My Last Book: Stephanie Chan on When Breath Becomes Air

When breath becomes air
When breath becomes air


STEPHANIE CHAN (aka Stephanie Dogfoot) has won national poetry slam championships in Singapore (2010) and the UK (2012). Her writing has appeared in Esquire Singapore, the Asian Literary Review, Griffith Review, QLRS, Pressure Gauge Journal, Rambutan Lit and various anthologies. She lives in Singapore.


The last book I read was a short memoir that felt more like a modern-day legend. It was called When Breath Becomes Air by Paul Kalanathi, an extremely accomplished neurosurgeon who was diagnosed with Stage IV lung cancer in 2013. He passed away in 2015 before finishing the book, and his wife wrote the epilogue.


Kalanithi was not just a surgeon—coming from a family of doctors, he initially never wanted to be one. Motivated by a fascination with what gave life meaning, he got an undergrad degree in literature (and human biology), and graduate degrees in the history of medicine and philosophy of science. Ultimately, he ended up finding himself studying medicine and eventually found the greatest meaning in trying to understand what separated life and death through training to be a neurosurgeon and working with the brain—the one organ in the body responsible for human consciousness. His diagnosis changed everything. He went from being a detached doctor/scientist/scholar to being in a position doctors (or let’s face it, most of us) don’t often imagine themselves in, a situation no amount of philosophy, literature or medical school could have prepared him for: a patient.


No one likes to think about losing control of their body, or how or when they might die, even though its something we know will happen to all of us. As an able-bodied, neurotypical person in their late 20s who has never broken a bone and has only stayed in a hospital twice, I take my body for granted and don’t think about it very much, let alone the fact that I will not live forever. But Kalanithi lays these and forces you to confront them in a way that is both matter of fact and beautifully-written.


But this isn’t a book review. There are many far better reviews of this book around the internet. I only heard of this book because my mother heard about it on a radio program and bought it, and it was passed around my family before I got around to reading it. I’m not sure precisely what prompted her to buy it and recommend it me, but it could be a number of things. We both have degrees in science, her in microbiology and me in biology, although neither of us are scientists or doctors. I write poetry and comedy, and she is a full time homemaker and caregiver to my younger sister.


My sister was diagnosed with ALS in 2014, the degenerative condition made famous by its oldest survivor Stephen Hawking and the ice bucket challenge. It is not a death sentence but it does prevent you from using most muscles in your body. Her diagnosis was the first time in my very privileged life that I was forced to confront the idea that people close to me could lose control of their bodies. It made me realise that people close to me will not live forever, and that terrible things can and will happen to us and people close to us. It made me realise that maybe the word ‘terrible’ is all in the mind. That it is possible to lose everything and still live a full life.


It has also (and this is a relatively, ridiculously privileged/self-centred problem to have) feel like much of what I’ve written, and what I want to write is frivolous in comparison. I will not write about ALS because that is my sister’s story to tell, not mine, and I still have not been able to write about my family because it seems too big a thing to tackle in a poem to be shown to the public yet.


And so reading When Breath Becomes Air was kind of cathartic. It spoke of many the things I have not been able to talk about. Kalanithi approached the idea of death as doctor, a terminal cancer patient, a writer, a philosopher and a human being above all. ALS is almost nothing like cancer, obviously, but I think the biggest thing I got from the book was how it brought to light all the things we are afraid of when we become ill, become patients: losing agency, becomes reliant on other people, at the mercy of doctors and caregivers. He reminds us that it is possible to maintain a sense of self and dignity until the end. Reading the book was like an assurance from a close friend that no, nothing will be all right, but at least you are not alone. In this, it has put into words ideas I am just beginning to dare to think about.