When Breath Becomes Air

Reading has always been therapeutic for me. It’s a way to decompress and relax. I am an avid reader of non-fiction and lately, I have found myself drawn to books with strong healthcare-related themes. When Breath Becomes Air is written by Dr. Paul Kalanithi, who is diagnosed with stage IV lung cancer in his last year as a neurosurgeon resident.

Much of the book discusses his transition from doctor to patient. At the beginning, he is deeply involved in treatment decisions, acting as decision making partner with his oncologist. At each decision point of his treatment, Dr. Kalanithi’s oncologist challenges him to ask, “What makes your life worth living?”

This question has resonated with me since finishing the book. As we evolve into a world where patients are key stakeholders in treatment decisions, this is a simple but important question, particularly for terminal patients. Therapeutic choice does not just involve efficacy, safety and cost considerations, but also must be tailored to fit with the immediate goals of the patient.

For Dr. Kalanithi, at diagnosis choosing a therapy with less neurologic effects in attempt retain the required sensory-motor skills of a surgeon was important. While later, after failing two lines of treatment, opting for palliative care to live out his final days in comfort made more sense. This book was an important reminder that the patient will always be at the centre of healthcare and time should be taken to determine how therapy can support their definition of a life worth living.