I was given this book by a stranger. Not a complete stranger as I almost wrote, for we had met twice over breakfast. Allow me to explain. If you saw my posts from the first couple of days in June you will be aware that I spent a few days in North Kerry taking in some of the events of Listowel Writers’ Week. We stayed in a small bed and breakfast establishment just outside Ballybunion. The other guests at breakfast on Thursday and Friday morning were Andrew, a professor of English from Santa Clara University in the last days of a six week sojourn touring around Ireland. In the course of conversation he revealed that Emma Donaghue’s father had been one of his professors.

The other guest at breakfast on those first two days was a lady named Elaine, down from Dublin for a few days. On Friday morning we talked briefly about the book shops in Listowel and the importance of independent book shops generally.

Saturday morning she had departed before we arrived in the small dining room. Andrew handed a paperback book to me, saying that Elaine had left it for me. A surprising and delightful gesture. I’m truly sorry that I did not have the opportunity to thank her. More so now that I have read it.

“When Breath Becomes AirWhen Breath Becomes Air” is both a memoir and a meditation on the meaning of life and death. The title is suggested by a verse from Baron Brooke Fulke Greville’s “Caelica 83”

Kalanithi’s family migrated from India to New York and thence to Arizona. They were a medical family but young Paul was more interested in literature than medicine. On obtaining a degree in English literature he realised his quest to discover the workings of the mind: the way it defines our personality and the way we relate to our fellow beings, required an understanding of how the brain functions. This, in turn, led him to neuroscience. Becoming a neuro-surgeon, he completed his residency and was ready to become head of his department when he was diagnosed with terminal lung cancer.

As a septuagenarian I am well aware that I have an ever reducing amount of time left. At the same time it is important to remember that death can arrive at any time. When I was in my teens three contemporaries lost their lives in tragic circumstances – a drowning, an accident with a shot gun and a motorcycle accident. Over the years since, too many friends have been taken by cancer. And yet there are people whose abuse of their bodies in their twenties ought to have finished them off decades ago but they are still living life to the full in their seventies.

Nevertheless, to be told in your mid-thirties that your life is about to end must be devastating. Kalanithi still harboured a yearning to write. In remission following treatment he is faced with a decision: have I long enough to go back to the work I love and that is changing lives or only long enough to write my book?

To say more would be to spoil the book for other readers.

There is medical jargon here, including words used in the USA to define the various levels of seniority in the profession that have different titles on this side of the Atlantic. It would have been helpful to have had a glossary. This, however, is a minor criticism.

People talk a lot about “bucket lists”: the things you’d like to see and do before you die. Too often these take on a selfish tone with a desire to see some of the wonders of the world, whether created by ancient civilisations: the Pyramids, say, or Machu Pichu; or by nature such as Ayer’s Rock or the Grand Canyon. Kalanithi’s book reminds us that it is what we leave behind us that is most important; what we’ve achieved, not where we have been or what we have seen. Life, he tells us, is essentially about striving. I would add that there are, in this 21^st century world, far too many who are more concerned to avoid that struggle than to take part. Kalanithi was not one of those. He epitomises the work ethic that characterises Indian as well as the best of American and European culture. As such, his story is one of the most inspiring you are ever likely to read.