Lessons from Death and Palliative Care

This week I caught Zen Hospice Project’s BJ Miller on the Tim Ferriss Show. If you’re not familiar with the show, Tim interviews top-performers from any field with the goal of deconstructing how they achieve success. The Man Who Studied 1000 Deaths to Learn How to Live digs into all kinds of lessons BJ learned from the accident that took 3 of his limbs, his time as a palliative care doctor and life in general. It’s worth listening to for that alone, but I’m writing to focus on a couple of points BJ makes about the patient experience and the practice of medicine.

Easing into grief with warmth and love

BJ contrasts the experience of dying in Hospice vs. dying in a hospital. At Zen Hospice they send each deceased resident off with a short ceremony where they sing and sprinkle flowers over the body. Everyone’s involved from the family to the care givers. They ease into grieving with warmth and love. It only takes a few minutes, but its very powerful. On the flip side, he says, when you die at the hospital amidst the ubiquitous beeps in a bland, sterile environment, the body is swept away, the room is cleaned and the physicians and other care-givers move on to the next patient. Think about the difference in experience for everyone involved. The difference in experience for the patient and their family is tremendous for sure. But lets think about the difference for the caregivers too. They’ve made a real connection with a real human being at a critical time in their lives. How does it affect them to deal with this day-in and day-out without any closure? How does that affect their next patient’s experience? Let’s not forget the care givers when rethinking the experience of dying.

Palliative Care as a Strategic Gateway to Change Medicine

The second big idea from BJ’s interview is that he views Palliative Care as an opportunity for change in the healthcare system. Palliative care is the act of helping people live their best at any point and not just at the end (i.e. Hospice). The practice goes way beyond traditional medicine and offers a “strategic” opportunity to introduce non-clinical things that are super-relevant to the human condition into healthcare. Think music, art, existentialism. It also offers the opportunity to experiment with things that have long been taboo like psychedelics (Tim Ferris is supporting this study at Johns Hopkins). Given the challenges we face in healthcare today, it stands to reason that we leave no stone un-turned. How can we lean on the experiences of palliative care to bring these non-clinical “tools” to mainstream care?

Checkout the podcast here:

His podcasts are long, but always worth it. I listen to every one whether I’m interested in the guest or not. I’ve never regretted it and I find awesome people like BJ on a regular basis.

Also, check out BJ Miller’s TED Talk here — its a much shorter intro to his story and ideas:

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