We're all scared of death, but I'm somewhat of an extreme case. Death terrifies me. It's on my mind an unhealthy amount.
So after years of anxiety, it's time for a new approach. Over the next few weeks, I'm getting up close to death to find out how we can come to terms with what's waiting for us all. It's this big, huge mystery that none of us really understand.
All my cats belong to dead people. Do they? Yeah, I inherited them all.
Oh my God. Last week, I was immersed in a movement of people running from death. This week, I'm going to learn what it's like when that's not an option anymore.
How do people react and what do they want when they know their life is ending? I'm going to meet Dr. Sunita Puri at Keck Hospital and she runs the palliative care ward there. She spends all day every day with dying patients. She's even written a book about death.
Nice to meet you. Thanks for coming on out. Thank you for having us. So I'm going to...
follow her for the day as she meets with her terminally ill patients. I'm so glad I get to show you what palliative care is. Yeah. Because it's so misunderstood. I think we're down this week.
One thing I've learned in this work is no matter where you are in the process of dying, you're still living. Right. And so what does it mean to live well? So our first patient today is Pete McGrath. Hello.
How are you doing today? Fine, thank you. And I know we talked about a little bit yesterday that maintaining independence, going to your Rotary Club meetings is important to you. And so I think if that is your goal, then I think that we will be able to really help you without hurting you.
I would like... I like it to be as painless as possible. Yeah.
And quick and easy as we used to say. So right now, if something happened, your heart stopped, or you needed to be on a breathing machine, I would not recommend that we go down the route of chest compressions or shocks or reviving you. I agree completely. Okay.
Or that we put you on a breathing machine. No, I agree completely. We seem quite calm. with the idea of being taken off a ventilator?
When I was 90 I gave myself a big party. And as I drove home, I said, you're 90, you've had a wonderful life, and something's going to happen in the next few years. This is just a continuation of life, or a way to term it.
Yeah. So I'm relatively, at this point, I'm still relatively calm. Calm and accepting. Do you feel calm about the idea of just not living anymore?
Does it scare you at all? No. Everybody does.
A terminal diagnosis can be harder to accept if it comes when you're not expecting it. So we're about to see Melissa. She's 39. She's exactly my age.
Wow. And she's ready for you? Yeah. Oh, amazing.
So... Today's a big day for you to go home. I'm scared, but I promised my kids I would fight, so I have to go back for them. Yep.
And I think one thing we talked about in that meeting with your family... was that we will respect the limits that your body imposes. Because some of this has so little to do with how hard we want to fight and so much to do with the limits of biology. But to have three kids, I don't want to leave my kids. I'm not ready for that.
So I'm still fighting for them. Do you encounter a lot of patients who... They just want to keep fighting even potentially beyond what's medically possible.
So that's something I encounter quite a bit. But to help people remember that at a certain point it's not about them, that it's really about their body, I have found that distinction to be really actually empowering for a lot of people, that this isn't something that I just need to soldier through another round of chemo, even if it devastates me. If I try hard enough and if I want to live enough, then I will. Yeah.
You can go down this way actually. This patient is a gentleman who has a very very aggressive lung cancer but because this cancer is so aggressive part of what I also need to try to talk to him about is really where we go from here. Hey good to meet you. It sounds like even overnight the pain got pretty bad even with the higher dose. So tell me what happened.
Suddenly yesterday like around around 4 a.m. it was like just a... brand new pain.
Wow. Just came brand new pain and that was a lot of suffering. I think one of my worries when I heard that you were having a lot of pain even with more pain medicine.
was what if the tumor is growing? But the plan is to, you know, if I respond to the radiation well and it starts shrinking the tumor, they're planning about doing surgery. That's the hope, yes. But it's still in your lung, and it's still in other places. And I also have a friend who lives with a third of her lung, and my vision is for them to shrink this thing, and I live with half a lung.
It's never my intention to kind of take away any of your hopes. but rather to make sure that we're hoping for things that are realistic. And it is so important to know that though we can make these efforts to minimize how the cancer affects you, we can't cure it. Do you know how much length of time I have when, you know, when I get something uncurable like this? I think we're probably looking at a period of a year or so.
You don't deserve to be going through this. You don't. It's hard to explain.
I don't feel like white men kind of thing. We all are born and we die sooner or later. Mine is a little sooner.
I felt like I was witnessing... It's like the biggest moment in someone's life potentially. I think the hardest part about it is doing it and being in that very sacred, difficult moment with a patient. And then having to leave the room and go on to the next. It's not just patients who have to contend with the weight that surrounds death.
I'm going to speak in Spanish first, but also in English, because not all people speak Spanish. I know that we have spoken. about the condition of her husband, her father, right?
That he is so sick because his heart is not working. All organs need machine support nowadays. But in five days, if he already needs this form of dialysis that we can only do in the ICU, and if he already needs the support of the heart machine, it is probably a sign that his body is so weak that he cannot survive.
Do you understand what I'm saying? Yes. life or are we prolonging the process of dying? Why can't it just be there until he initially passes away? Because that's what's helping keeping him alive.
Right, so why can't it just be there until he naturally passes away? Because the heart won't stop. If it's meant to stop, it's not going to stop unless...
That pump is gone. It's just the machine. If he's not going to get better, it's more money for you guys if he's on it.
It's not about money, Steve. He may not feel that that's how he wants to live his life. Unable to walk.
being in an ICU, unable to go home, being poked and prodded. And a lot of people are willing to do all that if we can take them from a bad place to a better place, like a place of healing. But if he's going to be here no matter what we do, if that is the case, then wouldn't it be best to let him have some dignity and comfort and peace at the end? And more or less in five days they're going to see what the result is. If he's reacting.
And we're going to talk also most of the days before Monday. So we're going to be in conversation. No es la ultima vez.
My parents have been married over 40 years, but not through the church. So my dad asked my aunts to ask my mom. She wanted to get married by a priest.
It's going to be great. This is our office. Great. How do you cope with having what for most people would be a once-in-a-lifetime difficult conversation, but you're having them like four times a day, every day?
I grew up in a very spiritual home. So my parents are very devout Hindus. And a lot of what I was raised with was this idea that life is temporary. Woo!
So how do we live our best lives and how do we make sense of what happens in our lives? Dear brothers and sisters, today is a very special day for Maribel and Roberto. A love story that began to be written more than 45 years ago, right?
Yes. God has walked with you all this life. God has been with you. But now, in a special way, he is here, writing, sealing this story.
We see little deaths all around us. We see the changing of the seasons. We see the trees and their leaves that change and that's not the same as losing someone you love But we do see loss every day We do see little deaths every day Without mortality. I don't know what humanity would be I feel grateful for the fact that I won't be here forever because it forces me to make meaning of the time I do have. Since we met, Mr. Lopez and Mr. McGrath have both died comfortably at home.
I'm really grateful that they and their families gave us some time. Reflecting on the day, I think that I got to see a side to... death and illness that I wouldn't have otherwise understood.
We're all aware of the scary and the painful aspects of dying but what we don't often get to see or understand is the peace and the calm that can be there as well. Thank you for watching episode 2 of Deathland. If you're curious about Dr. Puri's work there's a link to her book That Good Night, Life and Medicine in the Eleventh Hour below.
Next week it's going to get a little bit personal. I'm going to be talking about death anxiety, mine and yours. If you don't want to miss it click subscribe now and please leave us some feedback in the comments.