When Breath Becomes Air

Use these questions or activities to help gauge students’ familiarity with and spark their interest in the context of the work, giving them an entry point into the text itself.

Short Answer

1. In the memoir When Breath Becomes Air, neurosurgeon and writer Paul Kalanithi (1977-2015) describes his upbringing, his education, his career, and the ways in which his cancer diagnosis and treatment affected his life. What themes, concepts, and ideas might readers likely encounter in a memoir with these components?

Teaching Suggestion: Readers might create a list of 6-8 potential themes and concepts that they anticipate encountering in the memoir. It may be useful to refer back to this “anticipation guide” as they work through the text; those unfamiliar with Kalanithi’s background might be surprised to learn of his focus on literature during his early education and his passion for language and poetry, which impact the memoir’s writing, themes, and ideas in direct and indirect ways. Readers’ lists can be amended throughout the reading process as they encounter unexpected themes and concepts.

• “How Long Have I Got Left?” - This op-ed from The New York Times was written by Kalanithi in 2014, shortly after receiving his cancer diagnosis. In this article, he grapples with similar themes as his memoir. (Registration or subscription may be needed to view.)

2. Paul Kalanithi’s cancer diagnosis drastically shifted the way he existed in the world, including his relationship to time. How do lived experiences impact one’s perspective on time? Consider that time can refer to quantifiable measures, like minutes and hours and days and years, but that it can also refer to spaces and states of being, like a time of joy or a time of grief.

Teaching Suggestion: Brief exercises regarding time, such as labeling a 24-hour chart with typical activities or ranking a series of tasks or projects by their time involvement, might be beneficial in introducing this prompt. Students might reflect on the text’s themes, specifically The Meaning of Death and The Future, as they read the article below.

• “Before I Go” - This article from the Stanford Medicine Magazine was written by Kalanithi in 2015 and focuses on how his cancer diagnosis impacted his perspective on and experience with time. The article contains photographs of Kalanithi, taken by Gregg Segal, along with audio and video.

Short Activity

The two parts of When Breath Becomes Air are titled “In Perfect Health I Begin” and “Cease Not Till Death,” which come from Walt Whitman’s poem “Song of Myself.” Read and analyze an excerpt of this poem. Respond to these questions in your notes or a reading journal.

• Based on the sections you read, what is Whitman’s message in this poem?
• In what ways does Whitman’s message speak to not only the individual self, but a transcendent and universal self?
• How does an understanding of Whitman’s poem help establish context for the memoir and Kalanithi’s organizational choice?
• What does it add to your working understanding of Kalanithi’s purpose and intention in writing this book?

Teaching Suggestion: “Song of Myself” does not need to be read in its entirety for the purpose of this activity. Specific sections might be pre-selected for the class to read (e.g., the first 8 sections along with 48-52). As this poem lends itself to open discussion, students might read and discuss individually and in small groups prior to taking part in a full-class discussion.

• “Song of Myself” - Whitman’s poem was first published in his book Song of Myself in 1855; he revised the work until he published the final version in 1892. This poem is considered his most influential piece of work.

Differentiation Suggestion: For students who benefit from support in organizing their thoughts, consider creating a graphic organizer with space to record notes and quoted phrases or lines for each of the selected sections. English learners may benefit from guided reading questions for each poem section that focus on language and poetry techniques.

Personal Connection Prompt

This prompt can be used for in-class discussion, exploratory free-writing, or reflection homework before reading the text.

A significant element of Kalanithi’s journey in his memoir is the process of confronting and accepting his own mortality. Consider the concept of death. What do you feel or think when you reflect on this topic? What is your relationship to death? How has death impacted your own life? What social, cultural, or religious factors affect the way you view death?

Teaching Suggestion: The following poems all consider death in different ways and may be helpful to read with students before or after they consider the prompt. These poems might generate a larger discussion about death and the various ways we (as humans) might relate to it.

• “If I Should Die” - This poem by Emily Dickinson expresses the speaker’s comfort in knowing that the world will continue on, even after her death.
• “Do Not Go Gentle Into That Good Night” - Dylan Thomas’s poem expresses the speaker’s belief that one should meet one’s death with fierce resistance rather than resignation.
• “When Death Comes” - This poem by Mary Oliver reveals the speaker’s anticipated wishes at their death as they look back on life.

Differentiation Suggestion: Due to the sensitive nature of the topic, the option to address the prompt with a private, written response might be extended to students. For those who would prefer an alternative topic, they might compose a brief journal entry on a previously read autobiography or memoir, commenting on the narrative elements they found to be effective.