Insight: Examining life and death

By Ed Pierce
Managing Editor

My wife and I recently watched a TED Talk on YouTube presented by author and hospice and palliative physician Dr. BJ Miller called “What really matters at the end of life” and we found it fascinating how he was able to convey that as death approaches, many people just want respect, love, and comfort.

Author and hospice physician Dr. BJ Miller is known for
his TED Talk 'What really matters at the end of life' and 
says his own near-death experience has helped him to
transform how he looks at life. COURTESY PHOTO

Miller himself faced death as a sophomore student at Princeton University when after a night out with friends, he climbed onto the roof of a parked shuttle train and was electrocuted by 11,000 volts of electricity. First responders saved his life, but through his injuries, he lost both his legs below the knees and half of his left arm.

He was inspired to heal and adapt by his mother, who was disabled and in a wheelchair after contracting polio as a child. Spending months recovering in the hospital’s burn unit, Miller had time to think about how his mother embraced life with her disability and how despite his own physical limitations, he too had something to offer that would transform his life.

During his TED talk, Miller said he believes that a disability is not something to be ashamed of, not something to overcome or to put behind you, rather, he said he found it to be something to work with and it led him to seek a career in medicine specializing in hospice and palliative care, which he described as easing the suffering from physical pain.

According to Miller, through his work and his own near-death experience, he has been able to recognize and distinguish two separate fears that people have regarding death. One is the fear of dying and having to endure the suffering and pain associated with that, and the other is the fear of being dead and missing their loved ones and how the world will continue without them.

He said that from realizing those two distinctions, he can help address each concern and it’s made him a better hospice and palliative care physician.

Back in 1998, I had been experiencing lower back pain for several months and had unexpectedly lost weight. Four different physicians were unable to pinpoint what was wrong with me. Then I had CT scan, and it discovered a suspicious spot on my lung. It was recommended that I make an appointment to see a surgeon.

I met with the surgeon in his office on the Tuesday before Thanksgiving and after examining my scan results, he suggested I might have leukemia or some type of cancer and scheduled me for exploratory surgery the day after Christmas. It goes without saying that the holiday season that year was not very merry for me, and I felt like I had the Sword of Damocles hanging over my head.

After my exploratory operation, the surgeon informed me that I had a rare form of cancer. He had confirmed the results with the Mayo Clinic and recommended a course of treatment that included surgery and chemotherapy and said my odds of survival were 50-50. My thoughts while driving home from hearing that news turned out to be exactly what Dr. BJ Miller describes. I was fearful of the pain and suffering I would endure in treatment and wondered if this was indeed the end for me that I had accomplished very little in my life and I was unsure of what my purpose in living had been.

I spent many sleepless nights during my treatment reviewing my relationships with others, debating what I might have done differently and why this was happening to me. I came to accept that if I was going to die, that it was part of life and was my time to go. But I prayed that if I was to survive, I’d focus on being a better person and use my writing talent to tell stories that inspired others.

Miraculously, I survived, and within a few years, my life and career were back on track. Through personal experience, I can tell you that when you learn the end might be near, it’s not much of a fun and liberating time. The anticipation can be paralyzing and the stress of coping with it all can be utterly overwhelming.

Nowadays when I reflect on my health issues of 25 years ago, I am in awe that powerful medicine and some great physicians saved my life. It certainly gives me confidence to know I could have died but somehow didn’t. Because of that experience my outlook on life changed too. Some things that used to really get under my skin and bother me are now just trivial annoyances and not important in the greater scheme of things.

Dr. Miller’s TED Talk explores what's most important to people who are closer to death, and he lists those as personal comfort, feeling unburdened and not being a burden to those they love, finding existential peace, and living out your remaining days with a sense of wonderment and spirituality.

Those of us who have been given a second chance in life understand what he means. Wouldn’t the world be a better place if we all applied those attributes to our daily lives too?