Dr Lucy Kalanithi: 'Two years on, the sting of losing Paul is finally fading'
Paul Kalanithi’s wife should be thrilled that his memoir, an instant New York Times bestseller, has just been shortlisted for both the Wellcome Book Prize and the Pulitzer Prize for autobiographies. Instead, she has mixed feelings.
“It’s bittersweet watching it do so well because Paul isn’t here to see it,” Lucy says simply. “He never even saw the cover that I helped to design. I have this fantasy where I walk up to him and, even if I just have two seconds, I give him a hard copy of the book with the award nominations printed on the cover. That would be enough.”
Paul, a highly respected neurosurgeon, died of terminal lung cancer in March 2015. His memoir, When Breath Becomes Air, was penned in the last 22 months of his life - while he was still working his way up to become chief resident in neurological surgery at Stanford University in California. It is a culmination of his long-standing literary ambitions, and explores his thoughts on mortality and life as he takes the reader back to his childhood, his decision to choose medicine as a vocation, and his crushing cancer diagnosis.
As well as his musings on science and religion, he broaches personal issues, too, writing that “in truth, cancer helped save our marriage.”
Lucy, who read the book in “real time” as Paul wrote it, admits that it was “surprising when he wrote about some of the rocky difficulties” the pair had endured. At first, she joked that the way he wrote about their struggles to balance demanding careers was “a catchy narrative device, but now it’s one of my favourite things in the book. It would have been emotionally harder for me had he not written about it, because then it might feel like a secret. Instead I feel our whole relationship is on display in a way that feels true and redemptive.” Still, she disagrees that cancer ‘fixed’ their marriage: “We were sorting things out just weeks before he was diagnosed. But the cancer thing immediately made us both give each other the benefit of the doubt.”
Paul lived to see his manuscript sold to Random House, but died with the book unfinished. Some of his last words to Lucy on his deathbed were: “Can you publish my book?”; she fulfilled that, wrote an epilogue detailing his death (he was surrounded by loved ones at hospital), and went on a book tour last year.
“At first it felt like I was doing it out of obligation or commitment to Paul,” explains the 38-year-old. “Then it ended up feeling really personal and emotionally helpful to be pouring my emotions into that. Putting words around something brings you clarity.”
Paul and Lucy met at Yale medical school in 2003, and married three years later. They had been together for a decade when Paul was given the devastating diagnosis of terminal lung cancer. Even though they knew he had just a handful of years to live, they made the difficult decision to have a child together.
“He wanted to do it,” smiles Lucy. “He was more certain than me. There’s a conversation he writes about in the book where I said, ‘won’t it make dying harder?’ And he said, ‘wouldn’t it be great if it did?’ I really remember him saying that. It clarified a lot for me and made me feel like it was okay to do it.”
The couple had Elizabeth Acadia ‘Cady’ Kalanithi eight months before Paul died. “I was taking a lot of pictures. Time just slowed down. We weren’t wishing time away - we were just with Cady,” she remembers.
Cady is now two and a half-years-old, and Lucy is keen to make sure she knows all about her father. Their home in California is littered with photographs of him, and they visit his grave regularly. Lucy is also making a picture book of Paul for Cady to read alongside Elmo and Peppa Pig so he becomes “a tangible character” to her.
“She’s just starting to pick up on the fact that he’s not here,” says Lucy. “Two nights ago, for the first time, she said, ‘where is my Daddy?’ I said, ‘He died, his body stopped working’. She said, ‘My Daddy wanna come to our house?’ I said, ‘You want him to come to our house? Me too.’”
Paul’s memoir ends with a particularly poignant message to Cady that is now framed in her bedroom at home: “When you come to one of the many moments in life where you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests, satisfied. In this time, right now, that is an enormous thing.”
For Cady, Lucy says, the tome “is a gift. She calls it ‘Daddy’s book’ so it’s in her psyche. It’s in our house everywhere and one day maybe she’ll start reading it herself. Right now the whole family is in pain except Cady. She’s too young. But later she’ll have a different kind of pain. I’m nervous about her being sad about it and me not being able to take that away.”
Lucy has been on her own journey since Paul’s death. The first year was full of overwhelming sadness - “I was like, can you die of loneliness? I felt I’d never get better” - but she says now, more than two years after Paul died, the “sting” of grief has finally begun to lessen.
“I don’t feel completely at sea anymore,” she says. “I feel wistful, kind of. I cry intermittently. I was in a exercise class the other day and they played an Enya song I’d played in Paul’s hospital bed that we sat holding hands to. I burst into tears and had to go and sit on a bench. It made me just really miss Paul.”
In the book Paul stressed that he wanted Lucy to remarry one day (“Isn’t that so generous and beautiful of him?”) and though she took her wedding rings off six months after he died, it is only now that she is able to conceive of such a possibility.
“I feel like I have the ability to get a crush on someone which is a big deal,” she says proudly. “I’d love to have another very serious relationship and that feels totally possible in theory. But meanwhile the idea of actually starting over with someone sounds so wretched. I don’t know how to date. When I last dated there wasn’t even internet.”
She is back at work as a clinical assistant professor at Stanford Medical School, and has just bought a new house. Two years ago she couldn’t imagine moving out of the home she’d lived in with Paul, but has made the decision to relocate to a different neighbourhood with a garden near Cady’s future school.
“I can’t imagine closing the door,” she sighs. “But I will. We recognise it’s a fresh start and that doesn’t feel bad - it feels good now. It’s the next phase in our lives.”
When Breath Becomes Air by Paul Kalanithi (Vintage) is shortlisted for the 2017 Wellcome Book Prize. The winner will be announced on Monday 24th April
