"Write Your Best Chapter"

Ever since I became a podcaster and a blogger, and also since I moved to Hawaii, I am approached by people wondering what it's like moving and living here. So many questions. I had to do my own search before moving here. Some of what I learned were true, some of it was not. I am joined by the amazing and accomplished Dr. Rupa Wong, also not a native of Hawaii, sharing our pearls about what it's like to create your life here.

In times of COVID, as our grief process has been stunted due to lack of in person services, it is so important to move at your own pace. There is no hurry. You move as you need to move. Slow and steady. The society may want you to be done already. People are uncomfortable being around grieving individuals. Sometimes they feel helpless. It is ok. It is not about them. I am giving us permission to take our sweet time until we are good and ready.

First day of spring. A brand new year. A new beginning. I hope you will take this ancient tradition and honor its practices. Offer forgiveness to those who have hurt you. Ask for forgiveness from those whom you have intentionally or unintentionally hurt in the past year. Every year is a new beginning. I wish you love, peace, health and prosperity. Happy New Year: NoRuzetan Pirouz!

All aspects of our lives are opportunities for growth. The sudden loss of a loved one, especially the same age or younger, always feels unsettling. Following many recent losses my colleagues and clients have been sharing with me, I felt like it was a good time to talk about how we should manage our mind during these unprecedented times. There is no urgency, other than that of feeling aware of all that we are and all that we can be.

For the longest time, I went to vacation to get away from my life. When your life is so uncontrollable that you feel like the only way you can find peace is parked somewhere far away, it is time to revisit this thought. I talk about how I would put away my phone in the security box just so that I could shut down the outside chatter. Let's talk about how you can do that without going to Mexico.

The first time I heard about "Death Cafe" on NPR, I thought it was the most brilliant way of normalizing discussions about death and dying. I think that if my podcast is similar to anything, I would have to say it would be like that space. Except that I am the only one talking here. When I learned that a virtual Death Cafe was happening, I had to invite the host to tell us more.

With all the talk about mindfulness and its positive effect on our lives, how do we go about incorporating the practice? As we have been socialized to feel accomplished once we complete a to do list, and judge ourselves when we don't, how do we practice acceptance? How can we decide what matters most so that we can focus on those priorities instead? In this mini-coaching session, I will share with you some of my tools to help you pivot and focus on what can ground you in stormy days of your life no matter what life throws at you.

What if this life is all there is? If you are a non-believer and don't envision an afterlife, how do you grieve and where do you reach out for like minded support? My guest today is a phenomenal activist, mother and grief support leader. When Rebecca Hensler lost her young son, she experienced first hand what it meant to be given the wrong type of support. As a non-believer, she wanted to created a safe support group for all who may need it some day. "Grief Beyond Belief" was created as a meaning making celebration of her son.

What is Therapeutic Presence? Can you just sit there with a patient, without offering any treatment or even medication and yet have a meaningful impact? Turns out the answer is easier than one might think. A 'healer' shares her story of why she was drawn to end of life care. As one might imagine, the story is not always linked to a death story. What if you wanted to provide the best of care for humanity from the very beginning to the very end?

As a little kid, did you look at people who were older and wondered about how their hair turned gray? Andrea did. Then she grew up to become a gerontologist because she loved to really study them. She ended up serving that vulnerable section of our society with so much heart and authenticity. Now she lives in Georgia working as a Marketing Director for a local Hospice agency. She shares her story with us today.

Why is a chaplain here? I often hear that when we walk into a patient's room for a palliative care consultation. What is "Existential Distress"? I have been wanting to share the importance of chaplaincy and their work surrounding end of life care. Fred Grewe is a master story teller to help me do just that.

Sailing and Slow Travel. What is on your bucket list? There is so much we want to do with our lives until the very end. Some things are easy to keep doing, other things not so much. We talk about the first and last time I felt my father's dialysis thrill. Also, what it means to offer dialysis no matter how much time we have to live. Is it the right decision? Dr. Samra shares her amazing journey into medicine and answers my questions.

I had the absolute pleasure of taking part in a workshop led by Eckhart Tolle on Winter Solstice on December 2020. I wanted to hear about his take about how we should manage our emotions around this much death and suffering around times of pandemic. I can't think of any other joy than having him quote my all time favorite book: The Little Prince. Enjoy this treat.

We will all be hit by a serious illness diagnosis one day. How will we take that news? In a very heart touching episode, my dear friend and colleague, Dr. Sonal Haerter, shares her story of her father in law whom she lovingly calls her Dad. He was diagnosed with pancreatic cancer and lived his life more than ever before. He taught her "The Value of Here and Now". She shares his story.

In a very special Christmas episode, I want to share with you one of my more popular blog posts titled "Alicia". While the details of the story of the patient is changed to protect his identity, Alicia is an actual person who was an angel personified that day for me. If you got to know her, you would agree with my assessment. I want us all to take a moment and appreciate oncology nurses during this time of the year. They are truly our unsung heroes.

What do you want to be when you grow up? What if that wouldn't give you much joy and you wanted to shift gears? My special guest today is a wildly popular financial blogger who happened to be a practicing anesthesiologist until very recently. Instead of buying into "The Sunk Cost Fallacy", he decided to pivot and creatively help the world in a totally different way-all while slow traveling the world with his wife and young children. I know you will love his story.

What if your beauty routine was owning one lipstick? I was asked to discuss financial matters that relate to handling end of life. Do we live our bucket list and spend money because of FOMO (Fear of Missing Out) or do we save money for the rainy days ahead and appreciate JOMO (Joy of Missing Out)? I share my perspective of "Save and Savor" as far as relating to my attitude regarding finance and intentional spending. I think this attitude would serve us well whether we are of good health or heading into the end of our lives.

It is unbelievable. Truly, if you have never heard of it, you may be thinking this is an urban legend or conspiracy theory of sorts. I wish your intuition was right. In a stranger than fiction episode, let Dr. Gilcrease tell you about the atrocities of a government that forcefully removes organs of its prisoners of conscience to sell to the rest of the world. Prepare to be shocked and find yourself running to fact check this episode. Check out www.DAFOH.org

I wonder why is it that the oncologists are often the "Last Man" standing? When patients have no more options for life prolonging measures, they still want the final word to come from their oncologists and not their own free will. Dr. Gilcrease masterfully answers these difficult questions that we all struggle with. In a very heart felt episode, he shares all his highs and lows caring for his dying patients in the most compassionate way possible.

Palliative is from the Latin word pallium, which means cloak. When patients receive palliative care, they are cloaked with care and comfort as they receive focused pain and symptom management. I think there is another way we can cloak ourselves: To practice gratitude. In this Thanksgiving episode, I share with you two ways you can live a more grateful existence. It is my appreciation for your presence in this space. Mahalo!

'Name is Bond. James Bond'. Who does not get goose bumps when they hear those words? Yet when Sean Connery died last month, I had to ask myself: Did I know if he was still alive? There certainly was no mention or sighting of him. His wife released a statement that said he had dementia and it took its toll on him. "It was no life for him. He was not able to express himself in any way." She was happy he died in his sleep. Just how he wanted to die. Peaceful. At home.

As physicians, we often talk about 'Do No Harm'. We also know that culturally we associate feeding loved ones as loving them. Can these two ideas go against one another? Are there situations when inadvertently we feed our loved ones to death? When patients with end stage dementia are unable to swallow their food, how do we help family see that they are getting to the end of their road? Talking about the benefits of pleasure feeding by mouth, as opposed to artificial nutrition by tubes, tackles these emotional situations.

Hear the story of a patient who loved life so much that she wanted to live it her way until the very end. In this very special episode, we will listen to Dr. Deming from the last episode with her patient's daughter talk about Patsy. She was a fiercely independent woman who was very clear about her wishes. She was clear as to how she wanted to end her last chapter. Listening without judgment opens our minds.

I am very excited to share my special guest's story on the podcast: Dr. Katie Deming, who practices radiation oncology in the Pacific Northwest. As a doctor treating female patients with breast and gynecological cancer with radiation, she makes deep connections with her cancer patients. Listen to her story as how having volunteered in a hospice home led her to where she is today. We ponder whether the right questions are being asked during medical school application process to get the correct candidates care for our humanity. She shares her unique story with us on this podcast.

Patients with serious illness often want to know how much time they have left to live. It helps them plan. How to live the rest of their lives on their own terms. Do they want to keep coming back and forth to the hospital? Or do they want to spend the rest of their lives at home instead? We talk about prognosis discussions when it is not a timed based focus but rather functional or unpredictable prognosis.

We are sometimes asked by our patients about their prognosis. How much time do they have? While we may never know the exact answer to that question, we often have an estimate. Is it helpful to share that information with the patients? Can we assume that they actually want to know? In this episode, which is the first of two part series, I will share with you how to best approach those questions so that patients get to choose the right options based on the information at hand. I also share what not to do to protect our patients' fragile state of mind.

We often make assumptions about people. People often make assumptions about us. How do they make their assumptions? Are those right or wrong assumptions? Could it be because of how we live our lives? Is there a disconnect between what matters to us and how we live our day to day lives? Is it possible that if we lived our life on purpose and mindfully, when our time comes, we would be more ready to leave this world? Do we struggle to connect with other people because we misread them altogether?

Can you pause to learn what's most important even in the Emergency Room? My first guest is an ER physician who is also a board certified palliative care physician. Dr. Kate Aberger tells us her story of how she came to practice medicine the best way she knows how. She tells us how you can always have a medical pause when stakes are high.I am very excited to let her share her highs and lows of life in the front line caring for the living and the dying.

We do not want to get older. There are so many birthday cards making fun of getting older. We become despondent when as we get older, we become slower at life. As runners, we run slower. Our eyesight starts to go. Our hair turns gray. Our body starts turning into a shape of its own. I want you to know that aging is a privilege. We will talk about how we should not regret getting older. It's a privilege denies to many.

As palliative care physicians, we know how to hold space. In this episode, I will talk to you how it feels to hold space. I also talk about how it feels to be on the receiving end of when someone holds space for you. As physicians, it is our duty to know how to deliver difficult messages or have hard conversations.

When I started talking to friends about starting a podcast, they all wanted to know one thing: who is my audience? Was I talking to physicians or was my goal to reach patients? It is a difficult question. The truth is I believe if you are going to be struck with an illness in your life time, and you may die because of it, you should listen. I want to normalize conversation about life and death. I want to empower all of us to ask the right questions to get the right care. We explore what that really means.

Hope cannot possibly be inherently bad. In an earlier episode, we talked about how 'Hope is not a plan'. But, is there anything else we could hope for? In times of serious illness, are we hoping for the wrong things? If we are putting all of our energy for fighting a battle we cannot win (Death), are there other hopes that can add life to our living days? How to ask questions so we can get to those answers.

How do you talk with patients when the stakes are high? Can you establish trust with the patient, without taking away their hope, and aligning their wishes and goals with the medical treatment options we offer? In this episode, we will talk about how the words we choose to communicate with patients allow us to have more meaningful conversations such that both parties get the best outcome possible. Patients empowered to make meaningful decisions and physician being able to deliver bad news without feeling overwhelmed or a sense of abandoning their patient.

When we are diagnosed with a terminal illness, we all hope for longer time. Even when odds are not in our favor, somehow, we believe that we are immune to what's to come. Somehow we may get to cheat death in the end. It's my experience that 'hope' ends up blindfolding us from the reality of our lives. Hope keeps us from making the right decisions to get us the ending we would want for ourselves. By imagining that somehow we are exception to the rule, we lose the objectivity to make decisions that may give us a better life, a better last chapter. In this episode, I empower you to ask the right questions from your patient, or if you are the patient, I encourage you to focus on what matters to you most.

In an introductory podcast, I will introduce myself to you. I am a palliative care physician with 20 years of experience. I have practiced medicine in Michigan, Arizona, California and now Hawaii. You will hear about how I became interested in caring for seriously ill and dying patients. Why it matters to me that when struck by an illness, we should all have a say as to how our lives should end. I want to empower physicians to have better conversations with their patients about their goals and wishes, without thinking that they are taking their hope away. But most importantly, I want all of us to be encouraged to live a mindful life, one that allows us to appreciate the present moment. To consider checking off whatever is on our bucket list before it is too late. The major culprit for starting this podcast was the COVID pandemic. As I felt alone on a geographically isolated island, away from so many of my colleagues struggling with unimaginable death and suffering on the East coast, I imagined providing a podcast to share my thoughts and training may prove to be helpful. Welcome!