#135 - BJ Miller, M.D.: How understanding death leads to a better life

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.7 • 7.3K Ratings

🗓️ 2 November 2020

⏱️ 115 minutes

🔗️ Recording | iTunes | RSS

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Summary

BJ Miller is a hospice and palliative care specialist on a quest to reframe our relationship with death. In this episode, BJ begins with how his own brush with death radically shifted his perspective and ultimately forged his path towards palliative care and helping patients integrate and understand their life in a meaningful way. BJ recounts several moving stories from his patients, which reveal important lessons about overcoming the fear of death, letting go of regret, and what’s most important in life. He discusses the major design flaws of a “death phobic” healthcare system. Furthermore, he makes the case that seeing death as a part of life allows us to live well, as opposed to living to evade death itself. He concludes with a discussion around physician-assisted death as well as his hopes around the use of psychedelics to reduce suffering in end-of-life care.

We discuss:

BJ’s accident leading to the loss of his limbs and his experience inside a burn unit [3:00];
Coping with his amputations—being tough, the grieving process, and the healing properties of tears [14:30];
Going from art history to medical school: the value of a diverse background in medicine [28:15];
How BJ’s new body liberated him [40:00];
How losing his sister to suicide and his disillusionment with medicine altered his path [47:15];
Discovering his path of palliative care—distinct from hospice—in medicine [55:30];
Our complicated relationship with death, and how acknowledging it can release its grip and improve living [1:02:15];
The different distinctions around the fear of death, and how BJ helps his patients negotiate fears [1:10:00];
The major design flaws of a “death phobic” healthcare system [1:14:15];
Common regrets, the value of time, and other insights from interactions with patients in their final moments of life [1:23:00];
The story of Randy Sloan—a case study of playing life out [1:33:45];
Physician-assisted dying: Legality and considerations [1:39:45];
The use of psychedelics in end-of-life care, and what BJ is most excited about going forward [1:45:45]; and
More.

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Transcript

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0:00.0	Hey everyone, welcome to the Drive Podcast.
0:13.0	I'm your host, Peter Atia.
0:14.8	This podcast, my website, and my weekly newsletter, all focus on the goal of translating
0:18.7	the science of longevity into something accessible for everyone.
0:22.4	Our goal is to provide the best content in health and wellness, full stop, and we've
0:26.6	assembled a great team of analysts to make this happen.
0:29.4	If you enjoy this podcast, we've created a membership program that brings you far more
0:33.2	in-depth content if you want to take your knowledge of the space to the next level.
0:37.3	At the end of this episode, I'll explain what those benefits are, or if you want to learn
0:41.0	more now, head over to peteratiamd.com forward slash subscribe.
0:46.3	Now without further delay, here's today's episode.
0:49.0	I guess this week is Dr. B.J. Miller.
0:53.3	B.J. is a hospice and palliative care specialist.
0:56.4	We talk a lot about what that means.
0:58.2	The reason I wanted to speak with B.J. is I've been really thinking a lot about better understanding
1:04.6	what end of life means and how understanding the end of life could help us better understand,
1:09.8	frankly, what we want out of life.
1:12.6	By an amazing coincidence, B.J. and I met very, very briefly many years ago in medical
1:18.1	school, although I don't think he remembers it.
1:20.9	When I saw him again giving a TED Talk several years ago, I immediately realized, hey,
1:26.9	that's the guy I met at a party 20-some odd years ago and became really interested in his
1:32.6	work and then reached back out to him and said, hey, would you be interested to sit down
	...

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