When Breath Becomes Air, by Paul Kalanithi

A young doctor writes his memoir while dying of terminal cancer.

So, with the same caveat as my comments on Joan Didion's Year Of Magical Thinking -- that I might be taking out my anger at mortality and the universe on the writers of books about them -- I really didn't like this book. Unlike with Didion, where I felt alienated from her, in this case I just couldn't stop thinking that (in my opinion) he wasn't a very good writer or very interesting thinker. He seems like a nice person, I felt very sorry for him and his family's loss, and if this book reflects his thinking on a personal level then, on a personal level, fine. But this was the bestselling book in this genre of the last X years, it was widely lauded for both the beauty of its language and the depth of its thought, and I thought both were mediocre.

Specifically the book felt teenage to me, in the shallowness of its insights about the human experience and in its constant citations of Shakespeare and Beckett and so on in completely irrelevant places, in a way that strikes me as a teenager's idea of what it means to be smart. Again, it feels weird and bad to critique this book, because the author's story is truly tragic. But... yeah, that's what I actually think.

And I think that leads to various interesting theories about this book and its reception. One option is obviously that other people just see something in this book that I don't. This seems very possible!, I am not exactly the representative of the people.

Another is that some people were as unimpressed with it as I am, but... like, who wants to write a searing critique of a tragic memoir in some national newspaper? I certainly wouldn't, I feel bad enough saying this stuff in private.

A third option, I think, is that the book became popular mainly because of the author's prestige. He studied at Stanford and Cambridge and became a Neurosurgeon and was on track to make millions while running his own lab. And I guess to people outside that world that maybe feels very impressive and valuable in its own right? Whereas I've maybe met enough people like that to not feel very impressed by it, in and of itself -- I think that a lot of (i.m.o.) very medium people manage to get into Stanford and Cambridge, that these institutions attract conformity more than insight, that we shouldn't respect people for going to these universities in and of itself.

I thought the most moving chapter of the book was the last one, written by his wife, after he died. I don't know what to make of that. Maybe she's just a better writer, in my eyes -- got to the heart of something emotional and true, in a way that (to me) he didn't. Or maybe it's something else, I don't know -- maybe I was suppressing emotions while listening to his sad first-person tale, and only the shift in perspective gave me "permission" to feel what I could have felt all along? I don't know.

Anyway. The main thing I took from this book is affirmation that medical training in the US is deeply harmful and should be rebuilt from the ground up. At first he's not sure he has cancer because he might just be exhausted from working 16-hour days with no weekends and no holidays; after his diagnosis he keeps working 12 hour days, then goes back up to 16 to prove himself and graduate and all that. (His medical seniors seem to encourage this, maybe expect it?).

None of this is reasonable, none of this is healthy, none of this should be allowed. Obviously this might be clouded partly by hindsight: I know he's going to die by the end, and at the time he and they didn't know that. But I don't think that covers it: I don't think any person at all should live their life that way, I don't think it's admirable to suffer through it, and I can't get over the fact a system that is supposed to exist for health and wellbeing does this to its own participants. I don't think I'll ever understand.