Before We Go: Episode Summary - "There Is Hope"

Before We Go is a deeply personal and emotionally charged podcast hosted by Dr. Shoshana Ungerleiter, a physician, science journalist, and founder of the nonprofit organization EndWell. In the episode titled "There Is Hope," released on October 8, 2024, Dr. Ungerleiter shares her poignant journey navigating her father Steven Ungerleider’s terminal pancreatic cancer diagnosis, exploring themes of mortality, family trauma, and the complexities surrounding end-of-life choices.

Introduction to the Episode

Dr. Shoshana Ungerleiter opens the episode by recounting the moment she received the life-altering phone call from her father. [00:06] She describes the initial conversation where her father revealed the presence of a pancreatic mass, prompting immediate concern due to the aggressiveness of pancreatic cancer.

Notable Quote:

"I could tell that there was something different about his voice. He sounded just kind of worried. He said, Shosh, there's a mass in my pancreas. We need to do more tests."
— Dr. Shoshana Ungerleiter [00:06]

The Diagnosis

Dr. Ungerleiter delves into the grim prognosis associated with pancreatic cancer, highlighting its typically late detection and limited treatment options. She emphasizes the emotional and physical toll of chemotherapy, which often results in a reduced quality of life.

Notable Quote:

"Pancreatic cancer is one of those diseases that, as a doctor, you're like, that is what I do not want, ever. It's almost uniformly caught at its latest stage."
— Dr. Shoshana Ungerleiter [01:06]

Her husband, Ed Aton, recalls the pervasive fear surrounding the diagnosis, acknowledging the family's long history with cancer and the weight of past losses. [00:48]

Family History and Emotional Impact

The episode explores the deep-seated trauma within the Ungerleiter family related to cancer. Dr. Ungerleiter reveals how her father’s brother succumbed to the disease, shaping his and their family's perceptions of mortality. [02:03]

Notable Quote:

"The whole thing was really surreal and shocking at the same time. I almost had been expecting this phone call my whole life."
— Dr. Shoshana Ungerleiter [02:03]

Through candid conversations, including those with her sister Arielle, Dr. Ungerleiter underscores the silent burdens carried by her father, stemming from unresolved family tragedies.

Exploring Treatment Options

Following the diagnosis, Dr. Ungerleiter and her family consult with Dr. Steve Vargas, her father's primary care physician and family friend. [16:02] Dr. Vargas presents treatment choices, including traditional chemotherapy, hospice care, and the emerging option of medical aid in dying.

Notable Quote:

"Medical aid in dying is an option that patients in some states have whereby when they have a terminal diagnosis... they can control their destiny and take part in deciding when they would like their life to end."
— Dr. Steve Vargas [18:28]

This conversation marks a pivotal moment, introducing complex ethical and emotional dimensions to the family's decision-making process.

Medical Aid in Dying

A significant portion of the episode is dedicated to understanding medical aid in dying. Dr. Ungerleiter explains the legal framework, currently sanctioned in ten states and Washington, D.C., detailing the procedural safeguards required for eligibility.

Notable Quote:

"Medical aid in dying has only been legal in California, where my dad lived since 2016, but it's been around for much longer. In Oregon in 1997, voters approved the Death with Dignity act."
— Dr. Shoshana Ungerleiter [23:01]

The discussion highlights the personal empowerment and peace it can afford patients, juxtaposed with the emotional complexities faced by families and healthcare providers.

Perspectives from Experts

The episode features insights from Steve Einstein, a hospice nurse with three decades of experience, who shares the profound impact medical aid in dying has on both patients and healthcare teams. [23:22]

Notable Quote:

"It's a very important moment when somebody can tell their mom or dad or son, it's okay, you can let go. We're going to be okay. And there's nothing but love about it."
— Steve Einstein [25:28]

Einstein underscores the dignity and agency patients gain through this choice, emphasizing the compassion and support extended by their loved ones.

The Role of EndWell

Dr. Ungerleiter discusses her nonprofit, EndWell, founded in 2017, aimed at integrating end-of-life conversations into everyday life. [02:03] She elaborates on the organization's mission to provide resources and support, ensuring that individuals and families can approach death with intention and alignment to their values.

Notable Quote:

"We're all terminal, regardless of whether we have a diagnosis or not. And so, so much of what I'm always trying to think about is how can we live in the present moment?"
— Dr. Shoshana Ungerleiter [02:03]

EndWell serves as a platform for fostering meaningful dialogues around death, celebrating life, and empowering personal choice.

Conclusion and Teaser for Next Episode

As the episode nears its end, Dr. Ungerleiter reflects on the options her father faced and the family's diligent pursuit of expert opinions. The narrative builds anticipation for the next installment, promising revelations that will significantly influence both her family’s journey and her professional endeavors. [27:29]

Notable Quote:

"It was something that... determined the path of my dad's cancer journey, something that would impact me and my entire family."
— Dr. Shoshana Ungerleiter [27:29]

She invites listeners to continue following her story, encouraging them to engage with the community through social media and upcoming events.

Key Takeaways

• Personal Journey: The episode offers an intimate look into Dr. Ungerleiter’s experience with her father’s terminal cancer, highlighting the emotional and practical challenges faced by families.

• Medical Aid in Dying: A thorough exploration of medical aid in dying, its legal status, ethical considerations, and profound impact on patients and their loved ones.

• EndWell’s Mission: Emphasizes the importance of open conversations about death, advocating for a societal shift towards accepting and preparing for the end of life with grace and dignity.

• Expert Insights: Contributions from healthcare professionals provide a nuanced understanding of the options available to terminally ill patients and the support systems surrounding them.

Before We Go masterfully intertwines personal narrative with broader discussions on mortality, offering listeners both emotional resonance and informative perspectives on navigating life’s most challenging moments.