Paul Kalanithi ’99 M.A. ’00 was an instructor in Stanford’s department of neurosurgery and a fellow at the Stanford Neurosciences Institute, as well as a writer. Kalanithi lost his battle with cancer last March, after being diagnosed with Stage IV lung cancer during his neurosurgical residency at Stanford.
His book, “When Breath Becomes Air,” was published posthumously last week. In the book, Kalanithi discusses his medical career, his family and learning to face mortality.
While a student at Stanford, Kalanithi wrote for The Daily, played in the band and worked at Stanford Sierra Camp.
The Daily recently interviewed his wife, Lucy Kalanithi, to discuss Paul, his book, his life and his legacy.
The Stanford Daily (TSD): Describe Paul to us.
Lucy Kalanithi (LK): There’s a Dan Gilbert quote that says, “Humor is the place where intelligence and joy meet.” That was Paul. He was reverent and irreverent at the same time. He knew which rules were okay to break and he broke them.
The book is much less funny than Paul was. He was dying when he wrote it. The book is thoughtful and it’s beautiful, but in real life, there was this whole other dimension to him. He was totally funny and that was part of why I was drawn to him.
Paul loved the Stanford football team. The football team signed a football for him in 2014 when he was sick, and he went through the team roster with a highlighter to highlight who had signed his football.
He just really saw excellence throughout Stanford, including that team, and he was really proud to be a part of Stanford. That was why he wanted to come back for his residency. It certainly was a huge part of his life.
TSD: He writes in the beginning of “When Breath Becomes Air” that he had never intended to be a doctor.
LK: So Paul had gone to Stanford undergrad and graduated in ’99, and then he did a co-term in English literature after doing HumBio and literature… and then after that, he went to Cambridge in history and philosophy of science and medicine. He thought he’d be maybe in the literature department or the philosophy department, but as he mentioned in the book, he decided that medicine was the perfect place to grapple with big moral questions and matters of life and death, so to speak, in a very practical way.
TSD: In his book, your husband mentions that you met during medical school at Yale, but how exactly?
LK: We met in 2003 when we were both first-year students. It was fun because I at first didn’t notice him… I figured out a few months into med school that instead of being only an intellectual guy, he was really hilarious. He was wearing a fake mustache in his med school ID.
TSD: Could you elaborate on the process of turning Paul’s manuscript into a published work?
LK: Essentially, the book is exactly what he left when he died, so the title, the epigraphs, the section headings, “In Perfect Health I Begin” and “Cease Not till Death,” which are from Walt Whitman’s “Song of Myself.” And then after he died, we slightly supplemented a few sections with his intentional writing from other periods in his life — even his master’s thesis from Stanford — just little snippets to make sure it was a full book. But yeah, it’s all his.
TSD: Did he choose the title before his death?
LK: Yeah, he chose the title. The title, as you can see from the epigraph at the beginning of the book, comes from this little poem by Greville saying:
You that seek what life is in death,
Now find it air that once was breath
We were lying in bed during a time in which he was pretty sick and he was writing and reading the poetry book, and he said, “I think I came up with the title for my book. How about ‘When Breath Becomes Air?’”
TSD: “When Breath Becomes Air” addresses questions of mortality and some of the taboos surrounding death. How did your outlook on life change with your husband’s diagnosis?
LK: Both being doctors, we didn’t have any illusions about this prognosis. So the question for us was how to respond to that fact that we couldn’t really change. For us, it meant facing it, talking about it, and then continuing to create meaning and purpose… The book is about being alive. It’s not just about dying.
TSD: “When Breath Becomes Air” has been very well-received, even just in the week since its publication. In the long run, is there anything you hope readers take away from the book?
LK: First of all, Paul wrote it to our daughter, so I’m very interested in saving it for her. He also wrote it kind of as a journal about really grappling with what was happening to his body, unexpectedly in his thirties when he got cancer, but he really did write it for the reader. He wanted to bring people into the experience of grappling with big questions about how to build meaning and face mortality. People seem to be responding exactly as what Paul set out to do. The reason the book is being so well-received is because people are hungry to talk about this and that says something about society.
TSD: In a piece you wrote for the New York Times, you talk about how you have tried to make Paul’s gravesite a place of your own. How have you done that?
LK: [The night before his memorial] maybe 20 people or so went to Paul’s gravesite, which is really beautiful, overlooking the Pacific Ocean. We just poured a ton of whiskey out on the ground and everyone was drinking beers and whiskey and sitting on blankets on the ground and talking. Some people were crying and some people were laughing and there was that idea of grief being solitary and communal at the same time. You wouldn’t think of drinking beer at a gravesite but when it’s your friend, it just feels right to be there together in that way and to be together in a place that now holds Paul but in the way that we would have with Paul.
TSD: And in your life in general?
LK: It took me a while to even clean up Paul’s stuff from our house… but it’s not the place where Paul lives anymore. It’s the place where Cady and I live. For several months, it was really comforting [to have all his stuff around] but then, suddenly, instead of feeling cozy, it just felt kind of dark. I literally painted the walls white and changed some things in our house, and that’s all about coming to terms with [his death] and creating a new setting.
TSD: Your daughter was very young when your husband died. How will she remember him?
LK: I’ve thought about this a lot recently. She has no idea about any of this. She loved Paul, but Paul died and she wasn’t totally aware that Paul was there and then disappeared; she was really young when he died. And now she doesn’t know that Paul wrote a book and is a well-known writer. He wasn’t when he was alive. He was a dad.
TSD: As your daughter grows up, what will you tell her about her father?
LK: I certainly want to be able to help her understand who Paul was and where she came from, and I think the main things for me are that he really loved her and he really felt that striving was a very important part of being human and something he really valued. And that means trying hard and being a good person.
He writes in his book, “Darwin and Nietzsche agreed on one thing: the defining characteristic of the organism is striving.”
The other idea that he thought was important was that some of the central tenants of being human are love and suffering and the idea that life isn’t about avoiding suffering. Part of happiness is about building a meaningful life, and that’s not always choosing the easiest path.
Paul Kalanithi is survived by his wife Lucy and daughter Cady.
This transcription has been condensed and edited.
Contact Sophie Stuber at sstuber8 ‘at’ stanford.edu.