Podcast Summary: Alive with Steve Burns

Episode: What is Dying? with Hospice Nurse Julie McFadden
Release Date: September 17, 2025
Host: Steve Burns
Guest: Julie McFadden (Hospice & Palliative Care Nurse, Author)

Episode Overview

In this reflective and deeply honest episode, Steve Burns explores the universal yet frequently unspoken subject of death and dying. Joined by hospice nurse Julie McFadden—whose frank and compassionate insights have reached millions via TikTok—they demystify what dying physically and emotionally entails, drawing from both professional experience and personal stories. The conversation oscillates between the unknowns of the dying process, fears and myths about death, how our culture and healthcare system handle it, and how one's manner of living shapes their final days.

Key Themes and Discussion Points

1. Steve’s Personal Relationship with Death

• Opening (00:13–03:40):
  Steve shares the impact of persistent internet death rumors about himself, connecting it to his real-life experiences of losing loved ones.

  “There was this Internet rumor going around that I was dead... and it actually—kind of messed me up.” —Steve, [02:13]

• He underlines the motivation for the episode: if death is inevitable, why not talk about it openly?

  “The inevitable fact of our death is the one certainty we hold while we're alive.” —Steve, [04:20]

2. Hospice and Palliative Care: More About Living Than Dying

• Julie Explains Hospice (05:53) and Palliative Care (06:41):
  • Hospice focuses on helping people live as fully as possible until death, often at home with support.

    “Hospice is about living, and people think it's about dying.” —Julie, [05:56]

  • Palliative care manages symptoms for anyone with life-limiting or chronic illness, which Julie wishes started earlier for most patients.

    “Everyone should just get a palliative care team right away, can't they?” —Julie, [06:58]

  • Systemic barriers and lack of doctor awareness limit access to early palliative care.

    “Many doctors aren't fully aware of... what palliative care actually is.” —Julie, [07:18]

3. The Experience of Dying: Biological, Emotional, and Existential Insights

• Steve recalls his father's slow death from cancer (07:45–08:49):

  “It was a subtractive process... things were being taken... his strength... I remember his beard... And I was inches from his face, you know, and I never saw it happen.” —Steve, [07:50–08:50]

• Julie describes the body’s innate mechanisms to support a more peaceful dying process:

  “Our bodies are built to die.” —Julie, [09:30]

  • As death nears, hunger and thirst fade, dehydration can bring more comfort, and endorphins ease pain ([14:26]).
  • Intervening medically can sometimes make the process harder on the dying person.

    “Your body actually feels better physically, the drier it is... in ketosis, you actually get endorphins released that help dull pain.” —Julie, [14:26–14:47]

4. How We Die Mirrors How We Live

• Julie’s Core Observation (16:23):
  • “People die the way they lived.” —Julie, [16:23]
  • Family dynamics, personality, and levels of openness or denial in life usually play out in dying as well.
• Impact of Facing Death Openly:

  “Those people tend to live better and die more peacefully just because they were willing to acknowledge that it’s happening.” —Julie, [17:38]

• Steve connects this to Stoic philosophy:

  “All the old Stoics... would practice death... Has to change the way you live, right?” —Steve, [18:00]

5. The Role of Presence and Acceptance

• Steve wishes he’d been more present during his father’s dying.

  “The moments where I was present with that were the most important moments I've ever had.” —Steve, [19:54]

• Julie’s caregiver advice from her TikTok:

  “Are they safe? Are they clean? Are they comfortable? If so, you're doing fine.” —Julie, echoed by Steve, [18:57]

6. Animals and the Dying Process

• Steve describes how his dog seemed to sense his father's approaching death.

  “Apparently just two hours before he passed, my dog... went over and nuzzled my dad's hand.” —Steve, [21:58–22:20]

• Julie validates that animals often display awareness:

  “Big time. Animals know what’s up.” —Julie, [21:48–21:56]

7. Systemic Flaws: The State of Dying in America

• Julie highlights lack of 24/7 end-of-life care for families due to Medicare limitations.

  “In order to die well, in America, you have to be rich.” —Julie, [24:01]

  • Steve voices a fear prevalent among many: not death itself, but dying in an institutional, lonely way.

    "...an ugly room with a linoleum floor and fluorescent lights and a hallway that smells like pee..." —Steve, [24:27]

• Empowerment is possible through end-of-life planning:

  “At least have one person point of contact that knows what you want and don’t want.” —Julie, [25:01]

8. Easing the Fear of Dying

• Three Key Points (26:10–27:41):

  1. It’s normal to fear death—accepting this reduces the burden.

     “Just because you fear death doesn’t necessarily mean that it’s going to be awful… there’s nothing wrong with fearing death.” —Julie, [26:17]

  2. Education genuinely helps; understanding what death actually looks and feels like is calming.

     “Education around death and dying can really, really ease fear because our bodies… are built to die.” —Julie, [26:34]

  3. Julie shares her belief in an afterlife—not religious, but a feeling of going “home,” akin to the feeling she senses at both birth and death.

     “When we die, we go to a place more like home than here ever could be.” —Julie, [27:29]
     “I feel like when I die, I’m going to wake up in a place that I’ve always known, and it’s like, ‘Oh my God, how’d I ever forget this?’” —Julie, [27:52]

• The symmetry between birth and death provides comfort to Julie and, she hopes, listeners:

  “I get that same feeling when I see people take their last breath.” —Julie, [28:54]

Notable Quotes & Memorable Moments

• “The inevitable fact of our death is the one certainty we hold while we're alive.” —Steve, [04:20]
• “Our bodies are built to die.” —Julie, [09:30]
• “People die the way they lived.” —Julie, [16:23]
• “Are they safe? Are they clean? Are they comfortable? If so, you're doing fine.” —Julie, via Steve, [18:57]
• “In order to die well, in America, you have to be rich.” —Julie, [24:01]
• “Education around death and dying can really, really ease fear.” —Julie, [26:34]
• “When we die, we go to a place more like home than here ever could be.” —Julie, [27:29]
• “I get that same feeling when I see people take their last breath.” —Julie, [28:54]
• “If we die how we live, and we know we're gonna die, but we don't know when—how do we live?” —Steve, [30:25]

Segment Timestamps

• [00:13–03:40] — Steve reflects on his own brushes with rumors of his death and real losses
• [05:53–07:11] — Julie introduces hospice and palliative care
• [07:45–09:11] — Steve shares his father’s passing; the mystery of “the moment” of death
• [09:29–15:00] — Julie details physical signs and processes of dying
• [16:23–18:55] — “People die as they lived” and the role of family dynamics
• [19:54–21:45] — The experience of presence and caregiving at the end of life
• [21:45–23:09] — Animals sensing death
• [23:23–24:27] — Flaws in American end-of-life care
• [25:00–27:41] — Planning for death & easing the fear
• [27:41–29:28] — Julie shares spiritual reflections on life-after-death, birth, and dying
• [30:04–End] — Closing thoughts from both Steve and Julie, reflection on the episode's central question

Final Reflections

The conversation closes with Steve processing the emotional weight and philosophical scope of the episode—particularly the idea that “our bodies are built to die” and that “we die how we live.” He invites listeners to ponder how this knowledge should shape the way they live now.

“If we die how we live, and we know we're gonna die, but we don't know when—how do we live?” —Steve, [30:25]

This episode is a candid, compassionate invitation to face death more openly—to inform our lives with the acceptance that dying, too, is living.