How Do You Want Your Life To End? with Dr. Sunita Puri

The Unspeakeasy With Meghan Daum

Meghan Daum

Society & Culture

4.8 • 784 Ratings

🗓️ 31 October 2025

⏱️ 63 minutes

🔗️ Recording | iTunes | RSS

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Summary

My guest is Dr. Sunita Puri, a palliative-care physician and author of That Good Night: Life and Medicine in the Eleventh Hour. We talk about what it really means to care for patients when cure is no longer the goal, why our medical system resists honest conversations about death, and how clarity and compassion can coexist at the end of life.

Topics we cover:
• What palliative care really provides (beyond hospice)
• Why "more treatment" ≠ "more life"
• Prognosis, probabilities, and telling the truth kindly
• How families can ask the right questions
• Documentation that matters (and what to avoid)
• The moral distress of clinicians
• Cultural/faith factors that shape decisions
• Dignity, autonomy, and realistic hope

Guest Bio:
Dr. Sunita Puri is an Associate Professor of Medicine at the University of California, Irvine School of Medicine, where she is the Director of the Inpatient Palliative Care Service. She has written for The New Yorker, The New York Times, and The Atlantic, among other publications. She is the author of That Good Night: Life and Medicine in the Eleventh Hour, a critically acclaimed literary memoir examining her journey to the practice of palliative medicine, and her quest to help patients and families redefine what it means to live and die well in the face of serious illness.

Transcript

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0:00.0	What's so fascinating is what is said and what the subtext is. And so, for example, if I'm in a
0:06.0	family meeting and oncology or whoever is offering a treatment and says that studies show
0:11.9	someone will live an average of 5.8 months longer or something. One of my questions is always,
0:19.3	is the person before you, someone who would have been included in that study?
0:24.3	Would they have met the criteria for the study?
0:26.6	Because from a logical perspective, we have to interpret data based on the person in front of us.
0:34.7	And if the person in front of us would have been too sick to get that
0:37.9	treatment, then the results don't apply to them.
0:45.9	Welcome to the unspeak-easy podcast, the podcast formerly known as the unspeakable. I am your
0:52.7	host, Megan Downe. My guest is author and paleid of care physician,
0:57.7	Dr. Sunita Puri. She's a listener favorite. I don't know what that says about you guys,
1:02.8	since her subject is death, how to think about it, how to get through it, how to see others through it.
1:09.2	Sunita cares for dying patients, of course, and she
1:12.2	writes frequently about her work and about what we can do to try to have a good death,
1:18.9	whatever that means. She was last on the podcast two years ago talking about CPR and how
1:24.5	its overuse can hurt patients. She is back to catch us up on what's been on her mind since then, including changing
1:32.1	attitudes about end-of-life choices and physician-assisted suicide.
1:36.1	We also talk about what we can all do to make sure our wishes are known and respected
1:40.7	without having to get a DNR tattoo on our chest.
1:45.1	Apparently people do that.
1:46.9	This is a heavy topic, but as always with Sunita, it doesn't feel heavy.
1:51.2	It's actually kind of fun.
	...

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