10 years after losing her husband, Lucy

joins me to explore what grief looks

like after a decade.

>> He ultimately got the news that he had a

chest X-ray that essentially looked like

a cloudy sky. I mean, it was like dense

with tumors. We both knew what it meant.

I never thought I was going to feel

okay. It was like Paul died and I was

like, it's all over.

>> What did being so close to death teach

you about life and living?

>> There's two big questions. What would be

left undone? and how can I live most

fully in the time I have left?

>> Hey everyone, welcome back to OnPurpose,

the place you come to become happier,

healthier, and more healed. Today's

guest is Dr. Lucy Kanathy, 10 years

after losing a husband, bestselling

author and neurosurgeon Paul Kanathy.

Lucy joins me to explore what grief

looks like after a decade, how love

evolves after loss, and what being so

close to death can teach us about being

fully alive.

Lucy Kanathy, welcome to On Purpose.

>> Thanks for having me. I have waited for

this conversation

since I've read the book and when breath

becomes air and I read it

when I still lived in New York when I

moved to the states and it moved me so

much because I hadn't really come across

a book like that that felt like it was

written at such a powerful moment and

such a pivotal moment in someone's life

>> and then to have your reflections within

it as well. It's kind of left an imprint

on me and then my team and I were

sitting down and we're thinking about

books that had had an impact on us as a

team and and this came to mind

immediately and so I can't tell you how

grateful I am for your time and energy

for the trip over here. I know you've

traveled here especially to be with us

in LA and just want to start off by

saying thank you.

>> Thank you so much.

>> Tell me what does it feel like

remembering Paul 10 years on. I used to

think life was like a mountain that you

climb. Like I'll follow the path and

then I'll get where I'm going. And now

like having lost Paul, having taken our

daughter from being a baby to now being

a seventh grader, I think of life much

more as like a series of moments. In a

way, it's like that my marriage and

Paul's illness and even medical school,

right? Those were all mixed together.

Medical school, residency, being

married, losing him. That was like a

chapter. And now I'm in such a different

chapter. It's actually kind of amazing

for the opportunity to like dip back in

like to get sort of like talking about

Paul in a way that's really embodied

because you're also experiencing him and

we're talking about him in like in a

real way. And at the same time, he's

like sprinkled through my life all over

the place. Like, you know, I'll go

through like a breakup and think like

what would Paul say, you know, in this

situation to me, to him. And also just

like what would Paul think of Katie?

She's so different. She's such a like

singular specific person, not a baby,

you know? So, I guess like the things I

can say about it are like 10 years on,

you know, I never thought I was going to

feel okay. It was like Paul died and I

was like, it's all over. Who am I? What

happened? Like, it's me and I'm here and

I have this baby, but I'm so lonely. How

is this ever going to fill in? And my

mom said like things will fill in. It'll

become okay. And I was like, I literally

don't believe you. But it's like things

do like things become okay. And then at

the same time, like even after you lose

someone, like they don't even remain

static even though they're gone. Like

you're not static. You continue to learn

new things about them. You know, with

Paul, I hear from Paul's readers about

his book. And that's sort of like an

ongoing relationship with him through

other people. Anyway, I guess it's all

just like a beautiful, terrible mix.

Thank you for sharing that. Is there is

there anything you understand

differently about Paul?

>> Yeah. I mean like the thing that makes

me feel like when it burst into tears is

actually a thing I don't yet understand

which is you know Paul he was a doctor.

He was a young neurosurgeon

really interested in meaning and

mortality like thought he would become a

professor of philosophy or a writer and

then sort of surprised himself by going

into medicine. um and was incredibly

intoxicated by neurosurgery because the

brain is just an organ in our body like

our liver, like our heart, but then it's

also the seat of identity. And he was so

interested in okay, if you're undergoing

like brain trauma, a stroke, you know, a

tumor, how does that alter your identity

and meaning, but also how does like

neurosurgery alter your sense of

identity? He was really interested in

patients who were facing like upheavalss

in meaning and identity. Then he himself

became sick, had to face this whole

upheaval, had to face the end of his

life. And I felt like as Paul was going

through this serious illness and dying,

I really felt immediately in it with

him. I felt so like fused with him. We

had to do so many things together to

take care of him, to make sure the book

got written, to cope, to like show up

for each other in like every way. But I

wonder whether

like when and if something happens to me

and I'm sick and dying if I'll read

Paul's book and see how much I didn't

understand

>> and see like new things in the words or

like reflect on his experience and think

like oh was he alone in that and so like

that sort of breaks my heart like what

did I miss

>> you know in answer to your question of

like how have I gotten to know Paul

differently yeah I mean when someone

dies like stories come rushing in and

then I think reading his book at

different phases of my own life I even

get different things even though I knew

him so well. Um, and then I think you

know just the process there's a flip

side which is like how to not flatten

someone after they die. Like I think

like when someone dies they're sort of

suddenly they become like so amazing and

perfect and I can't believe we lost this

person and all those things are true but

at the same time it's like he like you

know left his socks on the floor and it

annoyed me like you know just he was

just a regular person and he was funny

and he drank too much whiskey and he

like just he was like textured you know

and so I often think about like all the

things I do remember about him. How do I

keep those like in memory and keep him

like complicated instead of like mythic?

>> Both of those answers to what you said,

you almost feel like you don't

understand, which maybe you never will

until we're all in the same position and

going through something similar. And

when we're facing not loss through

someone else, but loss of ourselves,

>> right?

>> There may be certain things that we miss

on that journey and we we don't

recognize and and maybe we shouldn't.

until

>> sure. Yeah. I couldn't. Yeah. Exactly.

But then on the flip side, the idea that

you're saying that

>> it's almost like

>> sometimes we don't celebrate people

until they're gone.

>> Sure.

>> And we only see all the bad things.

>> Isn't that interesting?

>> Yeah. And then as you're saying on the

flip side, when someone goes, we only

see the good things and we don't And

it's so fascinating how the mind does

that,

>> right?

>> I guess he would know as a neurosurgeon

like he'd know why we why we do that.

>> Yeah.

>> Yeah. and where that comes from. Like

why is it that we kind of

>> right like what's the neuroscience of

grief?

>> The neuroscience of that grief of how we

block people's good things when they're

alive and block people's you know bad

things when they're gone and

>> right or is it about remembering like

remember to notice when you have your

person here and then yeah when they

leave remember to yeah don't forget

>> when you hear the age-old phrase time

heals all wounds how does that sit with

you? I mean, it's sort of like

simplistic and it actually makes it

sound like the wounds will then go away.

And so, I don't believe that part, but I

do believe I do think time heals all

wounds in a certain way. Prince Harry

was writing about grief and he said

something like um grief is a wound that

fers. I was sort of like, oh, I don't

agree with that because if something

fers, it's like untended, right? And so,

I do think like there will always be a

scar. There will always be something

that looks different, feels different,

something you're carrying, something

you're literally carrying on your body.

Like that's also how grief feels. I

think if you can sort of think to

yourself like it's going to be okay in

some way. You just don't know what okay

means and like sort of let the pain move

through you. You will end up somewhere,

you know, that's different and better

than you thought.

>> Yeah. It's it's interesting how all

these statements have stood the test of

time.

But they have so much nuance when you're

actually living them.

>> Yeah. Yeah. And some of them don't work,

right? Like or you you have to decide

which ones work for you. Like if someone

sends you a card with something on it or

if someone says, you know, everything

happens for a reason and you don't

believe that, it's not helpful. But

you're right. I think many of those like

things in literature, sayings like that

hold up.

>> What do you feel about that one?

Everything happens for a reason. I don't

subscribe to that necessarily,

but I think more than I did before, I

think when hard things happen, I do

believe something beautiful will come

out of it.

>> Something even if the only thing that

comes out of it is that you suffered,

which connects you to every human being

everywhere across time ever. and then

potentially deepens your empathy for

other people or deepens your ability to

be a friend or you know whatever it

might be. So, and then I think like

>> suffering. Have you read Man's Search

for Meaning?

>> Yeah, of course.

>> Yeah, of course. No, it's so gorgeous.

No, no, you're saying Yeah. I'm not

surprised you read it. That's why I say

and like Victor Frankle who you know

survived the Holocaust in a

concentration camp and then went on to

become a therapist afterward. He talks

about witnessing all of these people and

how they survived the unservivable.

And he ends up talking about like how

purpose or relationships like you

wouldn't survive just because you had

those, but you could only survive if you

had something you were waiting for or

someone who was waiting for you on the

other side. And ultimately he ends up

talking about how suffering is actually

a really meaningful part of our lives.

He says like his construction is that

meaning comes from three things. And he

says he conceives of work and love and

suffering. And I love that. He says work

is like the things you do and create you

know like the imprint you leave on the

world. Maybe love is like all the types

of love between people and then

gratitude also and just like love at

large. And then suffering. He talks

about how like suffering is not this

sort of like side event that you wish

would go away. It is here. It will be

here.

>> Whether something beautiful comes out of

it, whether it connects you to other

people or whether just like the pure

achievement of just persisting alone.

>> I think there is like actual meaning in

that. And so I think the idea of like

everything happens for a reason. It's

like a reason will be found but only you

can find it. No one can tell you what it

is and no one can tell you that it's

okay. Like that's only yours and maybe

it takes years.

>> I appreciate that and the idea that

there wasn't some predetermined reason

or some reason that had to be the way.

It was a a journey of discovery.

>> Yeah. And I think some people think that

and that's also like a beautiful story

or a beautiful you know

>> what for you was actually helpful as you

just talked about the need for

relationships, the need for meaning.

What was useful to hear from your

relationships at the time?

>> Yeah.

>> And what do you find useful now?

>> Yeah.

>> And helpful. This isn't about other

people actually, but this was a really

helpful thing for me is

um so Paul got sick and we were both

doctors and there was something in that

that was immensely helpful

and obviously like the privilege and

logistics and all of that kind of stuff

that came out of like being a healthcare

person and a doctor was very helpful.

But the thing that was the most helpful

was having spent years and years taking

care of sick people and their families

and thinking like terrible things can

happen to wonderful people whether it's

like a car crash or sudden diagnosis of

cancer. And so when he was diagnosed

like at one point I was like whatever

you need to do to cope go for it. Like

would you like to punch a wall? We have

all these walls. Like they're all yours.

And he was like I don't need to. And I

was like, I don't need to either.

>> Like what's that about? And I think it

was kind of like,

>> okay, turns out like it's our turn to

like be the people who are doing this.

So it was really helpful to sort of like

have that perspective. And Paul in his

writing wrote, you know, like people

often ask, don't you ask why me? And he

said, well, why not me? Which I think is

really beautiful. Yeah. And in terms of

like what was helpful for us in terms of

coping, I felt like the most important

thing was just to feel witnessed. I

actually didn't need anyone to try to

fix it, to try to like say something

that was going to fix it or that it was

okay. Like one of the best condolence

cards I got after Paul died was it just

said this sucks really big. And I was

like oh so amazing. Like and it also

wasn't like too flowery or too

>> like perfect or whatever. It was just

like this is how this person feels. This

is definitely how I feel. Also, it's

still funny. Like even when you're

dying, you're still you, you know, like

>> you're still funny. Like one thing that

did that was really helpful for Paul

actually when he was sick, you know, he

was a 36 and 37year-old neurosurgeon,

right? So he's used to being like like

healthy, dominant, in charge, in

control, and then like loses all of that

in an instant. So when people would come

to visit and hang out, they'd say like,

"Okay, I'm coming to visit. Like, what

can I do that's helpful?" And I was

like, "Just come and hang out and like

be just like be you. Like be funny. Like

ask Paul for career advice, you know, if

that's what you would do anyway. Like

just because he's dying like doesn't

mean he doesn't want to know what's

going on with you. He's not like

radioactive. He's not different. You

know, I think illness can be so

flattening. And it's like people get

sick and it's like humor zips out of the

room. Like sexuality zips out of the

room and like you're just like I'm still

me. Like I'm still me just the same and

and losing all of these abilities but

also still have all these capacities. So

I think just like making room for

people's full self and people to be like

agentic and be if that's a word be an

agent

>> and like be a full person.

>> I think we all lose our powers when we

love someone and they lose someone.

>> Totally. And I think for a lot of people

listening and watching, I think

>> a lot of people become distant.

>> Totally. Cuz you don't really know what

to do. Yeah. And I think like showing up

is half the thing. And then also it's

like I do think there's something to

like being specific, you know, like

people often say like, "Let me know if

there's any way you can help." And you

really mean it.

>> And I've done that. But I think when

you're the sick person, it's like you

are quite overwhelmed. And so it is

useful to just like keep offering a

little thing with no pressure. Like I

had some friends whose baby was in the

hospital and the husband was like the

best thing anyone ever did for us was

say like I'm at the mall next door

getting a burger. Like what do you want

on yours? I'll drop it off in 20. And

they were just like the works. Thanks.

And then like they have to talk to the

person like just like you know that kind

of stuff. Hey like do you need

babysitting this week? Like let me know.

>> Yeah.

>> Like I'm dropping off food. Do you want

me to ring the the doorbell or just let

you know? Just text you when it's there.

just like something that has no pressure

but also is like present and keep doing

it.

>> What do you think most people

misinterpret about grief?

>> One thing is like, oh, if I say

something, I'm going to remind her or if

I say what if I say something and I make

her sad. And I think when you're a

grieving person, you're thinking about

it all the time. It's present for you

all the time. And so I think if somebody

says like, "Hey, I heard what happened.

I've been thinking about you." you know,

hey, I heard what happened. Like, how

are you doing today? Um, is there

anything you can do? It doesn't remind

you. It just makes you feel seen and

connected at a time when like it's

really hard to feel connected. My mom

said this amazing thing when we were

growing up. She used to say, "When in

doubt, describe." And it basically meant

like even if you don't know what's

happening to for you or even if you

don't know the perfect perfect thing to

say, like you can just describe what's

going on. So, you can just say like, "I

heard that so and so died. It's really

sad. I've been thinking about you so

much. I wish I knew the perfect thing to

say and I don't, but I want you to know

I love you."

>> And like that. Doesn't that sound so

cozy and nice? And it's like they didn't

have to say a special perfect

>> wise thing they just described,

>> you know? So, I think that's also really

helpful.

>> Describing what you're going through is

sometimes better than trying to say the

perfect thing or the right thing. Yeah.

Absolutely. To just be like, "This is

the worst day ever."

>> Is this hard?

>> Yeah. This is hard. Yeah. This is This

is really difficult.

>> Is so much more I don't know. There's

something about it that opens up the

heart rather than closes it.

>> Totally.

>> Yeah. Just It's almost acceptance.

>> Yes. Can I just come sit with you? This

looks so hard.

>> Yes. Exactly. Yeah. Yeah. To admit that

to ourselves. That's what we struggle to

do. What was I've It's been really

interesting as I was preparing for this

interview. I've had friends who've I

mean I've lost friends to cancer over

the last few years. I've lost spiritual

mentors. I've lost friends.

>> Yeah.

>> And different scenarios, but I had a

friend recently who is going through it

in the States.

>> His partner's a doctor, but he's not.

>> Yeah.

>> And his partner

wasn't as supportive as he wanted them

to be. Ah,

>> because to him cancer felt like the big

C word that was scary from the moment he

heard it. But her take was you're going

to be fine. They're going to figure it

out.

>> And I was wondering what were the kinds

of conversations you both had as both

being doctors and what was the most

important conversation you think you had

at that time? The way Paul got diagnosed

was um he'd been getting sicker and

sicker and then he ultimately got the

news that he had a chest X-ray that

essentially looked like a cloudy sky. I

mean, it was like dense with tumors. We

both knew what it meant. You know, we're

going to the hospital tomorrow for for a

CT scan. It's going to show, you know,

metastatic cancer. And it was so

interesting because as we were packing

for this hospital stay, he was going to

go and get expedated workup. I was

packing like practical things like phone

charger, insurance card, like fuzzy

socks or whatever. And he packed books.

It was so interesting. He packed um

Being in Time by Haidiger and Mirror

Christianity by CS Lewis and then a

novel called Cancer Ward by Souls Souls

Nitsson.

And it was this sort of like immediate

recognition of like the doctor stuff is

not going to help me. like I need to

turn to words and literature and or I

just need to turn to like the human

experience of this and for him that was

like oh I'm back to literature.

>> So that was really interesting. I think

one of the most important conversations

was right away which was we ended up

looking at the CT scan ourselves and

sort of like wordlessly absorbing this

diagnosis of like it was like looking at

a patient's scan and then you're like oh

my gosh it's you like it's you. And then

we like got into the hospital bed

together and then he said, "I want you

to remarry

before we almost talked about anything,

which was really beautiful, like

beautiful

and felt so sort of like shocking at the

time." But then there's like all these

layers to that. Like the biggest one is

like I love you into a future where I

will not be there. Like that's amazing.

That's such a like an amazing kind of

love and people have it, right? People

have it for their children. People have

it for their SP. It's like I love you

forever independent of my existence,

right? But he also was saying with that

sentence like it was so stark that it

was kind of like, okay, I'm going to go

I'm going to go there immediately and

then implicitly tell you like we can

talk about anything. And that was really

helpful, like super super helpful. And I

think like the battle metaphor for

cancer is so pervasive. Like it started

with like Nixon's war on cancer, but

then now it extends to like individual

level. Like we'll beat it, we'll fight

it, we're going to win.

>> Surviving.

>> Yeah. Surviving. And I think that

metaphor is so flimsy, you know?

>> Interesting.

>> Like it's sort of like there's winners

and losers and there's like one thing

you're supposed to do here and it's just

like survive at all costs. And I think

there's like when you survey people with

cancer, there's like so many things

people hope for. It's like people hope

for dignity. People hope for like

functionality as long as possible.

People hope that their loved ones will

be okay. I don't know. There was sort of

just like this paniply of hopes

that I think like we knew to like

sidestep the battle metaphor, which was

really helpful. And then I think part of

that was just we knew how sick he was.

>> We couldn't get away from it. We could

not escape like understanding how sick

he was, which was like the worst part,

but in some ways the best part

>> cuz then we could decide what to do.

>> What I'm hearing you say is that it's it

wasn't the the doctor conversation or

the medical conversation because that

was almost accepting what was in front

of you.

>> Yeah.

>> But it was the conversations that you

both allowed each other to have beyond

the knowledge that you both were aware

of.

>> Like luckily and at the same time like

I'm making it sound easy and it like

totally was. It was so so painful and

like so confusing and just so like it

took months months for us to like even

feel like we had our feet on the ground,

you know,

>> and then things are like it's a

constantly shifting landscape, you know,

>> and he's going through his emotions,

you're going through yours. Like

>> I can't imagine that they align every

day, every moment. Totally.

>> But I wonder about just the work that

you're doing as well. And as we kind of

navigate this conversation, I'm like, I

know that in my life, when I lose

someone I'm close to, especially when

they're around the same age, there's

something different than when I lose

someone older.

Because at least when someone's older or

at an age that feels appropriate

>> for loss, there's that story that you

can tell yourself. Whereas I lost one of

my monk friends. He was still a monk

when he passed away. We lived in the

monastery together, but he passed away a

few years back now and he died of stage

4 colon cancer.

>> Yeah.

>> And he was like maybe 2 years older than

me.

>> Yeah.

>> And I remember watching him through the

whole journey, present with him, talking

to him on the phone, seeing him when I

could, when I went back and visited him.

And I almost feel like I learned so much

more from him about life than I've ever

taught or known. Yeah.

>> And I wanted to know like what did being

so close to death teach you about life

and living?

>> Yeah. It's hard to separate actually

like being so close to death and being

so close to Paul

because it was like so embodied, you

know? And it's funny. It's like you're

talking about your friend dying and like

what a surprise that is when someone

young dies

>> and it's like the way I've ended up like

conceiving of it is sort of like turns

out that's what was going to happen.

Like that helps me a lot actually. I

think like being so close to someone

who's dying

actually taught me something about dying

which is that until you die you're

alive. You know like what happened for

Paul was like he got he was a

neurosurgeon got diagnosed with cancer

worked for a year as a neurosurgeon.

Like this is who I am. This is what I

care about. Then I got pregnant during

that year on purpose. Then he had sort

of serendipitously

and because he was a beautiful writer

transitioned to writing first essays and

then a memoir. And so he sort of like

built a new vocation during the time

that he was sick. And it's like he was

so sick and so like debilitated and

still like physically still and like one

you know he was ill and at the same time

he was so like engaged in what he was

doing like so just sort of like

intellectually engaged in the world of

ideas and in the world of relationships

too like being a new dad. And it was

just really interesting to to see like

one of the book reviews of Paul's book

was by this doctor named Gavin Francis

and he wrote like this book is

unforgettable or this book is something

it is crackling with life. And I just

remember thinking like oh how amazing to

be crackling with life when you're

dying. And I think the same thing is

true with aging. The same thing is true

with like disability or patient. It's

like there's this idea that like, you

know, something about like a human

identity is taken from you when you're

aging. But it's like some of my favorite

people are little old ladies who are so

giggly and hilarious and like not afraid

of anything, you know, and like I used

to think like little old lady and now I

think like gosh like Spitfire who like

knows everything and like you know

nothing shocks her. And so I think the

thing it taught me also as a doctor, you

know, like just how totally human like

everyone is, you know, and I think when

you're at work as a doctor, there's so

much dehumanization. It's like you're at

work, you're rushing around, you're

hungry, you have to go to the bathroom,

you have to get to the O. And so it's

like all of the families like sleeping

on the sofas outside the ICU are sort of

the furniture. like they're the

furniture at work because you're doing

your job,

>> but also it's like you're constantly

toggling between like this is the worst

day of this person's life and I have 36

minutes with them. And then in answer to

your question for real about like what

can dying teach us about being alive and

living? Dying is like the one of the

most human things we do. It's like it's

too big for any model. It's too big for

a medical model. It's too big for like a

lot of religious models. It's not a

medical event. It's like a human thing.

Frank Ostacees, he's like a Buddhist

teacher who founded Zen Hospice in San

Francisco. So gorgeous. He's so

beautiful. And like he talks about how

dying is all about relationships. So

interesting. It's like your relationship

to yourself, your relationship to people

you love, your relationship to like

holiness, whatever that would be. He's

like it explodes every kind of

relationship. And then Ira Bay who's

this like really beautiful doctor um

here actually talks about like having

worked with a lot of people who are

dying and then like you know what they

have to teach to people who are living

and he's like it's two big questions

that he uncovers and he says what would

be left undone or unsaid if I died now

you know like how can I live most fully

in the time I have left you know and I

think there is sort of a like

transcendence in just like death is not

like something that happens like at the

end of the road. It's like it is here

all the time. It is something you can

like tap into like finitude or

transcendence like even like a traffic

jam and you're just like road rage. I'm

going where I'm going. I hate these

people. They're in my way. Like it's

like no like you are the people. You are

the traffic.

>> Everyone in this traffic jam like was a

tiny baby like will be on a deathbed has

someone who loves them who will be like

bereft when they're gone. like God

willing, right? And so like suddenly

zooming out to that, you're like, who

cares about the traffic? Everything's

beautiful. So I don't know. I think

there's like a real like luminosity

that can be found

>> like when someone's dying

>> and then at the same time like traffic

jams suck and like

>> you know when someone's dying you also

have to like make dinner and you know

pick up the prescription. But I think

it's like a constant toggle between like

>> zooming in and zooming out.

>> [ __ ] and transcendence, you know,

which is like hopefully what we can all

do like every day.

>> Yeah. Yeah. Yeah. Yeah. Is zooming in,

zooming out. And as you said, Yeah. Like

for a few months now, my team and I have

been creating these

>> zoomed out versions when you were

describing that. Yeah.

>> Of almost like city crosswalks, uh,

parks. Yeah. And we just we place these

little thoughts on what everyone's going

through.

>> What? And and people are like moving

around in the park or sometimes it's

>> you like ascribe like a story. Correct.

>> Oh, I play that game with my kids.

>> Yeah. Oh, wow. Oh, no way. Tell me about

that.

>> We just play that like at dinner and

stuff. We're out to dinner. I don't know

what you're talking about. Yeah. Yeah.

We'll be like, "What are they talking

about?" And then you'll be like, "Oh,

this person just walked by like his

dog's name." Sometimes it's just sort of

like silly. It's like his dog's name is

Peanut. And just make it up. But

sometimes it's like,

>> "Oh, like do you think he's just gone

through a breakup? Like look at his

face." like just we just sort of make it

up like as a way to pass the time but it

is sort of like an empathy game.

>> Absolutely. Yeah. So we're doing exactly

the same thing except creating it on

social media and sharing them as stories

for people to zoom out a little bit and

so we'll take different scenes whether

it's an airport or whether it's a park

or whether it's a crosswalk and we'll

have lots of people walking around and

we just put little stories on on top of

them. I love thinking that way

>> because I always know that if I cut

someone off in traffic, I feel I have a

good reason.

>> Sure.

>> But if someone cuts me off in traffic,

>> the fundamental attribution, they're an

[ __ ] I have a great reason.

>> Exactly.

>> Yeah.

>> So, what are you trying to show? Are you

just trying to show like everyone has

like a rich life as rich as yours?

>> Yeah. And we're not alone in our

suffering.

>> Yes.

>> So, you may feel like you're suffering

right now. You're definitely not alone.

>> Right. that everyone you meet may simply

be projecting their own suffering onto

you and it isn't a reflection of who you

are.

>> Oh, totally.

>> And everyone has a story.

>> Everyone has a thing.

>> Yeah.

>> Yeah.

>> And so just trying to help us,

>> I guess, transcend. But then I like your

version of it's still [ __ ] traffic.

So I need to make one of that one. So I

need I think we need to end it with

that. I think you found the perfect

>> end. Cool. It's so cool. I can't wait to

see that.

>> J. No, as you're saying, it was just I

it's it's helpful hearing it from you. I

as you're answering these questions, I'm

so honestly like it it's stirring so

much within me because when you sit down

with someone who's really done the work

and really had to work through grief and

really had to think through this loss on

such a personal level,

your answers are beyond any

logic in a beautiful way.

>> Thanks. and they're they're

counterintuitive almost and that's

what's so

helpful and refreshing and yeah,

>> you know what's so weird though is like

partly it helps you and then partly it

doesn't cuz like the next thing that

comes is also really hard. Like

>> sometimes I think that about talking

about Paul and like going through that

experience. Like Paul's memoir came out

a little under a year after he died and

then I immediately went on a book tour

like an unexpected book tour

>> and was like processing in real time

like what had happened really just like

aching through grief and describing it.

And now I'm describing like I went

through this process and what came out

of it which is like a wonderful thing.

But then like the things that are

happening for me, like I talked to

somebody the other day actually who said

this who said like, "Oh, I'm raising

this like challenging teenager and it's

the hardest thing I've ever done." And

then she was like, "Well, I told a

friend that." And the friend said, "Wait

a second. Like 12 years ago, your wife

had cancer and you had young children.

Isn't that the hardest thing you've ever

done?" And she was like, "Oh, it is. It

definitely is. But right now, this feels

like the hardest thing. like it's the

new hardest thing,

>> you know, but at the same time, I think

you end up realizing like, okay, I've

done a hard thing before, you know, like

Jane Fonda on um Julia Lou Drifus'

podcast,

>> she was like, people always say that

being old is hard. And she's like, no,

being young is hard. She's like, being

old is amazing. Like,

>> you've been through so many things, you

know, you can do it. And I was like,

that's awesome.

>> If we're able to pull from that well

>> Yeah. of experience and tragedy. And if

we're able to look at it and go because

I think I think I think humans don't

give themselves enough credit for how

much they've survived.

>> Same.

>> Yeah.

>> We don't give ourselves enough credit

because we don't we don't look back at

that moment and think we were strong. We

look back at it and think we were weak.

>> That's so interesting. And then we just

I was a stupid teenager and then you're

like no, you had to learn that.

>> There's no other way to learn that.

>> Exactly.

which is

wow

that I mean I remember talking to my mom

once and my mom is not someone who gives

me motivational advice or gives me

wisdom she's loving and caring but not

>> a wise sage in her words and I remember

I was going through my most difficult

fight yet at a certain point in my life

around 9 years ago

>> and I was talking to my mom and she was

asking me how I was and what I ate for

dinner, which she it was usually our

conversation. And I just said to her, I

was like, "Yeah, you know, I'm just I'm

doing all right. I'm just stressed out,

doing a bit, you know, and and I would

say that in a passing way."

>> Sure.

>> And she said, "You're good at dealing

with stress." And I was like, "What do

like my mom doesn't just say?"

>> It was so helpful.

>> Yeah. And I said, "What do you mean?"

And she said, "Well, when you were in my

womb, you went through a lot of stress."

>> That's so beautiful.

>> And it was like,

>> oh my gosh, I'm going to cry. It gave me

so

>> so much. It It's still what I turn to

>> when I need strength.

>> Oh my goodness.

>> And it's it broke through the challenge

I had at that time. Like it gave me all

the resilience and conviction I needed

because my mom had just reminded me that

>> Well, that's so beautiful.

>> Yeah, it was it was unbelievable.

>> It's so amazing, too, because she's

saying like that's such an embodied

thing because like Oh my gosh, I'm going

to cry because like she's telling you

like your the fact that you were an in a

fetus, right? She's telling you like

your body already knows how to do this.

Like your body did this before you like

could even when you were preverbal.

>> Yeah.

>> Wow. What a like amazing form of trust

she gave you in yourself.

>> I've been thinking a lot about this idea

of the stories of your parents and the

stories of your ancestors.

And when I think about the stories of my

parents, which I learned early on, but

not in as much detail as I wished,

>> I just heard about how much they went

through. And I was thinking about this

with Katie is where I'm going with this.

>> And it's almost like I didn't live that

with them. I didn't live in those homes

they grew up in. My dad grew up in the

slums in India. My my mom grew up in a

war torn country. They both moved to

England, you know, when they got

married. And when I think about that,

I'm like, "Wow, that is that's so

difficult." Like, my parents did

something really hard.

>> My mom was studying for her exams when

she had soldiers on her rooftop.

>> Wow.

>> And my dad shared a bathroom with like

25 families.

>> Yeah.

>> And when I think about think, god, that

is insane. And and then when you think

and you're like, but I come from that.

>> Sure.

>> Like like I come from that. And like

what?

>> And so I wonder when like for Katie who

>> Yeah. as we were talking about earlier,

like doesn't necessarily know her her

father, but how do you think about

>> creating that experience for her in in

helping her make sense of it?

>> It's interesting that you're saying this

thing about your parents because like

the hardest thing is when your parents

lay it out for you, right? Like you do

need to sort of absorb it yourself,

>> you know? I did this and then you're

like, okay. But like it's so beautiful

that you really absorbed it. So, it's

like I guess I hope Katie will do that,

you know, from reading Paul's book or

from like watching me and, you know,

being me. Um, whatever she takes from

that. But I think I think so much about

how to like give her sort of like

spaciousness, like support and

spaciousness to like figure out what it

all means to her, you know, because

she's her own person. Her childhood is

very different from mine. in this other

way, right? Like she has the hardship of

losing a parent. I didn't. She's like

decidedly not Paul. She's decidedly not

me. She's very specific. I think none of

us honestly like comes to appreciate

that our parents are like full human

beings. Like it I remember in my 20s

being like, "Wait a second, my dad is

not a professional dad. He's like a

dude. He's just a dude." Like that

explains so much. Like that explains so

much in a really like gorgeous way. You

know, he's like someone who's just

amazingly doing his best. Katie has

fewer like signposts to know who Paul

was, but she has this book to read. And

the book essentially says like it's

important to try hard. It's important to

do your best and I love you. like he's,

you know, Paul wrote so much about

striving and about struggling to find

meaning and about, you know, like about

facing death squarely and then at the

end he like stops and he's writing in a

second person to her and like writes a

message to her and that's the last piece

that he puts for her.

>> As I'm raising Katie,

>> I try to have her sort of take in like

random information about Paul. Like just

truly random. Like you love taking a hot

shower. I hate a hot shower. I get in

and out. Like you and daddy like love a

hot shower. He loved a hot shower.

>> You take the hour power shower shower

just like daddy. So that's just like a

random thing that you would know if you

were like growing up like next to

someone, right? So I try to give her

those kinds of things instead of just

like

>> your dad died and he was so wonderful

and he loved you. It's like I try to

give her like

>> sort of specifics that are like neither

here nor there, but they're like they

like create a tapestry. Yes.

>> She like sees his brothers who are like

really funny and amazing and sort of

like just funny in the way that he was

>> and then I don't know what her

interaction will be with Paul's book.

Like it's all over our house. It's like

I mean not all over but like we have

five copies and they're on different

bookshelves and they're around and I

don't know when she's going to pick it

up. I don't know what she's going to

take. I don't know if he's going to feel

really close, if he's going to feel

really far or if she's going to say like

I'm not interested in this or if she's

going to be 30 and produce a movie

adaptation. I have no no idea. But I

hope that she'll find some way that

helps her like you did understand like

where she came from and

>> that she was loved and yeah, she came

from this. Like that's really beautiful

to hear you say that

>> I came from that.

>> Yeah.

>> So I I have no idea.

>> Yeah. Yeah. No, of course you don't. But

I I appreciate how you incorporate the

story, the tapestry, the the natural,

the real of of what an experience is and

and the not heavy also the version

that's digestible and inhalable.

>> Yeah. Yeah.

>> Without holding Yeah.

>> word because I've done a lot of like

speaking and you know doing this book

tour and connecting with like grief

groups and just all kinds of stuff since

Paul died. I've actually asked people

for advice. Like if anyone here in this

audience is the kid, you know, who like

lost a grandparent or lost whomever and

then you don't know them and you're

piecing it together, what advice do you

have? And like the resounding advice has

been like don't put away the pictures.

Don't lock it up,

>> you know? Like let the kid sort of like

have access, ask questions, like

discover it, and just don't like put it

away. What was it like making that

decision to have Katie at the time and

then actually go through both coming to

terms with Paul's mortality and then you

know wanting to create life together.

>> Paul and I had sort of always thought

like that would be the moment when we

would think about having children like

he was at the end of his residency. I

wasn't attending by then. This is when

things will like ostensively become

easier. And then right at that moment

he's diagnosed with metastatic terminal

cancer. the prognosis is like months to

a few years, but we both looked at each

other and thought like maybe we should

do this still. Sort of like surprised

ourselves. And he was more certain than

I was. He really really wanted to. And I

needed to sort of shore up like the

practicalities. It was sort of like

>> is the family on board with this? Like

>> we refinanced the mortgage like all of

these things. It's like can I be a solo

parent? Like that is what I'm going to

be. And then I also was honestly worried

about his I was worried about like what

you said like how to hold like birth and

death and all of it at one time. And I I

asked him actually and was like you are

you are sick and like as you're going

through this process don't you feel like

having a child will make dying more

painful for you?

And he said, he said, "Wouldn't it be

great if it did make it more painful,

which just like cracked the whole thing

open?" And I think actually for anybody

who has a child, like nobody is doing it

because it's going to make their life

easier. There's like a million things we

do

>> that make our lives harder. Like

everything, everything, right? Like, you

know, climb a mountain all the way to

the top to come down again in the exact

same day. It's like you didn't do that

because it was easy. And so I just think

wouldn't it be great if it did has

changed my life so much and cracked open

like not necessarily the best one.

Sometimes you cannot have joy without

risking pain or inviting pain. And for

me it was like another layer of

uncertainty. It's like pregnancy itself

is like so much uncertainty, so much

fear. And I actually as a new mom had to

keep reminding myself like you know it's

like you go in and you like make sure

the baby's still breathing and you're

like is everything okay? She gets a

fever and it's such a panic and like I

had to remember and be like I am 99%

certain that this person is going to be

fine Katie. I'm 99% certain that Paul

will not be fine. So like that is now

like where I need to hold

>> like my energy. So that was kind of like

helpful. Like when she was a baby, it

was like it's so easy to wish away time,

you know? It's like, oh, I can't wait

till she sleeps through the night or

like what's she going to be like when

she's like 18? And there was none of

that. It was like this is like the

moment that Paul will be here for is

like Katie's infantthood and like Paul's

final years. And so there was no like

wishing away the moment. It was all

present. And it turns out like that's

actually really good for you. It's like

the reason people like learn to meditate

or you know or it's like I'm washing my

hands in the sink like this is the

feeling of the cool water. It was like

that. It was like like a baby cries,

someone dies. I'm here like in this

moment, you know, and so yeah, and I

still can access that somewhat. And then

I also am like, you know, where are the

pencils for seventh grade? So like but

anyway it was it was like beautiful and

amazing and really good that we did it

and just yeah

it it worked out taught me a lot. Were

you always so evolved and or did this

accelerate it in a way that because when

I hear you speak I'm just like God this

is like a lot of growth a lot of in a

short amount of time a lot of

>> taking on a lot of different things in a

short amount of time and it's almost

like do you feel like you were somewhat

prepared for it from somewhere in your

past? The heaviest lift for me actually

I think in terms of like training my

like brain and heart to hold a million

things actually was in medical school. I

was like I cannot believe I'm using like

every fiber of my being to figure out

like intellectually and emotionally how

to take care of sick people and attend

to like every every layer of what's

happening in this room and then like

make a 10,000 decisions about like how

to make it all happen. So that was

really hard. I also went through an

episode of depression in residency. It

was incredibly painful. I wasn't like

hospitalized, but I took two weeks off

work and I felt like I just felt like I

didn't exist. I mean, it was depression.

It's like depression. Like Andrew

Sullivan says about depression, like

depression is not the opposite of

happiness, it's the opposite of

vitality. It's like so interesting.

>> That was really hard. And I think like

making it through that I don't even

think I could put into words what it

like taught me but touching that like

pain like left me with I don't know some

sort of ability to approach darkness or

something just be like okay like I don't

know I have no idea. Yeah. And then I

just have like really good friends and

we're talking all the time. Like I'm a

processor by talking obviously,

>> you know. And then at the same time it's

like I went through this hard thing of

all these ideas about like

>> what helps me cope and then you go

through a breakup and you're like

heartbroken and you hate everything and

you have to start again or like you know

you have to figure out how to explain it

to a kid and then you know like that's

impossible or they think you're stupid

you know like

>> I don't know. It's all everything. It's

all everything. It's the transcendence

and [ __ ] Yeah.

>> You know, this actually makes me think

of this thing. Yeah. Transcendence and

[ __ ]

>> Do you know this idea? It came out of

Dan Gilbert at Harvard, the social

psychologist. This idea of like the end

of history illusion. So like he talks

about like when you're asking this

question of like like what got you to

where you are today? And then like

>> he interviewed a bunch of people and he

said like how much do you think you've

changed in the past 10 years? And

everyone said so much. Like so much. And

they said how much do you think you're

going to change in the next 10 years?

People said probably not a lot. And he

interviewed people at every age and

there's like a little little bit of a

slowdown like in midlife but essentially

everyone changes all the time. Everyone

changes the same amount in the 10 years.

>> You walk around thinking it's the end of

history illusion of like I'm me. I've

made it here. I've got it sorted. Here

we go. You know, and then in 10 years

you'll be like a whole different you

with like different sensibility or like

different frameworks. Like, isn't that

crazy?

>> So, I don't know. I find that really

helpful. I don't know why. Just kind of

like

>> Yeah. Yeah. Allowing ourselves to be new

and different. I mean, it's interesting

when you first said that question, I was

like, "Oh, I'd say I haven't changed

much in the last 10 years." My that

would be my initial take. I feel like I

knew who I was. I'm pretty much the same

person. But I think that's not fully

true. I think there's there's also an

end of history illusion from 10 years

ago.

>> Yeah. Yeah.

>> In the sense of like I made up my mind

who I was 10 years ago in my head and I

stopped then. And it's like, well,

that's not obviously true. Yeah,

>> that's fascinating. That's that's really

cool to play with.

>> Yeah,

>> it's refreshing to allow yourself to

say, "I have changed. My ability, my

values have changed or what I care about

has changed." And

>> and then when a big hard thing happens,

you're like, "Oh, it's going to make

them me."

>> Yeah. Yeah. Yeah. Yeah. Yeah. I like

Dan's work, so I'll have to check that

out.

>> Yeah. I wanted to ask you actually going

back to something you said earlier, what

about Kat Katie reminds you most about

Paul?

>> Her eyes in her hands, her stubbornness,

it's like infuriating. She very much

knows her own mind, which is

infuriating.

>> I love them. Yeah.

>> It's like an entire parenting toolboxes

are unavailable to me because she's not

a pleaser. Um, and then she's like an

incredible physical comedian, which Paul

was also. Those are the things I think I

would say. She's introverted. Like Paul

I process by like speaking, like

relating. Sometimes I don't even know

what I think until I've said it. And

Paul was much more like inward. I think

that's like that's sort of like why he's

like when breath becomes air spun out of

his illness because he was like turning

and processing and reading and writing

and she's introverted like that.

>> But then she'll give you like, you know,

like a little gleam, you know, of

something she's thinking.

>> Yeah.

>> Has she ever asked you anything about

Paul? Like from her own curiosity?

>> Totally. And she's actually, it's so

interesting you asked that because I was

going to say of course and then but it's

not necessarily of course. She's just

sort of in the mix gleaning,

>> but recently she started to she said

like could you make me a album of videos

of daddy? And I was like sure and it's

like I so badly want to be like what's

she watching? When's she watching them?

You know, cuz she's like having iPad

time. But like there's a bunch of

videos. there's like some interviews and

there's some goofy like sketch comedy

stuff and there's some like Thanksgiving

someone shot a video of whatever and so

like she can look at that and then she

asks for like stories I'll tell her a

story of like oh here's a story about

daddy like in a chess tournament when he

was in seventh grade and he was like

really bratty and a terrible loser and

so like well you know she's like ah but

then there you know there's a lesson in

that

>> and she like recently like of her own

valition like put a small photo of the

two of them next to her bed, you know,

and I was like, "Oh, so interesting."

Like, she's like claiming him.

>> That's beautiful.

>> Yeah.

>> Yeah.

>> You know what's else is interesting

though is like she doesn't have a

sibling. Like it's me and her. And she

really wants a sibling. She wants a

little sister specifically. She really

wants me to keep dating so she can have

a sibling. I'm like, "We can't engineer

that whole thing. I'll keep you posted."

But it's interesting because I actually

think like for her losing Paul was a big

thing and not having like a dad there is

a big thing, but not having a sibling is

actually also a big thing.

>> Wow.

>> Or having like our family look different

from like most of the families at

school. The permission slip is

different. Like she's not self-conscious

about it, but I think she like knows it

and it's a thing.

>> So it's actually kind of interesting cuz

it's not the only thing, you know? So

it's like she's piecing together like

you know all of it like the structure of

everything as every kid is doing right.

>> Yeah. About that I mean you mentioned

earlier that Paul obviously wanted you

to remarry obviously Katie's encouraging

you to date. Like what was that process

like for you because you can say it when

he's there and say okay I understand

that that's how you love me in that

forever way.

>> Yeah.

>> But what does that actually look like

for the individual who has to go on and

try to love again? How did you even

begin to open your heart and mind to

that possibility? Yeah.

>> And when did it feel possible?

>> I wasn't like trying to open my heart or

I was just like it was just pure

intuition.

>> I was just sort of like I'll know when I

know

>> you know for my wedding ring I was like

I guess I'll take it off sometime. It's

not today. And then like 6 months after

Paul died I went swimming and like took

the ring off and then came out of the

lake and was like oh I think I'm not

going to put it back on. M

>> and then like right now I have like my

engagement ring and Paul's wedding ring

on this hand

>> which is interesting but maybe I'll take

them off like if I were like dating

someone really seriously I think I would

take off Paul's ring you know

>> so I was in this like support group

called hot young widows club

>> okay

>> after Paul died it was Nora McInner made

it was incredible

>> and there was actually a lot of

conversation in the group it was a it

was on Facebook at the time there's a

lot of conversation about like what did

your person say about dating again like

did you have this conversation or not.

Cuz I think a lot of people who had had

that conversation felt really freed by

it. Some people thought like what would

they want me to do or like is it a

transgression or is it a disloyalty? And

I don't think so at all. Like I think

like not at all.

>> But I think like I'll also always love

Paul. It's really interesting.

>> And I think like the analogy for me, I

mean it's just like love is infinite.

Like there's totally enough love to like

go around. And I think for me it's not a

perfect analogy, but it feels a little

bit like if someone's child had died and

then they had another child,

you would never think like, oh, the this

child replaced the other child or

>> do they have enough space to like love

the the new child. You'd be like, no,

they're just different. Like it's a

little different when it's your partner,

right? But I'm like, Paul, the way I

think of it now is like Paul's my

family. Like he's my family. His

family's my family. like he's my family

forever and I absolutely like can fall

in love, have fallen in love, like it's

just like there's enough love to go

around,

>> you know? It's been like pretty easy in

a way. And I think the grief part was

actually the harder part. It's like I

needed to like heal to be like ready and

be like emotionally available for like

anything. Like I was just like parenting

my kid and surviving and then I became

ready. Let me know if you want to set me

up.

>> Yeah,

>> they have to have one daughter younger

than 11.

>> Yes, Katie knows a little sister. Got

it. That's a good criteria. We're going

to put it out on the show right now.

>> Exactly.

>> I'm hearing from you that it's that it's

that intuitive tale. It's it's not Yeah.

It's not something that you consciously

pursue or prepare,

>> which like it's probably similar for a

bunch of people, right? Like after

someone gets divorced and is like going

through the like devastation and like

identity and like what was what and what

was my role? I don't know. It's just

like it's all an upheaval, right? That's

like also so like terribly hard. And so

I don't know then it's like

>> yeah when are you ready?

>> Yeah absolutely. Yeah. When are you

ready? And I think that's the question

that everyone keeps quizzing in their

mind. But like you said you can only

know internally. It's not like a

tactical practical thing that you can

kind of put into number of months or

years and yeah it doesn't it doesn't

work that way.

>> Right.

>> How do you define love today? I mean, I

saw you talk about it actually on a clip

where you were like, "The person who

loves you will never use your wounds

against you."

>> And then you talked about how your wife

like holds no judgment for you. And I

was like, "Of course, of course." Cuz

you're you like, and I don't mean you're

J. Shetty. I mean like you're you you're

the person they love. So like yeah,

there's no judgment of whatever the

thing is. There's just like partnership.

It doesn't mean you could like endlessly

hurt the person either, but like

I don't know. That's part of it. I think

I think there is like an

unconditionality to love for sure. And

at the same time, I think like that is

more true for like children than adults.

Like you don't love adults

unconditionally, right? You like have

boundaries that like adults like

>> can't actually cross.

>> But like as long as you can like work a

relationship within that

>> like real like partnership and

spaciousness and like non-judgment.

>> Yeah. It's a hard question. And it's

it's a really hard. What would you say?

>> I'm always changing my mind. I I think

there's so many nuances and facets to it

that it's so it's such a hard question.

I think that's why we all struggle with

it so much in finding it and looking for

it.

>> That's the answer too, right? It's like

I would also be like fun and growth,

isn't it? But it's like at the same time

you're like it's sort of like that thing

where it's like you know it when you

know like it's intuitive.

>> Yeah. Yeah, I mean ultimately it's

teamwork and teamwork requires all those

things you just said that teamwork

should be fun and it should have growth

and it should have uh mutuality and it

should have reciprocation and it should

have connection and communication and so

teamwork just it feels very simplistic

but but it it gives you a good visual.

>> Yeah. And at the same time like I do

think it's like I mean you know this but

like obviously it's never going to be

perfect either. Like there's something

actually really romantic in like

choosing and like choosing like on a

daily basis you know like that's very

romantic of like

>> sometimes one person's up one person's

down sometimes it's like you know

difficult

>> you know but similarly like that's your

team

>> yeah yeah exactly exactly and it's it's

shared

>> it's a shared experience it's a shared

life it's a co-created life

>> it's a co-creation I think is so

important and and co-holding and co- co-

everything

>> while also like you're still like two

beings like correct you're you

>> correct absolutely yeah

>> yeah it's complicated I mean it's like

it's a constant as you're saying this

it's like similarly to the like end of

illusion end of history illusion it's

like it's never done and dusted like

it's like it's like constantly like work

>> yeah absolutely I wanted to talk to you

a bit about this

>> idea of and I know you've spoken about

this this idea of like reimagining how

we die uh Because

>> yeah,

>> it kind of goes back to what you were

saying earlier about the survivor or the

beating cancer

>> Yeah.

>> approach. My monk friend who who passed

away like he

>> he was very positive

>> and he almost just didn't let anyone in

to what he was feeling and going through

and that was his version of how he dealt

with it.

>> And as far as I know from him, I believe

he was happy with that. And then of

course at the end of his life, he needed

support and help and everything and and

he and he got that. I wonder what your

take is on having obviously done this

been a doctor seen patients been at

grief groups like when you think about

this idea of people battling between

letting go and giving up and like what

the difference is and what you do when

you get a diagnosis and how you weigh up

whether I should fight till the end or

whether I'm giving up or actually am I

just letting go like can you help make

sense of that to some degree?

>> Totally. I mean, no is the answer.

>> Yeah.

>> Um, I mean, I I hear you about your

friend and it really is like to each his

own. Like, people really have different

ways of coping.

>> Um, it is a weird time to die in America

in history. Um, because like that sort

of like battle idea like death is very

medicalized and like very sort of like

western medicalized right now here. And

I think there's like a lot of reasons

for that, but the battle metaphor is one

of them. And another one is like we have

all of this technology

available that is like, you know, built

for emergencies, but is getting offered

to people who are like 90, you know,

with like failing organs. Um, I think

there's so much taboo around talking

about death and dying and meanwhile also

so much hunger to like crack it open and

think about it. I think like suffering

and dying are really hidden like from

view

>> the way that they haven't been across

history for people. This is like really

interesting to be like, oh, what's

happening over there? Like how are we

supposed to talk about it? So I think

there's sort of this like cultural force

to like intervene to like you know

anyone who's been through like a serious

illness with someone has seen how much

sort of like momentum there is toward

like aggressive medical care. I think of

it when you were saying like how do you

choose whether to like you know am I

giving up am I beating it? I guess in my

mind I sort of think of it as like a

thing is happening like a thing is

happening. It's like now there is

Parkinson's here or now this person has

metastatic cancer and like it's going to

play out the way it's going to play out.

And so like how do you like provide

healthcare that's going to make that the

best possible like extend life as long

as possible, extend functionality like

as long as possible, help people do the

things that they want to do that are

important to them. But there is some

like building of like you can sort of

choose healthcare within that to kind of

like design your healthcare or like make

your choices around what's important to

you.

>> But that requires like sort of facing up

to like what is happening, what is

possible

>> and then like having the team who's

taking care of you like also level with

you about that with their knowledge and

experience. I mean there's like two

things like for I'll like give you a

practical tip about it but if people are

like I am facing an illness my family

member has an illness I want to be able

to like

>> figure this out but like how on earth am

I supposed to do that

>> one like thing people can do is ask for

a paliotative care team to be part of

their care

>> people get really scared around the word

paliative so like paliative care hospice

is a teeny part of it so hospice is like

paliative care for people who are

actually dying soon. Like you literally

have to be certified like very likely

more likely than not that you would die

within 6 months. That's hospice. Then

there's pal of care which is huge. You

could be like a 22-year-old with

Hodkdins lymphoma who's going to be

cured in 2 years and is like really

struggling and suffering and they'll

take care of you too. Or you could be

someone with heart failure where it goes

up and down and up and down for years

and you could have palative care take

care of you. And basically it's it's a

concurrent care model alongside whatever

other care you're getting alongside the

oncologist alongside the neurologist or

whomever is taking care of you. It's

actually a medical specialty that only

was recognized in the US 20 years ago.

It grew up just like a little bit before

that. But they combine like chapency

nurses social workers like doctors or

other clinicians and then they take care

of your family too. So like when you

walk in the door they're like who else

is taking care of you? Who else is with

you? Hey, does this person need

something? It's so incredible. It's like

if you could just dissolve the health

care system, which Walter Kronhite said

is neither healthy nor caring nor a

system. You would just like start with

palative care and then just like build

everything else around that. There's a

lot of like mis misunderstandings about

what palative care is, but if anybody's

struggling and isn't sure where to turn

for that, they're so incredible. And you

could just ask, you just be like, can I

have a pal of care specialist be part of

what we're doing?

>> Yeah. Yeah, absolutely. Thank you for

sharing that. Yeah, it feels like

there's all these

>> hidden things that exist already that

that we miss out. And even even like the

um what was it? The hot widows.

>> Hot young widows.

>> Hot young widows. Lovely. Yeah. Like

that's

>> Yeah.

>> Even the camp you were talking about

earlier when before we started

recording.

>> Yeah. Katie's at Camp Kessum. Yeah.

Yeah.

>> And and just there's all these things

out there that humans are doing so many

beautiful Yeah. There's so many

beautiful things to to help people at

different stages and

>> you almost don't know and and hopefully

people who are in the position know but

if they don't it's yeah I really

appreciate you sharing that.

>> I think this is such an important

conversation that I feel like you're

such a big part of like how do we help

people take back their dignity when

they're dying? Like what does what does

that actually mean? What does that look

like?

>> I think the the broadstrokes answer is

like don't forget that they're a person.

Don't forget that they're still them.

Think about what you would want in that

situation. You know, I think like like

we were saying, it's like illness and

dying can be sort of so flattening of

like your humanity, your complexity.

It's so sort of like undignified, right?

You're like you become sort of like

infantilized, you know, or if you're in

a hospital or if you're somewhere if

you're in a healthcare facility, you're

literally naked, you know? You're not

even wearing your own clothes. So just

as much as like people can protect your

privacy, ask you what's important to

you, make things beautiful like

sensually, you know, like there are

flowers here, there's music here, like

people are touching you, like people are

looking you in the eye, like

>> I don't know, I could say a million

other examples.

>> I also think like respecting what

someone like cares about. You know, when

people are dying and they're trying to

make a difficult decision like Paul did,

I wrote about this in the end of Paul's

book, but

>> he was very, very sick and ultimately

got rushed to the ICU cuz he was

suffering so much and couldn't breathe

well and then had to make this decision

about whether to be intubated, like

whether to be on a breathing machine. A

lot of people who are sick end up sort

of with a north star of what's really

important to them. I want to be with my

family. I want to be free of pain. I

want to make it to my child's

graduation. For Paul, his was I want to

be mentally lucid. Like I want to be

mentally lucid to like be with my family

and keep writing as long as I can write.

He literally was like writing up until

like 2 to 3 days before he died. And so

that decision about whether to be

intubated

became really clear.

>> Yeah.

>> You know, where he's like, there's a

chance if I get intubated then I will

not be extated and instead like we'll

stop life support. And so for him it was

like the way to like maintain his

dignity was like or align with his

values was like okay if this is the end

of mental lucidity then this is the end

>> and like we'll listen to you know like

great like we'll make that happen.

>> Yeah.

>> Which was when that was actually

happening it was like incredibly

confusing incredibly painful incred like

so hard but also like so there was a

grounding thing which was like what's

important to Paul. When I hear that, I

think about how usually when we're

losing someone, we're worrying about how

it affects us.

>> Yeah.

>> And they're the one who's going through

loss, too. It's shared. It's shared. It

is two ways.

>> But it's almost like I think us, all of

us naturally would want the person to

stay. Obviously,

>> totally.

>> But there's a independence and decision

that

>> that person also needs clarity on. And

like you said, it may be yes, I want to

do this, but his one was so specific to

his totally helpless and mission in the

world.

>> Totally. And at the same time like

medically like families can go through

real trauma like literal PTSD from like

participating in medical care or having

like their loved one get care that

wasn't in line with their values or that

they ultimately thought like oh that did

cause them unnecessary suffering. So

it's like there's always a trade-off you

know like

>> it's like it can hurt everybody. Do you

believe anything needs to change in the

standard protocol of how doctors deliver

terminal news?

>> Um, totally. When I was in medical

school, which was 20 years ago, they

were just starting to teach like, hey,

make sure you attend to the emotion in

the room. So, like if someone is crying,

pause, allow some space. It'll feel like

a long time to you, doesn't feel like a

long time to them. And then you can even

say, I see the tears in your eyes. and

just leave it where you can say this

looks like it's feeling really sad. You

know what I mean? Like we were learning

those skills. It was really interesting

because they were teaching it to us like

they were skills because they actually

are. And then you have a little

pneummonic about like attend to the

emotion in the room but it's real like

it's you it becomes part of you.

>> Um I think you know there was a study of

doctors that said half of doctors said

they had like given a prognosis that was

rosier than what their actual medical

opinion was. So interesting. It's like

even in the hospital, it's like you sort

of make this assumption of like what

hope means to people. Like hope means

longer life. So I'm going to say that

I'm going to keep them on the outer

bounds of what could be possible. But I

think what many people respond to like

what I've ended up learning is a really

good way to share with patients or even