For the last two years the story of Paul and Lucy Kalanithi, a married couple from San Francisco, has gripped hundreds and thousands of people around the world. In 2014, Paul (aged 36 at the time) was diagnosed with inoperable lung cancer, right as he was on the verge of finishing his 11-year training as a neurosurgeon. But the crushing news didn’t stop the couple from living the limited time they had together to the fullest.
Paul and Lucy had their first child through IVF, Paul - an avid literature fan - penned an essay in The New York Times on his experience, he landed a book deal, and then raced against time and his deteriorating health to finish it. After he died on 9 March 2015, Lucy completed his memoir When Breath Becomes Air, which has gone on to top bestseller lists in America and the UK.
Ahead of the first anniversary of Paul's passing, Stylist’s Sejal Kapadia talks to Lucy about life after death...
“If it were me, I would’ve had a nervous breakdown,” I say to Lucy, 15 minutes into talking about how she’s garnered strength to give birth to her first child, see her husband die, learn to be a single mother, finish his book and now promote it.
She is kind, warm, friendly, passionate, determined and all-round wonderful to talk to. Meanwhile, I'm looking back at her in awe. In the past few months, Lucy's words about Paul's death in a New York Times opinion piece (“One afternoon, I visited his grave and lay on top of it. I slept more soundly than I had in weeks”) and in the epilogue to his book have turned me into a fast-blinking, tearful mess on the Metropolitan Line.
But today is different. Lucy is talking about her late husband and she's loving it.
“People worry they’re going to hurt you when they speak about someone who has passed away or that they’ll bring up sad memories. But I pretty much guarantee that the person who is grieving is thinking about it 100% of the time. So for you to then enter into that internal conversation is not at all making them sad or sadder. It’s just making them feel connected,” she says.
“For me it’s happening in this funny media context. People are approaching me and saying, ‘Hello Lucy Kalanithi, would you like to talk about Paul?’ And I think to myself, ‘Yes, I would LOVE to talk about Paul.’
“If you broke your ankle or if your grandparent died, people would ask about it. But the more close it gets, the less it happens. Bringing something out of the shadows is actually helpful for everybody.”
As the title of her New York Times put it, her marriage didn’t end when she became a widow. “I knew I would feel sad after Paul died but I hadn’t quite realised how solidly those other emotions would continue. You know that feeling where it feels so good to be in love? I still have that feeling.”
“I have many people to do something with. I just don’t have anybody to do nothing with.”
Of course, there are harder days when (to quote from her epilogue in When Breath Becomes Air) ‘the grief [is] so heavy that at times I shiver and moan under the weight of it’.
Right now that moment comes when their 19-month-old daughter, Cady, is sleeping and Lucy is home alone. “I find it really hard to watch TV. Even if someone was there; they’re just reading a book and I’m watching TV... But right now it actually just feels gloomy.
“There’s a quote which has stuck with me: “I have many people to do something with. I just don’t have anybody to do nothing with.” It’s this idea of getting used to being on your own again. I used to like being on my own, I used to really enjoy it, but now I feel like I don’t have an anchor.
“From my friends who are single and from even other people I’ve met who are widows – younger or older – it seems you do learn to become comfortable being on your own. I’m just in the process of feeling uncomfortable.”
She says her house used to feel cosy but a few months after Paul died it started feeling dark. “So I literally painted the walls white. And Joanna (her twin sister who runs the blog Cup of Jo) is helping me revamp things in my apartment.
“For months everything was the same and then it occurred to me: what would feel good now is having many pictures of Paul but not having Paul’s clothes still in all of the same drawers. So, I saved some of Paul’s clothes for Cady, some I gave to his brothers and some are in a box in my closet. But most of them I gave away. It’s no longer like ‘this is the house where Paul lives’. I decided I needed to change it.
“I think it’s helpful for me to not have particular expectations about the timing of things and how I should or shouldn’t feel. For me, grieving is about giving myself some permission to just let it be unpredictable and have some days be really emotional. Because then the next day is less painful.”
“I hadn’t known that that would be the day that I would take off my rings”
Lucy points out to me that she is no longer wearing her wedding ring but has Paul’s wedding band and her engagement ring entwined together on her right middle finger.
“For six months I was wearing my wedding ring and my engagement ring. But then I took them off to go swimming and I was like ‘maybe I’ll just keep them off’ and then I did and I just didn’t put them back on. But I hadn’t known that that would be the day that I would take them off.
“Suddenly you’re like ‘oh this is the day’. I’m not rushing myself to do anything in particular. Someday I’ll probably take these off, but not today. And someday I may get remarried, but right now I’m not actively pursuing it in any way.”
The day Paul was diagnosed with terminal cancer, he told Lucy he wanted her to get remarried.
“Being doctors [Lucy is an internist at Stanford University’s Clinical Excellence Research Center] we knew there wasn’t a cure and for him to say that was partly really crushing, because I was thinking ‘well, that wasn’t the plan’, and then I thought it’s really sad that he would even have to contemplate that idea, picturing what’s going to happen to me. And then I thought it’s really loving because he’s dealing with his own diagnosis and also thinking of me.”
“In that moment, he expressed to me this idea that ‘you’re still alive and you still have the opportunity to have a great life’.
“Even if a loved one doesn’t give you that gift of saying something like that [that you should remarry] before they die, I personally feel it’s reasonable to think somebody who loves you will want the best for you. It may be easier said than done because I know some people feel guilty or stuck. But losing someone is hard enough without feeling that way.”
Lucy’s strength and ethos is remarkable and something I want to soak in. The shock of loss can so easily consume us and turn us into an unhealthy and unproductive state.
“We [Paul and Lucy] were very connected emotionally and we really talked honestly about what was happening with the fact of his dying, how I was feeling and how he was feeling,” she says. “Everyone is so fearful of death so to actually name it and have everybody really say what they’re feeling – then there’s not the elephant in the room.”
Intellectually, it helped that Lucy and Paul were both doctors. They knew the process very well. “We weren’t protecting each other from something and in a way I think that gave us strength because we created this safe haven.”
“I treat running like it’s a medicine”
While Lucy cared for Paul, Paul made sure Lucy was also taken care of and had enough time to herself. Every other day, Lucy would carve out moments to jog by herself around their picturesque neighbourhood in San Francisco. “It helps me to sleep at night. Sleep deprivation in itself is literally a form of torture.”
To combat moments of stress and anxiety, she practices mindfulness meditation for five to 15 minutes the moment she wakes up, three days a week, using the app Headspace and a recording a friend sent to her. “It helps you recognise your emotions for what they are without giving them so much weight that they are incapacitating. It helps you function alongside strong emotions.”
It also helped her quash any self-judgement and criticism she inflicted upon herself – questions such as “What am I doing?” or “Should I be doing this?”
“Meditation makes you more aware of your mind wandering and feeling anxious rather than just going straight to the anxious emotions. You don’t fall into the spiral anymore.”
After Paul died, she also took comfort in poetry. “Poetry can be so distilled, beautiful and sharp. I used to be intimidated by poetry, I didn’t understand it. But now I find a good poem can express something and make you think ‘ah ha! That’s how I feel’. It makes you feel less alone.”
She literally googled "grief poems" and found Surprised by Joy by Wordsworth, a poem about the instinct to share a happy experience with someone who has died and suddenly feeling sad because of it. “It’s a good example of all the waves of emotions and the ways everything is unpredictable.”
I ask Lucy what moment she's felt happiest in the last 11 months, if there is one.
“The feeling of loneliness is challenging, and also getting used to a new family structure and routine," she says. "I’ve done a couple of things that help with that. One of the things during the transition when it was painful is creating something to look forward to. So I’ll invite friends to come over for dinner a few nights a week. But it’s ahead of time so that I know that it’s happening.
“Cady and I have also gone to stay with friends for the weekend a number of times. Not even on a trip like flying or driving to visit someone. We live very close to San Francisco but we’ll go stay with friends in SF for the entire weekend. It’s almost like we’re going on a little trip to visit somebody as if we’re going out of town, but we’re not.
"I also visit Paul's grave with friends. We drink a beer - we’ll pour one out for Paul - and we tell jokes. A lot of the time we’re there and we’re laughing. So there’s the flipside where I continue to act the same way I acted before.
"All of it is about being authentic to how you’re feeling and who you both are or were," adds Lucy. "This shit will just happen. It’s up and down and really not perfect. It’s really messy."
At that moment she makes me think of a sentence her husband, Paul, crafted so beautifully in his book. It's also a sentiment their life story represents: "Life is not about avoiding suffering. It's about creating meaning.”
How to write a condolence message
Since Paul's death, Lucy has been flooded with condolence messages, many which have helped her through the hardest times. Here's what helped her the most.
Send a text message
“What I learnt is that text messages are really helpful because it’s short. Even if you’re having a really hard time, you see it, but there’s not really an obligation to reply at that moment – it’s not like picking up a call. So text has this really great role of delivering messages such as: “Thinking of you, would love to talk any time,” or “Thinking of you, how can I help? XOXO,” or “Lasagne’s on your doorstep; text me if you want me to turn around and visit otherwise I’ll see you some other time soon”. People were really creative with that.”
If in doubt, describe
It’s a quote her mum lives by. “What she means is let’s say if your friend is going through something and you don’t understand it. You could be like, “I think about you all the time and am so sad to hear about X. I actually don’t even know how to be helpful. Do you want me to help you make a list? Or even ask “what could I do? At the ready!” Because when you know someone wants to help you can reply and say, “what I really want you to do is literally come sit with me for an hour while I do this pharmacy paperwork.” Just be really honest because otherwise it comes out weird.”
Remember, you won't offend anyone
“I’ve never been offended by something someone has said because it’s not like they’re trying to be a jerk. There are things that are more or less helpful and I think reaching out to someone helps them feel connected. It helps them feel they're not in a bubble.”
When Breath Becomes Air is published by The Bodley Head and is available in hardback (£12.99) or on ebook.