you the most?