A Chat With Lucy Kalanithi

The doctor and widow of Paul Kalanithi on finishing her late husband’s memoir ‘When Breath Becomes Air’ and learning to be a mom and a widow at the same time.

Lucy-Kalanithi_QuoteWhen deciding whether or not to start a family, Lucy Kalanithi said to her terminally ill husband, 
“Won’t having a baby make your death more painful?” And he replied, “Wouldn’t it be great if it did.”

And so they did.

Theirs is a modern love story: Lucy met Paul Kalanithi at Yale Medical School. Their residences took them to the Bay Area – she an internist at UCSF, he a neurosurgeon at Stanford – and they spent their minimal down time together outdoors. Marriage and then a rough patch ensued – their grueling work schedules allowed an emotional rift to form between them. It was barely weeks after repairing their relationship that Paul went to have his excruciating back pain examined and walked out with the prognosis terminal.

The life that followed is now documented in When Breath Becomes Air, the heartbreakingly tender bestseller that Paul wrote and Lucy completed upon his death. And that wasn’t their only project. Baby Cady, now almost 2, was born 8 months before Paul’s passing from stage four metastasized lung cancer in March 2015.

“We didn’t have a baby to spite cancer, we did it even knowing Paul was dying, though we definitely raised some eyebrows in the community. Would it be wickedly hard? Yes. Would it also be amazing? Absolutely. “

If you haven’t done so already, read the book – we read it in one sitting and then wept in the middle of Grand Central Terminal as one does when they read the most courageously beautiful memoir with an equally brilliant epilogue by Lucy.

Lucy got candid with us about the struggles of learning to be a mom and a widow at the same time, and shares how to comfort the grieving and how practicing medicine has changed for her. Meet the most self-aware, inspiring, and strong woman we’ve met maybe ever: Lucy Kalanithi.

New Focus 

My own career will be forever affected by this experience. It’s taken a slight turn since Paul died: I still spend half my time seeing patients as a general internist, but I spend the other half on end-of- life care. It’s an area where we can do so much better in terms of serving patients, and it feels like my higher purpose in life to improve upon it. It’s brought a real authenticity to my work that’s so sustaining.

On Having A Baby

The emotional decision to have a baby was easy for both of us, but it was worrying for obvious reasons. Paul really wanted to do it, but I needed to talk to our families and be sure I had their support. And I did. A resounding “yes” was reinforced for me after I read Andrew Solomon’s Far From The Tree, which is about raising children in really challenging situations. The takeaway is that nobody is having a child because they think it’s easy, yet even when parenting is challenging, it’s amazing.

Coming Back Together

Cancer is not the thing that saved our marriage. We had just started to draw back together before the diagnosis. We had both been emotionally isolated from the pressure of our work lives, and that came to a head 2 weeks before he was diagnosed. It was hard to recognize that except in retrospect. The moment he was diagnosed, we were alone looking at his scans, and it was so clear what we were looking at – tumors in all his organs and a grim prognosis. We knew he was dying, and we knew how much we would need each other. Especially when you throw in a baby and the book. We were like, ‘Oh, turns out this is the thing we will do together.’

Her Best Advice

The thing that was really helpful for us was talking about everything really frankly. We wanted Paul to live longer, but above all, we wanted him to live well. We were really open with each other about what was actually happening physically and how I could help him do what he wanted to do without suffering too much. Don’t be afraid to name the scary stuff – you have to say out loud your worst fears, then you can set them aside. It’s very liberating to do that. Even if things aren’t okay, they are going to be okay because you’ll face it together.

Don’t Forget About Yourself

The whole time Paul was sick, I made sure I was taking care of myself. My sister [Joanna Goddard] had postpartum depression twice, and I was worried about that risk. I kept thinking, ‘If I get depressed for 4 months and Paul only lives for 8, I’ll be out of it for half of our time together.’ I made sure I ate, slept, meditated, and accepted plenty of help.

On Grief

Paul died 18 months ago, and losing him was not only painful but totally disorienting. But I’ve learned how sustaining it can be to have purpose in your life greater than yourself, and thankfully I have plenty of that. I’ve rebuilt my own purpose by completing the book, and getting it out in the world, digging back into my career, and taking care of Cady – who demands a lot of attention! That’s where I find so much strength.

How To Help Friends In Tough Times

  • I love when people offer to help in a specific way. Last weekend, a friend suggested we switch houses for the night, so I slept over at her house and went out to dinner with friends, while she stayed at my house and watched Cady. The next morning, we all went to brunch. It was so thoughtful.
  • If in doubt, do the thing or say the thing – ‘I’m so sorry this is happening. I wish I knew what to say.’ People are so nervous to say the wrong thing, but it’s nice to hear just that.
  • With the publication of the book, everyone wants to talk about him, Paul. I love that. A lot of people tend to try and avoid the topic after someone dies, but I find it extremely helpful to talk about him. Grief gets hidden a lot.

Baby Lit

Cady is a crazy book lover, especially books about dogs. Her first word was “dog” – Paul would be so thrilled because he was a big dog person. But he didn’t like reading baby books, so he got her funny stories by great authors – T.S. Eliot’s Old Possum’s Book of Practical Cats and James Joyce’s Cats of Copenhagen – but I don’t make her read them now. I can’t wait until we can read Charlotte’s Web together. I can picture that – it’s a sign post I look forward to.

The New Normal

Cady is my little buddy, and I find it wonderful and even relaxing to spend time with her. There wasn’t enough future with Paul, so I learned to be more present and grateful for the moment. It’s easy to wish away the time (until the next milestone, age, or stage), but I’m really enjoying it all. Though, it’s funny how the airport, without a child, can suddenly feel like a spa – just drinking a beer and reading a magazine alone feels so luxurious!

Solo Parent Problems

I’m sort of muddling through parenthood on my own, and that’s okay. His memoir shows what Paul felt was important in life – striving, struggling to find your values, trying hard, and serving other people. I want to impart his values, and it’s so nice to have them in his words to share with Cady. And it’s almost like I can hear him giving me a pep talk, telling me I am doing a great job.

The Hardest Part

I’m an extrovert, so being alone is hard. Cady goes to bed at 7pm, so I have these hours every night that I’m home, and it’s really different. Doing the book tour is easy, but those nights alone are not. But there would be something missing if I didn’t take that time to reflect.

The Future

I’m not totally sure what I hope the future brings! I’m so much more comfortable with uncertainty now after needing to just tolerate all the uncertainty when Paul was sick. Life sometimes seems like it’s on a straight path, but it never is. Paul got diagnosed 3 years ago, 2 years ago we were having a baby shower, a year ago he’d just died, and now I’m promoting his memoir. My life since then has changed soooo much. In 3 more years… I have no idea. All I can do is make the best decisions I can in any given moment and trust that will get me where I need to go.