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🔢 Key Takeaways

  1. People I (Mostly) Admire is a podcast hosted by economist Steve Levitt, where he offers non-journalistic perspectives on various topics through conversations with experts, revealing a different and personal side to himself in the process.
  2. Follow your curiosity and seek inspiration from passionate individuals to create change, as seen in Steven Levitt's experiences with his podcast 'People I (Mostly) Admire'.
  3. Quality of life should be prioritized for the terminally ill, rather than sacrificing it for a few more minutes on the planet. It's crucial to have conversations about death and dying for anyone who cares about their own or their loved ones' death.
  4. Introducing children to the topic of death and encouraging them to process their emotions around it can help them develop valuable life skills and lead a more fulfilled existence by embracing and accepting the natural cycles of life and death.
  5. The medicalization of dying has led to a neglect of emotional and social needs, hindering conversations about closure and saying goodbye to loved ones. A more humane and holistic approach is needed.
  6. Having open, civil conversations about end-of-life care with doctors, patients, families, and friends promotes informed decisions that prioritize quality of life. It's time to focus on enhancing and cherishing life's inherent value and connections rather than simply extending lifespan.
  7. Prioritizing the patient's comfort and personal preferences in a safe space can bring peace and comfort during their final days. Hospitals should focus on the final aesthetic experience rather than machinery.
  8. Doctors and patients colluding to prolong life can lead to unrealistic hopes that hinder the benefits of hospice and palliative care. Insurance companies need to prioritize cost-effective interventions while promoting social awareness and improving medical education and training.
  9. Healthcare professionals need to build strong relationships with patients and families to discuss end-of-life care earlier. Delayed conversations often result in unnecessary suffering, and it's essential to prepare for difficult discussions before it's too late.
  10. Accepting death as a natural part of life can improve end-of-life care. To change the healthcare system, we must focus on society, infrastructure, medical education and training, and prioritize human connection and patient participation. Addressing the fear of aging is key to embracing life's natural cycle.
  11. B.J. Miller advocates for the creation of beautiful spaces to ease end-of-life anxieties, freeing individuals to live their lives fully. Collaboration across pillars of change can incentivize policy changes and promote a higher quality of care.
  12. Predicting the future is difficult, even for experts. We must hold them accountable for their predictions, learn from our successes and failures, and use that knowledge to improve our ability to anticipate and shape the future.
  13. Carbon taxes and economic sanctions can limit carbon emissions. Personal experiences of adapting to change can help us prepare better for the inevitable.
  14. Art can be a valuable tool in helping individuals with disabilities transition to a new sense of self by transforming their raw experiences into something new. This demonstrates the power of individuals to shape their own identity despite challenges.
  15. Accept and celebrate your unique qualities to positively impact how others perceive and treat you. Empathy and honest communication can help foster understanding and support in difficult situations.
  16. When discussing sensitive topics like death and loss, being true to yourself and expressing empathy through gestures and genuine concern is more important than finding the "perfect" words. Vulnerability is key to demonstrating support.
  17. Planning ahead for death can be uncomfortable, but it helps us appreciate time and have better moments with loved ones. "A Beginner's Guide to the End" is a valuable resource in starting the conversation of preparing for death.
  18. It's important to allow for a range of emotions, prioritize authenticity, and accept the unpredictability of end of life care. Remain true to yourself and don't worry if things don't go as planned.

📝 Podcast Notes

An Economist's Exploration of the World Through Interesting Conversations

People I (Mostly) Admire is a podcast that offers a non-journalistic version of the way economists like Steve Levitt and Stephen Dubner think about the world, featuring guests who share their great ideas. Hosted by Levitt, the show allows him to step back from being a producer of knowledge, giving him the opportunity to share a different side of himself that is kinder and gentler. On the show, Levitt is free to be open and honest, talking about even the weird parts of himself that most people would be ashamed or afraid of. The podcast is an enlightening and entertaining way to learn about a range of topics, from ancient Greek political history to garbage disposal in Paris, from the perspective of the experts who study them.

Steven Levitt's Journey to Finding Inspiration through Podcasting

In academia, Steven Levitt always felt discouraged from being curious about the world around him. However, through his podcast 'People I (Mostly) Admire', he has found a way to invest in learning about all the things he never learned before. Some of his favorite guests include Sendhil Mullainathan, Max Tegmark, and B.J. Miller, who inspired Levitt to form personal bonds and collaborate with them. He believes that to create change, one needs unlimited passion and magnetic communication, which he found in B.J. Miller. Through his journey, Levitt highlights the importance of following one's curiosity and seeking inspiration from passionate individuals.

Changing the Way We Die: A Palliative-Care Physician's Crusade

B.J. Miller believes that our society's approach to dying is completely wrong, and he's on a crusade to change the way we die. As a palliative-care physician who has seen how our medical system fails people at the end of life, he emphasizes the importance of quality of life in our final moments. He argues that our society needs to prioritize support and guidance for the terminally ill, rather than sacrificing quality of life for a few more minutes on the planet. This conversation about death and dying may be difficult, but it's crucial for anyone who cares about their own death or the death of loved ones.

Why Teaching Kids About Death and Mindfulness is Essential

Teaching about death and mindfulness in schools should be a fundamental education. Death is a natural part of life, and we should reclaim it as such. Kids are naturally empathetic, and when given the opportunity to express their emotions, can create a love fest instead of fear around the topic of death. Allowing children to understand and process death can help them cope in their own lives and teach them valuable life skills. By removing the fear and taboo around death, we can help individuals embrace the natural cycles of life and death and lead a more fulfilled existence.

The Medical System and the Dehumanization of Dying

In the last 150 years, the medical system has medicalized everything, turned natural phenomena like death into a problem to be solved, and sidelined the importance of family, community, and support. The conventional way of dying in a hospital is often far from ideal, as medicine keeps offering treatments that forestall attention to the inevitability of death. This detracts from the important conversations about closure and saying goodbye to loved ones, which should occur before it’s too late. This reveals cracks in our system and in the thinking of the medical model, and highlights the need for greater attention to the human aspects of dying.

Redefining End-of-Life Care: Prioritizing Quality of Life Over Quantity of Time

We need to have a more thoughtful and proportionate approach to medical intervention and end-of-life care. Rather than over-relying on technology, we should focus on having meaningful conversations around what constitutes a meaningful life, even in the face of death. By embracing the reality of mortality and having open, civil conversations with doctors, patients, families, and friends, we can make more informed decisions that prioritize quality of life over mere quantity of time. It's time to shift the focus from simply extending lifespan to truly enhancing and cherishing life's inherent value and connections.

Creating a Comfortable Home Setting for End-of-Life Care

Creating a setting that imitates a comfortable home environment is essential for providing quality end-of-life care. This setting should prioritize the patient's comfort and personal preferences, while also providing a safe space to have open-ended conversations and say difficult things. Many people within the medical community appreciate this approach, but it can be difficult to implement due to a lack of funding and a system that prioritizes machinery over human needs. Hospitals should focus on creating a space that prioritizes the final aesthetic experience, which is an appreciation for material life and personal connections. By doing so, patients and their loved ones can find peace and comfort during their final days.

The Problem with Colluding to Prolong Life: Hindering Hospice and Palliative Care

Collusion between doctors and patients towards prolonging life can result in unrealistic hopes that may hinder the benefits of hospice and palliative care. Despite the evidence that such interventions save money, improve quality of life, and reduce pain, depression, and anxiety, insurance companies are hesitant to push for them due to the fear of being accused of sacrificing life for money. Social awareness and willingness, as well as policy, infrastructure, and medical-education and training issues, contribute to the problem. Representative Earl Blumenauer's suggestion to include doctor's visits for advance-care planning in insurance coverage was turned into a baseless accusation of 'death panels'.

The Importance of Having End-of-Life Conversations Earlier

End-of-life conversations are difficult but necessary. The use of hospice and palliative care has increased, but it often happens far too late, resulting in unnecessary suffering. In an ideal system, these decisions should occur weeks or months earlier, allowing patients more time. Unfortunately, the human fear of death and our irrational decision-making often lead to delayed conversations on this topic. Healthcare professionals must develop strong relationships with patients and their families to effectively have the end-of-life conversation. The relatively recent phenomenon of modern medicine's ability to remove death from view has also made it harder for us to accept its inevitability. Still, we must prepare ourselves for the difficult conversations as it is essential to ensure that patients receive the care they need and deserve.

Accepting Death and Changing Healthcare

When we distance ourselves from the consequences of our actions, death becomes an abstract concept rather than a natural part of life. Those who experience death more regularly, such as farmers, seem to have a greater acceptance of it. To change the current medical system, there are four areas to focus on: society, infrastructure, medical education and training, and a revised mission statement for healthcare. We must actively participate in our own care, say no to unnecessary treatments, and acknowledge the importance of human connection in end-of-life care. The pursuit of youth and the fear of aging must be addressed to fully embrace the natural cycle of life.

The Importance of Beautiful End-of-Life Spaces

B.J. Miller, a palliative-care physician and death reformer, believes in creating beautiful places for people to spend their end-of-life moments. He suggests that every community should have a beautiful piece of brick and mortar that people can live near and know that they will be cared for in a certain way. This will free people up to live their lives more wildly, knowing that their end-of-life anxieties will be tended to. Miller believes that resources should be focused on collaborating across the pillars of change and marrying what he thinks needs to happen in society with his own pet interests - architecture and design. The fourth pillar would be policy pieces that incentivize these changes in the right direction.

The Pitfalls of Prediction and the Importance of Accountability and Learning from the Past

Predicting the future is difficult, and even experts can be wrong. It is important to remember the pitfalls of prediction and to hold experts accountable for both good and bad predictions. The rise of Bitcoin serves as a great example of how predictions can be wrong, but it also highlights the importance of understanding the past in order to understand the future. While Levitt's prediction about Bitcoin was off, he has made other successful predictions, including the impact of legalized abortion on crime rates. However, he also predicted the struggles of controlling greenhouse gases, which unfortunately have come to fruition. It is crucial that we look back at our predictions to learn from them and continue to improve our ability to anticipate and shape the future.

Advancing Climate Change Mitigation Strategies and Preparing for the Inevitable.

Switching to powerful tools like carbon tax or real economic sanctions may help in limiting carbon emissions as approaches taken now may not be effective. Learning from personal experiences of adjusting to changes can help prepare for a better death.

The Transformative Power of Art in Shaping Identity after Disability

Exposure to the idea of disability at a young age can be invaluable for understanding and accepting one's own disabilities. Turning to art history, or any form of creative expression, can help in the transition to a new sense of self after a life-altering event. It allows for the raw material of one's life to be transformed into something new, much like an artist creates from raw materials. By changing his major, the author found a new perspective on what makes a human a human and how he could choose to see himself despite his physical changes. This shows the power one has to shape their own identity and context, even in the face of adversity.

Embracing Your Uniqueness and Building Empathy for Others

Embracing and celebrating one's own unique qualities can change how others see and treat them. The way we hold ourselves can inform how people perceive us, and accepting and loving our bodies can positively impact our relationships and interactions with others. However, people may struggle to react appropriately in uncomfortable or unusual situations, such as the reactions Miller received regarding his prosthetics. Empathy and honest communication can help foster understanding and support in challenging times.

The Power of Authenticity in Conversations about Death and Loss

When it comes to talking about hard topics like death and loss, there isn't a perfect thing to say, and even if you land on something good to say to one person, that might be exactly the thing that offends another person. However, authenticity in your response, rather than trying to say the perfect thing, is what is truly healing. Being vulnerable and daring to not know and feel your way through the conversation is key to demonstrating empathy and support. This can include conveying your concern and feelings, offering physical gestures like hugs, and acknowledging that you don't have all the answers. The strength in vulnerability should be accessible to us all the time.

Preparing for the Inevitable: Two Essential Books to Guide You Through Life's Biggest Moments.

The book 'What to Expect When You're Expecting' has become a staple for first-time parents while the book 'A Beginner's Guide to the End' provides valuable insights on preparing for death. Despite the discomfort people feel about discussing death, it is important to plan ahead to avoid unnecessary difficulties around hospitalization and pulling the plug. Planning doesn't guarantee an easy death but it helps us appreciate time, the importance of love, and what truly matters to us. Earlier in life, we are less likely to stack up regrets and more likely to have better moments with loved ones. The book provides a valuable resource in starting the conversation of preparing for death.

The Importance of Authenticity in End of Life Care

When preparing for end of life care, it's important to allow space for a range of emotions, including tears, sorrow, and even anger. Authenticity should be prioritized, and families and patients should be reminded that it's okay if things don't go as planned. B.J. Miller's book, A Beginner's Guide to the End, emphasizes the importance of accepting the unpredictability of end of life care. His company, Mettle Health, encourages individuals to remain authentic throughout the process.