A Life & Death Conversation with Dr. Bob Uslander

Dr. Bob Uslander

In this podcast, we talk about life, death and everything in between. We'll explore how to age more gracefully, have meaningful conversations, and what you can do now to ensure the best possible end-of-life experience for yourself and your loved ones. Let's get friendlier with death.

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What have We Learned After Two Years of Aid-in-Dying Bedside Care? – Dr. Lonny Shavelson, Ep. 31

A Life & Death Conversation with Dr. Bob Uslander

11/20/18 • 54 min

Dr. Lonny Shavelson is the founder of Bay Area End of Life Options, a medical practice in Northern California devoted to educating about medical aid in dying and supporting patients and families through this process.

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Bay Area End of Life Options

Transcript

Note: A Life and Death Conversation is produced for the ear. The optimal experience will come from listening to it. We provide the transcript as a way to easily navigate to a particular section and for those who would like to follow along using the text. We strongly encourage you to listen to the audio which allows you to hear the full emotional impact of the show. A combination of speech recognition software and human transcribers generates transcripts which may contain errors. The corresponding audio should be checked before quoting in print.

Please note there is some content that is explicit in this episode.

Dr. Bob: Dr. Lonny Shavelson is the founder of Bay Area End of Life Options, a medical practice in Northern California, devoted to educating medical providers about medical aid and dying, and supporting patients and families through this process.

As you'll soon discover, Dr. Shavelson is an intelligent, articulation and passionate physician, who has a huge heart and is committed to providing excellent care to people dealing with terminal illnesses. He and I are bonded by a similar commitment. We also share a bond in that we were both emergency physicians in the past. We've seen the standard way people are cared for at the end of life, which is often not very pretty, and often not aligned with how they've lived their life.

As you'll hear in this interview, Dr. Shavelson has experienced his own brush with death, which has created far more understanding and empathy than he could've imagined. I hope you find this discussion as informative and interesting as I did.

Well, Lonny, I've been looking forward to this conversation with you for quite some time. I saw it coming up on my calendar. I was excited and woke up today really energized to have this conversation and be able to explore deeply, what it's like for you to be a physician that's in the same realm as I am, in support of medical aid and dying. Thank you for taking the time to speak to me and my listeners today.

Dr. Shavelson: You're really welcome, I'm glad to be here.

Dr. Bob: Yeah. So, just maybe give me a little bit of ... Give all of us a little bit of background, as to how you came to be the physician with Bay Area End of Life Options. What was your journey leading up to that, and what made you decide to venture into this?

Dr. Shavelson: Let's see if I can condense this a little bit. When my interest in going into medicine in general, as happens with many people who go into medicine, comes from a family history of dealing with illness. I think many people in medicine if you ask them this question, why you went in, they'll start off with the, "I want to help people," answer. And if you dig a little bit deeper, you'll find there was some illness in the family in their prior history.

So mine, very specifically, was my mother had Crohn's Disease. It's an inflammatory disease of the bowel. And because of that disease, imagine having cramps and diarrhea all of your life every day and having multiple surgeries on your bowel to try to accommodate it and bowel obstructions and all that. She was a pretty miserable person, and also in retrospect, severely depressed.

So when I was starting at the age of about 14, I became not only aware of the fact that my mother was suicidal, but she enrolled me in pacts for her death. Part of the reason that I was guided toward medical school was because of the, my mother sort of wanting to know that I would be available, not only to help her in her illness but also to help her die.

Dr. Bob: Wow.

Dr. Shavelson: So we used to have conversations around the dinner table about my mother's dying. And I thought that was the normal way people grew up. I didn't, you know ... You know, if you grow up in a certain way, you assume that that's the way it is. You don't have any other experience of any other childhood to compare it with. So I thought discussions about death and dying were what people talked about during dinner.

Dr. Bob: Not me, it wasn't happening at my dinner table, I'll tell you that much.

Dr. Shavelson: Yeah, now I realize that [inaudible 00:03:48] doing that. We didn't have football and baseball on the TV. We had sort of philosophical conversations about death and dying, including suicide.

Dr. Bob: Wow.

Dr. Shavelson: So my mother-

Dr. Bob: We had the Dick Van Dyke show, and the Andy Griffith Show.

Dr. Shavelson: Well, we did some of that too. It falls short to what it was.

So anyway, I g...

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Dealing With Loss, Elizabeth Semenova Ep. 6

A Life & Death Conversation with Dr. Bob Uslander

12/27/17 • 30 min

Elizabeth Semenova is the Director of Operations at Integrated MD Care. She shares her insights and personal stories about dealing with loss. The holidays can be an especially difficult time, listen to how Elizabeth handled her own loss and how she and Dr. Bob help others. Transcript Dr. Bob: Welcome to A Life and Death Conversation with Dr. Bob Bob Uslander. I'm here with a guest who I'm excited to introduce everybody to, and somebody who has a wealth of experience and insights. And I'm very pleased to have her as part of my expanding team here at Integrated MD Care. So you're going to get to know quite a bit about my new director of operations for the practice, Elizabeth Semenova.Elizabeth, say hello to our listeners. Elizabeth: Hello. Dr. Bob: So Elizabeth came to us a few months back. And the way that we initially met was through a referral that she had made to us for a gentleman who was struggling with Parkinson's disease and was really at the tail end of his life, and Elizabeth made a recommendation that he contact us. And it was a real blessing for us to be able to meet this gentleman and guide him through the last weeks of his life. After that, we just had a few more encounters. And, Elizabeth, maybe you can share how what it was about what we do that drew you in and kind of encouraged to you to reach out and try to become part of the tribe. Elizabeth : Well, after I referred friends, clients to you, I looked more into what it is that you do and how you do it, and explored information that I received from other sources about your work, and I was inspired by your openness to life and death and your perspective on the importance of accepting and talking about death as a part of life. I was particularly intrigued by your willingness to support patients and families who are looking for resources, education, and services regarding the End of Life Option Act in California. So that's how I came to connect with your practice. Dr. Bob: Cool. Well, we're very happy that you did, and just to kind of summarize, Elizabeth came on, and we didn't have a social worker who was working with us. Elizabeth has a master's in social work and had been working as a social worker within the hospice world for several years. And we were really blessed to have her come and go out. She went out on a handful of patient visits when I was doing initial evaluations for people who were looking at aid and dying. And it was a real blessing to have her expertise and just her presence there to support those patients and families. Then we just had some changes at the office, and it became very clear that Elizabeth had a strong leadership ... had some strong leadership experience and genes. And everybody in the practice really felt comfortable with her guidance, and I offered her the position to help lead the practice, which has been great. So it's just been a short time, but the difference in our efficiency and just getting things done has jumped quite a bit. So we appreciate your very wise counsel and leadership, and it will continue to be a blessing for all of us for a long time to come. Elizabeth: I'm very humbled by your confidence and appreciation. Dr. Bob: Well, there's more to come. So let's talk a little bit ... We've had some conversations, many conversations around our individual kind of perspectives and feelings about death and how to work with people through those challenges. I know that you've had some very personal experience with loss and death in your life, and I'd like to hear a bit about that if you're comfortable sharing. And let's see how we can provide some valuable guidance, comfort, wisdom for some other people who might need that at this point. Elizabeth: Sure. I first encountered grief and loss and bereavement when I was in seminary, and I took a class on the subject. I remember being very inspired by everything that we read and discussed, but feeling a little disconnected from it, not really knowing how to understand it or contextualize it. Dr. Bob: Had you had any personal loss up until that point? Elizabeth: I had lost grandparents, but no unexpected losses, no tragic losses at that point. And several years later, I was living in Colorado with my daughter, who was nine at the time, and we received a phone call from my brother-in-law, who was my daughter's father's brother. So my daughter's father and I were married when she was a baby and had since separated but stayed very, very close as family and friends. And his brother called me to let me know that he had died suddenly in a car accident. That was my first real experience with death and loss. And at the time, as I said, my daughter was nine. So my purpose was to make the process as comfortable and manageable for her as I could, to do what I could to contribute to her healing and resilience in dealing with the loss of her father. Dr. Bob: So you were dealing with it on your own and then having to understand, learn how to navigate that for her as well. ...

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We Croak: the App that Makes You Think About Dying, Hansa Bergwall Ep. 20

A Life & Death Conversation with Dr. Bob Uslander

06/08/18 • 29 min

Hansa Bergwall is the creator of a new app called "WeCroak". Out of his own personal meditation practice, he determined that death contemplation could be beneficial, not just for him, but for many people.

Dr. Bob: So, Hansa, I'm totally curious about this. What prompted you to put an app out there that is going to notify people several times a day to think about death? What was the impetus for that? It's fascinating to me. How did that all come about?

Hansa Bergwall: So I'm a daily meditator and have been for a while now. And regular death contemplation is actually a really millennia old part of most serious meditation practices. So that's how I first got ... I learned about some of these ideas. And some of them are pretty intense, much more intense than what I'm doing, meditating in [inaudible 00:01:19] grounds, where bodies decompose as a way of laying them to rest, to know about your impermanent nature. Stuff that would be hard to do today living in New York City.

Hansa Bergwall: And then I came across the Bhutanese formulation of the practice that was, one, recommended for everyone and just really simple. It was just think about it five times a day that you're impermanent, that one day you will die. And you must do that in order to be a happy person. Immediately, it appealed to me as the kind of death contemplation that I wanted to add as a compliment to my meditation practice. So I just tried to do it myself. I thought, oh, this will be easy. I'll just think about it five times a day. And what I found was it was actually really hard. We have this pretty stubborn cognitive bias that we don't want to think about mortality all that often and it's hard to do, so I would get through my day and get to the end of the day and realize I hadn't done it even once.

Hansa Bergwall: So that was when the idea of something to remind me came about and the idea of WeCroak, the app, which sort of fell into my head as a fully formed idea that honestly I never thought would go anywhere 'cause I'm not a coder and had no way of making it a reality until Ian Thomas, my cofounder, happened to rent my extra room on AirBnB and we got to talking one night and I basically told him/pitched him my idea for WeCroak and he wanted it on his phone, too. He never thought it would go anywhere. And we made it together for the next couple of months, so it happened really quickly and really fortuitously, organically out of me trying to do something that I thought would help.

Dr. Bob: That's crazy. So if Ian hadn't rented your room, there's probably a pretty good chance that this never would've come to fruition, right? Were you going to go out and seek an app developer? Had you gotten to that point?

Hansa Bergwall: I had. I made a couple of inquiries, and it was going to cost me $10,000 or something like that if I wanted to develop this on my own. And I didn't have that kind of money sitting around, first of all. And, second of all, sounded like a lot of money to spend on something that I was quite skeptical would be broadly popular. So really we made this kind of as almost ... We were talking about it when we started as it was like an art project or something that we really wanted for ourselves, maybe to share with our friends, and we wanted it in the world. That was how we went about it.

Dr. Bob: Great. Without any huge expectations or goals that would potentially disappoint you if you didn't achieve them. That's usually the best way to start something.

Hansa Bergwall: Yeah, and what it allowed us to do is we stuck to our guns a little bit, the Bhutanese folk saying is five times a day. So we had a lot of people asking, like, oh, shouldn't you toggle it, so people only want one? We're like, but that's not the recommendation. We're going to do this tradition. We're going to do it right. So because we have our day jobs and other ways of making money, we could really make it be something that we thought would be a real mindfulness tool.

Dr. Bob: Great. So when did it actually become available? When did you complete the development process and put it up there for people to download?

Hansa Bergw...

How Self-Compassion Helps The Grieving Process, Lydia Lombardi Good Ep. 22

A Life & Death Conversation with Dr. Bob Uslander

07/09/18 • 35 min

Lydia Lombardi Good is a licensed clinical social worker. She shares the importance of self-compassion, what it is, and how to get comfortable with it and how it helps the grieving process. Note: A Life and Death Conversation is produced for the ear. The optimal experience will come from listening to it. We provide the transcript as a way to easily navigate to a particular section and for those who would like to follow along using the text. We strongly encourage you to listen to the audio which allows you to hear the full emotional impact of the show. A combination of speech recognition software and human transcribers generates transcripts which may contain errors. The corresponding audio should be checked before quoting in print. Contact Lydia Lombardi Good, Pier View Counseling Transcript How Self-Compassion Helps The Grieving Process Dr. Bob: Yeah. That's my pleasure. This is a Life and Death Conversation, and we talk about things that we can do to enhance life and bring more joy and peace to life, and of course, we talk about death. We don't shy away from the topic of death. We always explore a bit about how our guests feel about the whole end of life, death and dying, what experiences they've had, how the awareness of death seems to show up in your life. For people who come on and have these conversations, most of the time they're pretty comfortable speaking about death and sharing their experiences and thoughts about it. I'm just going to open it up and let you share a little bit. I know that you do a lot of work in grief and loss, and you've been in hospice, and have a lot of experience. So share a little bit about what the idea of death and dying means to you, and how it shows up in your life. Lydia Lombardi Good: What I learned from my experience with death and dying, working with clients, having my own personal experience losing close loved ones, is the more we think about death and understand that it is inevitable, and we are all dying a little bit every day, I think the richer a life we are able to live, and we are more mindful of the choices we make, and the people we choose to surround ourselves with, and the life we want to live, knowing that nothing is permanent. Everything is impermanent. And if we live a life without regrets and can be more present to our lives instead of staying maybe stuck in the past, or focused too much on the future, we can look back and say, "You know, I fully experienced all that. I don't wish to be back there again. I wish to be right here, right now, to live my life fully," knowing that we really only have one shot at that. So that's how it's changed me a lot in terms of my own choices, the way I live my life, the way I try to stay compassionate. A lot of it's talked today, and what I really am passionate about is teaching people to embody self-compassion and treat yourself kindly, the way you would treat a close friend. And the more we can do that, the better life we can have. The more chances we take, the more we can just fix up things as they are, instead of always wishing things to be another way, or for us to be another way. And when we do that, we're missing what's happening right now. Dr. Bob: Yeah. That's beautiful. And I think it's pretty common to hear people share that when they contemplate death, when they recognize, like you say, the impermanence of everything, it really allows us to stay more focused on what's happening right now, and feel gratitude, and just feel very present. I want to talk about the mindfulness, the self-compassion, and the mindfulness, because mindfulness meditation, self-compassion have figured prominently in my life and I've done my work there, I've gone through courses in mindfulness. And it's so interesting what you said, to treat yourself the way that you would treat a close friend. Do we do that? I mean, do we really do that? The stuff that we lay on ourselves, and the way that we diss ourselves, which is so common. Like, if we were doing that to a friend, would they stick around? Would we still- Lydia Lombardi Good: We wouldn't have any. Dr. Bob: We wouldn't have any friends. Share a little bit more about that, about how you came to that, what your journey has been to become a teacher of self-compassion and mindfulness. Lydia Lombardi Good: Yes. Yeah. So, I was working in hospice since about 2007, 2008. Right out of graduate school I started this work, and I think I understood it to the best of my knowledge. I'd had a lot of loss in my past, and a lot of trauma that I thought I had worked through and had done a lot of healing around and was in this work. And I think I had as much compassion for the experiences of my clients and patients as I could have at the time, for that point I was in my life where I was at and what experiences I had been a part of at that point. And then it was 2012; I lost my dad to cancer. He died of prostate cancer...

Dr. Karen Wyatt Founded the End-of-Life University after a Tragic Incident Ep. 14

A Life & Death Conversation with Dr. Bob Uslander

03/16/18 • 35 min

Dr. Karen Wyatt founded the End-of-Life University. Hear how her father's suicide lead her to learn about hospice and a career that focuses on helping educate people about end-of-life care. Contact End of Life University Note: A Life and Death Conversation is produced for the ear. The optimal experience will come from listening to it. We provide the transcript as a way to easily navigate to a particular section and for those who would like to follow along using the text. We strongly encourage you to listen to the audio which allows you to hear the full emotional impact of the show. A combination of speech recognition software and human transcribers generates transcripts which may contain errors. The corresponding audio should be checked before quoting in print. Transcript Dr. Bob: On this episode, I'm speaking with Dr. Karen Wyatt. Dr. Wyatt is a family practice physician who specialized in hospice medicine for many years, and more recently has created the End of Life University, which is an online site that provides education and tools for people to learn about and become more comfortable with approaching end of life and having the most peaceful and dignified end of life possible. She's also an author, has written several books, including What Really Matters, Seven Lessons for Living From the Stories of the Dying. She also wrote a book called the Tao of Death and A Matter of Life and Death. She is a speaker and a great advocate for excellent, compassionate end of life care. During our interview, there were a couple of little connectivity issues, so there's a couple of very brief glitches. I hope it doesn't take away from the valuable content. You'll get some phenomenal insight and inspiration from this interview. Thanks for tuning in. Thank you, Karen, for being on our show today. Dr. Karen Wyatt: Hi, Bob. Thank you so much for having me. Dr. Bob: We had a chance to talk a couple of weeks age when I was interviewed for your podcast, and it was a great conversation. I think we both recognize that we have so much alignment, so many things in common regarding our careers and kind of where our priorities are, where our visions are trying to take us. You probably see this as well. Most of the people who are really passionate about providing great care for people at end of life have a personal experience or a personal story that kind of fuels their drive and their passion for that. I know you have one as well. Can you share a bit about how you became so aware of the importance of providing really phenomenal end of life care and making appropriate preparations? What's your story? Dr. Karen Wyatt: Yes. I'm happy to share that, Bob. It started for me a long time ago, when I was just a young doctor, brand new in medical practice, and I had trained in family medicine, but honestly had no training whatsoever in end of life issues. I hadn't received any ... at all around death and dying, which is shocking really when I look back and think about that. I really didn't have any knowledge or awareness of end of life issues and what was happening in that arena. But at that time I was in my early 30s, and my own father committed suicide, which was a horrific tragedy for me and my entire ... , but particularly devastating to me, because I was a doctor, because I had done extra training in psychiatry, just so that I could treat people with depression, and I had worked with some suicidal patients in my practice. The fact that I couldn't help my own father just completely tore me apart and really caused me to question, "Am I even a good doctor? Should I even be doing medicine?" I floundered for about three years with just overwhelming guilt and grief after my dad's death. One day I got the idea to call hospice, even though at that time I wasn't even really sure what hospice did. I knew so little about it, but this inspiration just popped into my head, "Call hospice." I called and had a chat with them, the hospice in my community, to see if I could volunteer in any way. It turns out their medical director had just resigned 30 minutes before I called, and so she said, "Actually, we have a job for you right now." Knowing almost nothing about hospice, or death and dying, or end of life care, I became a hospice medical director. From that moment on, my training started in really learning about dying. I was trained by the nurses. Our hospice at that time had nurses who had worked there for 10 and 15 years, caring for dying patients. I just followed them everywhere. I sat with them, and I just soaked up all this wisdom, and experience, and knowledge from them, all things that, looking back, I know I should have learned as a doctor. It was embarrassing that, as a doctor, I knew so little, but once I started making home visits to patients in hospice, I realized this is where I'm meant to be. This is the kind of medicine I was meant to do all along. I...

Helping Seniors Transition from their Homes, Jami Shapiro, Ep. 16

A Life & Death Conversation with Dr. Bob Uslander

04/13/18 • 40 min

Jami Shapiro helps seniors transition from homes with her company Silver Linings Transitions. Learn why she is so passionate about this work and how she can help you or your loved ones. Contact Silver Linings Transitions Note: A Life and Death Conversation is produced for the ear. The optimal experience will come from listening to it. We provide the transcript as a way to easily navigate to a particular section and for those who would like to follow along using the text. We strongly encourage you to listen to the audio which allows you to hear the full emotional impact of the show. A combination of speech recognition software and human transcribers generates transcripts which may contain errors. The corresponding audio should be checked before quoting in print. Transcript Jami Shapiro: Thanks for having me. Dr. Bob: Yeah. It's great to have you here. Jami Shapiro: This is exciting. I was really looking forward to this conversation, so I'm glad to be here. Dr. Bob: Yeah. Why is that? Jami Shapiro: Well, death and what you do, it has just really become ... I guess I should describe what it is that I do so that it can set the stage for people. Dr. Bob: Sounds good. Jami Shapiro: Okay. I own a company, as you mentioned, called Silver Linings Transitions and we started as a senior move management company, which is actually part of a National Association called The National Association of Senior Move Management, and I have to step it back a little bit because about 13 years ago, I was diagnosed with thyroid cancer, and I was 34 years old, and it was life-changing for me to have to wait on the diagnosis and at the same time, one of my closest friends died of ovarian cancer. When you look at cancer as a 34-year old, you realized, "Oh, this is borrowed time." A friend of mine who had cancer as a freshman college said that getting cancer was like getting a front row seat to life. Dr. Bob: Wow. Jami Shapiro: Right. I started to look at my own life, and I knew that what I was doing wasn't fulfilling for me. I ended up moving to San Diego from Florida with my now ex-husband, when he took a dean position out here, and it was an opportunity for me to explore what it was that I wanted to do and the first job that I had was actually working at a cancer foundation started by a family who had lost their daughter at 39 to gastroesophageal cancer stage four, and no one knew because we weren't talking about it or what the symptoms were. I loved that they took their tragedy and they turned it into something, which was really very close to who I was. Around the time that I needed to put my daughter into private school, a friend of mine approached me about starting a business selling things for seniors on eBay. That was how we were going to start. Then while she was researching that, we found out about The National Association and they were going to be having their conference in San Diego two months later, and went to that conference, and that was that light bulb that everybody hopes to get, and it was like, "This is what I'm meant to do," and the people that do the work that I do, which is helping seniors when they're transitioning from their homes. It can be the home they've been in for 60 years. It can be the condo that they've moved into, but going into a senior community typically or sometimes into a smaller space is actually very ... It's a tough transition. It's medically identified as relocation stress syndrome, and they say that it is the most difficult transition a person will make in their lifetime. I don't know compared to what you're helping them transition through, but it's tough. Dr. Bob: It's significant. Jami Shapiro: It's significant. Dr. Bob: It's significant, and it's probably under-addressed and under-recognized in general. Jami Shapiro: Absolutely. Right. Then, what their staff represents to them. That's what we're doing is we're helping them go through the mementos of their lives, so I started it that way with a partner. Then, things happen the way life does, and my partner ended up going to work with her husband because he had actually started a business as well. Then, I had to look at how am I going to do this business by myself because I planned on having a partner. I've got three children. Anyway, I ended up shortly after that, putting something on Facebook that I was looking for help because I'm actually as great as my company is, and you have to be very organized to do the work that we do, but I'm not organized. I knew I had to find somebody that was. Initially, I was looking for a partner, couldn't find the right partner. Then, I put something on Facebook in a group of women that I, in San Elijo Hills, we have a little women's site. I posted something, and the first person that responded to me was a woman who had been a stay at home mom for 18 years, and she couldn't find anyone that would hire her. That...

Debbie Ziegler Shares Her Daughter's Journey to End Her Life With Dignity, Ep. 30

A Life & Death Conversation with Dr. Bob Uslander

11/15/18 • 51 min

Debbie Ziegler's daughter, Brittany Maynard at the age of 29 was diagnosed with a terminal brain tumor she chose to end her life. Her story was controversial and painful. Debbie shares her daughter's journey in life and how she ended hers.

Photo credit: Simon & Schuster

Contact

Debbie Ziegler website – Get a copy of her book, Wild and Precious Life

Transcript

Dr. Bob: Well, Debbie, thank you. I can't tell you how much I appreciate you coming and spending time. We've had a number of conversations over, since we met, which was probably a year or two ago.

Debbie Ziegler: Yes.

Dr. Bob: I think each time we talk, we get a little bit deeper into the conversations, and I think we both are very aligned in what we're trying to do with our time here.

Debbie Ziegler: Absolutely.

Dr. Bob: Yeah. I would love to use this time for you to share a bit about Brittany so people can really know who Brittany was. I think a lot of people know the name, Brittany Maynard. It's become, in many areas, a household name, and I think certainly in California, and a lot of people think of her as groundbreaking, but they don't really know Brittany. Hopefully, after this, after people hear this, they'll get your book, and they'll learn a lot about Brittany and about her journey, but I'm hoping that you can share a bit about that, because I think it would be really valuable for people to understand who Brittany was, what she did, and then what you've been doing to carry on her legacy and honor her, so ...

Debbie Ziegler: Well, thank you for asking me to speak with you today. Brittany is remembered for the last act of her life, and those last minutes of her life are relived over and over again and spoken of over and over again. She knew they would be, and before she died, she asked me ... She said, "Mama, make sure people remember me for how I lived as much as they remember me for how I died." That is something that I try to honor her by doing, and one of the ways that I honored her was by writing a book about the way she lived, and I titled it Wild and Precious Life because Brittany did live a wild and precious life. She was very much in love with this world, and when she was terminally ill, she would say to me, "The world is so beautiful, Mom. It's just so beautiful, and I'm going to miss it so much."

She did not want to leave this earth. Nothing inside of her desired that, but the fact was that she was terminally ill, and she had a terrible and gigantic brain tumor that had been growing for over a decade. When I look back at Brittany's life, I try to focus on the brain and how marvelous and plastic it was to tolerate the growth of a tumor for 10 years and to, as that tumor slowly grew, her plastic, resilient brain transferred function. I try to remember that. Even when I first find out she was sick, she had already lived a miracle, and it's important to focus that. The miracle I wanted to happen, which, of course, was that she wouldn't die, didn't happen, but a miracle had already happened in that she had lived 10 years with the brain tumor growing.

Dr. Bob: What a beautiful awareness and a gift. It's so interesting because many people don't have that. Many people have a, are diagnosed relatively quickly after something that starts developing because it's created issues that can't be ignored or-

Debbie Ziegler: Yes.

Dr. Bob: ... their plasticity won't happen, and so everything changes from that moment on. Right? They're thrown into the health care system and start having procedures and treatments, and so ... You know that this is a fatal illness, even when it's caught early.

Debbie Ziegler: Yes. I think that one thing that Brittany and I talked about quite frequently is that every person's disease is different, and it annoyed Brittany that people felt that just because their uncle, cousin, niece, had had a brain tumor, that they somehow knew her journey. The same thing happens to, I think, cancer patients with any kind of cancer. We have to remember, as we interface and speak with and try to love these people through their illness, that every body's illness is different.

Just as our bodies are different, our cancer is different. It can be very, very frustrating for a patient to be told, "Oh, w...

Founding the Hemlock Society, Derek Humphry Ep. 8

A Life & Death Conversation with Dr. Bob Uslander

01/12/18 • 58 min

Derek Humpry is an author and principal founder of the Hemlock Society (now Compassion & Choices). Derek shares his poignant story about helping his wife, who was terminally ill, end her life and how he founded the Hemlock Society. Derek's website: FinalExit.org Transcript Dr. Bob: Welcome to A Life and Death Conversation with Dr. Bob Uslander. I'm very excited to introduce you to today's guest, who is a gentleman who I recently had the pleasure of meeting and listening to during a presentation at a conference. And I just knew when I met and heard him speak that he is somebody who you needed to hear from. I could go on for quite a long time listing his achievements and his accolades in this introduction, but I don't want to take too much of our valuable time away from the conversation, so I will just give a little glimpse of the instruction to Mr. Derek Humphry, who is the founder of the Hemlock Society of the USA, past president of the World Federation of Right to Die Societies, and Derek has been an incredibly strong proponent of people having the ability to determine how and when they their lives will end when they are struggling. He's been very active through his entire life in this regard and is in large part responsible for the movement through in this country that is certainly effective here on the West Coast, in California, in Oregon, in Washington that has allowed people to have a peaceful end of life. And I owe him gratitude because he has allowed me to delve into a part of my career that has really been incredibly gratifying, and he's brought great relief to many, many people around the world. So, Derek, I just want to introduce you and thank you from the bottom of my heart for all that you've done. So welcome. Derek Humphry: Well, hello. Thank you very much for inviting me. It's been a worthwhile journey. I founded the Hemlock Society in 1980 when I lived in Santa Monica and developed it from there. And it was, I didn't do it in any obviously pioneering way thought, but it proved to be the start of the right-to-choose-to-die movement in America as we grew and grew and fought off our critics and published little books and held conferences, the right-to-choose-to-die movement swelled and improved across America ever since 1980. Dr. Bob: So let me ask, how did this all start? I know, and I heard the story, but I'd like people to hear where this movement originated and how it started for you. Derek Humphry: Yes. I was living in London. I was a reporter on the London Sunday Times. And I had a good marriage, a wife, and three sons, and we were getting along fine. And it's great fun bringing up three sons. But suddenly in 1973 my wife, Jean, said that she had a lump in her breast. We rushed her to the hospital, and various testing and so forth. And they had to perform a radical mastectomy, much to her shock and all of our shock. She recovered from that as best she could, but we have further testing of her lymph nodes and blood count and all the rest of it. And it showed that she had cancer deep in her system. It was too late. But we fought, and she fought, took all medical help available, kept her spirits up looking after the family and so forth. She kept it only in a close circle of friends or family did she say that she had cancer. But in about a year it turned to bone cancer, very painful, very difficult to be moving at all except with heavy pain medications. And then after nearly two years, it was really serious, and she nearly died. She was in the hospital in Oxford, England, getting the best treatment that was available back in 1975, and she recovered from one bout, and the doctor thought she wouldn't come out of that. But she did, and she had a fighting spirit. Then came my epiphany. She sat up in bed feeling pretty well in the hospital bed, and I was visiting her. And she said, "Derek, I want you to do something for me." I said, "What's that?" She said, "I've had enough of this pain and unconsciousness. It's getting near the end. I want to die at home. I don't want ..." She took hospitals pretty well, but she was in the cancer ward, and she'd seen too many people die with the families rushing in in the middle of the night to say their goodbyes and a lot of pain and tears. She said, "I want to die at home. I also want to end my life at the point when I feel the quality of my life is gone and that there's no more hope and no more chance of living. And I want you to help me." There wasn't a right-to-die movement in America or Britain to speak of. There were little token meetings, but it was not a subject of public discussion or knowledge. I think I would have had to go to a dictionary to look up the word euthanasia or so forth. I said, "What do you want me to do?" She said, "I want you to go ..." In a way, she prefigured the laws. She didn't know she was doing this, prefigured the laws that are coming into place in six stat...

How to Stop Fearing Death and Start Living Today, Cathy Spatuzzi, Ep. 17

A Life & Death Conversation with Dr. Bob Uslander

09/20/18 • 25 min

Cathy Spatuzzi is a yoga and fitness instructor who works with Integrated MD Care. She shares how she helps patients and her views on why she doesn't fear death and, instead, makes sure she is living in every moment. Books on End of Life Being Mortal, Atul Gawande Knocking on Heaven's Door, Katy Butler Find more in this blog post, here. Note: A Life and Death Conversation is produced for the ear. The optimal experience will come from listening to it. We provide the transcript as a way to easily navigate to a particular section and for those who would like to follow along using the text. We strongly encourage you to listen to the audio which allows you to hear the full emotional impact of the show. A combination of speech recognition software and human transcribers generates transcripts which may contain errors. The corresponding audio should be checked before quoting in print. Transcript Dr. Bob: Hello and welcome to A Life and Death Conversation. I'm here today with a good friend and a really valued member of my Integrated MD Care team Cathy Spatuzzi. I'm very excited to introduce you to Cathy and to hear some of her insights. Cathy and I have known each other for a bit, and we've shared some incredible experiences with our patients. We're going to touch on some of those, let you know what Cathy does and how she does it because I think she's really quite an expert in her field and I know that she loves what she does. So, Cathy, thank you for being here and joining us. Cathy Spatuzzi: Hello, Dr. Bob. Thank you for having me. Dr. Bob: Yeah, my pleasure. It's great to see you. I'll share that trying something new, our podcasts, the ones that I've done previously have all been recorded on the phone. Today Cathy is in the office, and we're doing it together. It's really nice to be able to look at her in the eyes as we do this. Cathy Spatuzzi: Yeah, I agree, face-to-face is very nice. Dr. Bob: Yeah. So Cathy is ... her title is yoga and fitness instructor. I know that there's probably a lot of yoga and fitness instructors out there who work in various capacities but that doesn't really begin to explain quite what Cathy does because I've seen her in action and I've seen the results of her work. It's nothing short of magical; I have to say. Cathy goes in and works with some of our sickest and most frail patients. She works with people who have dementia. She works with people of all ages and abilities. They don't even know they're exercising. They actually just think they're playing games and meeting a really cool, fun, person. So Cathy, can you just share a little bit about how that happens, what you do, how you approach your patients and just share a little bit about how that magic happens? Cathy Spatuzzi: Sure. So I got my yoga instructor certificate, and I started teaching seniors. I took an extra class in teaching seniors, and I really loved it. Then I met Dr. Bob, and I've always been a physical exercising person myself, and so I've made up my own little program where I go into a person's home, and we have a whole hour of exercise. So we do physical weights, and whatever that person needs at the time, that's how I meet their needs. So we do dancing, we do marching. I bring some music sometimes. I have little balls that we do exercise with. They're bright and colorful. We play games with the balls. I also have just blown up regular balloons, and we hit the balloon back and forth and play a game that way. A lot of people that used to do tennis or volleyball, they remember that, and their muscles and cells remember that and they really get a lot of fun exercise just hitting the balloon back and forth. They tell me lovely stories. Most of my people are 80 to 90, some are a 100 years old, and they tell me fabulous stories. They all have a very positive attitude in life. Dr. Bob: I've met with people, I've been there after you've been with them and it really is pretty dramatic. A lot of our patients, because a lot of times they don't feel well, they don't have a lot of energy, they're dealing with pain, they're dealing with other challenges, and exercise is not something that they necessarily prioritize or look forward to, but that's not the case with you. They obviously don't feel like they're doing exercise. They don't feel like they're working. There's something else. There's another piece that obviously you're bringing to it, which, to me, it feels like you're just really connecting with them very deeply and appreciating them as human beings, and the exercise just happens as on the side. Cathy Spatuzzi: Yes, I agree. I don't think of it as exercise myself. I go in, and I have fun, yes, and I connect with that person one-on-one, find out what they like, what else do they like, then I bring that in with them. Dr. Bob: We've shared a couple of patients that had had ...

A Life and Death Conversation, Dr. Bob Uslander Ep. 1

A Life & Death Conversation with Dr. Bob Uslander

09/20/18 • 26 min

Dr.Bob Uslander: Just me. I will be having guests and bring a number of fascinating, interested, and dedicated people onto this show to share their wisdom and expertise. I thought I would take this first show as an opportunity to introduce myself and give you a bit more of an understanding of why I feel this topic and this conversation is so vitally important.

Every day in the course of my work, I have life and death conversations. I talk with people about how to make their life better, more comfortable, more supported and, frankly, more enjoyable. I also talk with people about how to make their death better. When people are no longer able to find comfort, or joy, or meaning in their lives because they're old or they're sick, the only thing that they really look forward to at that point is their death and it's amazing to me when somebody is willing to sit with them and talk about that in a comfortable way, in a way that doesn't make them feel judged or make them feel afraid. They open up. They are so grateful to have that kind of honest conversation and connection.

I've been a physician now for close to 30 years and I've had so many conversations. Initially, I was very uncomfortable with the whole concept of death. When I first finished medical school and began my training and then my work as an ER physician, I had a lot of encounters with death. But, for the beginning of the early part of my career, death was always the enemy. When somebody died, it was a failure and we tried to avoid that at all costs. As I've gotten older, hopefully, a little wiser, and I've had more experiences, personal experiences, as well as experiences in my career, I've come to understand the concept of death and how death fits in a much deeper way. I no longer feel that it's the enemy. I actually feel a close kinship, a friendship with death. That's what I want this conversation to do for others, to help you and everybody learn how to feel like death is not your enemy but your friend.

This is delicate stuff. I get that. It's very important stuff. I believe that as a society we need to become more comfortable with the concept of death. We need to understand how our idea of death influences our life day-to-day because death is as much a part of life as birth. They're two sides of the same coin.

We have no trouble talking about birth. Will it be a natural birth or will it happen in the hospital? Will it be quick? Will it go on for hours or days? Who will be in the delivery room? It's a very natural thing for people to excitedly discuss all the details of the birth of a child. We even have parties to celebrate the upcoming birth and that's great. I think that's the way it should be, but only a small number of people seem comfortable talking about death whether we're discussing our own death or the death of someone else. Most people do anything they can to avoid that conversation or they quickly change the subject when in a conversation.

This avoidance of talking about death leads to an amazing, incredible amount of unnecessary struggle. It leads to anxiety. It leads to regret. It leads to guilt that can last a lifetime for a person who experiences the death of a loved one or a friend. I want to repeat that because really that's the reason I'm having this conversation. Refusing to talk about death leads to an enormous amount of anxiety, struggle, regret, and guilt. Most of that is completely avoidable.

I believe the reason that I've been so successful in my new medical practice, which is in large part helping people to have a more dignified and peaceful end of life, is because I'm willing to talk about this. I'm willing to talk about death in a way that most physicians aren't. Unfortunately, most doctors are as uncomfortable and maybe even more uncomfortable talking about death than their patients. This really compounds the problem. One of my goals is to help you help everyone feel more comfortable talking about death because I'm convinced that's how we can achieve a better life.

I want you to be more comfortable so that you can figure out how to make sure that you or someone that you care about has the most comfortable and struggle-free death whenever that happens. I want you to have the tools you need so if you're supporting a loved one through the end of their life or you're approaching the end of your life, you don't end up having regret. If you are supporting a loved one, I don't want you to have regret and guilt about what you did or didn't do during that time. When you're right in the middle of that storm, that's not the time to be preparing. The time to do that is now while you ...

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FAQ

How many episodes does A Life & Death Conversation with Dr. Bob Uslander have?

A Life & Death Conversation with Dr. Bob Uslander currently has 30 episodes available.

What topics does A Life & Death Conversation with Dr. Bob Uslander cover?

The podcast is about Health & Fitness, Alternative Health, Medicine, Podcasts and Death.

What is the most popular episode on A Life & Death Conversation with Dr. Bob Uslander?

The episode title 'What have We Learned After Two Years of Aid-in-Dying Bedside Care? – Dr. Lonny Shavelson, Ep. 31' is the most popular.

What is the average episode length on A Life & Death Conversation with Dr. Bob Uslander?

The average episode length on A Life & Death Conversation with Dr. Bob Uslander is 40 minutes.

How often are episodes of A Life & Death Conversation with Dr. Bob Uslander released?

Episodes of A Life & Death Conversation with Dr. Bob Uslander are typically released every 8 days, 7 hours.

When was the first episode of A Life & Death Conversation with Dr. Bob Uslander?

The first episode of A Life & Death Conversation with Dr. Bob Uslander was released on Dec 27, 2017.

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A Life & Death Conversation with Dr. Bob Uslander

Dr. Bob Uslander

Top 10 A Life & Death Conversation with Dr. Bob Uslander Episodes

FAQ

How many episodes does A Life & Death Conversation with Dr. Bob Uslander have?

What topics does A Life & Death Conversation with Dr. Bob Uslander cover?

What is the most popular episode on A Life & Death Conversation with Dr. Bob Uslander?

What is the average episode length on A Life & Death Conversation with Dr. Bob Uslander?

How often are episodes of A Life & Death Conversation with Dr. Bob Uslander released?

When was the first episode of A Life & Death Conversation with Dr. Bob Uslander?

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