Speaker 1: Pushkin.
Speaker 2: He got to the airport, He's like on the tarmac literally,
Speaker 2: and got a message from his doctor that was like,
Speaker 2: I can see nodules on your chest X ray, which
Speaker 2: means I can see tumors in your lungs and obviously
Speaker 2: that's really bad. And he turned off his phone. He
Speaker 2: flew back and then I picked him up from the
Speaker 2: airport and then he told me the message he had
Speaker 2: gotten and then I said, I will never leave you,
Speaker 2: and that was that.
Speaker 1: Lucy Kalanathy remembers the moment her husband Paul told her
Speaker 1: he had terminal cancer. In that moment, Lucy says, she
Speaker 1: felt her future slip away, so she became hyper focused
Speaker 1: on the present. She decided that she would dedicate herself
Speaker 1: to helping Paul prepare for his death and make the
Speaker 1: most of his remaining time.
Speaker 2: There is so much that people go through when someone's dying,
Speaker 2: Like in terms of decision making, is this what they
Speaker 2: would have wanted? What if? And like guilt did we
Speaker 2: do it right? Is this really it?
Speaker 1: On today's show, when an unexpected death erases the life
Speaker 1: you'd imagined, how do you build a new one. I'm
Speaker 1: maya Shunker and this is a slight change of plans,
Speaker 1: A show about who we are and who we become
Speaker 1: in the face of a big change. I first came
Speaker 1: across doctor Lucy Klanethie when I read the book When
Speaker 1: Breath Becomes Heir. It's a memoir written by lucy husband
Speaker 1: Paul Kalanathi, who is also a medical doctor. He writes
Speaker 1: about his experience navigating a terminal cancer diagnosis in his
Speaker 1: thirties and his efforts to find peace with his impending death.
Speaker 1: Lucy wrote the epilogue for the book and helped to
Speaker 1: publish it posthumously. It was a finalist for the Pulitzer Prize.
Speaker 1: Lucy lost Paul more than eight years ago. Their daughter, Katie,
Speaker 1: was just a baby at the time. I wanted to
Speaker 1: hear how Lucy reflects on her life with Paul after
Speaker 1: all these years. What's changed since then and what hasn't
Speaker 1: we began with how they first met.
Speaker 2: Well, I'll tell you, like the real story. It was
Speaker 2: kind of a scandal. We were in the same class
Speaker 2: in medical school and we only had one hundred people
Speaker 2: in our class, so it actually ends up feeling more
Speaker 2: like high school, you know, and everyone is like sitting
Speaker 2: on each other's laps basically all day every day, and
Speaker 2: it's really kind of intimate because you're doing anatomy lab
Speaker 2: and you're all like learning and a little freaked out.
Speaker 2: So anyway, we I at each other there and at
Speaker 2: first I was like, Oh, there's the smartest kid in
Speaker 2: our class, Like he was running this bioethics seminar on
Speaker 2: the side and it was just really smart. And then
Speaker 2: one day I sat with him at lunch and he
Speaker 2: was super funny and it kind of came out of
Speaker 2: left field for me. I was like, oh my god.
Speaker 2: And then I sort of became interested in him after that.
Speaker 2: And meanwhile, he had a girlfriend and so that was
Speaker 2: like a little thing to work out. I was like,
Speaker 2: you need to find me after you know what's going
Speaker 2: on with that. And then I actually won a date
Speaker 2: with him in an auction, no way. We had a
Speaker 2: fundraiser and his date was actually a shooting range nearby Yale,
Speaker 2: and mostly guys put their names in the box and
Speaker 2: I was like, I'm just going to put one and
Speaker 2: I didn't even want to go to a shooting range.
Speaker 2: And then he went on a trip to Barcelona with
Speaker 2: his girlfriend and was in like an internet cafe in
Speaker 2: two thousand and three and got this email is like,
Speaker 2: Lucy has won your shooting range date. And then he's like, okay,
Speaker 2: I guess this is done. And then I saved the
Speaker 2: thing forever. It was like one of those creepy like
Speaker 2: shooting range outlines and then shows like where you shot
Speaker 2: the persons. I hated it, but I saved it for
Speaker 2: a really long time and hung it on the wall.
Speaker 2: I love that.
Speaker 1: I mean, I'm thinking back to when you know, I
Speaker 1: was trying to woo my husband, Jimmy, and I was
Speaker 1: willing to pretend that I liked philosophy more than I
Speaker 1: actually did. But you really you run laps around me
Speaker 1: in terms of your willingness to like show your interest
Speaker 1: in someone, because shooting range would have been out of
Speaker 1: it would have just been out of the question. Are
Speaker 1: we doing. Yeah, it's like philosophy paper, Okay, fine, I'll
Speaker 1: get into it. Shooting range never.
Speaker 2: Yeah, I like hated holding the gun and stuff. I
Speaker 2: was like, I hate everything.
Speaker 1: So I think the fact that you that reveals a
Speaker 1: lot to me about about your interests. True, yeah, your
Speaker 1: interest in Paul.
Speaker 2: Like yeah, you know how it's just like you have
Speaker 2: a little and you're trying to feel it out, Like
Speaker 2: you're sort of like walking around each other like animals.
Speaker 2: I feel like in a circle, like what's going on
Speaker 2: with you? What's coming on with you? So we were
Speaker 2: in like that phase. We were kind of friends, but
Speaker 2: we sort of were like falling in love secretly, unbeknownst
Speaker 2: to each other. So Paul's Indian and I'm white, and
Speaker 2: we were walking on the street in New Haven and
Speaker 2: this person who was sitting on the street yelled out,
Speaker 2: love is colorblind. And I was like, oh my god,
Speaker 2: we're not even dating, but like this stranger I can see,
Speaker 2: and I just remember being like, it's a thing. And
Speaker 2: I was like, that's my dude. And then that was it. Wow.
Speaker 2: Then we're together forever.
Speaker 1: So you and Paul ultimately get married, and about five
Speaker 1: or so years later things start to become a bit
Speaker 1: rocky in your marriage. Can you tell me a bit
Speaker 1: more about that period of time.
Speaker 2: Yeah. Sure. We fell in love at the beginning of
Speaker 2: medical school and sort of grew up as doctors together
Speaker 2: and then moved to and entered our residencies. And residency
Speaker 2: is just such a grind. There's a work hour limit
Speaker 2: on how many hours you can work every week and
Speaker 2: the limit is eighty and then people stop recording their
Speaker 2: hours because they're gonna get in trouble for staying longer.
Speaker 2: And so you're super tired. You're like ships in the
Speaker 2: night on your schedules, working overnight all the time, sleeping
Speaker 2: in the day, going back, and so I think some
Speaker 2: of it was just we were like so tired not
Speaker 2: seeing each other that much. I was still learning, we
Speaker 2: were both still learning, Like I'm highly extroverted. Paul was introverted.
Speaker 2: He was really gregarious, but also introverted in terms of
Speaker 2: how we processed his feelings, and he needed some time
Speaker 2: to process. I would be like, I just told you
Speaker 2: everything about how I feel, like say something back. He
Speaker 2: would be like, and like, I felt like he was
Speaker 2: stonewalling me, but he wasn't. He was like processing and
Speaker 2: it honestly, we'd been married for like a few years.
Speaker 2: It took me a while to see that, and so
Speaker 2: we just sort of started like budding heads or feeling
Speaker 2: not seen during that time and not quite giving each
Speaker 2: other the benefit of the doubt, but like loving each
Speaker 2: other so much during the whole time. It was very confusing.
Speaker 2: And then we were entering academic practice and I'm an
Speaker 2: internest and he was a neurosurgeon, and neurosurgery culture is
Speaker 2: also just so intense and it stays like that forever.
Speaker 2: And I was just like, is this going to get better?
Speaker 2: And his mode was like, I just have to get
Speaker 2: my academic job. I can only think about getting my job.
Speaker 2: And then he started to lose weight during that time
Speaker 2: and started to feel sick during that time, and I
Speaker 2: was like, something's going sideways, but we weren't able to
Speaker 2: talk about it, and that was just really a rocky time.
Speaker 1: Yeah, And what did you both describe those symptoms too
Speaker 1: at the time? Did you think it was just stress
Speaker 1: and burnout? I mean there's a lot of confounding variables there,
Speaker 1: I imagine totally.
Speaker 2: Totally. Yeah, So we didn't quite notice initially, but he
Speaker 2: started having back pain, He's getting tired, and then he
Speaker 2: started to get some scarier symptoms like night sweats. Night
Speaker 2: sweats are kind of spooky medically, it often means something
Speaker 2: more serious is happening, like cancer, tuberculosis something. We kind
Speaker 2: of both knew that. And then he started to have
Speaker 2: a cough and then during that time, we were going
Speaker 2: to go on a trip together to visit his college friends.
Speaker 2: A whole group of people were going to convene in
Speaker 2: New York, and we were kind of in the middle
Speaker 2: of what's going on with our marriage, and we're both hurtying,
Speaker 2: and I said, I don't want to go on the trip.
Speaker 2: I'm going to stay home and think about things and
Speaker 2: take a breath. And then he went on the trip alone,
Speaker 2: and actually during the trip was when he started to
Speaker 2: get his formal diagnosis. He describes how he was like
Speaker 2: in a train station going to meet the friends and
Speaker 2: then was having this horrendous back pain. His back was spasming,
Speaker 2: and he lay down on a bench and then the
Speaker 2: security guard came over and was like, excuse me, sir,
Speaker 2: you can't be lying down on the bench right now. Sorry,
Speaker 2: you have to stand up. And he like almost said
Speaker 2: I can't. I'm dying of cancer. And he didn't even
Speaker 2: know that he had cancer, but it sort of came
Speaker 2: into his mind or like I can't I have cancer,
Speaker 2: Like something flashed into his mind and he's like, oh
Speaker 2: my gosh. And then he told a friend. He's like,
Speaker 2: I think I might have cancer, not the good kind.
Speaker 2: And his friend was like, well, let me bring you
Speaker 2: to the airport. I'll mail your bag back for you
Speaker 2: so you don't have to carry it. So then he
Speaker 2: got to the airport. He's on the tarmac, I think literally,
Speaker 2: and got a message from his doctor that was like,
Speaker 2: I can see nodules on your X ray, which means
Speaker 2: I can see tumors in your lungs, and obviously that's
Speaker 2: really bad. And he turned off his phone. He flew back,
Speaker 2: it's like on his five hour flight. And then I
Speaker 2: picked him up from the airport and then we drove
Speaker 2: home and we were sitting on the sofa, and then
Speaker 2: he told me the message he had gotten. And then
Speaker 2: I said, I will never leave you. And that was that.
Speaker 1: I want to dig into your very immediate automatic response
Speaker 1: to Paul, like where did the clarity come from?
Speaker 2: You can be so mad at someone and hurt and
Speaker 2: love them so much, and it's like you can do
Speaker 2: all those things at the same time in a marriage.
Speaker 2: You know. I always had this idea of like, oh,
Speaker 2: this is the thing we're going to do together. Like
Speaker 2: we love each other somehow, We've grown together. We know
Speaker 2: each other so well. We have this like language built
Speaker 2: around suffering because we talk about our patients all the time.
Speaker 2: We talk about life, and then it was like, oh
Speaker 2: my gosh, it's happening to us and turns out this
Speaker 2: is how it turns out. And then this other weird
Speaker 2: thing happened where we sort of suddenly gave each other
Speaker 2: this spaciousness because because things were so extreme, Like I
Speaker 2: remember saying, I was like, how can I help you?
Speaker 2: Do you want to travel around the world with your brothers?
Speaker 2: I was just like, literally like what do you secretly
Speaker 2: wish for? Because I like want to help you get it.
Speaker 2: It was so interesting, and then he was like, I
Speaker 2: only want to be with you.
Speaker 1: So you tell him you're never going to leave him.
Speaker 1: What happens next? What are the next few days like
Speaker 1: in terms of getting that formal diagnosis.
Speaker 2: Yeah, he got admitted to the hospital the next day
Speaker 2: for what's called expedited workup, which is like you go
Speaker 2: in and you get your cat skins and all the
Speaker 2: stuff done quickly in biopsy, and we went to the
Speaker 2: hospital and then we got admitted to the hospital room.
Speaker 2: We had like hospital credentials, right, so we could log
Speaker 2: into the computer and like look at the records, and
Speaker 2: he opened up the actual radiology images of the cat
Speaker 2: skin and you're like scrolling up and down through the films.
Speaker 2: You can see the spine, you can see the lungs,
Speaker 2: and he talks about this sat skin was different because
Speaker 2: it was my own, Like I had done this so
Speaker 2: many times for patients, and he would have looked at
Speaker 2: this one and like dispatched with it and like I
Speaker 2: hate do surgery in this case. And instead he's looking
Speaker 2: at his own terrible scan. And it's like, you know,
Speaker 2: part of being a doctor is like figuring out how
Speaker 2: to be a mediator, right, like how to take these
Speaker 2: images and then relay them to somebody to help give
Speaker 2: them context stuff like what this means and what it
Speaker 2: means to them as a person and in their life.
Speaker 2: And there wasn't any of that. There was just like bang,
Speaker 2: you know.
Speaker 1: Ye.
Speaker 2: Also, as soon as he was diagnosed, he was like
Speaker 2: this was so crazy. It was the same day he
Speaker 2: was like, I want you to get remarried.
Speaker 1: The same day as the diagnosis.
Speaker 2: Literally the same day. Yeah. It was so interesting because
Speaker 2: I was like, oh, he's saying so much. By saying that,
Speaker 2: he's saying I see what's happening, You see what's happening.
Speaker 2: I care about you and love you into a future
Speaker 2: where I won't even be there, and I'm going to
Speaker 2: say the whole thing out loud. It's scary stuff to
Speaker 2: talk about, and I think a lot of times people
Speaker 2: are really scared to admit to each other what's happening,
Speaker 2: or like try to hide it. And so somehow, amidst
Speaker 2: the spaciousness, it also was kind of stark between us
Speaker 2: in a way that was really kind of raw and honest,
Speaker 2: and then we sort of like filled that in with
Speaker 2: scaffolding once we were able to like come back down
Speaker 2: to earth, because it takes away and it takes like
Speaker 2: months to even feel like you're in your body or
Speaker 2: like you have any sense of how you might piece
Speaker 2: together a different future.
Speaker 1: I am curious to hear more when you talk about
Speaker 1: opening up that space for one another, what did that
Speaker 1: look like for me?
Speaker 2: I think I backed off of expectation. I was just like,
Speaker 2: this is so huge. You know, he's like facing this
Speaker 2: complete upheaval and identity. He's understanding that he's dying sooner
Speaker 2: than expected. And I wasn't in his face like tell
Speaker 2: me how this is going, how's it going, how's it going?
Speaker 2: Like what are you thinking? You know? I was just
Speaker 2: like I am going to give him space and he'll
Speaker 2: talk to me sometime. And he started whispering to me
Speaker 2: in the middle of the night. He'd be like, I
Speaker 2: don't want to die.
Speaker 1: Wow.
Speaker 2: And then we would just be together under the blanket.
Speaker 2: And so I think I just instinctively gave him space,
Speaker 2: and then he sort of came to me, We'll.
Speaker 1: Be right back with a slight change of plans. Lucy
Speaker 1: Kalanathy and her husband Paul, met in medical school. They'd
Speaker 1: been married for seven years when Paul found out he
Speaker 1: had terminal cancer. Their daughter Katie hadn't been born yet.
Speaker 1: They were just two young doctors focused on their careers.
Speaker 1: I was curious to know whether their jobs as medical
Speaker 1: professionals affected how they processed Paul's diagnosis. As doctors, I mean,
Speaker 1: illness is front and center. You know, you engage with suffering, dying,
Speaker 1: and death constantly, even though you can never imagine what
Speaker 1: it's going to feel like when it happens to you.
Speaker 1: Do you feel like that exposure maybe helped foster faster
Speaker 1: acceptance in both of you, or made you feel more
Speaker 1: prepared for this moment or what was to come.
Speaker 2: Yeah, I think absolutely, and I think some of it
Speaker 2: was special to Paul just as a person, because he
Speaker 2: had actually never thought he would be a doctor. He
Speaker 2: studied English literature and then did a master's in bioethics
Speaker 2: and thought about being a literature philosophy professor, and was
Speaker 2: very interested in thinking about mortality and meaning. And then
Speaker 2: I think he wrote this interesting thing in his book
Speaker 2: where he says something like people ask themselves a lot
Speaker 2: why me, And he's like, I think a more helpful question,
Speaker 2: or maybe a more apt question, is why not me?
Speaker 2: And I think there's nothing that would exempt any of
Speaker 2: us from suffering of some kind and being doctors and
Speaker 2: just seeing so many seemingly unfair things happen to people
Speaker 2: all the time, Like as a neurosurgeon, it's literally like tumor, trauma, aneurism,
Speaker 2: all kinds of various neurologic disorders that totally screw with
Speaker 2: your identity and your sense of meaning. And so we
Speaker 2: had thought about it before, which I think helped somewhat.
Speaker 2: And then it was like, oh, my God, turns out
Speaker 2: this is our life too, which is not easy, right.
Speaker 2: It's sort of like you zoom in and out. It's
Speaker 2: not like he was like one and done acceptance. There
Speaker 2: was like luck on the first day in terms of acceptance,
Speaker 2: and then you just have to keep wrestling and pinning
Speaker 2: it down or letting it go and pinning it down right,
Speaker 2: meditating and getting it down. I'll just say an interesting
Speaker 2: thing about Paul, because it was so him. We were
Speaker 2: packing to go to the hospital, and I was like,
Speaker 2: insurance card, fuzzy socks, phone charger, We're going to like
Speaker 2: walk into this situation where he's going to find out
Speaker 2: he has terminal cancer. And then he packed books and
Speaker 2: he took like he took Being in Time by Heideger,
Speaker 2: this book called Mere Christianity by C. S. Lewis, and
Speaker 2: then a novel by the Russian author Sulsanitzen called Cancer Ward. Gosh,
Speaker 2: it's like this little like religion, philosophy and literature. And
Speaker 2: I was like, that is so interesting. Like he didn't
Speaker 2: take like medical textbooks. He's like, what I'm going to need,
Speaker 2: here's books.
Speaker 1: It says to me that he didn't see his sole
Speaker 1: job as simply fighting cancer.
Speaker 2: In that moment.
Speaker 1: It feels like he was continuing the project of finding
Speaker 1: meaning making in his life despite all the stuff that
Speaker 1: was going on around him.
Speaker 2: Yeah, there's a lot of things you could fight for right,
Speaker 2: You could fight for being able to do something you
Speaker 2: really love, or like fight to stay home or fight
Speaker 2: to have your family be okay after you go. And
Speaker 2: then I also think dying is a thing that people do.
Speaker 2: It's really hard, it's hard to get your head around,
Speaker 2: it's physically hard. And he thought a lot about how
Speaker 2: do people think about dying? And I think for him,
Speaker 2: encountering his mortality and going through that process pretty unflinchingly
Speaker 2: was a thing he was trying to do in his life.
Speaker 1: Yeah, I mean, it feels like his desire to, like
Speaker 1: you said, find peace with his mortality, his desire to
Speaker 1: find meaningful things to occupy the remaining time that he
Speaker 1: had on this planet, expressed itself in many very impressive ways.
Speaker 1: I mean, he returned to his work as a neurosurgeon,
Speaker 1: he wrote a memoir, and I think the biggest choice
Speaker 1: of all was ultimately you both decided to even have
Speaker 1: a child during this period of time.
Speaker 2: So despite all that we've talked about with having these
Speaker 2: challenges in our marriage, we had also been planning to
Speaker 2: have a baby around the same time, like that was
Speaker 2: swirling around, I mean, very soon after his diagnosis, we
Speaker 2: thought about it because we had to go to a
Speaker 2: sperm bank before he started treatment, and so we thought
Speaker 2: about it in different ways. I think he was more
Speaker 2: certain than I was at the beginning he really wanted
Speaker 2: to have a child. I was worried that it was
Speaker 2: just like the potential for more pain and uncertainty. I
Speaker 2: was like, whoa, that's like a whole uncertain process. And
Speaker 2: then the other thing I was scared of was I
Speaker 2: was worried that it would just be really painful for Paul,
Speaker 2: like as he got sicker, if and when he got sicker,
Speaker 2: like to say goodbye to a child, It's just like
Speaker 2: that's bananas, And how could you choose that? And so
Speaker 2: I was like, don't you thinks it's going to make
Speaker 2: this way harder for you? And he said, wouldn't it
Speaker 2: be great if it did make it harder? And that
Speaker 2: was like totally crystallizing for me. There's a million things
Speaker 2: we do in our lives that do not make our
Speaker 2: lives easier, you know, everything, Yeah, climbing a literal mountain
Speaker 2: just to get to the top and go back down.
Speaker 2: I mean like everything that's meaningful. And so nobody's having
Speaker 2: a kid because they think it's going to be easy,
Speaker 2: like that's not a thing. So and then our family
Speaker 2: was really into the idea. My mom was worried about me,
Speaker 2: but we just had family support to think about it.
Speaker 2: And so then yeah, we had our daughter and she
Speaker 2: was born eight months before Paul died.
Speaker 1: M What was it like to prepare for Paul's death?
Speaker 2: I should like think about it. Actually, at that time,
Speaker 2: he was like furiously writing when breath becomes their, like
Speaker 2: he had his editor and his literary agent and so
Speaker 2: like his body was like declining and collapsing, and then
Speaker 2: his like mind and focus on writing was like accelerating
Speaker 2: basically up until like the last three days.
Speaker 1: Wow.
Speaker 2: And so it felt like it was really weird contrast,
Speaker 2: and then there was like a ton of logistics around it.
Speaker 2: And then it was just painful, I mean physically but
Speaker 2: also just like really sad. Yeah, I talked to my mom.
Speaker 2: I was like, I think I kind of have to
Speaker 2: be planning his funeral and I'm like watching him sleep
Speaker 2: at the same It's just like a lot, but it
Speaker 2: was like a beautiful time too. We're together, Katie's there,
Speaker 2: the family was definitely like around all the time. It
Speaker 2: just felt really like saturated, like we do so much
Speaker 2: wishing away time. I mean I do this all the
Speaker 2: time now, But when Paul was dying, it's like I
Speaker 2: had no idea what it was going to be like
Speaker 2: after and I knew time was short, and so did he.
Speaker 2: And so you're not wishing away time. You're not like, ugh,
Speaker 2: can't wait till this baby sleeps through the night or whatever,
Speaker 2: you know, like, oh, what's her future doing to graduate
Speaker 2: from high school? There was none of that. It was
Speaker 2: just like we're here with the tiny baby, and everyone
Speaker 2: loves each other and that's what's happening. And so that's
Speaker 2: sort of how like mindfulness is good for your brain
Speaker 2: or good for you. It's like there is only now.
Speaker 1: Yeah, yeah, can you bring me back to Paul's final day?
Speaker 1: What was that final day like with Paul and Katie
Speaker 1: and the rest of your family?
Speaker 2: Yeah, I mean the final day had a lot of
Speaker 2: medical stuff going on, which was so confusing to figure
Speaker 2: out even as doctors, right, because you're always working with
Speaker 2: limited information, especially in his situation, like is this really
Speaker 2: the end? He was really sick, we were thinking about
Speaker 2: entering hospice, and then he got really sick suddenly, and
Speaker 2: like couldn't breathe, and then he sort of he had
Speaker 2: to make this important decision. He was lucid enough to
Speaker 2: make it. So a lot of the time when people
Speaker 2: are this sick, they actually can't decide this for themselves,
Speaker 2: but he happened to be able to and was awake enough,
Speaker 2: so he didn't want to risk going on a ventilator
Speaker 2: and being in a coma and having us have to
Speaker 2: make a difficult decision about when to stop. He just
Speaker 2: was like, we have seen that enough, and I think
Speaker 2: he was like, that is not for me. He looked
Speaker 2: at me and said I'm ready, which was like, oh,
Speaker 2: it's going to make me like burst into tears. It's like, gosh.
Speaker 2: He really was like I'm ready, I'm ready to stop.
Speaker 2: He was like, I actually just want to go home.
Speaker 2: Can I go home? That was part of it, like
Speaker 2: can I go home? I know I'm dying, but could
Speaker 2: we get home? And he was just like, way too
Speaker 2: unstable to go. He couldn't transferred to an ambulance. He
Speaker 2: really might suffer and die on the way home. In
Speaker 2: a way that just wasn't going to work and it
Speaker 2: wasn't worth it. And I was like, how can we
Speaker 2: make it feel like home here, and he was like,
Speaker 2: Katie needs to be I mean, it was obvious. It
Speaker 2: was obvious Katie needed to be there. And then he
Speaker 2: had to get some morphine ahead of time because it
Speaker 2: helps you feel better when you assure a breath, and
Speaker 2: then he kind of went to sleep, and then he
Speaker 2: was sort of unconscious for about nine hours and then
Speaker 2: took a last breath. I was surprised how hard it was,
Speaker 2: even with him awake, to say what his preferences were,
Speaker 2: even with us being doctors, to really get a sense.
Speaker 2: There is so much that people go through when someone's dying,
Speaker 2: Like in terms of decision making, is this what they
Speaker 2: would have wanted? Is this really it?
Speaker 1: What if?
Speaker 2: And like guilt? Did we do it right? I just
Speaker 2: feel like all you can do is do your best,
Speaker 2: you know. I have so many patients who are like,
Speaker 2: I don't know if we decided right. And actually he
Speaker 2: hears like a line that Paul said that really helps
Speaker 2: me with that same thing. He knew that I would
Speaker 2: be really trying to make decisions on his behalf if
Speaker 2: he couldn't speak for himself, and he was like, maybe
Speaker 2: it goes sideways, right, even if it's not the way
Speaker 2: you would have wanted, or you think it's not the
Speaker 2: way I would have wanted. The last day of your
Speaker 2: life is not the sum of your life. The sum
Speaker 2: of your life is the sum of your life. And
Speaker 2: it was so helpful, right because it's also like it's
Speaker 2: the last day, but it's just a day. It's kind
Speaker 2: of like the last day of anything is not the last.
Speaker 2: The end of a relationship is not the whole relationship.
Speaker 2: That was really helpful. Doesn't all come down to the end.
Speaker 1: I love that. I thought for so long that as
Speaker 1: a society we tend to overweight the deathbed regrets, the
Speaker 1: deathbed wishes, the deathbed feelings, and yeah, it's just one day,
Speaker 1: and so I really I reson. I don't think it's
Speaker 1: it's not discounting final moments, it's just saying maybe we
Speaker 1: ought to give them similar weight to all the other
Speaker 1: moments that preceded them. Yeah, you know, I know you
Speaker 1: had said like you couldn't even imagine what it would
Speaker 1: be like in the days following Paul's death.
Speaker 2: Yeah, I mean it was so hard. It is so
Speaker 2: crazy when it's like I knew he was going to die,
Speaker 2: and then still when he died, it was so shocking.
Speaker 2: It was like he was here and then he disappeared.
Speaker 2: It was that shocking. It's like he disappeared. And for
Speaker 2: six months, I like still had his shoes next to
Speaker 2: the front door, and he still had like a sock
Speaker 2: drawer in a bookcase, and I just like didn't want
Speaker 2: to change anything yet, and I was like, someday I
Speaker 2: want to, Like today it's not that day. And same
Speaker 2: thing with taking off my wedding ring. You sort of
Speaker 2: like molt over time, and I like really felt it physically.
Speaker 2: My hands were like burning and tingling. For a long time.
Speaker 2: I thought maybe I had some like neurological disorder. I
Speaker 2: was like, oh my gosh, what if I can't work
Speaker 2: and take care of me and Katie. I had all
Speaker 2: these catastrophic thoughts, and I really think that was actually
Speaker 2: just like a physical manifestation of grief. And then it
Speaker 2: ultimately just ended up being really helpful for me to
Speaker 2: work on Paul's book. I had to like work on
Speaker 2: it. It came out nine months after Paul died, and I
Speaker 2: was like really involved with the editor, everything from approving
Speaker 2: the copy edits, to writing the epilogue to like putting
Speaker 2: these other essays that he had written to supplement pieces
Speaker 2: that weren't finished yet to choosing the cover, So that
Speaker 2: was really helpful.
Speaker 1: And do you feel that that was Is that something
Speaker 1: you learned from Paul, like the importance of meaning making
Speaker 1: and how that can that can help heal?
Speaker 2: Yeah, I mean totally, I think, and like a lot
Speaker 2: of people going through something hard or who lose somebody
Speaker 2: or whatever like end up making something out of it
Speaker 2: that they never would have wanted to or wanted to
Speaker 2: have to. But I really like the book Man's Search
Speaker 2: for Meaning by Victor Franklin. It's all about building meaning
Speaker 2: and how meaning itself is sustaining and meaning itself is
Speaker 2: life giving in a way. He quotes Nietzsche who says
Speaker 2: he who has a why to live can bear almost anyhow.
Speaker 2: And it's sort of like Maslow's hierarchy, like turned upside down, right.
Speaker 2: It's like, if you have meaning, you can actually handle
Speaker 2: a lot of destruction around you because you have something
Speaker 2: to live for. But I think that's why these upending
Speaker 2: transitions are just so impossible, because you know you have
Speaker 2: this idea of who you're going to be in the future.
Speaker 2: Paul thought he would be free of illness. I thought
Speaker 2: I would be free of losing him. And I think
Speaker 2: when something so unexpected happens to you, you have to
Speaker 2: like rebuild an identity and rebuild meaning, and that takes
Speaker 2: a while, and it's like totally disorienting during the time
Speaker 2: that you don't have it.
Speaker 1: Yeah, and I think, you know, on a related point
Speaker 1: about the visions we have of the future, I think
Speaker 1: one of the many reasons I was so eager to
Speaker 1: talk with you for the show is that listeners can
Speaker 1: learn so much from you about what your grief trajectory
Speaker 1: has been.
Speaker 2: Like, Yeah, I mean, immediately after Paul died, I had
Speaker 2: a couple of anchors. It was like I had to
Speaker 2: take care of Katie, I had my job as a doctor,
Speaker 2: and I was working on Paul's book and the old
Speaker 2: Like it's like those things were just keeping me on earth,
Speaker 2: like keeping me on the ground, right, not just like floating.
Speaker 2: And then I feel like things started to fill back in,
Speaker 2: and like, since Paul died, I've fallen into love again
Speaker 2: and out of it and built my career in new
Speaker 2: ways where I've done a lot of work on things
Speaker 2: like caregiving and end of life care. And so I
Speaker 2: don't know, it's like things surprise you and feel their
Speaker 2: way back in back in.
Speaker 1: Yeah, how would you describe your relationship with pain and
Speaker 1: suffering and how would you describe your current relationship with Paul.
Speaker 2: Yeah, Sometimes we think about sufferings like it's this kind
Speaker 2: of like thing on the side that like, hopefully I
Speaker 2: won't have to do that much. I feel like I'm
Speaker 2: sort of like you're offering is a feature, not a bug.
Speaker 2: It's like everybody will have some kind of suffering. There's
Speaker 2: like no such thing as an uncomplicated life. And you know,
Speaker 2: I think one of the things I like that Victor
Speaker 2: Frankel says is he talks about how there's three places
Speaker 2: where meaning comes from. This is his formulation, but I
Speaker 2: like it. He's like work is one of them, love
Speaker 2: is one of them, which is like love for a
Speaker 2: fellow human beings, but also like gratitude, loving being alive.
Speaker 2: And then he's he's like work and love and suffering,
Speaker 2: and he's like suffering itself. And the way you respond
Speaker 2: to suffering can be meaningful, whether it's like you're working
Speaker 2: on injustice or you are proud of yourself for something
Speaker 2: you got through, or the pure fact of enduring suffering
Speaker 2: can be meaningful, and that resonates with me a lot.
Speaker 2: I think suffering can be tied to meaning, But at
Speaker 2: the same time, I think it's certainly not up to
Speaker 2: anybody else to tell you what the meaning of your
Speaker 2: suffering is. It's like only yours, and it can take
Speaker 2: a long time to figure that out. And some suffering
Speaker 2: I think doesn't have meaning. It just sucks. And then
Speaker 2: my relationship with Paul, I love Paul. I love Paul forever.
Speaker 2: My sadness has lifted some and my love is exactly
Speaker 2: the same. I think it'll always be like that. I
Speaker 2: feel proud of him. I feel like he's my family,
Speaker 2: He's Katie's dad. He's just sort of like in the mix.
Speaker 2: I think he's around, He's just part of my life.
Speaker 2: And hopefully I'll fall in love again. I really believe
Speaker 2: in love right now. I believe it'll like find me
Speaker 2: on my sofa in a pandemic. That's how much I
Speaker 2: believe in it.
Speaker 1: Hey, thanks so much for listening. Make sure to join
Speaker 1: me next week when I talk with doctor Richie Davidson,
Speaker 1: a pioneer in meditation science. He walks us through some
Speaker 1: fascinating research on meditation like his study on the world's
Speaker 1: most experienced meditators. I'm talking like thirty four thousand hours
Speaker 1: of meditation. It turns out they experience pain totally differently
Speaker 1: than the rest of us. Stay tuned for more next week.
Speaker 1: In the meantime, if you're interested in hearing another story
Speaker 1: of someone navigating grief, check out our episode Losing Dixie.
Speaker 1: In it, I speak with my family friend Quinn Lewis,
Speaker 1: who lost her teenage sister in a tragic accident just
Speaker 1: months prior. She gives us a rare window into what
Speaker 1: it looks like to be in the acute phases of grief,
Speaker 1: and I learned so much from our conversation. I'll link
Speaker 1: to it in show notes. A Slight Change of Plans
Speaker 1: is created, written, and executive produced by me Maya Schunker.
Speaker 1: The Slight Change family includes our showrunner Tyler Green, our
Speaker 1: senior editor Kate Parkinson Morgan, our producer Trisha Bobita, and
Speaker 1: our sound engineer Andrew Vestola. Louis Scarre wrote our delightful
Speaker 1: theme song, and Ginger Smith helped arrange the vocals. A
Speaker 1: Slight Change of Plans is a production of Pushkin Industries.
Speaker 1: So big thanks to everyone there and of course a
Speaker 1: very special thanks to Jimmy Lee. You can follow a
Speaker 1: slight change of plans on Instagram at doctor Maya Schunker,
Speaker 1: See you next week.