71 pages • 2 hours read
When Breath Becomes Air
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During Reading
Reading Questions & Paired Texts
Reading Check and Short Answer Questions on key points are designed for guided reading assignments, in-class review, formative assessment, quizzes, and more.
PROLOGUE-PART 1, SECTION 2
Reading Check
1. What symptoms initially cause Paul to see his doctor?
2. What college is Paul’s friend Leo accepted to?
3. In which two areas of study does Paul achieve undergraduate degrees?
Short Answer
Answer each question in at least 1 complete sentence. Incorporate details from the text to support your response.
1. What scheduled vacation did Paul and Lucy have planned, and why does Lucy end up not going?
2. What feeling is “nagging” Paul upon his undergraduate graduation, and what choice does he make in response to this feeling?
3. What degree does Paul pursue at Cambridge, and what circumstance allows for this opportunity?
Paired Resource
- This website from the American College of Surgeons, a professional medical association for surgical team members, explains the process of becoming a surgeon.
- This resource connects to the theme The Patient-Doctor Dichotomy.
- Much of Part 1 of When Breath Becomes Air focuses on Paul’s journey toward becoming a surgeon: his education, training, and residency program. How does this website help contextualize Paul’s experience and clarify the process of becoming a surgeon?
PART 1, SECTIONS 3-5
Reading Check
1. How many weeks gestation were the patient Garcia’s twins?
2. What specialty does Paul choose in medical school?
Short Answer
Answer each question in at least 1 complete sentence. Incorporate details from the text to support your response.
1. What does Paul discover in one cadaver’s stomach? What does this discovery tell him about that person’s death, and what is the impact of this discovery on Paul’s relationship to the cadaver?
2. Who is Mrs. Harvey, and what impact does her death have on Paul and his practice as a medical student?
PART 1, SECTIONS 6-9
Reading Check
1. What happens to Laurie, Paul’s friend from medical school?
2. What does the word “disaster” mean, at its root?
3. During his fourth year of residency, what related field does Paul study at a Stanford lab?
4. What is locked-in syndrome?
Short Answer
Answer each question in at least 1 complete sentence. Incorporate details from the text to support your response.
1. What is “informed consent,” and how does Paul decide to apply this concept in his practice?
2. How does Paul test his patient for a psychogenic coma, and what is the treatment for it?
3. What “stunning” questions does V ask Paul upon learning of his pancreatic cancer diagnosis, and what does this anecdote show about the human experience?
Paired Resource
- This poem by Mark Doty captures a dream the speaker has about a friend who has died after an illness. (In the context of Doty’s poetry, that illness is AIDS.)
- This poem connects to the theme of The Meaning of Death.
- In When Breath Becomes Air, not only does Paul grapple with his own mortality and impending death, but he also must navigate the deaths of those around him (his patients). How does this poem help supplement the way that death impacts the living, and the ways that memory, grief, and closure intersect?
PART 2, SECTIONS 1-3
Reading Check
1. What is the first question Paul asks Emma, the oncologist?
2. To what two concepts did the earliest definition of the word hope refer?
3. What does Paul’s first scan after starting treatment show?
Short Answer
Answer each question in at least 1 complete sentence. Incorporate details from the text to support your response.
1. How does Paul feel about having Emma as his oncologist, and what is the primary reason for this initial response?
2. Why does Paul turn back to literature during his cancer treatment, and what quote from Samuel Beckett does he use as a way to navigate his new lived experience?
Paired Resource
“Padraig O Tuama’s Poetic Spirituality”
- This article from The New Yorker explores Irish poet Padraig O Tuama’s philosophy of poetry as a spiritual practice.
- This resource connects to the theme of Books and Literature.
- Much of Paul’s sense of spirituality comes from literature and poetry specifically. How can poetry be a spiritual practice?
PART 2, SECTIONS 4-6
Reading Check
1. What surgery did Paul perform upon his return to the operating room?
2. Where do Paul and Lucy go with Paul’s parents when they arrive from Arizona for a weekend visit?
Short Answer
Answer each question in at least 1 complete sentence. Incorporate details from the text to support your response.
1. What does Paul realize about the job opportunity in Wisconsin, and what prompts this realization?
2. What does Paul enjoy about the pastor’s Scripture reading, and how do religious details like this impact his relationship with the church?
PART 2, SECTIONS 7-9
Reading Check
1. What does “M&M” stand for in a surgical context?
2. What complication forces the length of the surgery Paul performs to be extended?
3. What treatment does Paul start in Part 2, Section 8?
4. What does the acronym WICOS stand for?
Short Answer
Answer each question in at least 1 complete sentence. Incorporate details from the text to support your response.
1. How does Paul respond when the tech asks him if he wants to see his CT scans, and what is the likely reason why Paul responds this way?
2. What does Emma tell Paul when he and Lucy meet with her after his most recent CT scan, and how do these words impact Paul?
3. What does Paul hope for when it comes to his daughter, Cady, and what is his message for her?
EPILOGUE
Reading Check
1. Who wrote the Epilogue?
Short Answer
Answer each question in at least 1 complete sentence. Incorporate details from the text to support your response.
1. Why does Lucy film Paul after he stops taking the daily pill in preparation for the clinical trial, and what does Paul do on that video?
Paired Resource
“The Healing Power of Radical Acceptance”
- This article from Psychology Today explores the concept of radical acceptance. While some of the examples given seem trivial compared to Paul’s experience, the concept of radical acceptance is one that can be considered alongside When Breath Becomes Air.
- This resource connects to the themes of The Meaning of Death and The Future.
- Much of Paul’s journey throughout his cancer diagnosis, illness, and ultimate death is a journey of acceptance. How does the concept of radical acceptance appear in the book? How does the Epilogue in particular pay homage to the way Paul managed to navigate the acute presence of both life and death?
Recommended Next Reads
Being Mortal by Atul Gawande
- Being Mortal, written in 2014, explores the tension between the urge to extend life and the acceptance and embracing of a good death.
- Shared themes include The Meaning of Death and The Future.
- Shared topics include illness, mortality, medicine and medical intervention, acceptance of death, and finding meaning in life.
- Being Mortal on SuperSummary
Between Two Kingdoms by Suleika Jaouad
- Written in 2021, Between Two Kingdoms tells the story of the writer’s cancer diagnosis in her early twenties. After three years of treatment, she realizes that much of the recovery process is not just physical but emotional and psychological, and she sets out on a 100-day road trip to meet some of the strangers who had written to her during her hospitalizations.
- Shared themes include Books and Literature and The Future.
- Shared topics include cancer diagnosis, an interrupted life, navigating one’s mortality, and finding a meaningful life.
- Between Two Kingdoms on SuperSummary
Reading Questions Answer Key
PROLOGUE-PART 1, SECTION 2
Reading Check
1. Weight loss and severe back pain (Prologue)
2. Yale (Part 1, Section 1)
3. English literature and human biology (Part 1, Section 2)
Short Answer
1. Lucy and Paul planned to go visit college friends in New York, but Lucy decides not to go because she needs some space to “consider the state” of her marriage to Paul. She is concerned that he is not talking to her about his deep concerns about his health. (Prologue)
2. Paul has a “nagging sense” that he is not done studying and that he has too many unresolved thoughts and ideas, so he applies for a master’s program in English at Stanford to continue his studies. He is accepted. (Part 1, Section 2)
3. Paul pursues a degree in the history and philosophy of science and medicine at the recommendation of his professors, which he is able to do because the med school application process takes 18 months. This frees up a year of Paul’s life to pursue another area of study. (Part 1, Section 2)
PART 1, SECTIONS 3-5
Reading Check
1. 23.5 (Part 1, Section 4)
2. Neurosurgery (Part 1, Section 4)
Short Answer
1. Paul finds two undigested morphine pills, which suggests that this person died in pain. This detail humanizes the cadaver and reminds Paul that he was once a living person. (Part 1, Section 3)
2. Mrs. Harvey is an 82-year-old woman Paul treats with a minor operation for a bowel obstruction. While she first seems to recover easily, she develops complications that eventually lead to her death. Her death angers and saddens Paul, and he realizes that he will have to treat the subjects of all his paperwork as humans first, not just words on a page. (Part 1, Section 5)
PART 1, SECTIONS 6-9
Reading Check
1. Laurie is hit by a car and killed. (Part 1, Section 6)
2. It means a star coming apart (Part 1, Section 7)
3. Neuroscience (Part 1, Section 8)
4. Full paralysis, save the ability to blink (Part 1, Section 9)
Short Answer
1. “Informed consent” refers to a patient’s signing a document acknowledging that they understand the surgical process, risks, and benefits and that they authorize the surgeon to perform it. Paul adapts this concept to his own practice in that he considers the meaning of “informed consent” beyond a piece of paper; to him it is a way of moving forward in collaboration with the patient. (Part 1, Section 7)
2. Paul tests his patient for a psychogenic coma by raising the patient’s arm above his head and letting it go, as a patient in a psychogenic coma will stop the arm before hitting themself. The treatment for this sort of coma is to talk reassuringly to the patient until the words connect with them and they awaken. (Part 1, Section 7)
3. V asks Paul, “Do you think my life has meaning? Did I make the right choices?” Paul is stunned by these questions because, from his perspective, V is such a “moral exemplar.” This shows that many people, regardless of background or experience, share these same questions in the face of their own mortality. (Part 1, Section 8)
PART 2, SECTIONS 1-3
Reading Check
1. Paul asks to talk about the survival curves. (Part 2, Section 1)
2. Confidence and desire (Part 2, Section 2)
3. That his cancer is stable (Part 2, Section 3)
Short Answer
1. Paul likes Emma and feels a “kinship” with her. She approaches their initial consultation with three different plans accounting for different scenarios, which is what Paul does with his own patients. (Part 2, Section 1)
2. Paul turns to literature because he feels that he needs to translate his own experiences into language and that he “need[s] words to go forward.” He repeats Samuel Beckett’s words, “I can’t go on. I’ll go on” to remind himself that, while he knows he is dying, he is still living. (Part 2, Section 3)
PART 2, SECTIONS 4-6
Reading Check
1. A temporal lobectomy (or an operation to cure epilepsy) (Part 2, Section 4)
2. Church (Part 2, Section 6)
Short Answer
1. Paul realizes that, despite its appeal, he cannot take the job in Wisconsin. He considers what would happen if he had a serious relapse: Lucy would be isolated and single parenting alone, away from her family and support system. (Part 2, Section 5)
2. Paul laughs at the Scripture reading of Jesus becoming frustrated that his metaphorical language is being interpreted literally by his followers. Details like this “where there was a clear mocking of literalist readings of Scripture” brought Paul back to the church after grappling with atheism. (Part 2, Section 6)
PART 2, SECTIONS 7-9
Reading Check
1. Morbidity and mortality (Part 2, Section 7)
2. The attending damages the dura and they have to repair it. (Part 2, Section 7)
3. Chemotherapy (Part 2, Section 8)
4. Who Is the Captain Of the Ship (Part 2, Section 8)
Short Answer
1. Paul declines to look at the scans at that moment because he has a lot of work to do. This shows that Paul doesn’t want to be distracted by the status of his scans. (Part 2, Section 7)
2. Emma tells Paul that “this is not the end…this is just the end of the beginning.” Her words comfort Paul, and he feels better. (Part 2, Section 8)
3. Paul hopes that he lives long enough that Cady will have a memory of him, and he hopes that she knows the significance that her birth and existence give Paul in his dying days. (Part 2, Section 9)
EPILOGUE
Reading Check
1. Lucy Kalanithi, Paul’s wife (Epilogue)
Short Answer
1. Lucy videotapes Paul performing the same task each day to watch for any rapid decline of his health, as his cancer could “flare.” Each day, Lucy tapes Paul reading from T. S. Eliot’s The Wasteland. (Epilogue)
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