Why Its Important to Talk About Death
Death can be an uncomfortable subject, says Shoshana Ungerleider, MD, but it’s a part of life that needs to be talked about sooner and more often.
https://www.webmd.com/healthy-aging/video/shoshana-ungerleider?src=soc_yt
-TRANSCRIPT-
JOHN WHYTE Welcome, everyone. I’m Dr. John Whyte. I’m the Chief Medical Officer at WebMD. It’s hard to talk about death, isn’t it? It’s uncomfortable. There’s a lot of uncertainty. No one really wants to think about it. But my guest today has a new framework about end of life. Dr. Shoshana Ungerleider is a practicing physician, a board certified internist, and the founder of End Well. Dr. Ungerleider, thanks for joining me today.
SHOSHANA UNGERLEIDER Thank you so much for having me, John. This is a conversation that is challenging on many fronts, but I’m really honored to get to have it with you now.
JOHN WHYTE: It’s a hard conversation and it’s one that I talked about to colleagues that we don’t have enough. And that’s why I was so interested in talking to you about it because you really have a new framework of how we need to think about end of life issues. And you talk about it needs to be part of a wellness journey, and I wouldn’t even thought about it that way. So tell us what you mean by that.
SHOSHANA UNGERLEIDER Well, I think it’s helpful when talking about this in a broader context to just say that early on in my training, I was struck by how many patients I was caring for often in the intensive care unit who were quite frail, often of older age, dealing with a myriad of medical issues. And what was landing them in the intensive care unit was their end stage organ disease or widely metastatic cancer.
And I, looking back now, realize how distressed I was that we weren’t having conversations about goals of care about what the end of life might look like. There was a mismatch of expectations between what patients and families were sort of thinking was going on and what was actually happening in the context of what turned out to be the end of their lives. And I found that far too often people get care in their final days, weeks, moments of life that they don’t understand, they don’t want, and that doesn’t really honor the life that they’ve lived or their goals and their values.
And so it got me thinking about this broader conversation, both within medicine and in society, about the fact that we have a hard time thinking about and talking about and certainly planning around end of life. And there’s tons of reasons for this. We don’t even have time to go into all of them. But what struck me is that the end of life is not just a medical issue to be solved. It’s part of the human experience. It’s what actually defines life, is that one day it ends.
And in thinking about this personally and reflecting more deeply, and in starting End Well, I realized that if we can open the door or have a relationship with our own mortality. It can actually allow us to live better every single day.
JOHN WHYTE And that’s really your framework, but when should we start thinking about it? Because Shoshana, I’m sure a lot of people have said to you, we’re not supposed to talk about death. There’s almost a superstition for some, isn’t there? If talk about it, then something bad might happen. Or if I mention it to an elderly parent or an elderly grandparent, they’re going to assume I think they’re going to die soon, and I don’t want to make them worried. So when should we be having this conversation almost with ourselves about end of life?
SHOSHANA UNGERLEIDER Well, I certainly hear you. For some people, there are some cultural superstitions around talking about death and dying. I’ve certainly experienced that as a physician caring for patients. I get that some people are not really wired to be thinking about a future when they no longer exist. It’s kind of hard to do.
JOHN WHYTE It’s depressing, isn’t it? People are going to say that if think about death, that’s going to make me sad.
SHOSHANA UNGERLEIDER Yeah. Well, I think that in terms of the timing, I think it’s never too early frankly to talk about the end of life, whether it’s in the context of the first time in your family if you have young children, for example, you lose a pet. That’s often when children first experience a loss in the family. I think it’s OK to normalize these conversations. Because in reality, yes, it can be hard. It very often is sad, but it is truly a part of life.
And so the more that we can connect with the fact that living and dying are not actually separate things– if you think about it, we’re doing both at the very same time– how can, again, that allow us to live a better life every day recognizing that time for all of us is short. We never know what tomorrow will bring. Asking ourselves some of these bigger questions of like, am I living the life that I want to be living?
https://www.webmd.com/healthy-aging/video/shoshana-ungerleider?src=soc_yt