Before We Go: “All’s Well That Ends Well” – A Detailed Summary

Episode Release Date: October 29, 2024

Introduction

In the poignant episode titled “All’s Well That Ends Well” from the podcast Before We Go, host Dr. Shoshana Ungerleider delves deep into her personal journey intertwining with her professional mission to transform end-of-life care and conversations. This episode offers listeners an intimate look into the challenges and triumphs faced by Dr. Ungerleider as she navigates her father's terminal cancer diagnosis, alongside her efforts to reshape societal perceptions of mortality.

1. The Genesis of Dr. Shoshana’s Mission

Dr. Ungerleider begins by reflecting on her experiences post-residency, highlighting a growing concern:

“I saw the ways providers around them weren't equipped to help. And I knew I wanted to do something to change the way doctors talk about the end of life.” (00:04)

Burned out and seeking purpose, she took a role as a nocturnist, which provided her the time to conceive innovative ideas for improving palliative care education among medical professionals. She envisioned treating conversations about serious illness with the same rigor as surgical training, emphasizing communication as a vital procedure.

2. Collaboration and Documentary Films

Her vision took a tangible form when she encountered stalled documentary projects focused on end-of-life conversations. Inspired, Dr. Ungerleider collaborated with director Dan Krause to complete these films, which authentically captured the nuanced discussions between patients, families, and healthcare providers.

“I remember being at the hospital...I was crying.” (02:20)

The resulting documentaries garnered significant acclaim:

• Tribeca Film Festival Premiere: The first film premiered and won in the short documentary category.
• Netflix Acquisition: Both films were picked up by Netflix, amplifying their reach.
• Academy Award Nominations: The films received Oscar nominations, a testament to their profound impact.

3. Establishing the EndWell Conference

Building on the success of the documentaries, Dr. Ungerleider sought to create a platform that brought diverse voices into the conversation about end-of-life care. This led to the inception of the EndWell conference.

“...we end up selling out three months in advance and having hundreds of people on the waiting list...” (10:04)

Tracy Wheeler, who became the executive director of EndWell, played a pivotal role in shaping the conference’s vision. Together, they orchestrated an event that blended TED-style talks with inclusive discussions, attracting both everyday heroes and celebrities.

4. Bringing Diverse Voices and Impact

The EndWell conference quickly gained momentum, featuring speakers from various backgrounds, including:

• Celebrities: High-profile figures like Taraji P. Henson, Maria Shriver, and Tig Notaro shared their personal experiences with mortality.

  “Comedian Tig Notaro joined me on stage to talk about performing standup after a devastating breast cancer diagnosis.” (16:07)

• Everyday Heroes: Healthcare professionals, caregivers, and patients provided authentic narratives, ensuring a well-rounded dialogue.

The conference's content extended beyond live events, with short clips going viral on social media, reaching millions and fostering a broader national conversation about death and dying.

5. Conversation with Hospice Nurse Julie McFadden

A significant portion of the episode features an in-depth discussion with Julie McFadden, a hospice and palliative care nurse. Their conversation sheds light on the systemic challenges within hospice care:

“Our healthcare system is so based on survive and live no matter what, which is unhealthy because that's not real life.” (19:53)

Key Highlights from the Conversation:

• Challenges in Hospice Care: Julie emphasizes the limitations of current hospice services, noting the scarcity of 24-hour care and the overwhelming burden placed on family caregivers.

  “Hospice does not feel like that. Nursing can really feel really thankless and, like, task oriented and, like, doesn't matter.” (19:43)

• Educational Initiatives: Recognizing the gaps, Julie leverages social media to educate the public about hospice care, dispel myths, and normalize conversations around death.

  “I had to hire an assistant. That’s how many people sent me videos.” (24:23)

• Emotional Burden on Caregivers: She addresses the pervasive guilt felt by those caring for dying loved ones, reassuring them that their actions are rooted in compassion and necessity.

  “You're probably going to feel that way because I think you, right, like, you yourself can know that that's not true, but it's still because of grief...” (26:21)

6. Personal Journey in Caregiving

The episode takes a deeply personal turn as Dr. Ungerleider shares her experience as both a physician and a daughter caring for her terminally ill father. Despite her expertise in death and dying, she confronts the raw emotions and uncertainties that accompany her father's decline.

“How is Shoshanna gonna do this? How is she going to be able to step out of this role of being a daughter and also somebody so immersed in end of life?” (31:01)

Her partner Ed reflects on his unpreparedness to support her through the ordeal, highlighting the universal challenges faced by families dealing with terminal illness.

7. The Broader Implications

Dr. Ungerleider and Julie McFadden collaboratively emphasize that the true measure of a dignified death transcends the physical location, focusing instead on the quality of care and emotional support provided.

“Dying at home, which around 80% of people say they want, is often romanticized as a good death. But the harsh reality can be filled with suffering and a lack of proper support...” (29:02)

Conclusion and Teaser for Next Episode

As the episode concludes, Dr. Ungerleider teases the next installment, promising to delve deeper into the multifaceted experiences of balancing professional expertise with personal loss.

“That's next time on Before We Go.” (33:12)

Final Thoughts

“All’s Well That Ends Well” serves as a compelling exploration of death, caregiving, and the systemic reforms needed to support individuals and families during their most challenging times. Through heartfelt narratives and expert insights, Dr. Shoshana Ungerleider not only shares her personal journey but also advocates for a more compassionate and informed approach to end-of-life care.

Join the Conversation

Stay connected with Before We Go and participate in ongoing discussions by following them on Instagram @beforewegopodcast. Engage with a community dedicated to redefining how we understand and approach the end of life.