Reclaiming Illness and Death As Natural Parts of Life with BJ Miller, M.D.

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Statistics show that only 10 to 20% of us will die without warning. That means most of us have a choice as to how to orient ourselves for the inevitable. Where we will die and, most importantly, how to spend time meanwhile. Next to birth, death is one of our most profound experiences. Dying is not without its pain but it can be meaningful and we can decide to be more aware and more conscious in how we orient ourselves toward the inevitable end of our lives. Dr. Miller suggests that we need to be clear on our “goals of care.” Miller says, “[Death is] sad but for the most part it’s also really life affirming. When you come to terms with this body’s life is finite, then you start taking time seriously and you stop squandering your time. You start appreciating what you have while you have it. This is the secret that a lot of hospice providers know and that’s why a lot of hospice providers are actually very happy people filled with life.” The main takeaway in this deep dialogue is to “participate” and to free up as much of life as possible until we die. Miller holds our hand as he covers such subjects as practical advice on the medical, legal, logistical, and emotional aspects of an event that awaits us all. (hosted by Justine Willis Toms)


BJ Miller is a hospice and palliative medicine physician who has worked in many settings, inpatient, outpatient, hospice facility and home. He now sees patients and families at U.C.S.F. Helen Diller Family Comprehensive Cancer Center. Miller speaks all over the country and beyond on the theme of living well in the face of death. He’s also the founder of the Center for Dying and Living

BJ Miller is co-author, with Shoshana Berger, of:

To learn more about the work of BJ Miller go to

Topics Explored in This Dialogue 

  • How through modern medicine we stave off death by propping up a body almost indefinitely
  • Why we need to be explicit regarding our health directive in order to get off the medical “hamster wheel”
  • Miller’s story of a terrible accident that left him as a triple amputee and eventually led him into becoming a doctor
  • How the study of art history in college was helpful in his healing process and contributed to expanding his perspective on his own life and injuries
  • What are medical directives and advance care planning
  • Why medical directives and advance care planning are critical because the default setting on medical care is to sustain unless otherwise directed
  • Why we should revisit our medical directive each year like doing our taxes
  • Why we need to be proactive on our own behalf when it comes to advance care planning
  • What is the significance of the “silver tsunami” when more of us live longer with diseases, illness, and disabilities
  • What is the difference between chronic pain and acute pain and what is his advice in dealing with both
  • How Miller deals with his own disability and how the accident changed his life
  • What is the difference between palliative care and hospice
  • How signing up for hospice does not mean a death sentence
  • Justine tells the story of Michael Toms choosing hospice for himself prior to his death of complications from diabetes
  • What must be done when death occurs at home rather than a hospital
  • What are some specifics to be aware of if a loved one is dying at home
  • What are suggestions to ask your doctor about your diagnosis
  • How it is possible to say no to any treatment
  • As our life progresses, why it is important to constantly evaluate it by asking, “What is important to me now?”
  • What are our choices regarding flow of information about the prognosis of our illness

Host: Justine Willis Toms   Interview Date:12/3/2019   Program Number: 3696

Music Playlist

From Album: Fresh Impressions
Artist: Georgia Kelly & Steven Kindler
1987 Out Front Music #OFM 1010

Opening Essay: Track 01 Sicilienne
Music Break 1: Track 05 Gnossienne #2
Music Break 2: Track 07 Gnossienne #4
Music Break 3: Track 08 Gymnopedie pour l'enfant endormi