A searingly honest memoir about facing mortality—by neurosurgeon Paul Kalanithi, who died of lung cancer last year at 37—is rocketing up the best-seller lists.
When Breath Becomes Air
“You’re going to buy this book,” Ann Patchett, author and co-owner of Parnassus Books in Nashville, told an unsuspecting customer as she handed her a slim volume. “And it’s going to change your life.”
That book was Paul Kalanithi’s posthumously published memoir, When Breath Becomes Air, which shot to the top of Amazon’s best-seller list even before its Jan. 12 release, and debuted at No. 1 on the New York Times hardcover nonfiction list. You might remember hearing about Kalanithi’s story: After the 36-year-old neurosurgeon was diagnosed with stage IV lung cancer in May 2013, he wrote a widely shared New York Times op-ed, “How Long Have I Got Left?,” about coming to terms with his own death. The strength of that piece led to a deluge of queries from literary agents and editors, and eventually Kalanithi crafted a book proposal.
“It was a beautiful essay about having been on one side of this equation as a doctor for much of his life, and then suddenly, post-diagnosis, being on the other side of it,” says Andy Ward, Kalanithi’s editor at Random House. “Paul had spent a lot of time thinking about this stuff.”
In fact, he had spent plenty of time pondering life’s great mysteries, even before his diagnosis. Kalanithi had earned a master’s degree in literature and studied history and philosophy of medicine before attending med school at Yale. His widow, Lucy Kalanithi—who finished the book after her husband died in March 2015—says that he was “interested in these big questions of human identity and meaning. How does the fact that we’re all mortal influence the way we think about our lives? What does it mean to face your own impermanence?” Adds Ward, “You could write this book and convey a sense of fear or anger. He never does that.”
The graceful, measured, and unsentimental way Kalanithi addresses death caught the eye of early reviewers. Their reviews, along with a Times op-ed Lucy wrote, “My Marriage Didn’t End When I Became a Widow,” have propelled the book up the charts. Sally Marvin, director of publicity at Random House, chalks up the book’s stunning sales numbers—200,000 print copies alone—to both traditional media and social media. “First you had Lucy’s op-ed, and then you had Janet [Maslin’s] review [in The New York Times], which was so highly shared.” Indeed, the Times review, which called the book “unmissable” and promised “finishing this book and then forgetting about it is simply not an option,” was one of the most emailed articles on the site for days. Ward says, “[The book] just took on a life of its own after those two pieces came out.”
Death has always been a part of our lives; as Kalanithi writes, inevitable death is a living organism’s defining characteristic. So why is this book striking such a chord? Novelist and doctor Abraham Verghese, who wrote the foreword, says, “I think what’s refreshing is that Paul was, in a strange way, illustrating the beauty and poignancy of this, along with the sadness. It’s a much healthier image than the one we’re used to seeing.”
Ward believes people are responding to the memoir because Kalanithi could see death from all sides: “He’s writing as one of the most accomplished physicians that you could ever become, and also as one of the sickest patients that could ever exist.”
For his part, Verghese thinks the book’s appeal lies in Kalanithi’s bluntness. “Paul did something very different from many young people who die, which is that he kept it all as it was. The things that made him laugh and the things that mattered remained the same. He didn’t suddenly find God,” Verghese says. “He was just Paul, and he was showing us how to die.”