When Breath Becomes Air is Paul Kalanithi’s personal narrative of receiving the life-changing diagnosis of advanced lung cancer. A highly educated neurosurgeon, Paul and his wife Lucy were both on an upward trajectory of achieving their life’s goals when Paul received the diagnosis. In the beginning of the memoir, Paul bravely acknowledges the struggles in his marriage, and through Paul’s eloquent descriptions, readers are able to observe the re-connection of their partnership. Paul weaves the theme of time throughout the memoir: time spent studying to become a neurosurgeon, dreams of his future both professionally and personally, and the time he has remaining. His reflection on time across his own lifespan is raw and honest, and demonstrates the profound challenges such a diagnosis brings.

Counselors can use this book in order to better understand the lived experience of clients living with a terminal illness. Paul describes the physical and emotional impact on the patient, as well as family, friends, and co-workers. Most importantly, Paul highlights the ever-changing experience of the diagnosis by noting the days filled with hope, and conversely, the days filled with despair. It is important to recognize that each client’s experience is unique. However, by reflecting on grief and Paul’s experience, counselors can provide a therapeutic space for clients living with terminal illness. Such a space can then support clients in processing their thoughts and emotions, and counselors can serve as resources and advocates.