When Breath Becomes Air: A Conversation About Life, Death, and Humanity in Health Care
Setup
Illness and death are universal challenges, but not something we anticipate in our 30s. Kate Bowler and Lucy Kalanithi understand that any of us can confront these harsh realities at any time. Bowler was 35 when she was diagnosed with stage IV colon cancer. She tried to make sense of it in Everything Happens for a Reason: And Other Lies I’ve Loved. Kalanithi, an internal medicine doctor, completed her husband Paul’s manuscript, When Breath Becomes Air, after the neurosurgeon died of lung cancer at the age of 37. The two women discuss life, death, and the pursuit of humanity in American health care.
Ideas
- 2018 Health
Why it was so important to write about such deeply personal experiences
Kalanithi and Bowler begin by discussing the reasons behind their books. Kalanithi’s husband, Paul, was a voracious reader, and found some comfort in the final stages of his cancer by writing about it, naming it, trying to understand suffering through words. It was better than trying to seek comfort in statistics, Kalanithi noted. Bowler says she wrote her book to be honest about herself, not because she thought she was an important person with deep insight to share. But holding her “life up to the light” was intense and slightly uncomfortable, she admitted.
People react to getting sick differently, and that experience can be harshly enlightening
Bowler and Kalanithi discuss their reactions to the cancer diagnoses in their lives, and what it ultimately taught them. Bowler explains how her status in her family seemed to change when she became this “thing that happens to people,” and how it made her feel alienated. Kalanithi talks about her and Paul’s decision to have a child after he got sick, her worry for how the decision would increase his suffering, and how Paul reassured her.
Big IdeaThere’s so many things we do in our lives, that we don’t choose to do because they’re easy, but that we chose to do because they’re rich and meaningful and deep. And I’m not sure if there’s a point to suffering, except it connects you to all other human beings across time forever.Lucy Kalanithi
How to be helpful to a loved one who’s sick or dying
Bowler talks about how the language we use around someone who is sick or dying can make such a difference. She struggles with what she says is the American desire to always put things into perspective, to always have a lesson. But what she really needed from others during her intensive cancer treatments were the basics: help with errands, babysitting, food. “The best people realize there’s nothing special they’re going to bring,” says Bowler. “They just do a thing so that lifting this heavy weight doesn’t seem so heavy anymore.”
Takeaway
You might change your perspective on how to raise children when you’ve suffered
Bowler and Kalanathi discuss how they’re raising their children in the face of suffering and death.
-
Lucy Kalanithi: Can you tell us what it’s like to raise a child in the midst of this and what you’re teaching your son that maybe is different from what you would have? Or, just in general, what you feel like with your son, who’s four.
-
Kate Bowler: I thought my job before was to create the hamster bubble around him, and say we live in it here, and my job is to give you interesting hobbies and life enrichment and a vague but important sense of the problems of the world. But it’s my job to love you and let you grow in this perfectly insulated little ecosystem. Then I became aware that the worst thing in his life might be me, and that almost broke my heart.
-
Lucy Kalanithi: How old was Zach when you were diagnosed?
-
Kate Bowler: He was still one. And all my strongest memories of when I was the hospital, and I couldn’t pick him because of the surgical scars.
-
Lucy Kalanithi: And I’m sure you wondered whether he would remember you.
-
Kate Bowler: Oh my gosh, it was just the helplessness — exhausting. I think what I learned for myself and for Zach is that my job is not to pretend that I can use certainty or determination to solve every problem. But that if I can show him that the purpose of life is not to avoid pain but to find a way through, then I can raise the most compassionate softy in the world.
-
Lucy Kalanithi: I agree with that. I used to think, you try to raise a happy child. Now I’m like, no, you try to raise a resilient child.
-
Kate Bowler: Yeah. Brave in the face of reality.
-
Lucy Kalanithi: We talked earlier about the things that are important for your family to know about you and even your doctors to know about you. We talked about, what are the things you don’t ever want to give up? You only talked about Zach. You said, I would put up with a lot of suffering to be there for Zach, and you also talked about how you don’t want him to suffer. You yourself would make tradeoffs that would allow him to suffer less. I thought it was so lovely. I think it’s really important to know your own North Star.
-
Kate Bowler: Yeah, and that if fragility is a given, if we’re all paper sometimes, then the point is to choose between competing loves. I’m loving this life, but there are other things that I would trade a lot of things for. And thank god they happen to be the things that I chose in the first place.
Learn More
Additional Information
Explore More
USA
Global conflicts and health crises have put into stark relief deeply-ingrained gender roles in society. Yet the past years have also seen record-high numbers of women running...
The world seems to be moving and evolving faster than ever before, and democratic ideals are under threat in many countries around the globe. New York Times columnist and jour...
How is constitutional law being harnessed to address climate change? Ahead of Aspen Ideas: Climate, we caught up with Andrea Rodgers, Senior Attorney at Our Children's Trust,...
History has the power to teach us what to do in the present, but do we actually make good use of that tool? Many events in our recent past might suggest otherwise. American hi...
Of course, Black history shouldn’t just be a month-long nod on our yearly calendar — it is inextricable from American history and fundamental to the very soul of our nation an...
The unflinching humanity and morality that Martin Luther King, Jr. embodied is part of what makes his legacy so lasting. In addition to his preeminent civil rights work, he sp...
The stories we hear about migrants trying to escape difficult circumstances tend to focus on hardship, conflict, statistics and policy. We rarely get a deep look at any of the...
Most Americans today would agree that the dream of supporting a family and living a good life on one full time salary is not available to vast numbers of people. Wages have no...
Climate change catastrophes are already happening with increasing regularity, and it’s clear we need to take action. The Biden administration has set a target of zero carbon e...
Even when the economy is booming and unemployment is low, millions of Americans still face economic hardship. And in the last few years the United States has dealt with supply...
Almost everyone agrees that immigration policy in the United States is lacking, but despite decades of debate, Congress has not been able to pass comprehensive reform on the i...
Americans seem more culturally and ideologically divided than at any point in most of our lifetimes, with no prospect of bridging those divides any time soon. The only thing w...
It’s a fact: In communities where voting rates are higher, health outcomes are better. That’s why ER physician Alister Martin, the Founder of Vot-ER and CEO of A Healthier Dem...
Populations around the world have been electing more and more autocratic leaders in the past couple decades, via supposedly free, fair, and democratic elections. The freedom o...
Merely defining gun violence is difficult, and coming to agreement on what to do about it often seems near-impossible in the United States. But people on all sides of the deba...
The U.S. Supreme Court continues to issue major decisions that have profound impacts on the lives of Americans and the political future of the country. During the term that ju...
At the 2023 Aspen Ideas Festival, we dug into some of the most important and fascinating issues of our time, from rebuilding trust in our institutions and the promise and peri...
If one dives deeply into the statistics, the American Dream is actually quite alive and well. In his provocative book, The Myth of American Inequality, former U.S. senator Phi...
How do we describe the Republican Party today, and what are the dynamics that will shape its future?
In their new book, co-authors and Stanford professors Rob Reich and Mehran Sahami argue that big tech’s obsession with optimization and efficiency has sacrificed fundamental h...