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Observations BMJ Confidential

Lucy Kalanithi: Work, life, grief, love

BMJ 2018; 361 doi: (Published 25 April 2018) Cite this as: BMJ 2018;361:k1220


Lucy Kalanithi is an assistant professor of medicine at Stanford Medical School in California and is the widow of Paul Kalanithi, whose posthumous reflection on death and meaning, When Breath Becomes Air, became a worldwide bestseller in 2016. The couple met at Yale School of Medicine and had been married for nearly a decade when Paul, a neurosurgeon, had lung cancer diagnosed. Lucy finished the book after Paul’s death. She is a fellow of the American College of Physicians and has been recognised by the Massachusetts General Cancer Center’s “The One Hundred” initiative, which recognises 100 individuals who are changing cancer treatment. She serves on leadership boards for the Coalition to Transform Advanced Care and TEDMED.

What was your earliest ambition?


What was your best career move?

Being open to change. I’m a general internist but, because of concern about healthcare costs and a desire to lead, I moved from general practice to academic medicine to study and improve care delivery. Then, in 2013, my husband Paul was diagnosed with stage IV lung cancer as a young neurosurgeon, and my whole life shifted focus. We shared our experiences—as physicians, as patient and caregiver—publicly, and we had a child during his illness. After his death in 2015 I shepherded Paul’s memoir, When Breath Becomes Air, to publication, and I’ve been sharing our story since then, including in a commencement speech and a TEDMED talk. I’m now an advocate for better end-of-life care and humanism in medicine.

What was the worst mistake in your career?

Taking on too much; not knowing how to say no. I’m much better at that now.

How is your work-life balance?

I love it. I’m on faculty at the Stanford University School of Medicine, practising clinical medicine, teaching, and speaking about When Breath Becomes Air. It’s a work-life-parenting-grief-love balance.

How do you keep fit and healthy?

Running, meditation, sleep, social connection. Evidence based!

What single change would you like to see made to the NHS?

For the United States to have an NHS, too . . .

What do you wish that you had known when you were younger?

Things will be OK, even when they’re not. Lean in to suffering. Be grateful for help and mentorship.

Do doctors get paid enough?

Yes—although pay disparities between fields of medicine (such as between procedural and non-procedural specialties) don’t reflect relative value, skill, or work. That gets my hackles up.

To whom would you most like to apologise?

Not sure. I’ll think of the answer later, I’m certain—and then I hope to do it.

What do you usually wear to work?

Scrubs and glasses.

Which living doctor do you most admire, and why?

Honestly, all of us. Practising medicine is intensely meaningful and rewarding, but it’s like a marriage: constant work and recommitment.

What is the worst job you have done?

Pizza waitress with a leering boss at age 15.

What single unheralded change has made the most difference in your field in your lifetime?

Patient empowerment.

What new technology or development are you most looking forward to?

Cultural acceptance of mortality and of medicine’s limits.

What book should every doctor read?

How could I not say When Breath Becomes Air?

What is your guiltiest pleasure?

Cheese, cheese, and more cheese.

Where are or when were you happiest?

Most recently, with my daughter when she climbs into my bed in the morning, all knees and elbows, to snuggle. At some point she’ll stop. But not yet.

What television programmes do you like?

I have a 3 year old, so: Doc McStuffins, Peppa Pig, and Netflix’s version of The Gruffalo.

What personal ambition do you still have?

For now, advocacy for better end-of-life care. This includes facing up to our fragility and our obligation to dismiss the simplistic “battle” metaphor of illness (when it doesn’t apply) and to help each other through. Clinical practice, always. And being open to what comes next.

Summarise your personality in three words

Extroverted, empathetic, hungry.

What is your pet hate?

Professional burnout and threats to democracy.

What would be on the menu for your last supper?

Cheese, cheese, and more cheese.

What poem, song, or passage of prose would you like mourners at your funeral to hear?

“Now Thank We All Our God.” It was part of my wedding to Paul in 2006 and his funeral in 2015.

Is the thought of retirement a dream or a nightmare?

Dream. But then, so is my career.

If you weren’t in your present position what would you be doing instead?

Math teacher. Or eating more cheese.

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