BJ Miller: What really matters at the end of life
BJ Miller - Palliative caregiver
Using empathy and a clear-eyed view of mortality, BJ Miller shines a light on healthcare’s most ignored facet: preparing for death. He is executive director at Zen Hospice Project in San Francisco. Full bio
were horsing around,
a parked commuter train.
with the wires that run overhead.
like a great idea at the time.
and that was that.
with death -- my death --
my long run as a patient.
of dysfunction --
a hospice and palliative medicine doc,
who goes into healthcare
are also unwitting agents
does not serve.
answer to that question,
with diseases, not people, at its center.
it was badly designed.
of bad design more heartbreaking
for good design more compelling
to reach out across disciplines
into this big conversation.
opportunity in front of us,
about death isn't being dead,
it can be very helpful
which is necessary as it is,
essential part of life, part of the deal,
to make space, adjust, grow.
to realize forces larger than ourselves.
became fact, fixed --
reject this fact than reject myself.
but I learned it eventually.
about necessary suffering
is where healing happens.
as we learned yesterday --
on the other hand,
is unnecessary, invented.
since this brand of suffering is made up,
something we can affect.
to this fundamental distinction
and unnecessary suffering
design cues for the day.
as people who care,
not add to the pile.
of a reflective advocate,
important field but poorly understood --
limited to end of life care.
and living well at any stage.
have to be dying anytime soon
on top of long-standing HIV.
out loud together about his life --
his losses as they roll in,
the next moment.
but regret, quite another.
out of a Norman Rockwell painting --
when he came into clinic one day,
down the Colorado River.
and his health, some would say no.
while he still could.
of the Grand Canyon --
beyond our control.
so many of us would make,
what is best for ourselves over time.
is a shift in perspective.
when I went back to college,
I'd learn something about how to see --
for a kid who couldn't change
we humans get to play with,
at an amazing place in San Francisco
that helps with this shift in perspective.
wheeling the body out through the garden,
with flower petals.
to usher in grief with warmth,
in the hospital setting,
lined with tubes and beeping machines
even when the patient's life has.
the body's whisked away,
had never really existed.
in the name of sterility,
within those walls is numbness --
the opposite of aesthetic.
I am alive because of them.
and treatable illness.
that's not what they were designed for.
giving up on the notion
can become more humane.
in Livingston, New Jersey,
great care at every turn,
palliative care for my pain.
complaining about driving through it.
coming down all sticky.
smuggled in a snowball for me.
holding that in my hand,
onto my burning skin;
and turn into water.
in this universe mattered more to me
all the inspiration I needed
and be OK if I did not.
I've known many people
some final peace or transcendence,
by what their lives had become --
living with chronic and terminal illness,
or prepared for this silver tsunami.
dynamic enough to handle
something new, something vital.
for designers of all stripes to work with.
who are closer to death:
and unburdening to those they love;
of wonderment and spirituality.
from our residents in subtle detail.
one day to the next due to ALS.
while she has them.
at the foot of her bed,
coursing through her veins --
where in a moment, in an instant,
loving our time by way of the senses,
doing the living and the dying.
is our kitchen,
can eat very little, if anything at all.
sustenance on several levels:
happening under our roof,
interventions we know of,
the possibility of accessing
living and dying with dementia.
the things we don't have words for,
of the system was our first design cue,
by way of the senses,
the aesthetic realm --
and final bit for today;
to set our sights on well-being,
or human-centered model of care,
becomes a creative, generative,
highest forms of adaptation.
it takes to be human.
has given rise to architecture.
is a necessary part of life,
we take a light approach to dying
any particular way of dying.
that cannot move,
we will all kneel there.
to play itself all the way out --
getting out of the way,
a process of crescendo through to the end.
one way or another.
around this fact,
a shock of beauty or meaning
for a perfect moment,
About the speaker:BJ Miller - Palliative caregiver
Using empathy and a clear-eyed view of mortality, BJ Miller shines a light on healthcare’s most ignored facet: preparing for death. He is executive director at Zen Hospice Project in San Francisco.
Why you should listen
Along with the Zen Hospice Project he directs, palliative care specialist BJ Miller helps patients face their own deaths realistically, comfortably, and on their own terms. Through the work of Zen Hospice Project, Miller is cultivating a model for palliative care organizations around the world, and emphasizing healthcare’s quixotic relationship to the inevitability of death.
Miller’s passion for palliative care stems from personal experience -- a shock sustained while a Princeton undergraduate cost him three limbs and nearly killed him. But his experiences form the foundation of a hard-won empathy for patients who are running out of time.
BJ Miller | Speaker | TED.com