The Pursuit of Happiness: When Breath Becomes Air by Paul Kalanithi

When Breath Becomes Air is one of the few books that I have read twice. The first time I read it, shortly after the book was published, I was moved but not overly affected. It’s hard not to be touched by the book’s subject matter – facing a near and certain death after a terminal cancer diagnosis. But I was in a very different stage of life: recently newlywed, childless, and climbing the corporate ladder. I just didn’t relate too closely to Paul Kalanithi’s life experiences.

Fast forward six years later, and my reread of When Breath Becomes Air carried such gravity that it deeply and profoundly reached me. It was almost like talking to a college roommate – I often found myself nodding my head in agreement and thinking to myself “Yea, I’ve been there.” I could now relate to many of the anecdotes scattered throughout the book.

For instance, we learn that Paul’s marriage to his wife Lucy was strained toward the end of his neurosurgery residency due to its absurdly demanding schedule. Having found my own kindred spirit, I too endured the harsh realities of having a relationship with an aspiring physician. When I first met my wife, she too was a surgery resident. Compounding matters, feeling the fertility pressures of a biological clock, we decided to start a family and have a child during her medical training. Days, even weeks, at a time would pass where we barely saw our “mama bear.” Her unyielding dedication to her patients made me feel like a second-class citizen. For all intents and purposes, I was a single parent. Fortunately, as with Paul and Lucy, when my wife’s medical training was over the distance between us vanished. Moreover, Lucy writes in the epilogue that most of their family and friends will have been unaware of their marital trouble. We also chose to hide our relationship struggles from others – this paragraph being the only account of the burning ring of fire we almost fell into (any Johnny Cash fans out there?).

For most of When Breath Becomes Air, Paul grapples with an existential crisis as he tries to comprehend and digest a terminal diagnosis. He writes that his “life had been building potential, potential that would now go unrealized” and that his identity as a physician “no longer mattered.” This is exactly how I felt when I first became a stay-at-home father. I was no longer a scientist, or engineer, or runner, or musician. I was nothing more than a diaper changer, a bottle feeder, a baby napper…a bird that was now caged. As Paul’s identity instantly and irreversibly changed from physician to patient, so too did mine from working professional to caregiver. What would my life amount to?

Back in 2012, I was fortunate to sit in on a lecture by Judge John Charles Thomas (little did I know how fortuitous this lecture would be to me later in life). One topic he discussed left an unforgettable impression in my mind: life, liberty and the pursuit of happiness. Most would recognize these words as the well-known phrase from the United States Declaration of Independence. Few, he said, would know that the word “happiness” is highly debated (see here for an overview of the debate, or here for an in-depth analysis), and that the intent of the word “happiness” was really “meaning.” The pursuit of meaning is an unalienable right. That life must have meaning.

So how did Paul end up pursuing meaning, and thus happiness, in his life after his terminal diagnosis? Starting a family, of course, but he knew he would not be around long enough to form deep meaning in his child’s life. In large part, it was pursuing the one missed opportunity in his life: writing a book. “During the last year of his life,” Lucy writes in the epilogue, “Paul wrote relentlessly, fueled by purpose.” Even in the darkest of times a light can emerge, and for Paul that light was his writing.

This, to me, is the most profound learning contained within When Breath Becomes Air. When life gets turned upside down, find something meaningful to pursue, and that will make you happy again. For me, as I confronted the reality of stay-at-home parenting, I too was able to be happy again by pursuing meaning in my life. And what gives me meaning are all the little “projects” I work on, and, like Paul, writing (even if it’s only a blog).

As we continue to live through the coronavirus pandemic, I imagine we all can relate to life instantly changing and having to cope with the unforeseen consequences. Please keep Paul’s message in mind, and find a way to pursue something meaningful in your life – even if it’s something you never dreamed of pursuing until now. You can and will find happiness again!

Paul excerpts and quotes many philosophers, poets, and writers throughout When Breath Becomes Air. I leave you with my favorite inspirational poem (excerpted from The Poetry Foundation here):

If by Rudyard Kipling
If you can keep your head when all about you
     Are losing theirs and blaming it on you,
If you can trust yourself when all men doubt you,
     But make allowance for their doubting too;
If you can wait and not be tired by waiting,
     Or being lied about, don't deal in lies,
Or being hated, don't give way to hating,
     And yet don't look too good, nor talk too wise:

If you can dream--and not make dreams your master;   
     If you can think--and not make thoughts your aim;   
If you can meet with Triumph and Disaster
     And treat those two impostors just the same;   
If you can bear to hear the truth you've spoken
     Twisted by knaves to make a trap for fools,
Or watch the things you gave your life to, broken,
     And stoop and build 'em up with worn-out tools:

If you can make one heap of all your winnings
     And risk it on one turn of pitch-and-toss,
And lose, and start again at your beginnings
     And never breathe a word about your loss;
If you can force your heart and nerve and sinew
     To serve your turn long after they are gone,   
And so hold on when there is nothing in you
     Except the Will which says to them: 'Hold on!'

If you can talk with crowds and keep your virtue,   
     Or walk with Kings-nor lose the common touch,
If neither foes nor loving friends can hurt you,
     If all men count with you, but none too much;
If you can fill the unforgiving minute
     With sixty seconds' worth of distance run,   
Yours is the Earth and everything that's in it,   
     And--which is more--you’ll be a Man, my son!

Have you also read When Breath Becomes Air? Were you moved by Paul Kalanithi’s memoir? Let me know in the comments below!

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