End-of-Life Planning: What No One Tells You Until It’s Too Late with Alua Arthur

Summary

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Podcast Summary: "End-of-Life Planning: What No One Tells You Until It’s Too Late"

Alive with Steve Burns | Lemonada Media
Air Date: January 28, 2026
Guest: Alua Arthur (Death Doula, founder of Going With Grace)

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Episode Overview

In this episode of Alive with Steve Burns, host Steve Burns sits down with Alua Arthur—renowned death doula, lawyer-turned-mortality-advocate, and founder of Going With Grace. Their conversation candidly explores end-of-life planning: not just the paperwork, but also the values, emotions, and conversations we avoid until it’s too late. Through humor, warmth, and a touch of the surreal, Steve and Alua delve into why facing death head-on may make life sweeter, and how making clear choices now can be a true act of love for ourselves and those we leave behind.

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Key Discussion Points and Insights

1. Why We Avoid Talking About Death

• Steve opens with reflections on his own discomfort grappling with mortality, referencing a previous episode with Julie McFadden (00:46–02:10).
• The “affairs” in “get your affairs in order” is defined, as Steve and Alua agree that most people don’t actually know what that really means or how to begin (02:10–04:03, 07:49–08:31).
• Alua’s Origin Story: Her path from law to death doula began after a transformative, honest conversation with a cancer patient on a bus in Cuba (05:52–07:49).

2. What Does It Mean to Get Your Affairs in Order?

• Practical Steps (08:31–13:33):
  • Have a will or a trust for possessions and assets.
  • Prepare an advanced directive: specifies who can make health decisions for you and what kind of care you want if incapacitated.
  • Decisions about life support, resuscitation, and end-of-life medical interventions.
  • Plan for your body and services: burial, cremation, aquamation, green burial, embalming, type of memorial or visitation.
• Alua: “Start with your values” to inform your choices, especially when specifics are uncertain (10:05–10:55).

3. The Role of Values in Medical Decisions

• Rather than focusing on specific interventions, reflect on what conditions of life would feel ‘worse than dying’ (09:29–11:41).
• Example: Delaying intubation so loved ones can say goodbye aligns with the value of connection.

Notable Quote

“Start with your values... Think about conditions of living that for you would be worse than dying right now.”
— Alua Arthur, 10:22

4. Communicating Wishes to Loved Ones

• Importance of clarity: Removes pressure from families in crisis and avoids second-guessing (12:51–13:08).
• Steve’s father’s metaphor: “If I’m a car going off a cliff and you can tow me back, do it; but if I’m over the cliff, don’t hit pause. Let me fall” (12:33–12:42).

5. Facing the Specifics—With Joy

• Alua describes what her own perfect death would look like: sunset on a deck, surrounded by loved ones, incense, warmth, “no bra” and socks, followed by applause from friends (19:40–21:31).
• Why imagine the specifics? “Because I don’t know how it’s going to go, so why would I choose something that makes me feel anxious… I’d rather my dying time feel like a soft, cushy, bathtub ride out of this world” (22:00–23:30).

Notable Quote

“I want them to clap... I want them to be like, you did it, girl. Good job, girly.”
— Alua Arthur, 21:29

6. Navigating Grief, Guilt, and “Good Death”

• Steve reflects on how his own discomfort shaped decisions for his father and his dog, realizing some actions were for his comfort, not theirs (23:30–25:47).
• Alua reframes this: Regret is part of grief; families have to make choices they can live with, and that too can honor the dying (25:47–27:05).

Notable Quote

“Part of creating this elusive, good death... is also the impact on the people that still have to live after I die.”
— Alua Arthur, 26:30

7. Practical Tips for Talking to Elderly Loved Ones

• Be gentle—most elders want to talk about it but need the conversation approached thoughtfully (27:57–29:13).
• Use recent deaths or celebrity passings as openings.
• Be mindful of timing and setting (don’t bring it up at Thanksgiving).
• Practice starting the conversation to make the first sentence less daunting (30:04–30:52).

8. Why is it So Difficult?

• Facing death means confronting powerlessness and the end of ego (31:19–32:28).
• Some people want to talk about it but wait for “permission.” Alua’s experience: when she mentions her work, people open up unexpectedly.

9. Fears Around Longevity and Assisted Dying

• Steve voices a fear of “living too long”—longevity without joy (32:28–33:52).
• Discussion of physician-assisted dying:
  • Legal in 11 states and D.C. in the U.S.
  • Strict regulations regarding terminal illness, sound mind, and ability to self-administer medication (37:21–39:21).
  • Alua is a proponent: “I want people to be able to choose the type of death that they want.”

10. The Changing Fabric of End-of-Life Support

• Death used to be a community/family process; now, with separated families, professionals like death doulas fill the gap (40:33–43:12).
• Alua: “Our work exists... because of that breakup of how we used to do elderhood and dying” (43:12–43:55).

11. Why Start Planning Young?

• “None of us know when the actual end of life is.”
• Practical planning clarifies values and lends more vividness to living (46:00–46:50).

Notable Quote

“I have never felt so full of my own life than when I was thinking constantly and consistently about my death. Oranges taste sweeter, the sun shines brighter, my love feels more potent.”
— Alua Arthur, 46:50

12. How Death Work Changes a Life

• Steve asks: How does being close to death shape the way you live?
• Alua: Working with the dying has made her more present, honest, loving, grateful, and emotionally open; the “minutiae of life” becomes precious (47:06–48:47).

Notable Quote

“I am also a lot more, let’s say, present with the gift that my life actually is by virtue of working with death.”
— Alua Arthur, 48:45

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Timestamps for Important Segments

• Opening/Setting the Theme — 00:46–02:10
• Alua’s Origin Story — 05:52–07:49
• End-of-Life Paperwork and Values — 08:31–11:41
• How to Talk About Death with Family — 27:57–30:52
• Alua’s Ideal Death — 19:40–21:31
• Physician-Assisted Dying Explained — 37:21–39:21
• Modern Death Doulas vs. Traditional Family Support — 40:33–43:55
• How Death Work Changes the Living — 47:06–48:47

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Memorable Quotes

• “Start with your values... Think about conditions of living that for you would be worse than dying right now.”
  (Alua Arthur, 10:22)

• “I want them to clap... I want them to be like, you did it, girl. Good job, girly.”
  (Alua Arthur, 21:29)

• “I have never felt so full of my own life than when I was thinking constantly and consistently about my death. Oranges taste sweeter, the sun shines brighter, my love feels more potent.”
  (Alua Arthur, 46:50)

• “I am also a lot more, let’s say, present with the gift that my life actually is by virtue of working with death.”
  (Alua Arthur, 48:45)

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Closing Reflection by Steve Burns

Steve concludes by reinforcing Alua’s message: a clear end-of-life plan is a gift to those we love, easing their burden in crisis. Facing mortality can be an act of deep care and honesty, one which clarifies how we wish to live. Steve shares how imagining his own last day—down to wearing socks—informs who he wants to be right now.

“A meaningful death begins with a meaningful life. Live a life worth dying from.”
(Paraphrasing Alua Arthur, 49:05)

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This episode is essential listening for anyone curious—or anxious—about end-of-life planning. Both funny and frank, it offers tools and wisdom for living, loving, and leaving with grace.

Transcript

[A]

Lemonade.

[B]

Thinking through all the potential options for what you want done with your body after you die. And then your service. Do you want a funeral? Do you want a memorial service? Do you want a viewing? Do you want a visitation? Do you want to be embalmed? Why are you making that face?

[A]

People get embalmed.

[B]

Yeah.

[A]

Wow.

[B]

Hey. Hi.

[A]

It's great to see you. Come on in. Welcome to Alive.

[B]

Okay.

[A]

Speaking of alive, do you remember the very first podcast episode we ever did? It was about death. Right. Remember Julie McFadden, who is awesome, and we talked about my dog, my dad, and angels, and she said that we die how we lived, and that blew my mind. And at the end of that episode, I asked you if we know we're going to die, but we don't know when, how do we live? Right. Have you been thinking about that at all?

[B]

Yeah.

[A]

There's tea. You want tea? Yeah. I've been thinking about that a lot, actually, and it's been really interesting because I've been thinking about death intentionally, on purpose. And I've been trying to do it in ways that aren't morbid. I've been trying to do it in ways that are more practical. Right. For example, everyone always says you should have your affairs in order. And I think, oh, yes, yes, of course I should. But what does.

[B]

What.

[A]

What does that mean? He goes, what affairs? Which. Which order?

[B]

And.

[A]

And how do we even talk about that? And what conversations should we have about that while we're still young? And how do we advocate for loved ones in our lives that are older and that are closer to end of life? I guess what I'm asking is, how does someone prepare to die?

[B]

Yeah.

[A]

Yeah. Let's go. So my guest today is Alua Arthur, a death doula who has become, in my opinion, maybe the clearest, kindest voice in the conversation about how we can live with the knowledge that we're going to die? She founded Going With Grace, which is a company that helps people navigate the emotional, legal, and practical side of end of life planning. You might know her from her TED Talk, which has, like, a bazillion viewers, of which I am one. It is amazing. I cannot recommend that enough. And her new book, briefly Perfectly Human, which is exactly what it sounds like. It is a meditation on mortality, and that somehow makes you feel more alive, not less. She was a lawyer. We'll get into that. But now she sits with people at the end, supporting families and helping the rest of us think about something we try really hard not to think about. What I love about her is.

[B]

She.

[A]

Kind of talks about death, almost like travel in a way. It's like something you should totally prep for, but also even anticipate with some degree of joy. Oh, she's here. Okay. Alua. Arthur. Hello.

[B]

Hi. How you doing?

[A]

I'm doing great. How are you doing today?

[B]

I'm doing pretty good, thank you.

[A]

This is probably my favorite background I've ever seen. Tell me about what's behind you.

[B]

This is a piece I got in Thailand. It's just. I think it's teak wood that's been painted gold. It's carved. It's pretty intricate. It used to be a headboard, and now it's my zoom background.

[A]

How did you get it back? Did you just ship it?

[B]

We shipped it.

[A]

Yeah.

[B]

Packaged it very, very carefully and shipped it.

[A]

Oh, it is absolutely beautiful. You look resplendent, like you are. Like you are podcasting from the sun. It's lovely.

[B]

I was hoping for, like, a crown sun behind me.

[A]

We should add that effect just as the. As the window opens. That would be fantastic. I'm super psyched to talk to you and super psyched to meet you, by the way. I'm a fan.

[B]

Oh.

[A]

The way talk about this topic hits me in the guts, hits me in the feels in a real way. It is both real and transcendent at the same time, and it's a hard thing to discuss. And your approach to it, I think, is really. It's accessible, but it also honors the impossible nature of the conversation. Before we really kind of jump into stuff, would you mind talking a little bit about how you got into this work? I mean, I know you've got a really compelling origin story. Take me back to Cuba.

[B]

Yeah. So, gosh, 13 years ago, I was in Cuba, where I'd found myself after a pretty disappointing career in public service law, directed legal aid for almost a decade. And I grew up actually clinically depressed, where I went to Cuba, and I met a fellow traveler on the bus who had uterine cancer. And we talked a lot about her life, and I started asking her questions about her death, and she answered all of them. And it was the first real meaningful conversation I'd had with anybody about death. I was 34 years old, had barely ever considered my own outside of what depression had brought, so I barely considered my own. I hadn't really thought about anybody else's. Nobody in my family had died that I knew. I grew up without my grandparents, and so it was a big wall up to me that not only did people die, but that people Were really grappling with these huge questions around, opened up my eyes to how isolating it can be for somebody to be in the conversation around death. Because every time she'd try to bring it up with people in her life, they would encourage her to think about healing and not about dying from her disease. Which I thought was kind of unfair because we will all die one day. So why not start the conversation whenever it feels appropriate to do so? After we got off that bus, I threw myself headlong into thinking about mortality overall because it was like such a juicy conversation. I wanted to talk about it and nothing else. Definitely to the dismay of my friends and my family members. It was all death, all the time. But it was useful. It was really cool. And then when I came back from Cuba, my brother in law became ill. My older sister's husband and I got to support him through the last two months of his life, where this theoretical conversation I'd been having on the bus became suddenly very, very real. And we got to really learn first person what it's like to be with somebody who's dying.

[A]

My God, what a cinematic experience. You're both sitting on a bus on a literal journey toward the same destination in two very different ways. I mean, it's a pretty amazing story. Thank you for sharing that, by the way. Can we start practically? Can we start with like the admin, with the, with the Excel sheet? You know, because everybody says, you know, you should really, you should really have your affairs in order. And I say, my God, yes, I feel like I really should. I also have no idea what you're talking about. Like none. Like, what does that mean? Yeah, what are the affairs?

[B]

Yeah, there's. There's a lot of affairs. But since you mentioned practically, we'll start there. Even though I don't know if it's a. I like the idea of starting practically because it does open the door to talk about the deeper, like emotional and spiritual questions. But the affairs that we're generally talking about, everybody knows that you should get a will at some point. Get your. But that's about your possessions. Trying to figure out what will happen to your possessions after you die when you can no longer enjoy them. Right. So that's the practical stuff. Include your money and your stuff. Let's also deeply consider an advanced directive, some document that says very clearly who is empowered to make your decisions for you in the event that you're not able to. So somebody who's gonna take over when you can't say, this is the type of care I wanna Receive for myself for your healthcare. Also get clear on your desires for life support, how you want your body treated nearing the end. Like any measures that they're gonna take to prolong your life in the event that it's ending anyway as a result of an accident or some disease.

[A]

Can I ask you something there? When it comes to do not resuscitate and life support, I think, myself included, I think a lot of people don't even know what the options might be be in those situations. Right. So we don't. We. We can't define those terms because we don't even know what might happen, you know. Can you talk a little bit more about that?

[B]

Well, it's hard to try to figure out what will happen. And that's one of the big challenges people face when it comes to end of life planning is they think, well, I don't know where I'll be, or I don't know what I want, or I don't know what'll be going on. What if I'm pregnant and I have half a foot? Like maybe the circumstances would be different. You know what I mean?

[A]

Yeah.

[B]

And so it would be different. It's really hard to. It would be very different. So let's think big picture about what you might want. I ask people constantly to look at their values. Start with their values. Like think about conditions of living that for you would be worse than dying right now.

[A]

Yes.

[B]

Any condition of living that would be worse than dying, think about your values because that helps inform the decision making. Because we don't know. I cannot tell you right now what level of CPR I want. If I want to be intubated, I can't tell you what type of other treatment. A feeding tube, any IV nutrition or hydration. I can't tell you right now, but I can tell you that, big picture, these are the things that I value in my life, that I want to afford as much as possible so that they can use my values to make a decision about what kind of treatment I get when I can't speak for myself anymore.

[A]

I see what you're saying. I think it's less about knowing the, the terminology, like I don't want to be intubated, I don't want to be on life support. That is this. That the other thing. It's more about if my, if the conditions of my life get beyond a certain point. I don't want any of that. I don't want anything that's gonna, that's going to force me to be in a state that I wouldn't want to live in.

[B]

Right, exactly, exactly. And we can extrapolate that out even further to think about things like intubation.

[A]

Yeah.

[B]

If I would be intubated to a point to allow my friends and family to travel, to be near me, then I'm okay with it for a brief amount of time because my values are having a chance for the people that love me to say goodbye. Do you see what I'm saying?

[A]

I do see what I'm saying.

[B]

And so that informs the decision about whether or not to be intubated, to have cpr, to, you know, to have any other types of life sustaining treatment, because it informs it. It allows me to meet those values.

[A]

Right. Because the value of getting back to your friends so they can say goodbye. There are other values that supersede those life saving measures that you wouldn't want otherwise. That makes total sense to me. My dad always said I tried to talk about this with my father toward the end and he was like, well, I feel like I'm a car about to go off a cliff and if I'm on the edge of the cliff and I got the back wheels on the cliff and you can tow me back, do it. But if I'm over the cliff and heading down, don't hit pause.

[B]

Okay.

[A]

He's like, let me fall and crash and burn. Right. And I was like, I think I get that. It was very helpful to me. Yeah, it was.

[B]

Yeah. Yeah. I hear a lot of values in that.

[A]

Yeah. And I was grateful that he was clear about that.

[B]

You know, I'm sure you make a really good point about how important it is that we communicate our desires so that the people that love us are clear, so that they know what it is that we want. So that they're not left struggling in the middle of some catastrophic event. Try to figure out what you might want.

[A]

Yeah, exactly. So what else. What else is in there? Outside of. You mentioned a will, which I think we all understand. And in the subset of the will is a trust, which I think none of us understand, but thank God there's chat GTP in the world, we could figure that out. What was the planning?

[B]

Attorneys.

[A]

Yep.

[B]

So I trust a will. Advanced directives of decision making.

[A]

Yes.

[B]

Yep. Be absolutely clear about how you want your body taken care of after you die.

[A]

And that includes do I want to be cremated, buried? Do I want a service? Do I want what I want to happen to my body?

[B]

Yeah.

[A]

Okay.

[B]

Yes. A green burial. Aquamation Natural organic reduction. Thinking through all the potential options for what you Want done with your body after you die? And then your service. Do you want a funeral? Do you want a memorial service? Do you want. Want a viewing? Do you want a visitation? Do you want to be embalmed? Like, just talking through the. The elements of what you want for your body and your service afterward. Why are you making that face?

[A]

People get embalmed. People get embalmed?

[B]

Yeah.

[A]

Wow.

[B]

They do. A lot of people get embalmed.

[A]

I was not aware of that. So is that.

[B]

Oh, yeah.

[A]

Is that a popular permanent thing? So you're just. You're just embalmed and then you're there and like, there you are.

[B]

It's not like taxidermy. It's not like taxidermy. Right. You. Your body still eventually will decompose. It just delays the process because essentially they rid your body of a lot of the fluids in it and then pump it full of formaldehyde and other preservatives so that it delays decomposition for a while. Oh, and what you're left with is like a.

[A]

Is this just for like a viewing or. I thought you meant something like longer term. Okay, so I do understand.

[B]

No.

[A]

Okay.

[B]

Okay. Yeah. Not like you're. They bring you. Not like Weekend at Bernie's.

[A]

Right.

[B]

Okay.

[A]

Is that an option? Because honestly, that's an hilarious option. I could easily see saying, you know what I want? You know what I would like, guys? I would like to be embalmed, and then I would like to be taken around on a hilarious buddy adventure. And I would like the whole thing to be filmed. We're laughing about that. But honestly, I think it's hilarious. I mean, everyone's talking about getting more fiber and more protein lately. And I'm all about it as long as I don't have to give up bread, you know, and that's why herobread has been such a super easy swap. I use it for the stuff I already eat, like bagels. I do like an avocado toast. And I also really enjoy a PB and J. And what surprised me most is the taste and the texture. It's totally, like, fluffy and soft and satisfying. It's not like dry and weird. And if you. You can grill cheese. They nailed that. Peanut butter and jelly. Nailed. Wrap, nailed. Totally holds up. And it's also like 0 to 5 grams net carbs, 0 sugar, high in fiber, it fits for your life. Protection, protein packed breakfast bagels, quick wraps, even a nostalgic pbj, while helping me get more fiber and protein without cutting out carbs completely. And they've got Everything covered, sliced bread, buns, tortillas, bagels. Plus small batch drops like the 2 gram net carb Hero Croissant and the 1 gram net carb Hero buttermilk biscuit. That sounds so good. No compromises, just flavor. Get 10 off your order at Hero. Code with code Steve. That's Steve at H E R O CO. I love the idea of a nice cocktail. I just do not love what alcohol does to my sleep, to my brain, into my next morning. That's why I've been getting really into Little Saints. They make these elevated non alcoholic cocktails that actually feel like a real drink, you know, with like the big ice in the glass and the citrus peel. I say the whole ritual and it's zero sugar, like 5 calories and non intoxicating and it still feels like something you totally serve to your guests, which I totally have done. So Little Saints is made for that moment at night when you want something grown up but still want to sleep well and feel good tomorrow. They're enhanced with functional botanicals like lion's mane and reishi. And they're subtle, not showy, just enough to help you wind down. If you love cocktails but not the aftermath, Little Saints is worth trying. Check out little saints.com and discover your magic hour. That's littlesaints.com and be sure to use promo code alive for 15 off your first order. There really is no perfect time to get healthy. There's just now. And if you're looking for the easiest way to start, AG1 is it sustainable? Health isn't about perfection. It's about consistency. And AG1 makes that easy by putting your multivitamin, your probiotic, your prebiotic, your superfoods and antioxidants all in one scoop. One scoop. Boop. 20 seconds. Eight ounces of water, before coffee, before email, after email. I mean, I'm on the move constantly, right? And my meals are often. And AG1 is something that actually can travel with me and keep me feeling like I didn't totally abandon my health that day. So AG1 has over 50, 000 verified five star reviews and comes with a 90 day money back guarantee. Go to drink ag1.com alive. To get their best offer, get three free AG1 travel packs and three free AGZ travel packs, plus free vitamin D3 plus K2 and an AG1 welcome kit with your first AG1 subscription order. That's drink ag1.com alive. Drink ag1.com alive. I mean, I guess we can kind of jump, jump to this now, but you, you you say all these beautiful things about kind of future casting, your death, and, and you talk about being very clear about what you'd like done. And you do this with, with a fair amount of joy.

[B]

Right.

[A]

Why don't, why don't you talk a little bit about how you see it going, how you would love for it to be when you go for my dying time. Yeah.

[B]

Okay, great. Gladly. So. Because I think as much as I, I imagine this, the easier it gets to reduce my anxiety about it. So hopefully I've lived a nice long full life. I don't want to be too old. I still want to have some like joy being in my body. I don't want it to be painful all the time.

[A]

Yeah.

[B]

But I am outside somewhere would be lovely on a deck looking at the mountains and trees. And I want it to be sunset. I want the sky to change. I want to see the colors all over again. I want the people that I love, just a small handful of them around my husband, if we have children, my sisters, maybe just a couple of close friends. I want them to be talking amongst themselves though. I don't want everybody looking over me the entire time to see if I'm still breathing. I want them to let me do my thing. And I want to smell some really faint nag champa amber incense. I'd love to hear just a little bit of running water. I would love to feel like just a really light breeze. But I want to be warm. I want to have socks on. I don't want to wear a bra. I want to just be cozy. I want to be in my own bed. I want to know that I've done my best to get all of my affairs in order so they don't have anything to worry about but their grief. I don't want any machines. I don't want hospitals. I want, I want ease. I want, I want my body to be able to do what it needs to do in that time, which is to, to let go. To let go. And when they see that I have died, I'm not breathing anymore. I want the people there to clap. I want them to be like, you did it, girl. Good job, girly.

[A]

That's wonderful.

[B]

That would be nice.

[A]

That's so beautiful and it's so interesting to me. I think about it a lot and I always think, oh my God, it's going to be in no matter what I want. There's a possibility that it's going to be in a fluorescent lit room with linoleum floors that smells like pee. You know, And I'm interested why you kind of future cast your death with such specificity if you don't know how it's going to go?

[B]

Well, because the point is I don't know how it's going to go. So I don't know why then I would choose something that makes me feel anxious and sad and angry. I get pissed when I think about people dying in fluorescent rooms with maybe just a nurse or so if that's not what they want. I would rather my dying time feel like a soft, cushy, like a bathtub ride out of this world rather than one that is full of pain and fear and sadness, because that only increases death anxiety. You know, I want to live out the end of my life just as easily as I've lived the rest of it. Not without it at its adversity, of course, but I like to imagine and easy out. I don't know how it's going to go. And what we don't know, particularly when it comes to, like, death and the afterlife and stuff, we fill it with like, fear and fire and brimstone and pain. And that doesn't have to be the case. It doesn't have to be the case. There are hospice teams that work really hard to reduce pain. There are death doulas and folks that are working really hard to support people in making the most ideal death for themselves under the circumstances. I don't know what the circumstances will be, but I know that most of us die as a result of disease. And so given that that's probably how I will die, let me imagine an end that honors that and honors my preferences, my. My sentiments, my values, and the type of life that I've lived so far.

[A]

Oh, fantastic. You know, I think that one thing I learned, and I'm honestly a little bit. I have a lot of regret around, is how easy it was to center my own discomfort about death with my father. You know, as I was caring for him, I realized how much of the choices we were making seemed like they were for him, but they were for us. They were for making us more comfortable with what was going to happen. You know, I feel pretty confident that he would have rather died in his. In his comfy chair watching baseball with the volume down. You know, I think that's probably what he would have wanted, but we wanted it to look different and be easier for us. And one story I was just telling my friend was when my dog passed, it was kind of the same thing, right? My dog had cancer and I knew he was going to die. And we were up here, and he kind of scratched at the door. And I was like, whoa. And it was a blizzard. It was like, midnight, you know, and he went out into the snow and kind of looked back at me like, hey, man, no, this isn't for you. And then he went out, like, way out into the yard, and he curled up in a little ball, and he tried to die. And I was like, okay, okay, okay, okay, okay. And I was watching him, and then he started shivering, and he started, like, shaking violently. And I was like, no, no, no, no. He's suffering. So I brought him back in. In. And he tried that two more times, and I brought him back in two more times. And then I took him to Brooklyn where I could be in a room with him and hold him while they euthanized him. And I did that for me. You know what I mean? I did that for me. And I regret it, because both of them deserved probably better than that. You know what I mean? And. But it's just. It's just weird how you. How easy it is to think we're making decisions for our loved ones that make it better for them when we might be making decisions for our loved ones that are better for us.

[B]

You know, maybe I hear your pain, and I think I'm hearing maybe a little bit of guilt, certainly regret.

[A]

Sure.

[B]

And I want to encourage you to also think of this as an expression of grief. You know, people often just think through all the choices that they made and maybe wish that they would have done something different, which is grief talking. It's grief, like, leading the way. And. And. And. And ultimately, we all get the death that we will get. And I'm sure there's still elements of it that still honored. Because when I think about the type of death that I want to have, I don't want anything in my death to be difficult for the people that love me. Do you see what I mean?

[A]

Right.

[B]

That an element of creating this elusive, good death that people are reaching for is also the impact on the people that the people that still have to live after I die, I'll be gone. I'll be gone. And so if you or the people in my life have to make every choice they have to make along the way to know that either they tried everything that they needed to, or they feel confident that there was nothing more that could be done, or, you know, they weren't anxious and worried about my dying when the time came. And so they do things other than what they think I would have wanted that would ultimately be okay with me. Do you see what I'm saying?

[A]

I do. I do. And I do think that, you know, in both of those cases, they. My dog and my dad, both would have been like, you know, whatever's easiest for you guys. They probably wouldn't say, but do you, Steve?

[B]

Thank you, though. I'm sure they really appreciate your effort.

[A]

So I'm 52 years old now, and I have a lot of old people in my life.

[B]

Right.

[A]

I have a lot of elderly. So in my life who I love very much. And how can we advocate for people who are ill? How can we advocate for people who are closer to end of life in a way that isn't morbid, in a way that is supportive and loving? How can we begin to talk about all of this stuff with them?

[B]

I'm so glad you're starting to think about it with elderly folks in your life. We gotta do it gently. We gotta do it gently. Even though I think most folks. Most elderly folks really want to start talking about it because it's on their minds. One way that I found that's really useful is to try to center the conversation around somebody either in their lives recently that has died. Because if somebody in their life has died recently, they're thinking about it. And you can use that death to try to open up space for the conversation about their death. You know, like, oh, Aunt Teresa died two weeks ago, and this is what happened with her funeral. And if Mom's talking about that, then I can say, well, mom, what did you want for yourself? Or, you know, when Aunt Theresa died and she was in the hospital for a week? And what do you think about that? You know, just to start the conversation, we can use either death of relatives or other family members or even celebrities. Or, like, when Jimmy Carter died, it opened up great space for me to talk to one of my elderly clients about her dad. Yeah. Always consider, like, the set and the setting. You know, let's not have these conversations at a big Thanksgiving dinner in the middle of dinner to be like, grandma, do you want to be buried or cremated? Unless that's kind of how your family does it. You know what I mean?

[A]

Pass the sweet potatoes.

[B]

Yeah, thanks. If Grandma is a little bit more quiet unto herself, then maybe wait till you're doing the dishes with her to talk about these things. But, yeah, try to tie it to the death of somebody that we already know. Know. Consider the set and setting that you're doing it in and, you know, talk about medical care, talk about bodies, talk about your own. Your own body. Your own medical care, your appointments, what's happening with you. But chances are, they probably want to talk about it.

[A]

I know my mom does. You know, my mom's very, very open about these things, and that's kind of why I'm asking you. It's like, oh, man, this is an opportunity to really be here for her.

[B]

If, you know, she already wants to talk about it, then I think it just takes a little bit of him. So you want to talk about death? Yeah, yeah, yeah. You want to talk about your affairs?

[A]

But that's so hard, Al. You know, even you just saying that, like, I don't want to do that. I don't want to do that. I don't want to do that. I don't want to think about my mom dying. I don't want to talk about my mom dying, and I certainly don't want to talk to my mom about dying. You know, it's the last thing I want to do.

[B]

I hear you. Because it's hard. It's hard. It takes a decent amount of courage and vulnerability, I think, on both parts, but you'll both be so much better for it. And it really is just an act of love, you know? We just kind of got to get out of our own way. Yeah. And if you must. I don't know if this works for you, but practice it with somebody first. If you just need to get the first sentence out. Because once the sentence is out, then the conversation has begun. But whatever you got to do to work yourself up, psych yourself out, just to say the opening words. Practice. Wow. Wow.

[A]

Okay. I never thought of practicing that.

[B]

That.

[A]

That's kind of amazing, you know? Yeah. Why do you think it is so hard? I mean, there are obvious reasons, like, we don't want to face our own mortality, but we're all doing this together, right? Nobody gets out alive. Like, we're all. This is one thing we all have in common. We're all doing this. And yet no one wants to broach these conversations. Like, literally no one wants to, you know.

[B]

Yeah.

[A]

What do you think that is?

[B]

Although I think it's. I think it's a misnomer, I think some people do want to talk about it, because I noticed that when I share about my work, like, at a party or, you know, God forbid, on a plane or, like, with my Uber driver, and I mention what I do because they ask, and I don't feel like lying that day, then people start talking about it. They talk to me about what happened when somebody in their life died or their ideas about the afterlife, or they want to know the weirdest thing I've ever seen. Or I think people want to. I think my work gives people permission. And so if we were to grant other others the permission merely by opening the door a little bit, the conversation can start. But part of the reason why we shy away from it is because of the sadness, the grief, the loss, the pain, the. The part about death that makes us feel so powerless and small. Like, we don't like that feeling. I'm human. My ego wants to lead the way and say, I'm strong, I'm capable, and I'm not fallible. I will not die. Yeah. And I don't feel grief, and I don't feel pain. And acknowledging my death means none of those things are true.

[A]

Yep. Yep.

[B]

That's a hard one to swallow.

[A]

Yes, it is. You know what I fear when I think about death, which I do more and more these days, but I fear living too long sometimes. You know, I fear. I fear. Like, yo, they're doing all kinds of stuff now where people can live way past what makes. I don't know how to even say it would. Way past what makes any form of sense almost. They're sort of extending our lives beyond our ability to enjoy them. It seems like that maybe sometimes it does.

[B]

Kind of. When I see my, like, super elderly clients, like, folks that are approaching 100 and older, a lot of them, you know, their friends are all dead. They don't have peers anymore. They're sometimes uncomfortable in the body, and many of them are just waiting. I heard the story not that long ago about somebody's Grandma's, I think, 101st birthday. And as she blew out the candle, she said, please let this be the last one. She's done. Yeah, done, done. But her body is still really healthy and it's still here, but she's like, I'm done.

[A]

Yeah.

[B]

I don't think that I want to be really old either.

[A]

Right. This episode is sponsored by BetterHelp. So one thing I hear all the time at the top of the new year is new year, new me. And I'm not so into that. I'm not going for a whole new me. I'm gonna go for a slightly different me, a less burdened me. Because we carry all this stuff around with us all year. Shame, doubt, everything. And. And it becomes all too easy to just think that all of that's simply part of the deal. But therapy can help you sort through what's actually useful to hold on to and what's actually slowing you down. And BetterHelp makes it easy to take that first step. Step they can help you find a qualified therapist. They they work with fully licensed US therapists and they do the matching work up front with a short questionnaire so you can focus on your goals instead of weird paperwork. And if the first match isn't quite right, you can always switch to another therapist at any time. And they've served more than 5 million people worldwide and they have an average of 4.9 out of 5 rating for live sessions. So they're definitely doing something right. So sign up and get 10% off at betterhelp.com Steve Alive that's B-E-T-T R H lp.com StevaLive Alive with Steve Burns is brought to you by Progressive Insurance. Fiscally responsible financial geniuses, monetary magicians. These are things people say about drivers who switch their car insurance to Progressive and save hundreds. Because Progressive offers discounts for paying in full for owning a home and more. Plus you can count on their great customer service to help you when you need it. So your dollar goes a long way. Visit progressive.com to see if you could save on car insurance, Progressive Casualty Insurance Company and affiliates. Potential savings will vary. Not available in all states or situations. Look, I know you're wildly busy, and I know that because literally everyone one is. And that's why I appreciate anything that can quietly make my life easier. And that's where my DIA comes in. They make genuinely wow worthy appliances. They take the work off your plate like they've got that one touch Autofill French door fridge. You press a button.

[B]

Boop.

[A]

Fills your cup perfectly. Like the Jetsons and their dishwashers have a three stage total drying system and they even pop open when you're done. The future is here. And the mydea range, well, it's five burners, three racks and endless possibilities. So whether you're actually cooking or just really want to look like you're actually cooking, the point is, when the everyday stuff takes care of itself, you get time back for you and for your people and for doing absolutely nothing. And that is a win. So go to mydea.com to see how you can bring home a little wow today. That's mydea.com One thing that really fascinates me is the concept of physician assisted death and medical assistance in dying, which always seems very fraught to me because part of it very much sounds like mercy to me and part of it sounds very much in conflict with sanctity of life. Can you Just tell us what those things are like, what we mean when we talk about medical assistance and death, for example.

[B]

Sure. Medical aid and dying is when somebody has a terminal illness, so it's clear that they have less than six months to live as a result of some illness, and then they go to their doctor and they have to talk to. It depends on the laws in the state. Currently it's legal in 11 states, I believe, and the District of Columbia in the states, but many countries in Europe, where they go to the doctor, two different doctors, two different times, with a certain amount of time in between, and they make the request for the medicine, and then they get the medicine. It's three different medicines. There's a waiting period to get the medicine. After they make the request to the doctor, they get the medicine. Generally three different medicines, at least in California, and anti anxiety and anti nausea, and then eventually the medicine that will make the heart stop beating. This choice is a really big, powerful one to make. There are certain safeguards around it, like you have to be of sound mind in order to make the request, so it's not available for people with dementia. And you also have to be able to physically administer the medicine yourself, which sometimes makes it not possible for people with degenerative diseases like ALS if they've passed the point where they can either swallow or depress a plunger or something of the sort. Which are some of the challenges with it, is that, you know, it may not be appropriate if we're two major categories of folks who might really, really want it. I'm a big proponent of the medicine and of the choice because my work is about agency overall, and I want people to be able to choose the type of death that they want. And, you know, this type of death allows people to know when their end is coming, to create a lot of ritual around it, to say all their goodbyes. To not have to suffer. Also to not to have to suffer. Like, why would we want to have to suffer through the end if they don't have to and if they don't want to?

[A]

You know, I do, and I tend to agree. You know, I. I think it does sound like mercy. It sounds. It sounds like an enlightened way to look not only at our death, but, you know, at how we lived. And I love your idea, by the way, of it being this party at the end. And at the end, everyone's like, hell, yes. You know? Yeah, you know, I. That's just a. That's a. That's a really amazing thing. You know, I think that's great. But then I. I also like the idea of being floated out onto a river and flaming arrows being shot at me. I like that too. That sounds nice.

[B]

I'm sure you do. I'm sure you do. That does sound like an interesting time. An interesting time, yeah. Not for me, but great for you.

[A]

Yeah. You know, it occurs to me when my dad was. Was sick and we tried to do as much of it as we could at home, right. Because that's what he wanted. But I lived three and a half hours away. My sister lived an hour and a half away. And I was doing some reading around it at the time.

[B]

And.

[A]

It used to be different. It used to be everyone kind of lived in the same community, if not in the same house. Right. You had multiple generations living in the same house, and grandma was in the spare bedroom and the grandkids helped her die. And it was built in support that was local. And then, you know, it's interesting that, you know, kind of cheap airfare changed that because people started splitting. Parents were like, I'm out, I'm going to Florida. Right. So you go to Florida where it's warm and you're more comfortable while you're alive. But then when it comes time to die, you're not accessible to your children and to your loved ones. And it creates all of the stress and all of all of these problems. I'm wondering if you notice that as a death doula, if you notice that people reach the end of lives and their loved ones can't access it them because of distance.

[B]

Yeah, I noticed it a lot. I mean, and it's a big part of why I think my work can exist in the professional capacity that it does is because in the community based model that you're talking about, the village based concept is that we were all centered around a family unit where there was built in support for the dying person. And then more often than not, there was also probably somebody in the village or in the community who was a person that you went to when somebody was dying, or the person who came to check in to see how they were doing. Not the medical, but just the emotional, legal, maybe practical support around the person who's dying. And that person helped the dying process. And I think as families split up, as we built cities and industrialization occurred, the nuclear family became like the center of society. Then we stripped away that idea of the elderly still living with us and them being cared for in the home and them being cared for in the community. And enter a death doula, a professional, somebody who goes to support in the dying time because there isn't anybody available to do it otherwise. So many of my clients are in these elder care facilities in various places and either they need visitors, somebody to sit and listen to stories, somebody to support with legacy projects, somebody to help see what affairs still needs to be in order, somebody to talk through life and lessons and help repair relationships and you know, our work exists. Our work is able to exist largely because of that breakup of how we used to do elderhood and dying.

[A]

Yeah, you're filling that void. Yeah, yeah, I see that.

[B]

It needs to be filled.

[A]

Yeah, I love the idea. I'm just so fascinated by your work and I loved your interview with Rainn Wilson as well. And I know that you've been a huge inspiration to that guy and I, I, it just seems so incredibly valuable to have objective wisdom around death, you know, which is such a difficult time. Having a guide just seems like something society should have invented a billion zillion years ago. It feels like this, this should be something that we've always had and we've always been familiar with, you know?

[B]

Yeah, I think we have had it, I think we've had it for a really long time, but I think it just, it got long lost. It's gotten lost in this capitalistic structure is just like gone anymore. Because we don't, you know, we don't center the community anymore because as long as people have been living, people have been dying and other people have been supporting them through it. And it may have just not been somebody outside of the family system or the community that came in. And now that's what we do, you know, but doulas have been around.

[A]

Well, what I mean is you have an objectivity that the family cannot have have. Yeah, you know, I go back to, you know, decisions that I made that my family was making around my father as he was dying. They were made out of just mortal panic and fear and just. Dear God, I, I wish this wasn't happening, you know, and.

[B]

Absolutely.

[A]

And to have to have someone rational and thinking in a clearer, more sober way, boy, I feel like that would have been invaluable.

[B]

You know, I, I hear you and I wish you would have had that too. I, Part of the reason why I started this company going with Grace is because when my brother in law was dying and I was like, where is somebody? We need somebody who can listen to us, who is clear and kind and compassionate and has resources and knowledge, who can hear all the different things you were saying and say. I think this is what you all really need. Let me see if I can find it for you. You know, just somebody answer questions about how to talk to kids about death and what to do with all of the medicine that was left over after he died. And just somebody that was a big one.

[A]

Anybody that was a big one because we had all this stuff and it's stuff that you can't really have and you can't flush it, you know, like that we. That was a whole thing. Yeah, yeah, yeah. Why do you think it's important for people who are younger to start thinking about these especially practical affairs? You know, people who aren't close to end of life, why should they be getting their affairs in order anyway?

[B]

Yeah, that's a great question. Well, for starters, none of us know when the actual end of life is. And so to say somebody isn't close to the end of life. We don't ever know. We don't ever know. Yeah, for starters. And next, also, when we are present with our mortality, either thinking about my end and how I'd like to meet it, or even better, doing some practical planning for it, it allows me to really see where I place like, value and meaning in my life. I have never felt so full of my own life than when I was thinking constantly and consistently about my death. There's so much we can gain from being present with our death. Like oranges taste sweeter, you know, the sun shines brighter. My love feels more potent when I'm present with mortality. So I think that's a. I think that's a pretty damn good reason.

[A]

Agreed. Okay. And I'm going to ask you a question I'm sure every single person asks you, but I'm going to ask it anyway. How has working so closely with death informed how you live your life?

[B]

I think working closely with death, it's changed everything. For starters, I was a lawyer before. A terribly depressed lawyer. Life felt very bleak. I was kind of doing the things that I needed to do. I made some money. The work looked good on the outside, but it wasn't filling me up. I was scared to learn the type of death that I would eventually meet. And when I started thinking a lot more about my death and then working with people every day, I see how valuable and precious this gift is. Is. And it doesn't always feel like it. You know, sometimes it feels like real drag to have to think about my taxes and, you know, all the traffic and like, getting a prescription or all the, like the minutia of living. And yet when I bring, when I look at it through the lens of the fact that one day I won't have this anymore. One day I won't feel the water coming out of the faucet as I wash my dish. It allows me to be present for that moment. It allows me to, like, sink into this one, like, really wild ride. This whole life is, I think I say, I love you a lot more. I apologize a lot more easily. I eat more delicious foods for myself. I eat nourishing ones also, because they sometimes are one and the same. But I'm just more honest. I'm more honest. I'm more real. I'm more grateful. I'm more loving. I think I also cry easier. I am also a lot more, let's say, present with the gift that my life actually is by virtue of working with death.

[A]

Well, Lua, I have loved speaking with you today. This was an absolute gift of a conversation, and I truly thank you for stopping by the window today. All right.

[B]

Thank you, Steve. Thank you for having me in your window. It was nice peeking in.

[A]

All right, bye. I loved that conversation, and I love Allua. Arthur, I wrote a million things down. I'll just pick a few. Yes, we all die, but almost none of us prepare right, which is wild because we're all on the same terminal journey. It's literally something everyone has in common, and yet it's something we are all reluctant to share. A clear end of life plan is actually a way of caring for those who end up caring for you. Right, because when it comes time, in a time of crisis, your family or your loved ones will cling to whatever you've said aloud. Or. Or they're gonna suffer in silence by guessing. Clarity is a way of saying, here's how to care for me when I can't speak for myself. Which is kind of a gift to your loved ones. And, yeah, we keep coming back to this. The more we talk about death on this pod, the more we come back to this idea. A meaningful death begins with a meaningful life. And I love how Allua says this. She says, live a life worth dying from. I mean, that's not just poetic. That's also straight up practical advice. Let's go. I loved how Alua talked about her final moments. With warmth and with joy and grace and with unexpected specificity. By the way, I, too, would like to die with socks on. That's not something I had considered until today, but that definitely landed with me. There's something really comforting about that. Isn't it like imagining who you'd like to be on your final day as a way of informing the person you are right now. It's cool. And I also loved how she said it's a good thing to practice talking about death with your friends in the same way that it's good to practice anything else that matters. So if you could choose your perfect final day, what would that look like? Not just for you, but also for the ones you love? Wow.

[B]

Wow.

[A]

Wow. Great conversation today, huh? Yeah, for sure. I'm glad we're doing this. Yeah. Thanks for coming. By means a lot. You look great. Alive with Steve Burns is a Lemonade of media Original Original. If you haven't subscribed to Lemonada Premium yet, now's the perfect time. You can listen to the show completely ad free, plus you'll unlock exclusive bonus content from me as I reflect on this episode. Just press subscribe on Apple podcasts, head to lemonadapremium.com to subscribe on any other app, or listen ad free on Amazon Music with your prime membership. That's lemonadapremium.com Alive is hosted by me, Steve Burns and produced by Jeremy Slutskin. Our editor is Christopher Champion Morgan Morgan, our Associate producer is Akshay Tharabailu, audio engineering by James Sparber. Lemonada's SVP of weekly programming is Steve Nelson. Executive producers are Jessica Cordover, Kramer, Stephanie Whittles, Wax, and me. We'll see you next week. And you look great, by the way. Alive with Steve Burns is brought to you by Progressive Insurance. Fiscally responsible financial geniuses. Monetary magician. These are things people say about drivers who switch their car insurance to Progressive and save hundreds because Progressive offers discounts for paying in full for owning a home and more. Plus, you can count on their great customer service to help you when you need it. So your dollar goes a long way. Visit progressive.com to see if you could save on car insurance, Progressive Casualty Insurance company and affiliates. Potential savings will vary. Not available in all states or situations. Want to listen to your favorite Lemonada shows without the ads? Subscribe to Lemonada Premium on Apple Podcasts. You'll get ad free episodes and exclusive bonus content from shows like Wiser Than Me with Julia Louis Dreyfus, Fail Better with David Duchovny, the Sarah Silverman Podcast, and so many more.

[B]

It's a great way to support the work we do and treat yourself to.

[A]

A smoother, uninterrupted listening experience. Experience. Just head to any Lemonada show, feed on Apple Podcasts and hit subscribe. Make life suck less with fewer ads with Lemonada Premium.