lucy kalanithi!


2016 may 9 at random house:  lucy kalanithi is the widow of paul kalanithi, a neurosurgeon who passed away from cancer last year.  he loved literature and studied english in college, and, after he was diagnosed, he wrote two beautiful essays, the first in the new york times titled "how long have i got left?" and the second in stanford medicine a few months before he passed, "before i go."  his book, when breath becomes air, was published by random house this january.

lucy kalanithi is an incredible woman -- poised, articulate, thoughtful.  she wrote a poignant piece for the new york times, "my marriage didn't end when i became a widow," and she's an internist who is also involved in changing the ways medicine approaches end-of-life care/decisions.

she was in conversation with glamour's liz egan.

liz egan:  this book has been out for exactly four months.  can you tell us a little bit about how your life has [changed or not]?

lucy kalanithi:  it's funny because today is exactly fourteen months since paul died, and this book, for our family, has been one of the best things, and paul would have been thrilled to see what has happened and the conversations it's generated.  it's kind of a disorienting time for me, too, because it's kind of weird to be public but also to be so lonely at the same time.  being a doctor, the topic's are near and dear to my heart, too, so i can see my future stretching out in ways that i didn't expect to, so the book isn't just the past but also the present.

LK:  i did this early interview with a reporter from elle who said, "so, this might end up on people's shelves next to the year of magical thinking," and i was like, "are you serious?"  [...]  andy ward, the editor, wrote [paul] this really nice letter saying that [random house] would approach [the book] to get it to be a new york times bestseller, and paul was like, "seriously?"

LK:  he was writing it as a journal but also to bring people into this experience.

LE:  his first step onto the world stage was i believe january 24, 2014, when he published a piece in the new york times called "how long have i got left."

LK:  it was surprising and great.  there was that essay, and there was another, and that was the one that ends with a love letter to our daughter, and he was around to see the response to that.  [at the time, paul was pretty much restrained to their home.]  to have this social media response to an essay -- social media really enables you to feel like you're participating in the world; it's one of the great things it can do.  he was grateful for that.

LE:  how did you find the courage to write [your new york times] piece?

LK:  it was -- again, paul really liked the process of writing, and i find it a real struggle and had a lot of help with those essays.  i felt like my heart ended up on the page, and that feels amazing to have that.  when i was working on that piece, someone gave me the advice that the more sensory detail you can give, that's what makes it really universal, that people can empathize with it.  when they asked me to write the epilogue [to when breath becomes air], i didn't know if i could do that, if i could follow paul, and, if he could have done it, to write about his death, he would have done that.  it felt, as with everything else, like doing a service to him.

LE:  there was a phrase in your epilogue -- you write about the ways in which you took care of him, and, also, you said, "with music and the simple act of witnessing."  can you talk a little bit about why it's so different and also why it's so important?

LK:  i think that when someone is really ill or terminally ill, all you can do a lot of the time is just sit with it.  and being able to do that for someone else -- "i'm here for you no matter what happens."  "i'm here with you."  paul and i escaped a lot of emotions, like anger, [but there were other ones] and i think we could just with them.

LK:  [did an interview with charlie rose earlier in the day]  he [charlie rose] asked, "what do you regret?", and i said i didn't have much to regret because we sat in the muck together and talked through it so much.

LE:  how would you respond to all the people -- when someone is that sick, there's always someone who wants to assure you that you will get better, you'll be all right.  i think it takes some bravery to sit with it and say that, no, there is no happy ending, this is it.

LK:  paul's parents were in that camp, and i think that narrative helps some people.

LE:  how would you handle that?

LK:  i think, for me, that narrative was less helpful.  i think it's a human response -- even in medicine, the way we talk about things are hopeful.  i wouldn't begrudge someone that because whatever narrative that helps you cope is fine.

LE:  i think people always want to know what they can do.  are there things you would say to those who know someone who is [ill]?

LK:  what paul found really helpful was people showing up and acting the ways they did before.  [not like pretending everything was okay.]  like, his friends were really humorous and made a lot of jokes, and they would come and make jokes about the bed rail.  just because you're sick doesn't mean you're not you anymore.

LK:  my mom has this great advice:  when it doubt, describe.

LK:  i think, after paul died, people are afraid to talk about him.  but the person left behind is always thinking about it.

LE:  he wrote so much about language and what he loved reading.  are there books that you've read that have been particularly helpful?

LK:  when we were decided to have a baby, i read far from the tree.  it's basically about -- andrew solomon embarks on this quest to -- he himself is both gay and dyslexic -- and he learned that his mom was really supportive about his dyslexia but not about him being gay.  each chapter is about how a child is different from a parent.  the upshot is that he thinks that most families are really resilient and will do anything for each other.  in the end, he and his partner decide to have children.  it deepened my desire to have a child.

LK:  since paul died, i've read some poetry that's been really nice.  there's this really long elizabethan poem ["caelica 83"] that the epigraph of paul's book is from and the title is taken from.  it's greville mourning the death of his friend, and he just goes on and on and on about al the things he misses.

LE:  [mentions w.s. merwin's "separation" and quote it]

your absence has gone through me
like thread through a needle. 
everything i do is stitched with its color.

LE:  did he leave a book for you?

LK:  no.

[he left a book for his parents, the title of which i apparently did not write down, but, if i can find it, i'll update this.]

LK:  that book is actually really helpful.  it's super christian, and it's super agonizing about losing a son, and one of paul's friends sent it to him when he was diagnosed, then he wanted me to give it to his parents, which i did.  they both read it, and his dad carried it around for weeks, kind of like an amulet.

LE:  you have now been interviewed many times.  is there a question you wish you'd been asked?

LK:  i don't think so, but i say this because i've learned this technique where you can say whatever you want to whichever question.

LK:  when i started doing interviews, i was afraid that people would treat me with kid gloves.

LE:  do you feel you've entered the new normal?

LK:  not quite.  again because this has been so topsy turvy.  although this funny thing happened when paul got sick, that the future shrank down.  i knew we had months to a couple years, so the future was a lot shorter, so i learned to live in the present.  so i haven't really learned to live in the new normal, but i'm okay with it.


[audience Q&As]

LK:  even when we got engaged, he was going to be a psychiatrist, so i thought i was going to marry a literary psychiatrist.  so he really surprised me and his friends when he decided to become a neurosurgeon.

LK:  i don't love the operating room.  it's freezing cold; there are no windows; and the patient's asleep -- it's just not my scene.  you have to love it to be a surgeon.  he loved it.  i think the physical technical aspects of it didn't come as naturally to him as it did for other people.  like, he was a terrible driver -- he would be so mad at me for saying this -- [so he had to work hard at it].

LK:  there were three charities we found really helpful.  [lung cancer]'s a weirdly stigmatized illness, so the charities -- i love the lung cancer communities.  it's a very strong and compassionate community.  we liked team draft, and paul's oncologist really liked an organization called free to breathe, and there's another one called bonnie j. addario lung cancer foundation.  they were really helpful to us, even being doctors.

LK:  one of my attendings once said, "sometimes, it's nice to start a sentence with 'i wish,' like 'i really wish you could be cured" -- so you get out what you want to express while realizing you probably won't get it.

LK:  i think there is so much you can provide and you are providing just by being there and someone knowing you're there.

LK:  his death makes me really feel and empathize with the disorienting [aspect] of being sick.  so i feel encouraged to explore that space with patients and to think about -- there are all these things we can do with medicine, but what can do to maximize thins for you?  also, [within medicine], i get to talk about end-of-life care, so being able to talk about that is really compelling to me and gives me a sense of purpose going forward.

LK:  i think being in medicine -- once i entered medical school, i felt like that was a point of transition for me, so i think practicing medicine made me more present in a certain way.  and paul talks in the beginning of the book about troubles we were having in our marriage and how we were missing these attempts to communicate, so i think [we were] probably less present [then].  so i think this will change me going forward, but i think [being present]'s a challenge for everyone.