When Breath Becomes Air: A Conversation About Life, Death, and Humanity in Health Care
I used to think, you try to raise a happy child. Now I think, no, you try to raise a resilient child.
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
Economy
The United States spends $4.3 trillion—almost one fifth of the nation’s GDP—on health care. As the scale of the medical enterprise expands, venture capitalists are pursuing th...
In a time of growing wealth disparity and changing societal values, can capitalism adapt? How is the economy being transformed by investments in infrastructure, AI, energy, an...
In a time of growing wealth disparity and evolving societal values, can capitalism adapt to sustain the American Dream?
Women are twice as likely to invest in female-led businesses. Explore the ways women approach wealth building and investment, and how they create opportunities to build financ...
Join Jim Farley as he explores how drivers' needs and priorities are guiding the future of vehicle technology and reshaping our expectations of cars and trucks.
With ESG caught in the political culture wars, business executives must decide to speak up or stay quiet about climate, diversity and democracy. What do employees and citizens...
Africa is a rising giant. By 2050, one in four people on the planet will be African, and by 2060, Africa will have the largest labor force in the world. A former Nigerian pres...
Peter Thiel has made no secret of his feelings about economic and cultural issues. Hear him discuss his vision for the future, his bets on AI and digital currencies, his thoug...
Of the 1.2 billion youth aged 15 to 24 worldwide in 2019, close to half were out of school, out of work or underemployed, and this number will continue to grow. Listen as glob...
If you want to know where the economy is headed, ask an economist. If you want to know why (and more), ask a treasury secretary, an economic diplomat, a director of the Nation...
The market is at record highs. Unemployment is at record lows. And most economists will tell you the American economy is the envy of the world — but far too many working famil...
Poverty doesn’t care what color you are. Declining manufacturing jobs, income inequality and inadequate social safety nets affect all Americans. The problem of poverty demand...
With a staggering $84 trillion projected to change hands by 2045, the United States is on the brink of a historic intergenerational wealth exchange. How are our institutions p...
The U.S. is spending record amounts on infrastructure, with billions of federal dollars going to bridges, clean drinking water, broadband, and climate and energy. The governo...
In a recent op-ed, former U.S. climate envoy and secretary of state John Kerry declared that rich countries are failing to respond to the climate crisis. If extreme weather wi...
Renewables are on the rise, but so is fossil fuel consumption as global development demands more and more. Does the oil and gas industry have a role in reaching net-zero goals...
Niall Ferguson, the celebrated historian who predicted Cold War II in 2018, has assembled the sharpest minds from both sides of the Bamboo Curtain for a discussion on the futu...
Two legends — a baseball superstar and a Wall Street titan — discuss how they are leveraging their passion for professional sports as a team stakeholder and an owner.
Climate change is a threat multiplier with a disproportionate impact on vulnerable populations. Girls and women, who are denied equitable access to education and economic oppo...
