An Indies Introduce Debut Author Q&A With Katy Butler

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Katy Butler is the author of Knocking on Heaven’s Door: The Path to a Better Way of Death (Scribner). Butler was born in South Africa and grew up in London and in the Boston area. She started her writing career at the San Francisco Chronicle, where she worked for 12 years as a staff reporter. Her work has appeared in Best American Essays, Best American Science Writing, the New York Times Magazine, The New Yorker, Mother Jones, Vogue, the Village Voice, and Best Buddhist Writing, among other publications. Butler has won numerous awards for her work as a journalist and nonfiction writer. Knocking on Heaven’s Door was a featured title at this year’s Adult Editors Buzz panel at BookExpo America.

What inspired you to write Knocking on Heaven’s Door?

Katy Butler: Seeing my father suffer through a medically prolonged death, and then seeing my mother defy her doctors, refuse open heart surgery, and face death head-on. At the time of their final sicknesses, of course, I didn’t see this as a story. I saw it as a rolling family catastrophe and an ordeal that forced me to grow up and step up at the age of 60. I’d been an investigative reporter for years beforehand, though, so I could not rest until I understood the larger political, economic, medical, and even spiritual context that helped shape my father’s final misery.

Your book is more focused on end of life care for the elderly; however, do you hope that it will add to end-of-life discussions for people of all ages?

KB: Absolutely. Through writing the book, I’ve become an advocate of “Slow Medicine” — a more considered approach to medical care at all ages. I think we need a far deeper reform of our medical system to accomplish this — something like the Canadian system. A Slow Medicine insurance system would pay doctors far better for their time instead of paying them on a piecework basis for tests and procedures that can be unnecessary, inappropriate, and even harmful — especially for the elderly and those with chronic illnesses. On the other hand, if I’m in a major car crash or get a terrible infection, I want all the Fast Medicine you can throw at me until the emergency is over!

When you travel, do you stop at bookstores? Any particular indies make a lasting impression?

KB: I love my neighborhood bookstore, Book Passage, and go there frequently for events, readings, and to teach. It’s not just a commercial enterprise, but also a community hub, always buzzing. And that has helped keep it commercially successful in tough times. Bookstores and libraries are oases for me. I love the feeling of calm inside them — and that I can wander and explore ideas I might never have run across. While I was touring, I loved my time at Elliott Bay in Seattle and Tattered Cover in Denver. To be a first-time author of 64 who’s written a book about death — that’s three strikes against it! And it was so touching to sign numerous back stock copies, and get a feel from the booksellers of their faith in me, and of their own stories about caring for people they loved through the final chapters of their lives.

What are some of your favorite works of nonfiction?

KB: Two studies of the tragic clash between particular subcultures and the equally bewildering world of modern medicine: The Immortal Life of Henrietta Lacks by Rebecca Skloot and The Spirit Catches You and You Fall Down by Anne Fadiman. I could call them medical anthropology of the highest order, but then you wouldn’t realize that they are as profoundly and beautifully written as the greatest novels. They were models for me when I was writing Knocking on Heaven’s Door, because of the authors’ compassion and capacity to abstain from moralistic judgment of all the characters, even those who did terrible things.

If you were a bookseller for a day, what book would you want to put in every customer’s hand?

KB: The two I mentioned above. Also Hard Choices for Loving People by Hank Dunn and My Mother, Your Mother by Dennis McCullough, M.D. Those are books for people like me, the 24 million of us helping care for aging parents and coping with their mortality within a broken medical system.

What was your favorite book as a child?

KB: I remember Noddy, the Babar the Elephant series, The Little Engine That Could. (I grew up in England.) All of these memories are intertwined with my father reading to me, an expression of deep love.

As a young adult?

KB: I read a lot of the classic English Victorian novels. And I really remember the short stories of Saki (H.H. Munro) and Rudyard Kipling’s Stalky and Co., about boys in an English boarding school. Virginia Woolf. Reading absolutely saved my life when I was an unhappy teenager. It introduced me to people outside my troubled family and inspired me to write myself.


KB: I’ve been enjoying This Town by Mark Leibovich, Mother Daughter Me by Katie Hafner, The Lucifer Effect by Philip Zimbardo, and Holding Silvan: A Brief Life by Monica Wesolowska.

If you were stranded on a desert island, what three titles would you want to have with you?

KB: The Bible and The Complete Works of Shakespeare (is that cheating?). The third choice would either be the collected essays and journals of Virginia Woolf, or the classic Pali sermons of the Buddha. Depends on how long I have to be there!

Are you working on anything now?

KB: I’ve been speaking to medical groups and readers about how to reform the current torturous and wasteful American Way of Death, but I’m itching to return to my former introverted self and write more! I just started keeping a journal again.

Knocking on Heaven’s Door, by Katy Butler (Scribner, Hardcover, 9781451641974). Publication Date: September 10, 2013

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