11 - Uncertainty in Medicine: How We Die
The Nocturnists
Emily Silverman
4.8 • 614 Ratings
🗓️ 12 June 2025
⏱️ 40 minutes
🧾️ Download transcript
Summary
Today, we explore the paradox of mortality: something both certain and utterly unknowable. Through a haunting parable from Ursula K. Le Guin and stories from doctors and loved ones, we hear what happens when people try to plan for death—or avoid it. A daughter processes her mother's calm decision to pursue assisted dying. A physician grapples with an ambiguous advance directive. A neurointensivist weighs the line between hope and false hope. What do we do when clear answers are impossible? And what happens when our attempts to control death only bring more suffering? And in the midst of all this uncertainty, how do we find peace?
Find show notes, transcripts, and more at thenocturnists.org, and subscribe to our substack.
The "Uncertainty in Medicine" series is generously funded by the ABIM Foundation, by the Josiah Macy Jr. Foundation, and the Gordon & Betty Moore Foundation.
The Nocturnists is supported by The California Medical Association and donations from listeners like you.
Host: Emily Silverman, MD
Series Illustrations by Eleni Debo
Transcript
Click on a timestamp to play from that location
| 0:00.0 | Support for the Nocturnist comes from the California Medical Association. |
| 0:04.4 | At the Nocturnist, we are careful to ensure that all stories comply with health care privacy laws. |
| 0:09.6 | Details may have been changed to ensure patient confidentiality. |
| 0:13.1 | All views expressed are those of the person speaking and not their employer. |
| 0:30.6 | Okay. Welcome to the icy planet of Geffen in the kingdom of Carhide. Along a treacherous mountain path, Lord Barosti picks his way through ice and wind and snow. |
| 0:41.2 | He carries in his bags half the years yield from his orchards, and as many riches as he could gather. |
| 0:48.7 | He hopes the tribute will be sufficient for the foretellers, a group of seers said to be able to glimpse the future. |
| 0:57.5 | Lord Barosti knows the answer he seeks |
| 1:00.0 | is not cheap. |
| 1:02.5 | He wants to know the unknowable. |
| 1:06.2 | His question, |
| 1:08.0 | On what day will I die? |
| 1:11.6 | When Lord Barosti finally reaches the foretellers' stronghold, they accept his offering, and so he asks his question. |
| 1:21.6 | They enter their trance, disappearing into the darkness of their visions. |
| 1:29.6 | Barasti waits anxiously. |
| 1:37.7 | When they finally emerge, their answer is simple. |
| 1:41.2 | You will die on the 19th day. |
| 1:46.0 | Barasti panics. Barasti panics. The 19th, but which month, which year? |
| 1:49.0 | When? |
| 1:50.0 | He demands, they tell him more, |
| 1:52.0 | begging, threatening, yelling, |
| 1:55.0 | but the foretelling is done. |
... |
Please login to see the full transcript.
Disclaimer: The podcast and artwork embedded on this page are from Emily Silverman, and are the property of its owner and not affiliated with or endorsed by Tapesearch.
Generated transcripts are the property of Emily Silverman and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.
Copyright © Tapesearch 2026.