One Night with Doctor Paul
Paul and I were friends at university and across cities and continents in the years following. The following conversation took place in 2007 at our friend Robin’s parents’ home in St. John, Virgin Islands. That home, Purt-Ny-Shee, was destroyed by hurricane Irma in 2017.
What follows is a lightly edited conversation from 2007.
Paul and I have been friends for about ten years. As I recall, we were first introduced by Andy. when Andy recruited me to join the Ovalshow sketch comedy group at Stanford University, in the fall of 1997. At the time, to a smart-alecky sophomore, Paul, along with RM, represented the brooding genius of the show — writing and performing sketches that were arch, literary, and absurd. In those days of Nico and Mr. Eddy, he often sported a dark trench coat and a casual disregard for convention, giving Paul as much of an air of danger as could be claimed by a man who studied moral philosophy, the philosophy of science, and later, medicine.
After college, Paul, well, Paul continued to go to college. Our friendship continued and matured, over the years and across continents, as Paul completed a Master’s at Stanford, spent a year at Cambridge, and then finally settled on a medical career at Yale. Included in this time were a memorable, if ill-advised, weekend of martinis in New Haven, a week-long tour de force in London, Brussels, and Amsterdam, many evenings of dinner and drinks in New York, and two separate, rum-soaked weeks in the Virgin Islands.
Paul, recently married, and even more recently turned 30, agreed to sit down with me for my first experiment in interviewing. During the most recent of our trips to the Virgin Islands, over wine and then whiskey, on the deck of Purt-Ny-Shee, overlooking the Caribbean Sea, we talked about growing up, our friends, Christianity, becoming a doctor, and anything else that crossed our minds from two until six in the morning.
Name: Paul K.
Occupation: Neurosurgery resident
Hometown: Bronxville, NY and Kingman, AZ
Family: Paul is the middle brother of three. Paul’s parents immigrated to the US from India. His father is a cardiologist and his mother took care of the family. Paul is currently married to Lucy G-K.
Paul spent the first half of his youth in Bronxville, NY, and the second half in Kingman, AZ, two vastly different towns located on opposite sides of the country. In terms of influence, neither town is immediately obvious as heavily molding young Paul, other than his once-ardent support for Senator John McCain, and his continued support for the Phoenix Suns.
RRD: In terms of growing up do you identify more with Bronxville or Kingman or both equally?
PK: I think when I lived in Kingman, I identified more with Bronxville, but after coming to Stanford, and just to clarify, the way I conceptualize these two places Bronxville is very urbane, wealthy, highly educated, Kingman, very poor, no one goes to college, no one graduates high school, it’s out in the wilderness, and I know it doesn’t make a whole lot of sense to say, because my career trajectory is very Bronxville-ian, but, in the end, I think I identify more with Kingman.
RRD: So what about Kingman is it that you identify with?
PK: Outdoorsiness, being in the outdoors. I much prefer rural settings to cities. I like the small town, where everyone knows everybody. A little bit of the suburbanite dream where you can go live in this place where its very safe, very nice, but it’s more than that because it’s in the middle of nowhere.
I may never get to do this because the kinds of jobs I am headed towards require a high concentration of technological capital, but my fantasy world, I would just move to Wyoming or Montana, just live in the middle of nowhere and just fix broken legs or whatever.
Time in the Wilderness
Over the past ten years, Paul has lived in some very urbane communities, surrounded by people who are brilliant in their fields. With a lengthy spell on and around Stanford campus, a year in Cambridge, England, and four in New Haven, and with an imminent return to the Bay Area, I was interested by Paul’s desire to live in a more remote place, like Wyoming or Montana. I asked him to talk a little more about his vision of Paul, the Frontier Doctor.
PK: I describe it as being kind of a fantasy. It seems like a concept that, I guess none of us really wrap our heads around it yet, the idea of a real home and a community. Like when I do my political daydreaming, I’d love to live someplace for twenty years and then run for office. I don’t know if it’ll actually happen, just because of my career.
So my small town fantasy may just be that. Define it as an absence of something that is in my life now. But I don’t exactly think of it that way, because I really came around to the small town as an ideal, not when I lived in Kingman. I remember this one image, during my last year in Kingman, I feel like an electron on the edge of something, waiting for the photon to just shoot me off, into space. I couldn’t wait to leave Kingman and when I got to Stanford, I was really into the idea of San Francisco.
Then going to Sierra Camp, ohmygod, I love this place. I loved being out in nature, the encounter with the sublime, being on the top of a mountain, the quietness of nature, the drama of nature. I was like, Wow, these are the fireworks for me, much more than going to clubs, or whatever, that’s where the ideal began to form.
RRD: That’s interesting to me, because I don’t associate big nature, big sky backpacking as part of the Paul idea.
PK: Most people don’t, weirdly enough, If I was a fictional character they would totally pick out Bronxville and Kingman, because they define the two poles of this character’s life. There is a huge Bronxvillean aspect to my personality, that is in many ways the more dominant. The literariness, the goofy intellectualness. But ultimately, if you ask me would I rather read a good book or go on a good hike, I’d take a hike any day of the week.
RRD: Did you hike a lot in Kingman?
PK: Yeah, yeah, I did actually, but not because I was in love with nature, but as a way of escaping. I would often go back behind my house, hike out into the red, rocky mountains. I could disappear for hours into the mountains. Also as a way to get to downtown, where this girl I was dating worked, at this coffee shop. I’d do that a lot. But even when I had a car, I would hike down rather than drive over.
RRD: So what are the best places that you’ve ever hiked? What are the real kind of holy places, that you remember, that you’ve been inspired by?
PK: The first time I hiked Tallac, the big mountain by Sierra Camp, there is this phenomenal thing where you leave at 2 in the morning on a full moon, you hike out by the light of the full moon, you actually don’t need a flashlight, and you summit right as the sun is rising, and as the sun rises the sky begins to lighten, and there is a moment where you can see the sun peeking over the horizon, and it’s light blue, and it gets slowly darker until directly above you it’s pitch black, and you turn around and look behind you and it’s still night. The stars are still out, the moon is still out, and you look one way it’s pitch black night, and you look the other way and it’s day.
The Machu Pichu trip with Robin was fantastic for totally other reasons, Hiking with Jeevan in Chile. That’s where the stories come from, because they are sort of ridiculous. Other sublime things: Desolation Wilderness, for a whole host of reasons reasons, out behind Kingman, of course. Now, with Lucy, the White Mountains.
Does A Neurosurgeon Have Uses for A Fake Moustache and A Gorilla Suit?
In college, and really only slowing a little bit in the post-collegiate days, Paul made a reputation for embracing an absurd sort of prankishness, with the joke most often at the expense of convention, rather than anyone in particular. From wearing a fake mustache to a good friend’s wedding, to wearing a fake mustache in his medical school ID, to getting drunk in a gorilla suit, these pranks often involved fake mustaches and/or gorilla suits. And they weren’t always well received. I wondered how the general undergraduate knack for hijinks would translate to the more serious world of medicine.
RRD: Do you feel like you are maintaining or losing or is there any difference between Paul, guy who wears a fake mustache to Dave’s wedding, owns a gorilla suit and Paul, important neurosurgeon?
PK: Yeah, oddly enough right on this deck, three or four years ago, Robin and I were sitting, and Robin said, Paul, at some point you are going to drop this whole medical school thing and do something crazy, because I don’t understand why you went to medical school. Because it is a little incongruous, with the way I was. Because a lot of the things I was known for and did are not congruous with being a doctor.
As I said to a friend, as we were having drinks last weekend, he said what are you doing, and I said was going to be a neurosurgeon, and he just started to laugh. Everyone I know well that I tell just starts to laugh. So am I going to lose the fake mustache / gorilla suit part of myself? Probably. That ostentatious side of me hasn’t been as ostentatious and won’t be as ostentatious as it was when I was younger. But I think that’s sort of normal. There are serious things that I care about more.
RRD: So how does it work? Do you compartmentalize two parts of what you do? Or do you integrate them and one part diminishes?
PK: You compartmentalize. Even when I was applying to medical school, there was this great moment. I was doing one of my Yale interviews, my interviewer was challenging me, he asked me, are you just going to use your MD to become some kind of philosopher, just to get credibility out of it. What’s that all about? Do you really want to be a doctor?
After we interviewed, he said come back and have beers with me, which I regret not doing. And then he said, every recommendation letter you have mentions your comedy work not one mentions your sense of humor. Why is that? And I was like fuck, great question. And I had an instant answer.
When I’m working, I’m very serious. I’m not Patch Adams. When I’m doing my philosophy, I’m not cracking jokes about Heidegger. With my professional relationships, with people who are going to write letters, I don’t have that sort of ease where I can shift into funny mode when we’re doing something serious. When we’re doing something serious, I’m pretty focused on it. I have pretty radically different gears.
RRD: You kind of wove your way around and got back to doctoring, after four or five years of kicking around. Do you feel like at this point, that being a doctor is a true calling? Do you really see at some point abandoning being a doctor, or is it so fundamental that you could never see you not being a doctor?
PK: Oh not at all. Sometimes I think to myself, if I can’t be a neurosurgeon, what would I do, would I be a psychiatrist, would I stay in medicine? And my gut feeling is no. I’d leverage the neurosurgery thing into a position with Medtronic, or even in consulting. Make a total lateral move.
RRD: Do you see it as service?
PK: Yeah, absolutely. The reason that I chose neurosurgery over anything else was the service component. Literally, I didn’t say what would Jesus do, but what was important in the world from a moral/religious standpoint. I could be a psychiatrist. Everybody was pushing me to be psychiatrist. Because I’m a good writer, I do good science. And I’ve been told repeatedly, you’re just the sort of guy who needs to come into this field.
But in the end I feel there was a sort of vanity to do that. The people I cared about helping were neurosurgical patients. People whose lives were suddenly and utterly fucked up — whether it was trauma, epilepsy, a brain tumor, something is seriously fucked up and it’s fairly sudden and it totally upends a whole family. And what I love about the job is that you are the only person, literally the only person, who can help those people, because there are only about 3000 neurosurgeons in the United States. And I love the seriousness of it and the badass-ness of it, it’s really, really hard work. There are harder jobs in America, obviously, but not a lot. I love that I can do it and, I think most people can’t do it. But part of what I mean by that is I’m not sure that I can do it. It’s so fucking difficult. And I love that challenge.
But really the number one thing was that, these people are suffering so acutely, and so profoundly, more than almost anybody else in healthcare, and those are the people I wanted to help. So would I do this until the day that I die? Probably not. Because it’s backbreaking work, in two senses, in that you break people’s backs, to get to their spinal cords, but also because it’s fucking hard work, physically demanding, both in the sense of physical strength, endurance, and it’s emotionally demanding, intellectually demanding, demanding on your time as well. So I see doing this for twenty, thirty years, however long, and then I see retiring. I wouldn’t die in the OR.
And the other thing I should say about it, you are so close to death all the time, death is a real thing. I remember reading a book called Death, and I remember thinking distinctly, at some point, if you can get your head around death, you’ve really accomplished something intellectually. So being in the company of death, constantly, was something that was attractive to me in medicine. You are really there at the life and death moments, and those, in some sense are the real authentic moments in life. So there’s that attraction, as well. So it’s definitely a calling. You can’t see it as a job, because if it’s a job, it’s one of the worst fucking jobs there is. So you have to see it as a calling. But at some point I’m doing and I’m writing my weird books. But not for a while.
His Girl Lucy
Last September, in a lovely ceremony on the Connecticut shoreline, Paul married Lucy. Some seven months later, Lucy turned up at the dock in Cruz Bay, expected, but a couple days later than the rest of us, and a couple fruity rum drinks behind. Also a doctor, and having just returned from a doctor’s conference in San Diego, one of Lucy’s first announcements upon landing was that the eye doctor, who was super cool, had informed her that her eyes were crooked and that explained why she didn’t like reading. Which was news to me. I asked Paul to talk a little bit about Lucy.
PK: What I really treasure about Lucy is that her capacity to love is barely finite. Such an empathetic, caring person, it’s unbelievable to me most of the time. She gets very freaked out that she can not talk intellectual bullshit, since that’s what I do a lot of the time, with my friends. She was like, “Yeah, I don’t get any of that. I don’t read those books.” But fundamentally, on what counts, she has everything. And I really saw that in her almost immediately.
It’s silly to believe in love at first sight, but as I as soon as I saw her in medical school, I was like “Oh, shit.” Because I was still dating Nat. “This is a girl I can not get to know.” Just because of the way she carries herself and interacts with people. I thought, this is a girl I am not going to get to know. And that’s going to be fine. Because I had this idea that I’d come to medical school, be very studious, not have many friends, hang out in New York, have a social life there. And that worked pretty well for a few months. Until I went out to a big social event, had a few drinks, made a lot of friends, including Lucy. And after that, Lucy and I were now friends.
I like to pretend that Lucy comes after the breakup but that’s not how it really works. Lucy and I went running once, then she came over to a barbecue that I threw, and then we started hanging out a lot. And then she knew that I was going to Barcelona to meet my English girlfriend, and she wrote me an email about Barcelona, all the things to do and see in Barcelona, and some really sweet, personal touches, just because that’s who she is and how she is with everybody. Needless to say this did not help.
Nat and I broke up while we were in Barcelona. And a coincidental, funny thing, the Hunger and Homeless auction in November, people put up date boxes, you don’t have to be single to do it. So I made one: the Guns and Freaks Date, for the raffle box. Going to Bridgeport, possibly the worst city in the universe. But it also has a Ringling Bros. & Barnum and Bailey freak museum and it has a shooting range. And I was like, this is clearly what I want to do one Saturday. So that was my date.
Mostly dudes entered it, because they were like “This is awesome!” But Lucy put in one ticket. The way she tells it, as she was leaving the auction, she figured, “I’ll put in one ticket. Paul’s my friend.” And within hours after breaking up in Barcelona, I checked my email. I got the email from the coordinators: “Lucy won your date.” And I thought, “Well, I guess that’s that.”
RRD: It’s a funny thing, I remember you telling me, I had met Lucy, and I remember asking you, “What do you like?” and you said one thing, which was “Her bookshelf.” Which contained all the books that someone who would be really interesting would read. Funny in the light of our conversation of the last couple of days, that Lucy doesn’t really like to read.
PK: I remember this conversation because we were in the subway, and I said “These are the sacrifices you make to date someone who was really smart,” but I sort of paused, because I was going to say “Hot.” And of course I meant both things. But that was one of the funny surprises about Lucy.
RRD: That she doesn’t like to read…
PK: Yeah, that she doesn’t like to read. She does have a great bookshelf of books she’s never read. During the early stages of our relationship I kept buying her books. And I was like “What is your deal? These are great books I’m getting you. But you read a few pages and you’re like “Let’s do something else.’”
RRD: One of Lucy’s qualities is a sense of wonder…
PK: Absolutely. Lucy’s alive in a way that I fee l like I’m not. That sounds a little more profound than I mean. Maybe not. It’s true. She’s one of these people who has been able to preserve the childlike fascination with the world while not being a child.
One of my favorite things about Lucy is that she is so present in every moment, in a way I’m not really able to be. For her that distance that doesn’t exist. there was this very funny moment. We’re studying EKGs, so there’s the normal ones and then there is Vtak or Vfib, maybe it was Vtac. One of those.
When it happens, it means you’re about to die. I thought, it’s just a wavy line on a page. And the first time Lucy saw it she started to cry. Because it meant that somebody was about to die. And I said, you know, you’re right. To me that’s a bunch of wavy lives on a page, I was sort of analytic about it, but to her, she knows what that is, she knows what that means. And I thought, god that’s amazing, that you can be that in touch with things. You look at squiggly lines and it brings you to tears.
Walking With Jesus
RRD: Walk me through the Christianity thing
PK: Sure. You want me to give you the biography?
RRD: Well, start with that, if you think it’s the best. I guess the thing that I don’t get is, you’ve told me, written, self-identified as a Christian. And personally that means one thing, and politically and culturally it means something. It means one thing to say that I believe in Christian teaching and another thing to say that I am a Christian. That’s a distinction that people enforce from outside, but it is a distinction. To my understanding, you’ve said “I am a Christian.”
PK: Sure. Totally.
RRD: But you’ve created some definition as to what that statement means, right?
RRD: Maybe walk me through that. You wrote something to me about what one of your Professors told you, that he said, “Paul, when you become a doctor, you’ll understand that you need to be a Christian.”
PK: Well, he said to me, I think we were having some conversation about religion, where I used the term post-theist, that was I was trying to promote — that religion is some ancient, ridiculous thing, it isn’t even worth being an atheist, so let’s move past that. So I said, you know Bill, I’m more into this idea that I call post-theism. What is a world like when religious metaphysics is not a question people engage in.
And he was like, “Never use that term again, because it’s absurd.”
Then he said, “I hope it’s not weird of me to say this, but, Paul , you are already a Christian, you just haven’t realized it yet.”
And at that time I was like “Ok ,you’re my boss.” And left it at that.
And I think I know what he means by that now. Sort of.
So I guess the biography of it, if we start there…
RRD: Well, let me start earlier. You were raised Christian?
PK: Oh, yeah. My parents were very religious. We prayed every night, read from the Bible, a very nice family thing to do.
RRD: Prayed in what sense?
PK: We sat around on the floor, legs crossed. You were encouraged to pray out loud, but you didn’t have to. So, we were a very religious family, and my parents are still very religious.
I think by the time I was fifteen I started to take ownership of religion. It wasn’t something I just did because my family did it. I started to think about it critically, and still coming out on the plus side. I remember talking to Suman, who was in college, and saying that meditating about a problem, thinking about a problem was different than praying about a problem.
RRD: Can you articulate the difference?
PK: Sure, praying about something creates a mental space where an answer will suggest itself more profoundly than just meditating, this will sound mildly psycho, but you sort of hear the voice of God, or Jesus or whoever, in a thought that you are having, a thought that is half yours, but half not yours.
I definitely remember being openly religious at the age of fifteen or sixteen, saying that I understand that people don’t believe in God, that there are legitimate reasons to doubt. And then gradually things started to fall to pieces. My church got very crazy, because some of the leaders were fundamentalist. There was this one moment where someone stood up and denounced Mormons as being servants of Satan, and I decided that these people are a little bit crazy. So, OK, the church, a human institution is fallible. That’s fine.
And then I read the Bible, as part of my first year in college, and I was like, this book is crazy. Not only is it crazy, it doesn’t make any sense. OK, so that’s a fairly big problem. So, now, I feel that the church, very fallible, and the Bible, pretty fucking crazy. I’m not totally sure I can sign on to the Bible. Well, so what does that leave me with?
I guess I have some sort of notion of God and Jesus and stuff. But this is getting pretty tenuous. And at this time, I read a book called Satan’s Psychotherapy and Cure — which was not a very funny book but should have been very funny — and there is a point in the book where one of the characters makes a statement about how the mind is material. And I was like, holy shit, of course it is! What else is it? The mind is something that the brain does. It’s not anything else. And that was kind of a mindfuck. And that started me on the whole neuroscience kick.
So religion was a dead question to me for a while. Then [fast forward] to a year after I finished college, but I was still living in the area, with Ben and Jeff, and working with Bill, and… so the three guys that I spend the most time with, they are Christians in super sophisticated ways, and I don’t get what their deal is with religion. And then Bill says, “Ok you’re a Christian, you just don’t recognize it yet.”
So, the thing I wrote about, one time I’m getting breakfast with Ben, salmon and lox and capers, and I say to Ben, “I’m just so curious, your dad says you’re a Christian, are you a Christian?” And he says “Yeah.” And I asked him, “Do you believe God exists?” And he pauses and then says, “I don’t even know what question means.” And I was like, “Fuck, that’s a really interesting answer to that question.” And that opened a lot of doors.
You can be a Christian and not place a lot of chits on giant white men and robes and beards and that opened a lot of doors for me. So because I found the central values of Christianity so compelling — sacrifice, redemption, forgiveness. There is a big tension in the bible between justice and mercy, between the Old Testament and the New Testament. And the New Testament says, you can never be good enough, goodness is the thing and you can never live up to it. The main message of Jesus is that mercy trumps justice every time.
I should say as my freshman year, as a backdrop to this, I was very concerned about moral questions. My goal was to design the perfect moral system. One of the things I got on was good and evil. I don’t know how useful those terms are. At least modern life turns on being good, but not quite good enough. So you allow bad things to happen. Then a lot of the inequalities we have is because people settle for good enough, not that they are bad people, but because they are settling morally.
[For me,] the basic message, original sin isn’t “Feel guilty all of the time.” It’s more that, we all have a notion of what it means to be good and we can’t live up to it all the time. That’s what the message of the New Testament is. Even if you have a notion as well defined as Leviticus, you can’t live that way, it’s insane. And even if your notion is more sensible, you still can’t do it. That was one of the central points about Christianity for me, that struck me as existentially very, very true. So, well, I was like, I think I buy into Christianity philosophically, but not metaphysically. Beards, resurrection, I have no time for that. But this basic thing makes a lot of sense.
And then, I should say, that like a year ago, two years ago, one Good Friday, I had a more “religious’ religious experience, not philosophical. When approaching the cross during a Good Friday service I had that old school, fifteen year old experience, where Jesus was talking to me, not like I was hearing voices, but Woah! I was humbled by the cross, that Jesus suffered for us, that this is the right way to think about life, that all of my failures, in one sense is failing to live up to Christ sacrificing himself for our sins, and I really had that sense of forgiveness, and I was like well, I guess that’s the last step,.
I remember one conference I was at — midway through this transition — there were years, where I was in the in-between stage. I was walking with Archbishop George Pell [the Archbishop of Sydney, Australia], at this conference we were both attending, and I asked him, “What does it take to be a Christian?” Because I bought into it philosophically. And so I asked “You know the whole resurrection of God question… I don’t have a whole lot of use for that. I don’t buy into that. Can I still be a Christian?” And there was a pause and then he said, “No. No, you can’t.” And so, at the time, I decided I’d just be a Christian sympathizer.
And then later, as I said, I had my own sense of the reality of Christ. And now I guess I have all my chips in. That’s the religion story.
And without that I wouldn’t work in a free clinic nearly every Saturday. And I wouldn’t be a neurosurgeon.
RRD: Last question. What do you think about this beard?
PK: The beard is more or less Lucy’s idea. I was clean cut for interviews. Lucy was like “Why don’t you grow a beard?” I just let it grow out. Then I really didn’t like it. I really didn’t like it. Although, now it’s grown on me. But a beard is a lot more work than shaving.
RRD: Are you going to keep it?
PK: No, it’s gone. It’s gone. My medical school ID, I wore the fake mustache for that. So for the last banquet, I want the real mustache. But clean shaven for residence. Beards are a complete hassle, and would be an extra hassle.