Lucy Kalanithi discusses her late husband’s ‘When Breath Becomes Air’

Facing a stage IV lung cancer diagnosis at age 36, the neurosurgeon Paul Kalanithi packed more books than clothes for his trips to the hospital. He read deeply, thought deeply and, as his time grew short, wrote eloquently about mortality and meaning.

Kalanthi died in March 2015. But he’s found something like immortality in the posthumously published memoir “When Breath Becomes Air.” The book earned widespread acclaim and became a runaway bestseller early this year, starting a cultural conversation about our denial of death and how to celebrate life (and practice medicine). A brain surgeon who had also studied literature, history and philosophy, Kalanithi beautifully parses the biggest of questions.

His wife, Lucy Kalanithi, has spent much of this year talking to the world about Paul and the book that’s reshaping how we think and talk about death and life. She’ll be the guest of honor at Aspen Words’ summer benefit on June 22, featuring Kalanithi in conversation with novelist Ann Patchett. The spirit of the event – a festive gathering of writers, readers and fine wines – is in keeping with her husband’s, she says.

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“I think that Paul would have loved coming to this,” she told me recently from Philadelphia, where the internist was attending a palliative care conference. “Before he died he was alive – and he was very connected to being alive and so obviously intellectually and emotionally engaged.”

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Andrew Travers: What has it felt like talking to the world about Paul, his life and words, and seeing how many people “When Breath Becomes Air” has touched?

Lucy Kalanithi: There are a couple levels to it. On a personal level it’s been helpful for me. A lot of times, after a person dies, you sop saying their name and talking about them. It can be difficult for people to bring it up or they don’t want to make you sadder. For me, with the publication of the book, everybody I meet wants to talk about Paul. Which is the best, because I still really miss him and I’m still processing the experience.

I’ve been surprised by the degree of the response. On a broader level I think that indicates the fact that people are hungry to talk about mortality and meaning in a real way. Oftentimes death is kind of hidden in our culture in a way it never has been before in human history. It’s everywhere and nowhere at the same time. The response to the book indicates something else about the zeitgeist. There’s a change in medicine of needing to get better at talking about it.

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AT: Paul writes about that in the book, about how “death averse” we are as a culture. Did that hunger to talk about it surprise you?

LK: Before it was published, I talked to Paul’s literary agent [Dorian Karchmar] about how she thought the book would do. And she said it would either do really beautifully or it will flop. And it just depends on whether or not people want to read a book about death by someone that recently died, or if that’s a barrier to entry. And thankfully Random House, when they secured the book deal, told him that they were really excited about it and thought it could be a bestseller. That was really exciting because, as you know, he died before it was published.

And there is the dying/cultural piece of it. He is talking about how to spend his time when he’s dying. In doing that he’s not talking about dying, he’s talking about living. So people who don’t have a terminal or serious illness are thinking about those same big questions.

The overall response has been shocking and great consolation, because it would have meant so much to Paul.

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AT: You write in your epilogue about his writing process and his singular focus to complete the book, despite physical pain and discomfort. What do you think writers can learn from Paul and his dedication to this project?

LK: Even though Paul was debilitated during the process of writing he felt a) connected to a bigger purpose and b) to the reader he hoped to have. He was communicating something, reaching out.

The flip side is that literature was so important to him his whole life and especially when he was sick. He found poetry more comforting than scripture. When he was going to receive his diagnosis, which we had an inkling of, I was packing the insurance cards and socks and stuff like that. He was packing books. “Being and Time” by Heidegger, “Cancer Ward” by Solzhenitsyn, “Mere Christianity” by C.S. Lewis – this whole swath of religion and philosophy and literature. That was the importance of literature to him. He always dreamed of being a writer. It was a deep of what it meant to him to be a human. I don’t know if it’s advice to writes but that’s a statement about the importance of writing.

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AT: Did your experience of his illness and death change the way you practice medicine?

LK: It’s deepened something that I already felt, which is the thing that Paul is expressing in the book about needing to find your values and what it is that you value in your life and aligning your medical care so that you can achieve whatever that is. Mentally, I think the thing that’s most important to him was having lucid, meaningful time. He died when that was no longer possible. So I think having gone through that intense experience, even in much less intense medical experiences, I’m trying to get at the questions of, what are our patients’ fears and hopes? Even if it’s just a question of you coming into my office and you have a cold and you want to take antibiotics and I don’t think they’ll help you. That’s a common conundrum in communication between a patient and doctor. But then you find out that the patient is extremely afraid of pneumonia because a family member died of pneumonia, or the person is traveling tomorrow and they don’t want to have symptoms when they’re traveling. Those are things you can tackle in other ways, and those are things that you can address without antibiotics, so it’s not really about the antibiotics.

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AT: Has becoming a public figure and standing in for Paul impeded your ability to grieve privately?

LK: It doesn’t feel like an impediment. Talking through this is actually helping me. Like, now I’m talking to you for this publication but it really just feels like I’m just talking to you. I’m not thinking about some bigger thing. It all just feels so personal. So that feels okay. But there are some weird contrasts. I’ll speak on a panel and then I’ll go to Paul’s grave. So it feels like there are contrasts between the public and the personal but in some ways they feel like the same thing in a good way.

I still really love Paul and feel so proud of Paul. Even though he’s not here. So supporting this thing that he dreamed of doing is meaningful and sustaining to me. I still feel as if we’re a team.

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AT: Ann Patchett wrote a blurb for the book. Have you developed a relationship with her?

LK: Not yet. The first time I’m going to meet her is in Aspen. But I’ve read a ton of her writing – I read “Bel Canto” like 15 years ago and I read “Run” and “This is the Story of a Happy Marriage.” So when she blurbed the book, I came running down the stairs like “Look at this!” It was so kind and amazing.

atravers@aspentimes.com