The book is subdivided into two parts; pre- and post-cancer diagnosis. The first half chronicles Paul's path as a young man starting his future, torn between his love of literature and medicine; driven by the need to understand what makes human life meaningful. To him "literature provided the best account of the life of the mind, while neuroscience laid down the most elegant rules of the brain." Despite his love of the spoken and written word, Paul ultimately listened to his heart's calling and following graduation applied to medical school. With warmth and humanity Paul shares insights into the stresses and moral burdens carried by doctors in the decisions they make for their patients and the lives they touch day-to-day. He shares the sad fact that the first birth he witnessed was also the first death or that he lost his first patient on a Tuesday. Each touching account is laden with compassion and uncompromising honesty.
In deciding to specialize in neurosurgery, Paul explains that "while all doctors treat diseases, neurosurgeons work in the crucible of identity: every operation on the brain is, by necessity, a manipulation of the substance of our selves." Later affirming "Neurosurgery requires a commitment to one's own excellence and a commitment to another's identity". Can you imagine the weight of knowing that you can irreparably change the course of someone's life forever? For better or worse. Through every recollection of patients and surgeries, the reader is given a glimpse into the integral parts of Paul, the man and surgeon. The reader gets a true measure of the man, so that when he says "the call to protect life - and not merely life but another's identity; it is perhaps not too much to say another's soul - was obvious in its sacredness," you sense the truth and conviction of his words. They are more than mere words used to fill a page in a book.
While the first part of the book gives the reader an insight into the man, his talent and calling, the second part gives us an insight into his soul as he lays it bare for us to share in the fears, pain, and sorrows faced as he battled for his life. Through it all, he fought. With his love, Lucy, by his side and later his baby girl Cady, he battled. The words "I can't go on. I'll go on" were his battle cry, until he could fight no more. Though the book ends with an epilogue written by Lucy, recounting Paul's final days, since he was unable to finish the tale of his own odyssey, it is that last paragraph written by his hand addressed to Cady that grips your heart and squeezes, leaving a fist-sized knot in your throat and tears in your eyes, for in them the beauty of this man loved and mourned by so many shines through.
Sometimes in our deepest sorrow and darkest days we find the most profound truths about life and ourselves. When Breath Becomes Air offers a poignant, beautiful and heart-wrenching story of courage, love and honesty, and in so doing, teaches us a little about life as we face our own mortality.
