♪ It's not easy to talk about death.

It may be even harder to talk about dying or maybe dying or being told you're dying, but pandemic or not, these kinds of conversations are a requirement for the living.

Kate Bowler has spent a lot of time thinking broadly and personally about death and dying.

As a professor at Duke's Divinity School and a stage 4 cancer patient, she has cross-examined the topic from multiple perspectives-- historical, religious, medical.

She has wondered aloud in multiple "New York Times" columns and bestsellers what promises can prayer and positive thinking really keep, what's right and wrong with health insurance and clinical trials, often with her 8-year-old son in her lap.

I'm Kelly Corrigan.

This is "Tell Me More," and here is my conversation with academic, writer, patient, and prayer Kate Bowler.

♪ So I wanted to spend my time with you talking about dying and death.

And you are an academic.

You studied the history of Christianity in North America.

How did you pick that as your area of inquiry, and what does it have to teach us about dying and death?

I think I picked religion because I'm naturally nosy.

You can just at least ask the question that people don't want to answer, which is: What do you think happens after we die?

Is life, you know, for pain or for pleasure?

Are we--do we belong to ourselves, or do we belong to service?

Do you have opinions about all those things?

I love what John Green, the young adult writer-- he said about water-- "The Fault in Our Stars."

yeah, why he writes young adult books as opposed to any other genre.

And he said that he loves writing those books because you never learn to feel embarrassed of asking those awkward, hard questions.

Uh-huh.

And I guess that's sort of how I feel about the study of religion-- is I get to approach a good answer, then feel like it comes apart and then try again.

I want to know what makes life really beautiful and painful and what answers can we get to the mystery of it?

What answers were you raised with, and were they convincing to you?

They were medium convincing.

I wasn't raised with a civil religion, meaning that I was never told a story about how God chose Canada for special purposes.

So I never had the kind of American story about "city on a hill" and a divine destiny for the country I belonged to.

I had two parents who became Christians later in life.

And so, I didn't grow up with only Christian albums or like the heavy subculture stuff.

What is the Prosperity Gospel?

I am very interested in the bolder spiritual promises that people believe about whether or not their lives, if lived righteously, will work out.

And so, I started studying this thing called the Prosperity Gospel, which believes that God wants to give you health and wealth and happiness if you have the right kind of faith.

So I spent about, like, a decade traveling around, interviewing televangelists and megachurch leaders.

Is that primarily where it lives, that message, is in megachurches?

There's tons of small Prosperity churches, and it's not just American, it's around the world.

But what's most fun about big Prosperity is it's a show-and-tell faith.

[Rhythmic clapping] So, it's most obvious when it's in, like, a massive building with like an eagle that's been released to fly freely or a huge aquarium that says, "Behold!

I will make you fishers of men," and then there's like a massive shark.

There's fog machines everywhere, and I think, yes, this is the natural home for the belief that all good things can be possible for those who believe.

And often that involves tithing.

Right.

The sense is that God has set, like, a template for believers.

So you sow into the righteous ministry.

I'm using these quotation marks because it's terms that was invented in the late 1960s.

The term "seed faith" was a term used by Oral Roberts, the famous televangelist and university founder.

A righteous Christian can expect that they will always get back more than they ever gave, that they'll never really stay sick, even if they get a cold.

It's almost like the pain of life is more like a tripping hazard and not like a real obstacle to feeling successful and fulfilled.

But it's sort of devastating when you think about the implication of it for people who don't get better or don't find the spouse or don't beat their cancer.

Yeah, it's-- it's like a blade without a handle.

Like, it cuts you while you hold it.

It's always the weird double-edgeness of the Prosperity Gospel and other self-help messages like it, which is on one side, it feels tremendously empowering to be told that in impossible circumstances, you are actually just one decision or good thought or one hope away from climbing out of the tar pit of your terrible life.

Simultaneously, it is a heavy burden to be told that you're not just failing if your life is coming apart, but that you are spiritually a failure.

And that was part of the pain and beauty of doing so much interviewing, as I met hundreds of people who felt they had tried to claim God's best for them, and their life was endless devastation.

It's really those messages that I always, like, feel acutely when I get the e-mail that says, um... that was the church where I thought I needed to claim my faith.

That was the church where my husband died of cancer.

That was the church that abandoned me and didn't want to do their funeral.

There--I don't know, 2,000 megachurches in the United States?

There's about 1,800 churches, over 2,000 people, and about 60% of them really a Prosperity-believing church.

And it saturates 24-hour Christian television.

It's so ubiquitous and it tells us a story about winners and losers.

And, unfortunately, most of us spend so much energy trying to be the winner and so devastated in the embarrassment of the moment we know we're losing, and then when we slide all the way down, there's really not a lot of places to go to tell that story and to still feel somehow faithful.

There's also something that you think about a lot around toxic positivity.

So the Prosperity Gospel, you know, it has the story about the American dream that's woven throughout our history.

And then there's a strand that comes out of something we call "new thought," but it really is the idea that you are actually a spiritual incubator, and if you just direct your mind and then Speak those thoughts out loud, you will be able to make any good thing come true.

And that didn't just find its way in the Prosperity Gospel.

It found its way all over our self-help and wellness culture.

Now, billions of dollars are poured into industries that tell us that we are primarily the results of our thoughts, which is lovely and false.

I mean, it creates a sense that we are mental machines and that in response to tragedy or failure, that--that all we have to do is think our way out of it.

So when you think about the culture of self-help and therapy talk and this idea that if you just think harder the outcome will change and then you cross that with getting diagnosed with a really serious case of colon cancer at a really young age after a lot of infertility, where does that leave you?

I think I knew right away, it made me a failure.

That's certainly how I felt.

But I think our cultural messaging is so intense.

I have always loved the illusion of progress.

I mean, give me a million small steps, and I will checklist my way into a glorious future.

And then I was the person who was supposed to die in the spring, and it was the fall, and I couldn't even find a way to explain to other people... that it really-- that it wasn't my fault.

It's so weird that that was like such an intense feeling, but I felt like I had to explain myself, and I think that's what cultural script to do-- is they make us problems to be solved.

Right.

It's like anti-acceptance.

Nobody's saying life is hard.

Depending on what your tragedy is, there's a-- you feel like you have to explain yourself to a greater or lesser degree.

So brain cancer is different than, for instance, colon cancer, 'cause it could be something I ate.

Whether we decide to feel sorry for each other has sort of exposed the way that pain makes us all into accountants.

Like, we're just trying to add up each other's sorrows and decide whether-- how bad we should feel.

It's gross how much I wanted to be someone whose pain mattered and counted, and then even if they did, even if they added it up, wouldn't the math be all wrong?

But I could hear it as I was so desperate to try to get doctors to invest in my difficult-to-treat, complicated diagnosis.

I wanted to be the kind of person worth saving, and at the same moment knew that it was, uh... like a really important thing that we have decided that pain needs to be explained and that some people's pain matters more than others.

How easy was it for you to find a diagnosis?

How easy is it for you to get care that you need?

It was hard from day one, and it stayed awful.

I mean, I was diagnosed late.

I was almost 6 months in to begging for care.

By the time I yelled, for the first time in my life, in a professional setting and said I wasn't gonna leave his office till I got a scan, and that's how they found out that it was stage 4 by then.

But I mean, I've been sent home from the emergency room with Pepto-Bismol.

I was told that I must be exaggerating.

No one would say tumor.

I should be able to understand the basic language around my own diagnosis of care, but I had-- for that first stretch, I was just like-- I'd be sitting at home, just...medical papers just surrounding me.

All I knew was that I had a 14% chance of living, and that I will be very fortunate if my body responded to a clinical trial.

I could go to one if I could get it covered by insurance and if I could afford to fly there.

And it was initially not covered by insurance, and I certainly couldn't afford to fly there.

So everything about my care from that moment on was like the most beautiful group project I've ever been a part of, where people donated, like, airline points for me.

They were, like, saving my family from--from bankruptcy.

And it's just-- it's wild to me.

It's wild to me that medical bankruptcy is what is the number-one cause of bankruptcy in this country.

I just--I find it so abhorrent.

It's so mean.

It's like--it's the worst moment of your life.

Hope you weren't attached to your house!

Right.

It's--it's wild.

So when you're trying to make decisions about where to focus your attention, either on the giant drawer of bills that are just infuriating and cruel or on the 2-year-old, who wants to go to the swing set, like, did you learn things about how to focus your mind?

My first version was aggressive and thrilled positivity.

I was just the happiest person who's ever gotten stage 4 cancer.

That mostly just wore me out.

I think it was just so related to the guilt.

I felt like I was doing this to us.

So shouldn't I, then, try to carry the weight?

I think pain makes us feel like an apology.

Then I realized I was gonna need some guardrails on this thing, because everything felt too meaningful and too freighted, even the loving your kid.

I mean, just being close to him and then he smells so good and then, you know, will I get to be your mom?

And then it's just-- you can fall all the way down.

So I made rules: no existential talks before 8 a.m. or after 8 p.m.

Carefully screen things for whether they were hilarious or not.

If they were hilarious, I was allowed to watch it.

I had to cut out a lot of opportunities for small talk because they all heard, you know, even just--"What are you gonna do this--" like any anything that spoke the language of the future was not available to me anymore.

So I needed things that felt possible, and I started throwing weird and specific parties.

Ketchup taste-testing.

Diet Coke--is the Harris Teeter or Kroger Brand good?

That's when I started visiting the world's largest statues, world's largest outdoor fryer, world's largest fire hydrant.

It was a weirdly joyful time because the diagnosis was so random and so terrible that the randomness could only be met on the frequency of like the randomness of joy, like fun, dumb whimsy.

It's a very indulgent time.

Like, you can pretty much have anything you want when you have cancer.

I just remember that always being my favorite part of movies.

The second I got sick was like the moment where someone flips a table.

Uh-huh.

And you're like... "That's it!"

And, like, if you're never gonna get that moment, shouldn't you have one?

Uh-huh.

I remember doing that a few times.

I rented a bulldozer.

I just leveled some trees.

I was at a really nice business lunch and I was like, "I don't need business.

I'm gonna die anyway!"

And I--all I ever heard myself saying was, "I don't think I have time for this, like really loudly.

Uh-huh.

Tick- tick, buddy.

Yeah.

The story is really boring.

Right.

OK, so do you know that we have a little speed round?

[Laughing nervously] I--I feel very nervous about it, but let's give it a whirl.

First concert.

They Might Be Giants.

Best live performance you've ever seen.

I saw "Spamalot" with Tim Curry, and I laughed so hard that the sound guy asked me to not stand so near to the actors anymore 'cause it was distracting.

Last book that blew you away.

It's still "The Road" by Cormac McCarthy only 'cause there's this line where he's looking at his son and he says, "If that boy ain't the word of God, then God never spoke."

What's your go-to mantra for hard times?

"This is the worst."

I mean, I do something like "This is--you feel awful because this is terrible."

"You feel tired 'cause this is exhausting."

I just-- Yeah.

I like the--the affirmation of reality.

So every episode, we ask our guests to bring someone else into the conversation.

We call it "Plus One," and it's a way of reminding all of us that nobody gets anywhere by themselves and that we have this incredible impact on one another.

Who's your plus one?

I picked my friend Suleika.

Suleika is an author and she was also a cancer patient.

And she wrote this gorgeous book called "Between Two Kingdoms."

It's that Susan Sontag quote that there is a chasm between the kingdom of the sick and the kingdom of the well, and that place between is somewhere that she lives so beautifully.

And I think, um... so many of the people I knew that died already, um... or they're the caretakers of someone who's very sick.

And Suleika's just been so wonderful and like a--just a very loving, faithful friend in the place between, which has been really nice to not feel alone or weird in that, so she's dear to me.

And her words always feel like, you know...

I wish I'd written them.

You know, they're just beautiful.

That's great.

She's amazing.

So word got out that you were sick, and you identified 3 different kinds of people who came to you: the minimizers, the teachers, and the solution people.

Tell us a little bit about these categories you've got.

Oh, well, the minimizers are ready to start any sentence with "At least."

At least I'm in a good hospital.

There's all kinds of spiritual versions of minimizing.

"Well, at least Heaven is gonna be wonderful."

And did that sit with you at all, given that you actually are a true believer?

Yeah.

I really do believe that there will be a Heaven where God will dry every tear.

And yet I found it very-- it made me s--I was mad.

It really made me mad.

To me, Heaven was the place where I would miss it all.

I wouldn't get to be my kids' mom.

I wouldn't get to, like, have every day.

Like, there's no-- and there's no solving that.

It was the desire to solve it on God's behalf that I found very insulting.

Mm-hmm.

I mean as if, if I were more spiritual that it would solve the problem of pain.

The second kind of person were the teachers.

Oh, yeah.

Teachers.

They're like, "I actually really want to help you out with this.

I've been doing some research."

Most people just mean light Googling-- Right, right, right.

but there was a lot of-- I mean wide variety of the people who thought if they mastered the medical specificity that it would be of use.

Yes.

So they're asking a lot of questions.

"Let me just-- was it in your family?"

I remember when someone gave me a copy of "Prevention" magazine, and I was like, "Oh, sweetie.

"We are way past-- we're not-- We're not in that place anymore."

Right.

The third way that people were reacting to you was the hardest for you is the solutions people.

Yeah, 'cause it was so tempting to believe it was possible, but it was mostly the idea that it would just be with a couple heroic acts like nutmeg oil or a smoothie diet or just a flurry of kale or repentance or a better attitude.

It just reminded me of all those old Prosperity sermons, where, you know, "God has written you a check and you just won't take it to the bank."

And it's that feeling that sort of puts back on the sufferer that sense of ultimate responsibility to fix everything about their own life.

So it's--it's hard being around suffering people without wanting to rush in with the solution, but most of the things that change us won't be things that anyone can help us with.

And that is a-- that is like a strange hard thing about love.

So, we had Atul Gawande on "Tell Me More," and he talked about how the sort of scramble to preserve life at all costs often makes things much worse.

Do you have feelings about hospice or palliative care?

I think palliative care is such a beautiful framework for how I hope that I can make decisions about life.

The beauty of that profession isn't having the wisdom to learn when and how to let go, 'cause that's a different kind of courage.

I want that courage, too, to, like, when you feel it, to let go at the right time so you can make things... beautiful even in your limitations.

You and I have both lost friends.

Did you have any thoughts about how to talk to somebody in those final days?

Have you learned anything that everyone else should know?

Think there's just such a rush, right?

That rushed, panicked feeling of wanting to say everything.

Mm-hmm.

I think just, um... reminding myself that there's nothing-- there's nothing to say except the funny stuff and the loving stuff.

And just--it's mostly just being willing to get up close, 'cause that's what kind of takes a minute, to have the courage to be close to something that's gonna break your heart.

I think it's hard to love people all the way.

It's easier to let go right before.

So just stepping into those last, hard little bits...

I think that's just-- that's just presence.

Mm-hmm.

How old do you think you'll live to be?

I like to imagine.

I'll hit 50.

That gives me 9 years to be a menace.

With my diagnosis and the kind of constellation of what's possible right now medically, it feels not painful for me to reach for that.

So then I can imagine my kid graduating.

I can imagine... enough to have the luxury of imagination.

So the more I can keep putting hopes in front of me, the more I can tell that I am, like, doing the serious work of living.

Hmm.

You talked about this thing that, uh... Thomas Aquinas called "the sweetness"?

Yeah.

I came out of my terrible surgery right after the diagnosis, and nothing in my life was going to be OK again.

And I couldn't even imagine... Next week.

It just felt like everything dissolved, but I had this overwhelming feeling of feeling loved, like really loved.

Um...

Differently than you had known before?

Just kind of like cherished, you know?

And--and part of it was like the-- like I'm in a hospital bed looking around at people's gorgeous moony faces-- Yeah.

like shining love on me.

and then I felt not like a failure, you know, I felt not disposable.

And it had just been so long of not having my pain listened to.

And so when I felt loved and I felt weirdly spiritually loved by God and that it had nothing to do with any of my efforts.

And I think that was maybe the first time in my life where I didn't really feel like I needed to do any spiritual work at all.

There was no, like, getting in your prayer time or going to church or feeling like I was trying to be a good person.

I just felt as I was in my most absurd state, I felt, um... beloved, and that was intense and lasted a few months and then it went away.

I know.

Well, that was what was so interesting to me is that after it went away, you were talking to people who'd had similar experiences-- academics and writers and believers of all types, And they said, "Mm-hmm."

Yeah.

Yeah.

So it goes.

You just get a taste of lovely things.

It just-- it's a strange feeling to feel like nostalgic for the worst moment of your life.

But I do.

I did kind of have a sense that, like, maybe that's what Heaven feels like-- something--something that feels a lot like love.

So...all this life experience, all the study, all these moments, do you have a... a statement or a position about the meaning?

Yeah.

I think-- I think life is really bad math.

I think anything we try, any formula, we try to make it add up.

And it won't, not like that.

I guess 'cause I-- it's where-- I always try to think of, "Is there a Prosperity Gospel "that I really believe in?

"Is there a version of a good, like, the best life now that I would stand by?"

I think it's that... when you are in the worst moments of your life, God and other people will show up, but all of it, like, all the best parts, even with stuff I'm absolutely terrified about, like, all of that is just love.

Like it's all the things I don't want to live without.

So, yeah.

Life is terrible math.

Ha ha!

But, like--but love, it really is kind of the only Prosperity Gospel I really believe in.

I'm so happy that you came.

Thanks a lot for saying yes.

Kelly... you're my favorite.

If you loved this conversation, you might also enjoy related episodes with Atul Gawande and Father Greg Boyle.

For more on the science of faith and character that Kate Bowler so exemplifies, please, listen to my follow on podcast at "Kelly Corrigan Wonders" or watch our companion video at pbs.org/kelly.

♪ ♪ ♪