Podcast Summary: "Alua Arthur Comes Home"

Podcast: Before We Go
Host: Dr. Shoshana Ungerleider
Guest: Alua Arthur
Air Date: September 18, 2025
Episode Theme:
This episode explores the transformative role of death doulas in supporting individuals and families at the end of life, through the lens of Alua Arthur’s personal journey. Dr. Shoshana Ungerleider and Alua delve into the origins of death doula work, the challenge of shifting medical and societal perspectives on mortality, and the profound importance of presence, preparation, and self-knowledge in facing death.

Main Themes and Purpose

• The Role of Death Doulas: Explaining what death doulas do, why families need them, and the difference they can make.
• Personal Journeys with Mortality: Delving into both Shoshana and Alua's intimate experiences with death in their families, and how those experiences shaped their professional and personal paths.
• Changing the Culture Around Death: Addressing the resistance and misconceptions in medicine and society about discussing mortality.
• Presence and Self-Work: Exploring why self-reflection, presence, and emotional understanding are essential skills for both death doulas and clinicians.
• Broadening Access and Training: Highlighting growth in the death doula field, cross-pollination with medical professionals, and hopes for cultural change.

Key Discussion Points and Insights

When Should We Call a Death Doula? (00:06 – 02:58)

• Shoshana recounts her father's diagnosis and the missed opportunity to involve a death doula early.
• Alua's philosophy: “Now is the right time for everyone. Disease or not. Now is the right time.” (Alua Arthur, 02:27)

The Beginning of Alua's Calling (03:05 – 06:39)

• First meeting between Shoshana and Alua at a hospice event—instant connection and shared mission.
• Alua’s approach: Advocating for making discussions of death as commonplace and integrated as those about birth.
• Alua’s favorite part of her work: the return home and living her real life balanced with her "death work."

  “Being in my life is what's feeling really, really good right now.” (Alua Arthur, 05:49)

A Life-Changing Journey to Cuba (08:36 – 11:27)

• Alua’s burnout as a lawyer and severe depression led her to a serendipitous trip to Cuba.
• Encounter with Jessica, a young woman with terminal cancer, opened Alua’s eyes to how society fails to make space for death and dying.
• Realization: people don't talk openly about their mortality, even when facing it.

Family Loss and the Failure of Systems (11:27 – 16:12)

• Alua supports her brother-in-law Peter through illness. The healthcare system fails to clearly communicate about death; late hospice referral leaves no time for meaningful support.
• Alua’s frustration:

  “I just needed a point person to answer the questions. ... And so I decided to make it for myself.” (Alua Arthur, 16:12)

The Making of a Death Doula (17:30 – 19:14)

• Alua’s relentless pursuit: she trained with Sacred Crossings, volunteered with estate planning and alternative funeral homes, and immersed herself in hospice care.
• Struggles with imposter syndrome and the weight of death work.
• Recognizing the need for extensive “inner work” and preparation.

Launching Going With Grace & Facing Obstacles (19:27 – 21:20)

• Initial rejection from 77 hospices before some finally accepted her work.
• Nervousness and reverence each time she’s invited to sit with dying people; “every death is like the first.”
• On outsiders’ skepticism:

  “I think advocating for the work feels easy when folks hear about what it is... It's hard to deny the impact and the necessity when you’re thinking about the humans involved.” (Alua Arthur, 21:20)

The Growth of Death Doula Work (22:21 – 24:43)

• Growing field: Over 3,000 death doulas trained across 58 countries through Going With Grace alone.
• Increasing interest from medical professionals (including surgeons!).
• Lighthearted story: An orthopedic surgeon gently corrects Alua’s anatomy in a death meditation.

The Essence of Death Doula Training (24:43 – 31:51)

• Shoshana shares her own transformative death doula training experience—surprised by how central self-knowledge and self-care are.
• The lessons go beyond clinical skills to emotional self-regulation and awareness.

  “People can only meet you as deeply as you've met yourself. ... My job is to meet people where they are. So I gotta do my work in tandem with the practical and the knowledge.” (Alua Arthur, 28:34)

The Power of Presence (28:59 – 34:31)

• Discussion of “co-regulation” and the importance of steady, grounded presence in emotionally charged environments, illustrated through a cat video metaphor.
• Presence means groundedness and flexibility—being able to meet each situation authentically.
• Clinicians are often untrained in this; Shoshana advocates for elements of death doula training to be integrated into medical education.

Changing Medicine’s Relationship with Death (33:34 – 35:05)

• The inability to “fix” death and grief; sometimes “showing up is what makes it better.”
• Sitting with suffering:

  “We don’t have to fix, and it's okay to just sit in the present moment and say, I'm here. ... The reality is, your cancer is no longer curable, but we can still take care of you.” (Shoshana Ungerleider, 34:15)

Notable Quotes & Memorable Moments

• On time to bring in a death doula:

  “Now is the right time for everyone. Disease or not. Now is the right time.”
  Alua Arthur (02:27)

• On coming home:

  “Being in my life is what's feeling really, really good right now.”
  Alua Arthur (05:49)

• On systemic failures in end-of-life care:

  “I just needed a point person to answer the questions. ... And so I decided to make it for myself.”
  Alua Arthur (16:12)

• On the need for clinicians to confront mortality:

  “If people could just even sit with their mortality for a little bit, it would help a lot.”
  Alua Arthur (33:34)

• On presence:

  “I must enter myself first. ... I have to be grounded in my own body. ... The only way I can do that is by staying present.”
  Alua Arthur (30:39)

• Doctor’s perspective on training:

  “Doctors aren’t trained in those things. ... It's just learning how to connect with people, especially on the worst day of their life.”
  Shoshana Ungerleider (32:30)

Important Segments and Timestamps

• 00:06–02:58 – The right timing for death doula involvement.
• 08:36–11:27 – Alua’s life-changing realization in Cuba.
• 11:27–16:12 – Family loss and the lack of timely support.
• 17:30–21:20 – The journey through training and founding Going With Grace.
• 22:21–24:43 – Field growth and medical professional involvement.
• 24:43–31:51 – The internal work of death doulas and the nature of presence.
• 33:34–35:05 – Changing clinician approaches to death, sitting with suffering.

Tone and Atmosphere

The episode is warm, candid, and occasionally humorous, with deep vulnerability and hope for cultural change. Alua and Shoshana speak as friends and colleagues deeply invested in reshaping how we approach death—both personally and as a society.

Final Reflections

This episode offers an eye-opening look into the role of death doulas—underscoring not just the practical, but the deeply human work of supporting people at the end of life. Through Alua Arthur’s story, listeners gain insight into how we might all live more intentionally and meet death not with fear, but with presence, care, and connection. The call is clear: transforming our relationship to dying begins now, with inner work, honesty, and wholehearted presence.