Readers seeking insight on life are flocking to a book that ends with the author’s death.
“When Breath Becomes Air,” a memoir by neurosurgeon Paul Kalanithi, just placed second among Amazon’s print and Kindle best sellers of 2016, after “Harry Potter and the Cursed Child, Parts 1 & 2, Special Edition Rehearsal Script.” It has sold nearly a million copies in print, digital and audio formats since its January release. Rights have been sold to 42 countries and a screen adaptation could be in the offing.
The nonfiction book by Dr. Kalanithi, who died within 22 months of his diagnosis with stage IV lung cancer at age 37, arrived to critical raves. Beyond its literary merits, the memoir owes its success in part to the author’s wife, Dr. Lucy Kalanithi, who fulfilled his wish to bring what was then an unfinished manuscript into the world. The book, a meditation on life and death by a brain surgeon determined to understand his own priorities in the face of his terminal illness, moved readers with its insight and courage.
The book, which Dr. Kalanithi’s widow now describes as his life’s purpose, became one of her life’s missions. To promote it, she opened up her personal life, answering questions about everything from her husband’s first symptoms to his last hours. She kept her composure even when strangers wept while talking to her about him. She deflected misguided assumptions about Dr. Kalanithi and his illness, like when readers asked if his decision to return to work after the diagnosis hastened his death. She has spoken about the book around the country, in settings ranging from the Yale School of Medicine to Google. “I made this joke recently,” she said, “that he was built to write a book, and I was built to do the book tour.”
Lucy Kalanithi said readers often want to talk about the moment in the book when she and her husband discuss whether to have a baby. “Don’t you think saying goodbye to your child will make your death more painful?” she asks in one passage. His reply: “Wouldn’t it be great if it did?” The couple went on to have a daughter, Cady, now two years old. Readers want to confront emotional passages like this one, Lucy Kalanithi said: “This is a singular moment in history where suffering and dying are hidden. It is a more expansive way to live if you acknowledge suffering rather than push it away.”
The 37-year-old practicing internist at Stanford Health Care said she is unsure if she will write a book of her own but noted that her life has already taken turns she couldn’t have predicted. She has lined up a lecture agent, WME-IMG Speakers, which describes her as an expert on subjects such as end-of-life care, the nature of grief and bereavement, meaning in medicine and “learning to live while learning to die.”
Since the book published, scores of producers, studios, actors, writers and directors have expressed interest in a possible screen adaptation, according to Dr. Kalanithi’s agent, Dorian Karchmar. The late author’s family is approaching the idea with care. “No one feels in any rush to make any decisions or commitments, but we’re proceeding in a slow and cautious way,” Ms. Karchmar said.
Dr. Kalanithi, who worked in the neurosurgery residency program at Stanford Health Care, wrote furiously as his condition worsened in late 2014. He took his laptop to chemotherapy treatments, typing with special gloves when his fingers hurt. He wrote up to three days before his death in March 2015. Just hours into her widowhood, Lucy Kalanithi wrote Ms. Karchmar and together they vowed to work with Random House editor Andy Ward to finish the nearly completed manuscript. The final draft incorporated powerful material the author wrote before and during his illness, Mr. Ward said.
‘It is a more expansive way to live if you acknowledge suffering rather than push it away.’
The timing was propitious. The book was one of a string of recent works exploring the end of life, most notably surgeon Atul Gawande’s 2014 best seller “Being Mortal: Medicine and What Matters in the End.” In 2015, a Stanford Medicine magazine video went online featuring Dr. Kalanithi speaking to the camera about his illness, nearly nine minutes of footage that allowed the author’s voice to be part of the book’s publicity after his death. During his illness, Lucy Kalanithi’s twin sister, Joanna Goddard, wrote about him on “A Cup of Jo,” a lifestyle blog with more than five million monthly page views. News outlets ran profiles as well as moving personal essays by both Kalanithis. Social sharing kicked in, fueled by a network of friends and family that a Random House publicist called “Kalanithi Nation” and an audience of baby boomers confronting mortality.
Dr. Kalanithi did get to experience a measure of his literary success. In late 2014, he sold the book as publishers were “literally calling, begging, writing letters, ignoring their families on Christmas Day” to secure the deal, Ms. Karchmar said. “He got to see the literary world light up in response to what he’d done.”