Lucy Kalanithi: What Loss Can Teach Us About Living (The Perspective Shift That Changes Everything)

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25:46Jay Shetty: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. 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 yeah i can't imagine that they align every day every moment when 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 had an AIDS that feels appropriate for loss, there's that story that you can tell yourself.

26:53Jay Shetty: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 four colon cancer. And he was like maybe two 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. And I wanted to know, like, what did being so close to death teach you about life and living?

27:30Yeah, 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 won 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.

29:10And 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 patienthood. 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.

29:43And 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 OR. 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.

30:16But 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 Ostaseski is 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 Biok 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.

31:23He 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. It's 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.

32:07Right. 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 bullshit and transcendence, you know, which is like hopefully what we can all do like every day. Yeah, yeah, yeah.

32:42Jay Shetty:Zooming in, zooming out. As you said, yeah. 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, parks. Yeah. And we just, we place these little thoughts on what everyone's going through. What? And people are like moving around in the park or sometimes it's parks. And you like ascribe like a story? Correct. Oh, I play that game with my kids. 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 if that's what you're talking about. Yeah, yeah.

33:15We'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, oh, like, we just sort of make it up like as a way to pass the time. But it is sort of like an empathy game.

33:35Jay Shetty: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'll just put little stories 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. Yeah, it's like the fundamental attribution error. I feel like they're a terrible error.

34:03Jay Shetty:You're like, they're an asshole. 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. end but then I like your version of it's still bullshit traffic so I need to make one of that one yes I think we need to end it with that I think you found the perfect ending yeah cool oh it's so cool I can't wait to see that yeah no as you're saying it was just it's it's helpful hearing it from you I as you're answering these questions I'm so honestly like 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 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 because like the next thing that comes is also so really hard.

35:28Like 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.

36:08And 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 Julia Louis-Dreyfus's 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.

36:42Like, you've been through so many things, you know, you can do it. And I was like, that's awesome.

36:48Jay Shetty:If we're able to pull from that well of experience and tragedy and if we're able to look at it and go, because 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 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 that we just about got that. Or like, I was a stupid teenager. Exactly. And then you're like, no, you had to learn that. Yeah, yeah. There's no other way to learn that. Exactly. And like owning that is what gives you what I think what you're sharing, which is, oh, I can look back and think, wow, I got through the heart.

37:22Jay Shetty:And I can relate to 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 nine years ago. and I was talking to my mom and she was asking me how I was and what I ate for dinner which it was usually a 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 I would say that in a passing way sure and she said you're good at dealing with stress and I was like what 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 gonna cry it gave me such a gift so much it's still what i turn to when i need strength oh my goodness it broke through the challenge i had at that time like it gave me all the resilience and conviction i needed because my mom 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 gonna cry because like she's telling you like you're the fact that you were an infant fetus right like 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 pre-verbal 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.

39:01Jay Shetty: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 it 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 mom grew up in a war-torn country. They both moved to England, And, you know, and 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. Yes. My mom was studying for exams when she had soldiers on her rooftop.

39:36Jay Shetty:Wow. Yeah. And my dad shared a bathroom with like 25 families. Yeah. And when I think about it, I think, God, that is insane. And then when you think, and you're like, but I come from that. Sure. Like, I come from that. And like, what? Yeah. And so I wonder when, like, for Katie, who, as we were talking about earlier, like, doesn't necessarily know her father, but how do you think about creating that experience for her 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?

40:12Like, you do need to sort of absorb it yourself. Yeah, yeah, yeah. You know, like, I did this again. And 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, whatever she takes from that. But I think so much about how to 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.

40:57I 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 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.

41:41It'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 the 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.

42:20You take the hour power 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.

42:55It's like, we're 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. Like I have no, no idea. But I hope that she'll find some way that helps her, like you did, understand where she came from and that she was loved. And yeah, she came from this. That's really beautiful to hear you say that.

43:26I came from that. Yeah. So I have no idea.

43:29Jay Shetty:Yeah, yeah. No, of course you don't. But I appreciate how you incorporate the story, the tapestry, the natural, the real of what an experience is. And they're not heavy also. So the version that's digestible and inhalable without holding it. Yeah, I actually ask, 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.

44:04What 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.

44:21Jay Shetty: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 was in attending by then. This is when things will like ostensibly 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.

44:58And 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 refinance the mortgage like all of these things it's like can I be a solo parent like that is what I'm gonna 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?

45:43And 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.

46:23Sometimes 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. I'm 99 % certain that Paul will not be fine. So like, that is now like where I need to hold like my energy.

47:01So 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 infanthood 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.

47:36Like, 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 beautiful and amazing and really good that we did it. And just, yeah, it worked out. Taught me a lot.

48:23Jay Shetty: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 10 ,000 decisions about like how to make it all happen.

49:14So 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, which is 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.

49:54Just be like, OK, like, I don't know. I have no idea. Yeah. And then I just have like really good friends. 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 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

50:22Jay Shetty:like i don't know it's all everything it's all everything it's the transcendence and bullshit Yeah. You know, this actually makes me think of this thing. Yeah. Transcendence of bullshit. Yeah. 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.

50:53And they said, how much do you think you're going to change in the next 10 years? And people said, probably not a lot. and he interviewed people at every age and there's like a 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 yeah so i don't know i find that really helpful i don't know why yeah yeah allowing ourselves to be new and

51:31Jay Shetty: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 that's interesting 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 interesting 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 gonna make the me 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 kate katie reminds you most about paul her eyes and her hands her stubbornness It's like infuriating.

52:22She very much knows her own mind, which is infuriating. It's like an entire parenting toolboxes are unavailable to me because she's not a pleaser. 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 sort of like why he's like when breath becomes air spun out of his illness because he was like churning 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

53:08Jay Shetty: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 an 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, because 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.

53:42And 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. So like, well, you know, just like, but then there's a lesson in that. and she like recently like of her own volition 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 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 sit 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 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 because it's not the only thing you know it's like she's piecing together like you know all of it like the structure of everything

55:05Jay Shetty: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 yeah 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 so i was just like it was just pure intuition i was just sort of like what i'll know when i know yeah you know for my wedding ring i was like i guess i'll take it off sometime it's not today and then like six 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 gonna put it back on and then like right now i have like my engagement ring and paul's wedding ring on this hand, which is interesting.

56:01But 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 after Paul died. It was Nora McInerney made it. It was incredible. And there was actually a lot of conversation in the group. 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? Because I think a lot of people who'd had that conversation felt really freed by it. Some people thought like, what would they want me to do?

56:30Or 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 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.

57:16His 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.

57:52Jay Shetty:Yes. Katie, you know it's a little sister. Got it. That's a good criteria. We're going to put it out on the show right now. Yeah, exactly. I'm hearing from you that it's that intuitive tell. Totally. Yeah, it's not something that you consciously pursue or prepare for. Which is 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 and I don't know it's just like it's all in 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 right practical thing that you can kind of put into a 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 because you're you like and i don't mean you're jay shetty i mean like you're 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 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 yeah but it's like the same time you're like it's sort of like that thing where it's like you know when you're not like Like it's intuitive.

59:59Yeah.

1:00:00Jay Shetty:I mean, ultimately it's teamwork and teamwork requires all those things you just said. Yeah. Teamwork should be fun and it should have growth and it should have a mutuality and it should have reciprocation and it should have connection and communicate. And so teamwork just, it feels very simplistic, but, but 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 and like choosing and like choosing like on a daily basis, you know, like that's very romantic.

1:00:34Yes. Of like sometimes one person's up, one person's down. Sometimes it's like, you know, difficult. Yeah. You know, but similarly, like that's your team. Yeah, yeah, yeah. Exactly, exactly.

1:00:45Jay Shetty:And it's shared. Yeah, totally. It's a shared experience. It's a shared life. It's a co-created life. Yeah, yeah. It's a co-creation, I think is so important and co-holding and co-co-everything. While also like you're still like two beings, like 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. 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 re-imagining how we die, because it kind of goes back to what you were saying earlier about the survivor or the beating cancer approach.

1:01:32My monk friend who passed away, like he was very positive and he almost just

1:01:38Jay Shetty: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 he got that. I wonder what your take is on having obviously done this, been a doctor, seen patients, been at grief groups. 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 hear you about your friend and it really is like to each his own like people really have different ways of coping.

1:02:32It is a weird time to die in America in history, 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. 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.

1:03:17I think like suffering and dying are really hidden, like from view the way that they haven't been across history for people. It's 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.

1:03:55It'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 health care 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 health care within that to kind of like design your health care 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.

1:04:49My 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 palliative care team to be part of their care. People get really scared around the word palliative. So like palliative care, hospice is a teeny part of it. So hospice is like palliative 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 six months. That's hospice. Then there's palliative care, which is huge. You could be like a 22-year-old with Hodgkin's lymphoma who's going to be cured in two years and is like really struggling and suffering and they'll take care of you too.

1:05:30Or you could be someone with heart failure where it goes up and down and up and down for years and you could have palliative care take care of you. And basically, 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 U.S. 20 years ago. It grew up just like a little bit before that. But they combine like chaplaincy, 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?

1:06:04Who else is with you? Hey, does this person need something? It's so incredible. It's like if you could just dissolve the healthcare system, which Walter Cronkite said is neither healthy nor caring nor system, you would just like start with palliative care and then just like build everything else around that. There's a lot of like misunderstandings about what palliative 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 would just be like, can I have a palliative care specialist be part of what we're doing?

1:06:33Jay Shetty:Yeah, yeah, yeah, absolutely. Thank you for sharing that. It feels like there's all these hidden things that exist already that we miss out. And even like the, what was it? The Hot Widows. Hot Young Widows Club. Hot Young Widows Club. Yeah. Even the camp you were talking about earlier before we started recording. Yeah, Katie's at Camp Kasem. Yeah. Yeah. And just there's all these things out there that humans are doing so many beautiful things to help people at different stages. and you almost don't know. And hopefully people who are in the position know. But if they don't, it's, yeah, I really appreciate you sharing that.

1:07:09Jay Shetty: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 that actually mean? What does that look like? I think the broad strokes 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.

1:07:52So 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, like, you know, when people are dying and they're trying to make a difficult decision, like Paul did, And I wrote about this in the end of Paul's book, but he was very, very sick and ultimately got rushed to the ICU because he was suffering so much and couldn't breathe well.

1:08:28And 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 two to three days before he died. And so that decision about whether to be intubated became really clear.

1:09:02you know where he's like there's a chance if I get intubated then I will not be extubated 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 yeah 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 incredibly so hard but also like so there was a grounding thing which was

1:09:36Jay Shetty: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 yeah they're the one who's going through loss too right it's shared it is two ways right but it's almost like i think us all of us naturally would want the person to stay. Sure, 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 purpose 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.

1:10:49So 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. Or 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 mnemonic about like attend to the emotion in the room, but it's real. Like it's you, it becomes part of you. I think, you know, there was a study of doctors that said half of doctors said they had given a prognosis that was rosier than what their actual medical opinion was, which is so interesting.

1:11:32It'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 frame it to yourself, is thinking A, about like prognostication, for example, as a range. So like instead of saying like you have six months to live because like that's the median and the studies, you say like it's likely a few months to a few years, which is like broader but more accurate really.

1:12:09And that's like enough information for someone to decide, like, do they want to have a baby during this illness or not, you know? And then similarly, another way that we've been trained to tell people that we're training our students to tell people is a model where you say you share the best case, the worst case, and the most likely case. And actually people can have a lot, people get a lot of information from that where they can decide, like, how much risk do I want to take to aim for the best, to prepare for the worst? And then they're kind of like, well, I'm still allowing space for the best and in the meantime i'll make sure my family knows what i want when i'm gone yeah so like i think like doctors are being taught to allow just like space space space space

1:12:50Jay Shetty:and more like accuracy yeah yeah yeah that's really helpful to hear it's helpful to hear how humans process yeah it's also like not just one conversation like of course the first time you hear the news like you then you don't hear anything else right then you have to hear it again And, you know, you heard from different people. But yes, it needs to change and it is changing. Thank goodness. I think right now in the world, we're talking a lot about aging well. Yeah. What's your sense of what it means to die well? I think that living well is the same. I think like the way to not be afraid of dying is to feel that you've had a meaningful life.

1:13:29That's what I think. I think that's what ended up being true for Paul. and I'll just tell you like something beautiful that like Paul felt that I hope I feel too because I also think this sort of encompasses like a good tip is like similarly, if you're lucky enough to like have the tools to like build a life that you felt is meaningful, I think Paul ended up feeling, like not to sound cheesy, but I love this. He ended up feeling, I'm not dying, feeling that I'm losing everything. I'm dying feeling that I have everything. which I think is so cool you know so I don't know hasn't happened to me yet so it'll be a surprise

1:14:10Jay Shetty:that's a really powerful answer and quite an unfathomable mindset because you could argue he he could have felt he didn't have everything like he hadn't had Katie and you know like hadn't had that experience and which seems like the natural thing we all feel at that time where it's like I haven't done this yet or haven't seen this or want to make it to this and sort of really say. That will always be true. Yeah. That'll be true for everyone. But he was able to say he had everything. He felt that. Yeah. Or enough, like enough. Enough. Yeah. Enough. Yeah. I struggled with it later too. And then a friend was like, what if it was enough?

1:14:46And I was like, what if it was enough?

1:14:49Jay Shetty:Lucy, thank you so much. Thanks for having me. So grateful. Truly. I'm so grateful to meet you. So grateful for your openness. So grateful to learn about Katie and Paul. and yourself. Thank you. I'm truly in awe of your resilience and courage. That's wild to hear you say that. It's true. I really mean it. Yeah, what a treat. I mean, truly. No, it's melted my heart. Truly, I really mean that. Thank you. Yeah, my pleasure. Yeah, such a joy. If you love this episode, you'll love my conversation with Malala Yousafzai on how she transformed extreme adversity into global purpose. I was hanging out with some friends and what was supposed to be a fun night just took a sharp turn and immediately I froze.