9 powerful life lessons you can learn from death experts

As a physician, I have been present at the end of many lives and witnessed the deep pain that families face during a loved one’s final moments. While most family members express deep gratitude for the care provided by doctors and nurses, some tell harrowing stories of unnecessary pain their loved ones endured in their final days. These disturbing stories highlight a disturbing ambiguity in the care we provide, blurring the line between compassionate treatment and what can feel like unbearable torture.

Motivated by my encounters with grieving families, I dedicated the ninth season of the series Fix healthcare podcast to explore the final chapter of life and address the shortcomings in end-of-life care. The eight experts who joined me this season have profoundly changed the way I view life and death. Here are nine powerful lessons from this season that I hope will resonate with you and provide guidance and comfort as we navigate the pinnacle of life.

1. “People have goals other than living longer.”

In the best-selling book To be mortalrenowned surgeon and author Dr. Atul Gawande tells the story of his father’s death from cancer and the difficult medical decisions his family faced. In our recent conversation, he emphasized the importance of drawing the line between a life worth living and a life that has lost all meaning.

“(My father’s oncologist) was able to recommend eight different types of chemotherapy and knew the pros and cons of each. For us, the question was, ‘What if we don’t choose one?’”

Doctors have difficulty accepting the limitations of medical interventions and often overlook patients’ personal goals. Gawande urges physicians to ask patients: (a) “What is most important to you?” and (b) “What are you not willing to sacrifice even if it means your life may be shorter?”

2. “The last day of your life is not the sum of your life.”

Dr. Lucy Kalanithiwidow of Paul Kalanithi who wrote When breath becomes airunderstands the pain of losing a loved one. Her husband’s memoir details his battle with advanced lung cancer, and her advice reflects the valuable lessons they learned together.

Lucy shared with me her concerns that aggressive medical interventions would cause Paul unnecessary pain and anxiety in his final days, fearing that attempts to prolong his life could come at the expense of his dignity, thereby tarnishing her memories of him.

Paul gently reassured her, “The last day is only one day.” His words encourage loved ones to focus on a person’s entire life rather than its end.

For families dealing with regret, medical trauma, or unspoken words, Lucy offers comfort: “You did the best you could, and that’s all anyone can ever ask for.”

3. “We are sexual beings all our lives.”

Dr. Pebble Kranza specialist in sexual medicine, dispels the common misconception that sexuality must diminish as people approach death. During our conversation, she emphasized that sexual desire remains a core part of human identity, even in the final stages of life.

Dr. Kranz advocates an open, compassionate dialogue between patients and doctors: “Doctors talk about poop, we talk about mental illness and all kinds of very personal things with patients. Why dismiss sex as an arena that is too personal?”

She reminds us that terminally ill patients deserve to pursue what brings them joy and fulfillment, just like anyone else. According to Dr. Kranz, honoring our full humanity, including our sexual identity, helps preserve the meaning of life as it comes to an end.

4. “The time to see a palliative care doctor is not when you die, but sooner.”

Dr. Monique Schaulisan emergency room doctor, emphasizes that her specialty – palliative care – does not only apply to end-of-life situations. Instead, it should be integrated into medical care at every stage of serious illness to improve people’s quality of life.

“Palliative care is transdisciplinary and holistic and focuses on patients from diagnosis to the end of life,” she emphasized during our interview. It focuses on physical, psychosocial, spiritual and existential issues and helps patients and families navigate complex emotions and decisions.

Importantly, Dr. Schaulis explains that hospice is only one part of palliative care, and it does not mean surrender for the patient or their loved ones. Rather, it focuses on making patients stronger, better nourished and pain-free. This approach usually leads to a longer and more satisfying life compared to traditional treatments.

Former President Jimmy Carter serves as an inspiring example: He spent more than a year in a hospice and is enjoying a fuller life since joining the program.

5. “No one should suffer.”

In a very personal episode, New York Times columnist Steven Petrov shared the story of his sister Julie, who chose Medical Aid in Dying (MAID) after a terminal diagnosis of ovarian cancer.

Initially hesitant about MAID, Petrow’s perspective changed after witnessing the extent of Julie’s suffering.

“I had no doubt at all that this was necessary,” Petrow said, grateful that his sister’s life ended in peace. “If people don’t have this option, there will be unnecessary suffering and painful deaths.”

For patients like Julie, the ability to take charge of their own destiny—to decide how and when to alleviate their suffering—can make life more bearable. Often, having this control can allow them to extend their lives. Julie’s story underscores the importance of maintaining personal agency and making informed decisions about our own medical care.

6. “Spiritual care is an integral part of compassionate medicine.”

In her role as chaplain Rabbi Melanie Aron has supported hundreds of hospitalized patients of various faiths, highlighting how spirituality and community can comfort patients.

“Religious leaders are grappling with how to best support people and provide a sense of peace and purpose in a rapidly advancing healthcare world,” she said. “Spiritual support can alleviate emotional pain and suffering and help people cope with end-of-life issues.”

She emphasizes that it is important that doctors, in addition to the medical aspects, also pay attention to the moral and ethical dimensions of dying. She has noted that when healthcare professionals integrate spiritual care into their medical practice, they contribute to emotional healing and comfort in people’s final days.

7. “We should not save a life at any cost.”

Dorothee Caminitia bioethics expert from Santa Clara University, is interested in the ethical dilemmas surrounding life-saving interventions. In our conversation, she questioned the principle of saving a life at any cost.

“We can extend life forever,” she said. “We have to decide if this makes sense.”

Balancing the rights of patients, the insights of physicians, and the wishes of families presents a complex challenge. Caminiti emphasized the crucial role of advance directives, or advance directives, which ensure that a patient’s preferences are known and respected in situations where they cannot speak for themselves. She emphasized, “The best way to ensure your health care wishes are honored is to clearly document them before a crisis occurs.”

8. “Good relationships lead to health and happiness.”

In our final episode of the season, author and public health expert Brad Stulberg reflects on his recent New York Times column: ‘The key to longevity is boring.’

In our interview, which airs on August 27, he emphasizes that regular exercise, a nutritious diet, avoiding smoking, limiting alcohol consumption and maintaining meaningful relationships are the keys to a long and healthy life.

Boring? Yes, especially when you compare it to the hype surrounding various unproven supplements and treatments. But Stulberg pointed to research showing that people who do these five things live seven years longer, including six years in good health.

His insights remind us that vulnerability does not have to determine how we age. Investing in our health at a young age makes the outcome more positive.

9. “Embrace optimism at the end of life.”

Reflecting on this season’s guests on the Fixing Healthcare podcast has given me a more optimistic view of the final stages of life. Each of these eight experts has convinced me that we can positively improve people’s end-of-life experience and uphold human dignity during these sensitive moments.

Palliative care can empower patients, hospice can ease suffering, and intimacy can still flourish. Healthy habits can support our vitality, and spirituality can help us find peace and acceptance as we face the final chapter of life. Ultimately, the love we have cherished all our lives can provide comfort and support until our last breath.

While none of us like the thought of saying goodbye, it’s comforting to know that the end of life can be a meaningful, connected and peaceful experience – much better than today.

Join us for the first episode of season 10 on September 3, 2024. This time on the Fixing Healthcare podcast we talk to experts in medical and AI technologies. This season kicks off with a familiar voice: returning guest and author of ‘Deep Medicine’, Dr. Eric Topol.