When Breath Becomes Air

1. General Impressions

Gather initial thoughts and broad opinions about the book.

• How does Paul Kalanithi’s journey from a medical professional to a cancer patient alter your perspective on the doctor-patient relationship?
• How do you think Kalanithi’s reflections on mortality, purpose, and identity challenge conventional views on the meaning of life? 
• How does Lucy’s epilogue shape your understanding of Kalanithi’s legacy and the impact he hoped to leave through his memoir?

2. Personal Reflection and Connection

Encourage readers to connect the book’s themes and characters with their personal experiences.

• How has When Breath Becomes Air influenced your perception of life and mortality? Did it make you think differently about your priorities? 
• In what ways did Kalanithi’s journey through his illness resonate with your own experiences or those of people you know? How does his story of balancing hope with acceptance of reality impact your perspective on facing challenging situations, health-related or otherwise? 
• How do you relate to Kalanithi’s passion for both medicine and literature? Do you find meaning in both science and the arts? 
• Kalanithi and Lucy’s decision to have a child, even knowing his time may be limited, is a pivotal moment in the memoir. How do you view the idea of bringing new life into the world under such circumstances? 
• At the end of his life, Kalanithi finds happiness in the present moment, particularly in spending time with his daughter. How has this book influenced the way you view the present versus the future? 

3. Societal and Cultural Context

Examine the book’s relevance to societal issues, historical events, or cultural themes.

• How does the book highlight the role of the medical field in shaping cultural understandings of life, death, and the value of health? How do Kalanithi’s experiences as a doctor and a patient reflect larger societal beliefs about healthcare and mortality? 
• What insights does Kalanithi’s journey provide about the American healthcare system, particularly in regard to physician workloads, emotional tolls, and burnout? How might his observations challenge or reinforce societal expectations of doctors? 
• Kalanithi’s identity as a first-generation Indian American and son of immigrant parents influences his values and career path. How does his cultural background shape his perspective on success, family, and service to others, and what does this reveal about immigrant contributions to society? 
• In what ways does the memoir address the societal pressures surrounding end-of-life decisions and the taboo around discussing death openly? How does Kalanithi’s approach to his terminal diagnosis reflect or challenge cultural attitudes about illness and mortality?

4. Literary Analysis

Dive into the book’s structure, characters, themes, and symbolism.

• Examine the concept of the “Physiological-Spiritual Man” in relation to Kalanithi’s career. How does this concept encapsulate the intersection between medicine and the humanities, and why is it central to Kalanithi’s understanding of meaning?
• How does Kalanithi’s relationship with statistics and survival curves evolve throughout the book? What does this shift reveal about his journey from seeking control to accepting uncertainty in his life and death? 
• Analyze Kalanithi’s use of medical language in the memoir. How does his choice to include technical details about surgery and treatment contribute to the memoir’s impact? What might this suggest about his view on the connection between body and personhood? 
• Discuss how Kalanithi uses literary and philosophical references to make sense of mortality. How do figures like Whitman, Eliot, and Tolstoy influence his meditations on life and death, and what does this reveal about his worldview? 

5. Creative Engagement

Encourage imaginative and creative connections to the book.

• Create a list of questions you would ask Kalanithi if he were speaking at a book event today. Focus on questions that explore his views on literature, philosophy, and medicine, and how they intersect with his personal journey through illness.
• If you were tasked with writing an introduction to this memoir, what would you say? 

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