{"id":23021,"date":"2021-04-10T15:39:42","date_gmt":"2021-04-10T19:39:42","guid":{"rendered":"https:\/\/globalwellnessinstitute.org\/global-wellness-institute-blog\/2021\/05\/10\/qa-dr-shoshana-ungerleider-copy\/"},"modified":"2024-12-10T14:26:34","modified_gmt":"2024-12-10T19:26:34","slug":"qa-dr-shoshana-ungerleider","status":"publish","type":"post","link":"https:\/\/globalwellnessinstitute.org\/global-wellness-institute-blog\/2021\/04\/10\/qa-dr-shoshana-ungerleider\/","title":{"rendered":"Q&#038;A with Dr. Shoshana Ungerleider: What Has the Pandemic Taught Us About\u00a0Wellness, Death and Dying"},"content":{"rendered":"<p style=\"text-align: left;\"><a href=\"https:\/\/globalwellnessinstitute.org\/global-wellness-institute-blog\/category\/qa\/\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-21925\" src=\"https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/QA_website_header.jpg\" alt=\"\" width=\"1297\" height=\"200\" srcset=\"https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/QA_website_header.jpg 1297w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/QA_website_header-300x46.jpg 300w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/QA_website_header-1024x158.jpg 1024w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/QA_website_header-768x118.jpg 768w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/QA_website_header-600x93.jpg 600w\" sizes=\"auto, (max-width: 1297px) 100vw, 1297px\" \/><\/a><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-21877 alignright\" src=\"https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/shoshana_thumbnail-300x300.jpg\" alt=\"\" width=\"268\" height=\"267\" srcset=\"https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/shoshana_thumbnail-300x300.jpg 300w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/shoshana_thumbnail-1024x1024.jpg 1024w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/shoshana_thumbnail-150x150.jpg 150w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/shoshana_thumbnail-768x768.jpg 768w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/shoshana_thumbnail-600x600.jpg 600w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/shoshana_thumbnail-184x184.jpg 184w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/shoshana_thumbnail-100x100.jpg 100w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/shoshana_thumbnail-24x24.jpg 24w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/shoshana_thumbnail-48x48.jpg 48w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/shoshana_thumbnail-96x96.jpg 96w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/shoshana_thumbnail.jpg 1080w\" sizes=\"auto, (max-width: 268px) 100vw, 268px\" \/><\/p>\n<p>&nbsp;<\/p>\n<p class=\"p1\"><span style=\"font-size: 19px; line-height: 22px; font-weight: bold;\"><em>Shoshana Ungerleider, MD, founder of the End Well project<\/em><\/span><\/p>\n<p><strong>Dr. Shoshana Ungerleider<\/strong> is an award-winning physician, writer and producer\u2014and founder of <a href=\"https:\/\/endwellproject.org\/\">End Well,<\/a> a series of events and a media platform focused on transforming the end of life into a human-centered experience. She is a leading voice in healthcare who regularly appears on <em>CNN, MSNBC<\/em> and <em>CBS News<\/em> and is the executive producer of two Academy Award-nominated documentaries about the end-of-life experience: <em>Extremis&nbsp;<\/em>and<em>&nbsp;End Game<\/em>. Her most recent documentary is about the life of Robin Williams, <em>Robin&#8217;s Wish. <\/em>She was a keynote speaker at the 2020 Global Wellness Summit.<\/p>\n<p><span style=\"font-size: 19px; line-height: 22px; font-weight: bold;\">In this edition, the GWI\u2019s Beth McGroarty asks: <\/span><\/p>\n<ul>\n<li><strong>What has the pandemic revealed about what most needs fixing in our culture around health, wellness, death and dying? <\/strong><\/li>\n<li><strong>Is there tension between the \u201cdying well\u201d movement and the wellness world\u2019s obsession with longevity and anti-aging? <\/strong><\/li>\n<li><strong>What can any wellness business do to embrace the \u201cend well\u201d movement? <\/strong><\/li>\n<li><strong>What is the future of \u201cdying well\u201d? Where do psychedelics fit? <\/strong><\/li>\n<\/ul>\n<p><strong><span style=\"font-size: 19px; line-height: 22px; font-weight: bold;\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-17904 size-thumbnail alignleft\" src=\"https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" srcset=\"https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1-150x150.jpg 150w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1-300x300.jpg 300w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1-1024x1024.jpg 1024w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1-768x768.jpg 768w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1-1536x1536.jpg 1536w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1-600x600.jpg 600w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1-184x184.jpg 184w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1-100x100.jpg 100w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1-24x24.jpg 24w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1-48x48.jpg 48w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1-96x96.jpg 96w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2020\/04\/beth-1.jpg 1624w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/span><\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Beth McGroarty, GWI VP of research and forecasting: 2.7+ million global deaths. Who could have predicted exactly one year ago that our world would be gripped by so much grief, trauma and dying? What has this year revealed about what most needs fixing in our culture around death and dying\u2014and in health and wellness?<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Dr. Ungerleider: <\/strong>I will speak from my experience: I see a significant shift in the conversation around mortality among my friends, colleagues and relatives. People have realized, no matter your age, that tomorrow is never a given: You can be impacted by serious illness and death at any stage of life.<\/p>\n<p>And, I think to some degree, every single person in the world is grieving right now. Not everyone has lost a loved one, of course, but we\u2019re all feeling this collective loss of life, and <strong>this experience of <em>truly collective grief<\/em> is new for modern society. <\/strong><\/p>\n<p><strong>The pandemic has also shined a light on the hidden world of caregivers<\/strong>, both informal (untrained and unpaid) family caregivers and our frontline healthcare workers. We\u2019ve all learned something about what it\u2019s like to be on the frontlines during a pandemic and risk your life every single day.<\/p>\n<p><strong>Our workforce of clinicians has been dramatically traumatized by this experience<\/strong>: from not having the PPE to not having the mental health support when we need it at our hospitals. One year out, the professional burnout is intense, and it\u2019s hard to even think about the number of people who may leave medicine altogether\u2014which is hugely problematic for everyone.<\/p>\n<p>So many of my clinician colleagues are now really suffering and grieving but don\u2019t have the time or space to experience it or get support because they\u2019re so busy taking care of patients. A key lesson we\u2019ve learned: We need to do far more to treat our frontline healthcare workers as human beings and create the services\/support that they need to continue doing their job.<\/p>\n<p>When I think about all the ways this last year has unfolded for people, I don\u2019t think we even have <em>the vocabulary <\/em>that could hold the weight of what this has truly been.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-21884 alignleft\" src=\"https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/End_Game_31m48s45752f-1024x576-1.jpeg\" alt=\"\" width=\"478\" height=\"269\" srcset=\"https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/End_Game_31m48s45752f-1024x576-1.jpeg 1024w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/End_Game_31m48s45752f-1024x576-1-300x169.jpeg 300w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/End_Game_31m48s45752f-1024x576-1-768x432.jpeg 768w, https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/End_Game_31m48s45752f-1024x576-1-600x338.jpeg 600w\" sizes=\"auto, (max-width: 478px) 100vw, 478px\" \/><\/p>\n<p><strong>One issue that the pandemic has cracked wide open is that every medical clinician needs to be trained in palliative care. <\/strong>Palliative care is a team-based medical specialty, usually consisting of a nurse, doctor, social worker and chaplain who think holistically about quality of life and reduction of suffering for people and their families facing a life-limiting illness.<\/p>\n<p>Because of the speed and severity with which COVID-19 takes hold of people, it made it painfully clear that providers in the emergency room and ICU (and other specialists) aren\u2019t always trained in having conversations with people about their goals of care. If it\u2019s not clear whether a patient may survive a hospitalization, they may need to communicate things like: If we have to put you on a machine to help you breathe, would you still want that type of intervention if it meant you may not be able to come off that machine? And, identify what people actually want based on their goals and values for however long they have.<\/p>\n<p><strong>Medicine is always poised to offer more treatment because that&#8217;s, frankly, how the healthcare system is set up,<\/strong> and some perverse incentives are at play. The culture of medicine means that, by default, you will receive the most aggressive, invasive treatment, no matter how old or sick you are, and sometimes even if it won\u2019t help you. You will end up in the ICU hooked up to tubes and machines unless you opt out loudly or have someone in your corner advocating for you to receive something different.<\/p>\n<p><strong>COVID-19 made it <em>even<\/em> clearer that people of all ages need to talk openly about what they want and put it in writing. <\/strong>And that every single person in medicine needs to be trained on how to have honest conversations with patients and families to get at what they truly want from their care.<\/p>\n<p>The \u201cend-of-life\u201d experience: Serious illness care, caregiving, the emotional\/psychological aspects of the death and dying process, as well as grief and bereavement, are all part of a human journey that every person experiences in their lives. We need to make this experience better for people at every single level.<\/p>\n<p><strong>The pandemic also revealed<\/strong><strong>\u2014<\/strong><strong>in real time<\/strong><strong>\u2014<\/strong><strong>that we have a radically unjust healthcare system<\/strong>. Black and brown communities suffer a disproportionate burden of disease; they have less access to medical care and representation within the system. These, and a number of other factors, led to far greater rates of COVID-19 hospitalization and death, especially because of increased rates of obesity and other comorbidities such as high blood pressure and diabetes. This was further exacerbated by communities of color being more likely to be essential workers who don\u2019t have the ability to take time off work if they are sick. The racial inequities at every level\u2014from access to healthcare to preventive wellness throughout life to end-of-life care\u2014need to be addressed in a very explicit and real way.<\/p>\n<p><strong>What we learned this year: We need to have many very hard conversations, starting with access to healthcare and wellness is systemically racist. <\/strong><\/p>\n<p><strong>McGroarty: What personally made you interested in rewriting the end-of-life experience?<\/strong><\/p>\n<p><strong>Dr. Ungerleider:<\/strong> When I was just out of medical school, I spent many months training in the ICU. I was utterly shocked by the amount of suffering I saw for people at the end of their lives\u2014people of every age, but especially older people, who were often very frail, with end-stage cancer or organ failure, spending their final moments hooked up to machines and surrounded by strangers, hidden away from people they loved. I would look into their eyes and see tears and so much pain.<\/p>\n<p>And I thought, my goodness, did this person choose this trajectory? How did they end up here? Nobody ever asked them, if time is short, how do you want to spend that time? What are your goals and values? What does a good day look like for you? I guarantee that the vast majority (if asked) would not have said, with IVs placed all over my body and sedated\u2014hidden away from everyone in my life.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-21883 alignright\" src=\"https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/1712-EndWellSymposium-181206-1024x683.jpg\" alt=\"\" width=\"584\" height=\"389\">So, I started End Well, thinking, wouldn\u2019t it be amazing if we had a TED-style conference where we invited people from many disciplines\u00ad\u2014design, tech, philanthropy, the arts, education, law, policy, healthcare, patients, and caregivers\u2014to really talk about their experiences and learn from who\u2019s doing the great work on the ground, so we could create new solutions, services and products that make a more humane end-of-life experience accessible for more people.<\/p>\n<p>It turned into a global movement, transforming the end of life into something more human-centered, finally seeing the end of life as <em>part <\/em>of life.<\/p>\n<p>We then created a media platform (written and video content), and even though we\u2019re a tiny little team with no media or content delivery experience, we get tens of millions of views organically\u2014evidence that this is a relevant issue for people.<\/p>\n<p><strong>McGroarty:<\/strong> <strong>The dying well movement is accelerating and lives under the \u201cwellness umbrella.\u201d&nbsp; At the same time, the wellness world leads with a strong message around anti-aging, \u201cdo this and live forever\u201d<\/strong>\u2014<strong>in biohacker circles, even \u201ccuring death.\u201d What\u2019s the impact of this \u201cwellness paradox\u201d on our culture? <\/strong><\/p>\n<p><strong>Dr. Ungerleider: <\/strong>We just did a Clubhouse panel (with the founders of <em>Wired<\/em> magazine and TEDMED) on this exact topic, one that fascinates me personally. <strong>I don\u2019t think there is any paradox between the \u201cdying well\u201d and the longevity focus in health and wellness. <\/strong>We\u2019re all after the same thing: How can I live as well as possible as long as possible? It would be amazing if people could live longer, and there is amazing research into how cells age over time.<\/p>\n<p>But it\u2019s not just about living longer; it\u2019s about having a good quality of life for those years, being able to have experiences that are meaningful and bring you joy. Until scientists figure out how to keep us alive, living well, and in a sustainable way for the Earth, there are many millions of people impacted, right now, by illnesses that modern medicine cannot cure\u2014so the focus also needs to be on helping people end well. <strong>We can all unite around this: Live long, live well, and die well. <\/strong><\/p>\n<p>The wellness world needs to embrace that having a relationship with your own mortality is a key part of wellbeing; grasping that your life will end allows you to live better every day. You pay attention to life\u2019s small miracles: the sunset, that hummingbird visiting your window during the pandemic.<\/p>\n<p style=\"text-align: left;\"><strong><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-21885 alignleft\" src=\"https:\/\/globalwellnessinstitute.org\/wp-content\/uploads\/2021\/02\/EndGame_115inH_x_79inW_CityLight_RetroFit_FIN-2-704x1024.jpeg\" alt=\"\" width=\"505\" height=\"734\">McGroarty: Most wellness businesses are, of course, not in the end-of-life space. What can they tangibly do to support this movement? <\/strong><\/p>\n<p><strong>Dr. Ungerleider:<\/strong> Every business (big or small) can be a change-maker by talking openly about what employees are facing (are they caregivers? facing grief and loss?) and creating a safe, supportive space in the workplace, whether that\u2019s in person or remote. It starts with the C-level leadership saying this is important and acting accordingly. There are so many programs and services you can embrace: providing caregivers paid leave, helping them get trained to be better caregivers at home, connecting people to bereavement support options for those facing grief.<\/p>\n<p><strong>We need to think differently about workplace wellness: It\u2019s not just about yoga, meditation and healthy food<\/strong>. There are so many day-to-day life issues to address, and the end-of-life piece gets missed because it\u2019s hard and not sexy. But it\u2019s so incredibly important for employees.<\/p>\n<p><strong>McGroarty: Any predictions for the future of the \u201cend well\u201d movement? How about the eye-opening research on psychedelics\u2019 impact on end-of-life distress?<\/strong><\/p>\n<p><strong>Dr. Ungerleider: <\/strong>The early data I\u2019m seeing in the psychedelic space is really encouraging.<\/p>\n<p><strong>What we know: The use of psilocybin, for example, under very strict guidance in a therapeutic setting does significantly reduce existential distress for people facing a life-limiting illness.<\/strong> And with very few side effects and a durable effect, meaning it lasts a long time: <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5367557\/\">Johns Hopkins University found<\/a> that it continued to reduce anxiety and depression for 80% of people with a life-threatening illness after six months.<\/p>\n<p>We don\u2019t have any modern, FDA-approved medications that achieve that effect. Nor do we recognize existential suffering as we should: We sedate people who exhibit symptoms that are very normal when people approach end of life. So, if psychedelics can reduce suffering with little risk of negative side effects, we need more studies that demonstrate this\u2014and then we need to shift our thinking and make them more accessible as a therapeutic option.<\/p>\n<p>I\u2019m so data-driven; I\u2019m not prone to making predictions. But I can tell you that in 20 years, my hope is that I don\u2019t have to do this work anymore\u2014that I can shut End Well\u2019s doors\u2014because we\u2019ve sorted out how to treat people thoughtfully at the end of their life, and it\u2019s just part of normal care that we provide to people.<\/p>\n<p>We\u2019ve learned some terrible lessons this past year. I\u2019m hopeful we can grow from this experience, and everything we\u2019ve learned will help us move forward toward making ending well possible for all.<\/p>\n<p><strong><a href=\"https:\/\/globalwellnessinstitute.org\/global-wellness-institute-blog\/category\/qa\/\">Read More Q&amp;As with Experts<\/a><\/strong><\/p>\n<hr>\n<h1 style=\"color: #2e6ab3;\"><strong>We want to hear from you<\/strong><\/h1>\n<p><strong>One year into the pandemic, what do you think it has revealed about what most needs \u2018fixing\u2019 in health and wellness?<\/strong><\/p>\n<div id=\"i4c-dialogs-container\" style=\"font-size: 18px;\"><\/div>\n ","protected":false},"excerpt":{"rendered":"<p>&nbsp; Shoshana Ungerleider, MD, founder of the End Well project Dr. Shoshana Ungerleider is an award-winning physician, writer and producer\u2014and founder of End Well, a series of events and a media platform focused on transforming the end of life into a human-centered experience. She is a leading voice in healthcare who regularly appears on CNN, MSNBC and CBS News and is the executive producer of&hellip; <\/p>\n","protected":false},"author":8,"featured_media":24832,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"give_campaign_id":0,"content-type":"","inline_featured_image":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","footnotes":""},"categories":[14,71],"tags":[70],"class_list":["post-23021","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-qa","tag-qa-with-beth-mcgroarty","wpautop","clearfix"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Q&amp;A with Dr. Shoshana Ungerleider: What has the pandemic taught us about\u00a0wellness, death and dying<\/title>\n<meta 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