The day that Dr. Lucy Kalanithi’s husband was diagnosed with metastatic lung cancer, he turned to his wife and said: “I want you to remarry after I die.”
To outsiders, it may have seemed like an odd or even inappropriate comment. As Kalanithi describes it, the declaration gave the couple permission to talk openly about often taboo subjects: the time they had left together and Lucy’s future without him.
Kalanithi is the widow of Dr. Paul Kalanithi, author of the New York Times bestseller When Breath Becomes Air. The memoir documents the young neurosurgeon’s cancer diagnosis and his quest to determine what makes life worth living.
Lucy Kalanithi wrote the epilogue to her husband’s memoir and now speaks about patient-centered care and end-of-life care. She presented at Eventide’s Leaders in Living, an annual community education series, in late September. Kevin Wallevand, reporter at WDAY-TV, moderated the event.
Kalanithi’s message was one of hope and love, even in the shadows of death. She emphasized a line from the memoir: “The fact of death is unsettling. Yet there is no other way to live.”
Lucy and Paul met in 2003 as first-year medical students at Yale University. They married in 2006 and funneled their energies into their residencies: his as a neurosurgeon; hers as an internist. Just as the end of those stressful years came into sight, Paul received his diagnosis.
Prior to those circumstances, both young doctors practiced matching medical treatments to the values of their patients. They believed that physicians had a responsibility to understand how their patients wanted to live before helping them determine a course of medical action.
Overnight, that philosophy became personal. The couple not only faced mortality, but followed the question of what makes one’s life meaningful.
“In healthcare, we treat everything as an acute problem,” Kalanithi said. “That isn’t always the best decision when treating a person with a terminal disease.”
Paul believed deeply that until he died, he was living. For the Kalanithis that meant that Lucy supported Paul’s decision to return to work after his diagnosis. “I told him that whatever makes this time meaningful for you and keeps your claws on this world, do that,” she said.
It meant choosing to have a child, even knowing that Paul would not live to see him or her grow up. As they discussed the possibility, Lucy asked Paul if having a baby would make it harder to die. His response: “Wouldn’t it be great if it did?” Their daughter, Cady, is now 3.
There were challenges to Paul’s transition from physician to patient. Both Lucy and Paul were surprised at the upheaval of identity that accompanied his terminal illness.
“Your future concept of yourself reflects on who you are now,” Kalanithi said. “If your purpose evaporates, it takes real work to rebuild that.”
Paul spent the last year of his life writing. His book proposal was accepted for publication a few months before he died at age 37. Now Lucy carries his message to others, encouraging individuals and families to face taboos and fears as they navigate serious illness and care.
Every individual, every family will face death, “and you can be resilient through these things,” Kalanithi said. “It’s a human thing to hope for the best.”
During her presentation, Dr. Lucy Kalanithi recommended additional resources for families facing serious illness and care.
Being Mortal by Atul Gawande
After the Diagnosis by Julian Seifter, MD
The Conversation by Angelo E. Volandes, MD