"When Breath Becomes Air": On the Age-Old Question of the Meaning of Life

The perennial contemplation of “What is the meaning of life?” has become especially emphasized in my life as I teeter on the brink of adulthood. What is my purpose in life? What is it that which I wake up for, go on for, would sacrifice all else for? What happens when I feel as though I’ve fallen behind my contemporaries, in academics, talents, passions, morals? How do I find the Something that keeps me going? What if I can’t find it?

I never imagined that through reading When Breath Becomes Air by Paul Kalanithi, I would gain not only insights into these questions but eye-opening wisdom about how to live this life in general. Kalanithi’s interests aligned with my own, and I felt relieved to know that having passions in both STEM and humanities—or, even more specifically, in biology and English literature—isn’t as confusing or self-contradictory as I’d previously led myself to believe; right off the bat, I was engrossed. The book is about Kalanithi’s own story as a lover of literature who later changed plans and attended med school to better understand mortality up close, and later, his harrowing journey as a neurosurgeon who was diagnosed with lung cancer. Initially, the diagnosis threatened to throw everything out of control—his career goals, his dreams, his family. Kalanithi hadn’t expected that he would experience revelations about mortality by personally staring death in the face, and yet, as he relentlessly pushed himself forward in his neurosurgery career, ceaselessly striving towards the “asymptote of perfection,” as he put it, and stubbornly refusing to let his lung cancer defeat his purpose in life…he discovered this purpose. Medicine, neurosurgery, helping people, this was his calling—and ultimately, Kalanithi’s realization was that one does not and cannot assign their own meaning externally, but rather, internally.

This philosophy of his was, at first, difficult for me to understand. Has Kalanithi assumed that we will all one day hear our calling and only then be able to understand our true meaning? How does one even go about assigning meaning purely internally, anyway, when so much of how we operate in life is through interacting with externalities? And yet, as I proceeded in life with this new concept of internally assigned meaning in the back of my mind, I began to notice changes.

One prominent example manifested in my self-perceived academic success as, this year, college has become an increasingly central consideration of mine. Prior to reading this book, I’d already recognized many people in my life to be role models, especially those who have interests and life aspirations similar to my own. But now, I began to notice how quick I was to pick up on discrepancies between them and myself; I noticed how readily I would compare myself to them and shut myself down when I realized my achievements were nowhere near as numerous or as impressive as their countless accolades. Despite understanding that I had a passion for literature, I frequently noticed myself berating myself for ever having dared to dream that I could find my meaning through writing when so many of my fellow writers have long since earned recognition, receiving award after award. It was only after reading When Breath Becomes Air that I noticed the final, most important piece: I needed to implant myself in the powerful reminder that I must define my meaning internally. I cannot allow externalities, whether they be people or otherwise, to dictate my direction in life and how I view myself.

Such a thought process may sound extreme and potentially unnecessarily dramatic, but I’ve recognized that especially at this time, when I and so many people I know are about to embark on the college process or college itself, turning the page on the next big chapter of our lives, understanding that we can have complete trust and faith in ourselves to find and feel our own internal meaning, independent from life’s externalities, is a powerful thing indeed. Unabashedly owning one’s purpose even in the face of death, as Kalanithi did, is an even greater indicator of strength. As Abraham Verghese wrote in his foreword in this book, “The earth is quickly turned over by worms, the processes of nature marching on, reminding me of what Paul saw and what I now carry deep in my bones, too: the inextricability of life and death, and the ability to cope, to find meaning despite this, because of this. What happened to Paul was tragic, but he was not a tragedy.”

Kalanithi passed away from his lung cancer in 2015, but today, five years later, his words still resonate ever so deeply. And, I admit, it is difficult to read, not because it is riddled with medical jargon, and not because it penetrates too deep of a philosophical sphere for the average reader to understand. It is difficult to accept. Some of the scenes are so downright heart wrenching and raw that they can feel borderline nauseating. But, my God—When Breath Becomes Air is such a beautifully written, unforgivingly candid, and mesmerizingly potent piece, and to read it is to invite an essential flavor of life to pierce your very being.

I may only be seventeen years old, nearly an adult in age but still critically naive in my youth, and yet, closing this book opened my eyes not just to life and about meaning, but to having wisdom in meaning and life. Here is a quote cited by Kalanithi in the first quarter of the book that remained in my mind long after I’d turned the final page: “‘I don't believe in the wisdom of children, nor in the wisdom of the old. There is a moment, a cusp, when the sum of gathered experience is worn down by the details of living. We are never so wise as when we live in this moment.’”

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