What advice would Stanford physician Lucy Kalanithi, MD, give to students beginning their medical journey? That was one of the questions that Dean Lloyd Minor, MD, asked Kalanithi -- whose late husband Paul, a Stanford neurosurgeon, wrote the memoir When Breath Becomes Air before dying of lung cancer in March 2015 -- at a talk for incoming MD and MSPA students on campus last week.
Kalanithi’s answer: to expect the unexpected.
“I never thought I’d be speaking so publicly about such personal stuff,” she said. She added that while she used to think that medicine offered a direct path, she has since learned that many unforeseen events can take people down unanticipated roads. The key to adapting to change is to be open to uncertainty, she said, and to “keep rising to the occasion.”
That’s exactly what Kalanithi had to do four years ago when she and Paul transitioned from being providers to patients. Since When Breath Becomes Air — in which Paul reflects on end-of-life care, medical training, and meaningful living — was published in January 2016, the book has been on the New York Times Best Seller list for 64 weeks.
“What struck me most” about the book, said Minor in his opening remarks, “was Paul’s perfect articulation of the vivid bond between physician and patient.”
Minor, who is collaborating with Kalanithi as part of a winter seminar called “Literature, Medicine, and Empathy,” also asked Kalanithi what she learned about the patient’s perspective during her husband’s illness.
“I was desperate for people to empathize and listen,” she said. On a given day, while a care provider may be thinking about the long list of cases they need to handle, the patient has waited weeks and weeks for that one encounter, she explained.
“There’s real data on patient adherence being related to how much they feel allied with you as their provider,” she told Minor and the students. “You are the medicine.”
Acknowledging that When Breath Becomes Air describes this responsibility as both an enormous blessing and a burden, Minor asked Kalanithi about physician wellness. She said that medical institutions have a clear role to play in removing the stigma of asking for help.
“If you feel burned out, or if you feel depressed or anxious, it’s not that there’s something wrong with you. It’s a greater system issue,” she said, adding that Stanford Medicine is becoming a national leader on these topics.
As for her own well-being, Kalanithi talked about navigating life in the years since Paul’s passing. She said that she thinks often about how to describe Paul to their daughter, Cady, who is now three years old.
“I’m really happy that he wrote this book because he did it in part for her,” she said.
In response to an audience member’s question about whether her definition of happiness has changed since losing Paul, she said, “I used to think, ‘I want to be happy all the time’ or ‘I want to raise a happy kid,’” she said. “Now I really want to have meaning in my life and I really want to raise a resilient kid.”
Previously: Life lessons after death: Stanford Medicine's Lucy Kalanithi at TEDMED, When Breath Becomes Air: A conversation with Lucy Kalanithi and Paul Kalanithi's book will probably make you cry
Image courtesy of Stanford Video