It is disturbing, at first, to read an autobiographical book in which the author knows he is dying and you know that he will be dead by the end of it. The book, which he wrote as he was dying, is published posthumously. He died at the age of 37, before he could ever practise as a fully qualified surgeon. He wrote his moving book When Breath Becomes Air as he approached the completion of his training as a neurosurgeon, but after he had developed metastatic lung cancer. He was, in his own words, overwhelmed and intoxicated by neurosurgery – feelings which I certainly shared when I started my own neurosurgical training 35 years ago. P aul Kalanithi became a neurosurgeon because he felt compelled by neurosurgery and “its unforgiving call to perfection… it seemed to present the most challenging and direct confrontation with meaning, identity and death”.
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