TrueLife - Dr. Brad Stuart - Facing Death

Episode Date: October 13, 2024

One on One Video Call W/George https://tidycal.com/georgepmonty/60-minute-meetingSupport the show:https://www.paypal.me/Truelifepodcast?locale.x=en_US🚨🚨Curious about the future of psychedelics? Imagine if Alan Watts started a secret society with Ram Dass and Hunter S. Thompson… now open the door. Use Promocode TRUELIFE for Get 25% off monthly or 30% off the annual plan For the first yearhttps://www.district216.com/🎙️🎙️🎙️ Today, we are honored to welcome a guest whose life’s work has navigated the mysterious and often misunderstood terrain between life and death. Dr. Brad Stuart is not just a physician, but a pioneer—someone who has spent over four decades at the front lines of modern medicine, reshaping how we understand the end of life. As a General Internist, Hospice, and Palliative Care specialist, he has witnessed firsthand the profound gap between curing and healing, and through his groundbreaking work, he has begun to close that gap.But Dr. Stuart’s journey didn’t stop at the bedside of his patients. He became the architect of Advanced Illness Management (AIM) at Sutter Health, leading the charge to bring compassionate care to those facing serious and terminal illness. His efforts garnered a $13 million grant from the Center for Medicare and Medicaid Innovation, and his visionary leadership earned him a place among the Top 20 HealthLeaders Difference-Makers in the U.S.Yet, as monumental as those achievements are, Dr. Stuart’s greatest contribution may lie in the deep insights he shares in his book Facing Death: Spirituality, Science, and Surrender at the End of Life. In this work, he challenges the very foundations of how we perceive death—not as an enemy to be fought, but as a gateway to transformation. He explores the convergence of science and spirituality, shedding light on the limits of the material world and inviting us to consider a deeper, more transcendent reality. Through his patients, he has learned that dying is not the end, but an opportunity to discover who we really are.Today, we have the privilege of exploring with Dr. Stuart not just his incredible career, but the profound lessons he’s learned about life, death, and everything in between. Prepare to be challenged, to think deeply, and perhaps to see death in a way you’ve never imagined. Please join me in welcoming Dr. Brad Stuart.https://bradstuartmd.com/ One on One Video call W/George https://tidycal.com/georgepmonty/60-minute-meetingSupport the show:https://www.paypal.me/Truelifepodcast?locale.x=en_USCheck out our YouTube:https://youtube.com/playlist?list=PLPzfOaFtA1hF8UhnuvOQnTgKcIYPI9Ni9&si=Jgg9ATGwzhzdmjkg

Darkness struck, a gut-punched theft, Sun ripped away, her health bereft. I roar at the void. This ain't just fate, a cosmic scam I spit my hate. The games rigged tight, shadows deal, blood on their hands, I'll never kneel. Yet in the rage, a crack ignites, occulted sparks cut through the nights. The scars my key, hermetic and stark. To see, to rise, I hunt in the dark, fumbling, fear. through ruins maze, lights my war cry, born from the blaze.

The poem is Angels with Rifles. The track, I Am Sorrow, I Am Lust by Kodak Serafini. Check out the entire song at the end of the cast. Ladies and gentlemen, welcome back to the True Life podcast. I hope everybody is having a beautiful day. I hope that the sun is shining, the birds are sun. singing and the wind is at your back. I have with me an incredible show today with an incredible individual. We're going to get to some really fascinating topics on the edge of life and death

and palliative care. Today we are honored to welcome a guest whose life's work has navigated the mysterious and often misunderstood terrain, not just a physician, but a pioneer, someone who has spent over four decades at the front lines of modern medicine, reshaping how we understand the end of life. As a general internist, hospice, and palliative care specialist, he has witnessed firsthand the profound gap between curing and healing, and through his groundbreaking work, he has begun to close that gap. But Dr. Stewart's journey didn't stop at the bedside of his patients. He became the architect of advanced illness management at Sutter Health, leading the charge to bring compassionate care to those facing serious and terminal illness. His efforts garnered a $13 million grant from the

center of Medicare and Medicaid innovation, and his visionary leadership earned him a place among the top 20 health leaders, different makers in the U.S. Yet as monumental as those achievements are, Dr. Stewart's greatest contribution may lie in deep insights he shares in his book facing death, spirituality, science, and the surrender at the end of life. In this work, he challenges the very foundations of how we perceive death, not as an enemy to be fought, but as a gateway to transformation. He explores the convergence of science and spirituality, shedding light on the limits of the material world and inviting us to consider a deeper, more transcendent reality. Through his patience, he has learned that dying is not the end, but an opportunity to discover who we really are. Dr. Brad Stewart, thank you so much for being here today. How are you?

I'm good, George. Thank you very much for having me. Yeah, the pleasure is all mine. It's what an interesting time we live in. And I'm just going to jump right. in here. You've written a really amazing new book, and the first part that jumps out is this idea beyond healing and curing. Maybe you could unpack that a little bit for us. Sure. You know, I think we all, especially those of us who are, you know, in the baby boom generation and, you know, have lived a nice long life. You know, we're very concerned about our health, and we want to stay as healthy as long as we can. And so, you know, I've been through cancer myself and out the other side.

I think I'm cured of prostate cancer. That was 20 years ago, and it was quite an upset. I detail my own reactions in the book. But, you know, medicine's capacity to cure has just exploded. And I think we're on one of these accelerating curves now, where there's an inflection point, and we're going to see more and more curative technology just bursting out of medical science. So, you know, cure is, as physicians, that's our goal.

We want to return people to health. But early in my career, in fact, when I was in medical school, I realized that the people, I sometimes get a little nervous calling them patients, the people that we deal with who are most fascinating and who absorb my attention the most are the ones that I couldn't cure. The ones who, no matter what we did, we couldn't make any headway against their disease. What do you do then? And our teaching doesn't go very far in that area. So I wound up in hospice and palliative medicine for the last two-thirds of my career.

And, you know, I realized that healing is just as important as curing. We need to be doing healing all the way through, even as we're trying to cure, and especially when there is no cure that's still possible. And that's why I got fascinated with the end of life and with healing. We'll talk more. I think our whole discussion will be about what healing is. But it's reconciling ourselves to who we really are and where we may go after we die because that's where the science and the spirituality are now coming together.

It may be that death is not the end of everything as we've always thought. And that throws a whole new light on healing and curing. Yeah, it's really well said. Often if you read a lot of spiritual teachings or you can turn to religious text and you can see this idea that that on some level our whole life is this sort of classroom or

maybe we're dying since the day we were born but it seems like we're picking up trauma from the day we're born and we don't even are not even able to integrate that trauma until something big happens in our lives. Maybe we lose a loved one. Maybe our parents split up. There's all kinds of different things that can happen to us to kind of simulate death

in a weird sort of way. What is that, you think we're picking up trauma the whole way and death is some sort of way for us to integrate this process? Is that the healing part of it? I think that's a great way to put it. I think that, you know, if you know anything about Buddhism, you know, all of life involves suffering. Yeah. And you don't realize that when you're at a wonderful dinner with friends, drinking wine and having a great time. But, you know, the living involves trauma all the time. And I think what that translates to is everything we encounter in life

is a challenge in some way. It's either a challenge because it's a shock and we have to adjust to it and we don't like it very much, or it's a trauma because we love it and we get attached to it and we don't want to lose it. And that's what happens in life. You know, you get, I'm 75 you get to my age and you know you're kind of attached to being alive and uh you know i there's not a day goes by that i don't think about the fact and it's a fact that my life's not going to go on forever and i've i've been through most of my time already uh i hope i've done uh you know as well as i can do in that time but that time is uh doesn't go on forever and that's that's a trauma too There's future trauma as well as past.

So healing, I think, amounts to reconciling yourself inside to who you really, really are. And that's a place inside that you may reach in meditation. I think psychedelics show us something about, you know, not only who we are, but what reality might actually be. and near-death experiences, which now are being studied scientifically, that's where spirituality and science really are coming together. You know, at the time of death, when we let go of the body, it may be that we don't let go of our essence,

our consciousness, we may continue on. That's what everybody reports, and there's more and more of those reports now. And, you know, then you get perspective at that point. Yeah. On what your life was like. And hopefully we get a little perspective and take the time before we get to the end to look at, you know, who we are and what we're here to do. It's so well said. You know, being able to have an event that allows you perspective, be it psychedelics or losing someone, or perhaps in your case, you would mention, you were absorbed.

by the people that you couldn't cure. Like that particular lesson that those people taught you sounds life-changing to me. And it's like, maybe we can talk about that a little bit. Like, given the opportunity to learn from someone who knows that their time is coming up, what was so absorbing about it? And did that change your life, getting that perspective? That's like a central question that all doctors ought to be. be asked, I think. Because, you know, when I encountered, and it happened in my third year of medical

school, it's really the first chapter in my book, I encountered a patient who, as a third year medical student, I had to work up. And, you know, he obviously was close to death. And nobody in my university medical center seemed to notice that, but me. He was scheduled to receive heavy duty chemotherapy for his end stage cancer. And what did I know? But it appeared to me that he was going to die no matter what we did. And he was probably going to die quicker if we gave him this experimental chemo. But, you know, I called a meeting.

A whole lot of people showed up. I had to stand up and say what my concerns were. And, you know, I had two questions for everyone in the room as a third year student. Should we do this? Should we give this potent chemo that's going to wipe out his bone marrow and speed his death? Should we really be doing that? And number two, shouldn't we be talking to this person and his wife who came there from a thousand miles away to be cured? it was obvious to me that probably was not going to happen shouldn't we be having a really in-depth

conversation with them and you know the meeting broke up they decided to treat him i asked to give him him the medication myself so i could really have an in-depth learning experience and i did because he died that night we we did wipe out his bone marrow and he bled into his brain and died so that changed my whole perspective on medicine. It set the course of my career. And that second question, which somehow I thought to ask, became one of the guiding questions of my whole career, and that is, shouldn't we be talking to people about what they're in for? We as doctors can see what's coming. Shouldn't we be talking? And not only that, how do we do that? And the answer that became clear after doing it and learning by the seat of my pants for decades and actually how to do it well, it comes down to as a clinician, you have to leave yourself at the door and meet that person who's usually in a pretty extreme state if they know what's happening.

you need to meet them, feel into who they are, not get lost in their problem, keep your center, but get as close as you possibly can, really on a level that amounts to your heart as well as your mind. You need both. And when you're as close as you can be, then you can have a conversation. And you both go through a healing process when that happens. That's what my career really became, and that's why I wrote the book, because I think we would all benefit. We would all engage more in healing if we had those deep encounters. And it's not just in the examining room or the hospital or the ICU that that happens. It's everywhere as we get down to who we are and meet other people.

where they are, I think we'd have a lot fewer of the political differences that we have, for instance, if we made that a priority. And that's really what my career became. And that's why I wanted to write the book, too. How do we not just talk to other people? How do we find out who we really are? How do we get underneath the self that we think we are, that we're convinced that we are? Because when you get, excuse me, to the end of your own life, you will find that you drop almost all of who you think you are before you actually die. You'll let go of it. The dying process will do that for you. And whatever goes on, because it's looking more and more like something does, that something that goes on is who you actually are. So why not look for that center or that essence of who you are before you let it go and don't bother and then let dying do it for you?

Get a little experience first. And I think that's what a lot of spiritual practice really is about or ought to be. Thanks for sharing that. I think there's so much wisdom in people who find. find themselves. There's that old saying that says, he who dies before he dies never dies. And on some level,

you know what I mean? Like on some level, if you can get close to it, you can really have a rebirth in your life. And it sounds like that's what happened to you. Like on some level, this person that was passing away became an ultimate teacher.

And I think the people that are on that cusp, like we can learn so much from them about how to live a meaningful life. It seems some people that I've spoken, and I'll ask you this question. They're not, they're not talking, when people are at the edge of death, they're not talking about buying a new sports car or I wish I would have spent more time at work. It sounds like they're saying, I wish I would have been a better father.

I wish I would have told him with my family. I wish I would have told my mom I loved her, you know, or what are some of these lessons that maybe when you have a foot in both worlds that people are talking about? It's not the superficial stuff. Is it? It's more meaningful? No, it's, you know, it's, you know, It's looking at your life as a whole and feeling through what kind of person were you,

what kind of person are you? Who are you becoming? And how are you treating yourself first? Because, you know, you can't, I don't believe you can treat other people well until you learn how to treat yourself well. And I don't know about anybody else listening or watching, listening to or watching this. But for me, that's been a lifetime project. You know, we need to, I think, sit back and relax and let go and learn respect for ourselves, all our mistakes, others who are close to us, all of what we see is their mistakes,

because there probably really ultimately aren't any mistakes. They're just things that may come back to bite us, and that's part of the learning experience, but it's getting deep enough to get a sense of the essence of who we are underneath all our thoughts, underneath all the things that your mind is saying to you, and realizing that all those things that your mind is saying to you that you regard as you, you just feel like you're talking to yourself,

well, you know, I think in reality, who you are is deeper than your mind. That's the whole essence of Buddhism. I think it's a lot of what Jesus talks about in the New Testament, finding the kingdom of heaven within. It doesn't matter what religion you look at,

the founders of those religions, all found or realized who they really were. And they came from that place. And that was what was so revolutionary about their teachings, because in this life, we're convinced that we are what our mind says and that we are the self that we've built over our lives in response to the trauma that you referred to and all the other things that have happened to us. We build a self in response, and we're just convinced that we don't think about it.

That's me. Well, no. If you listen to the teachers, the spiritual teachers, and you do a little looking into yourself and sitting really quietly, you may find that there's something of yourself of you that's underneath yourself, the self that you think you are. And if that's all you ever learn and experience, I think you've got the essence of all the major spiritual teachings because I don't use the word God lightly because that term has so much baggage attached to it. But if God lives anywhere or comes through anywhere, it's that place inside where you really are connected, where creation comes through. And, you know, so that those kinds of insights are the things I think we can gain if we spend some time quietly looking and feeling deeply within ourselves and other people. And I think it's what everybody learns as they come up to the actual time of death. That's what appears.

Yeah, it's, it's a really fascinating. way of looking at education from our life and from our elders. And sometimes I feel like, and you write about the bridge between medicine and spirituality in your book, it seems that somehow in Western science, we've thrown out things that we don't have a tool to measure with. Like, okay, we can't measure that. So let's just put that aside for right now. But it seems where those spirituality and medicine are sort of coming back together on some level. Do you see that happening? I do. I think it's a slow process, but I think there's been a lot of progress. I mean, I went to medical school in the in the 70s. You know, what's that 40, 50 years ago? You know, there's been a huge amount of progress that's been made since then. There are courses now, you know, in medical school and in medical training where students and physicians and, you know, nurses, all clinicians.

in training now get a little bit of exposure to the kind of things we're talking about. But it's when you get into practice and you're in the trenches and, you know, the battle lines are drawn and, you know, every day you work, you're in an environment where you're compelled to think in terms of, you know, as a physician, it's like, okay, I'm, say you're in the emergency room and, you know, a patient rolls in. I'm just thinking back and I tell a lot of of stories in the book. You know, a person rolls in who is in a state where you don't have time to stop and think about any of the things that we're talking about here. All you have time to do is react. And, you know, you react using all the facts that you get as quickly as you can.

In seconds, you can examine someone, ask them a few important questions after you do it for a while, you know exactly what to ask. And within 20 seconds, you kind of know what's happening. You grab a few numbers from their labs and their x-rays, and you make a decision based on what you need to do to pull them out of the fire, and you do it. And that's what physical medicine is about. Now, say, say you have someone come in who, where it's not such an emeritus,

You know, I tell the story in the book about a young man I met in his 30s. He wasn't my patient. He was just in town visiting his family. And I got called over to the emergency room, which is across the street from my office at the time, because he had pneumonia just out of nowhere. He had a right middle lobe pneumonia, which is common. It's a common place to get pneumonia, but an otherwise healthy 30-some. year old guy doesn't just get pneumonia out of nowhere. So I looked at his x-ray and he had some

big swollen lymph nodes in the middle of his chest. And, you know, alarm bells go off when you see that because it usually means that the person has cancer and it's probably going to be lymphoma. It's a cancer of the immune system and the lymph nodes get very large in the middle of your chest and they can block off your airways that go to the segments of your lungs. and that's probably what had happened with him. So I had a long conversation with him. You know, the pneumonia, that's easy to treat. I mean, you just write a prescription.

He wasn't sick enough to hospitalize. And, you know, you write a prescription for the right antibiotic. And you, you know, tell him to come back immediately if this list of things happens. It's all, you know, through guidelines that are written for doctors. But I decided we got to go be happy. that and talk about what is obviously really going on here underlying the pneumonia. And we had a conversation that lasted maybe 15, 20 minutes. And we got to a place where he told me what he thought was going on.

And the only way to get there is to ask questions. So I detail in this chapter in the book in this story, what questions I thought to ask that allowed him. to get insight step by step into what was happening. And what was happening, and it sounds very blunt to say it this way, what was happening was he was getting to the point with his cancer where his treatment wasn't working very well anymore, and his life probably wasn't going to go on for that much longer.

And here he is in his 30s. That's a horrible thing to contemplate. And yet in 20 minutes through just asking questions, we got to where he very calmly came to that conclusion himself. And that's the kind of conversation that I think you learn to have with people when you develop the empathy to know how much it hurts, you know, to feel the terror and the horror of understanding that you're probably going to die at a young age. And there's not much that anyone is going to be able to do about it.

And yet we got there in 20 minutes in a very calm way. And it's because we had a heart-to-heart talk. And if you read the chapter, I didn't do any psychology. I didn't make any empathetic statements. I made a couple. But, you know, I wasn't a psychologist. I just was a doctor. I just asked him what he thought about various things.

And it was very clinical and very commonplace conversation. and yet in a deep way, I think for him, and for me too, it was very healing for us to go together to that place where once he understood where he really was in his disease process, then he could go home and talk to his five different doctors, specialists that he has back home who are treating his cancer. and they're obviously not telling him or asking him questions that will bring him to realize that he's got to get his affairs in order. If he doesn't want to be shocked as he really gets ill,

because he wasn't quite there yet. He'd lost a lot of weight, but he wasn't sick. But he's that far away from getting very, very ill. and it pays to prepare for that. And there are ways to introduce people to that and begin that process of preparation in a very humane, gentle and, I don't know, spiritual way, and that's what we did.

So I think there's more of that being taught in medicine now, and yet in practice, just because it's so pressure-packed and there's so many time constraints for clinicians, it doesn't get done as often as it could. Wow. It causes me to stop and think for a minute about a lot. You know, the root word of, when I think of pallet of care, I think of the root the root

word pow, which means to hide. And I can't help but think, like, just hearing that story and thinking about all the things that may have gone through his mind, how momentous it is, the feeling. fear, like the shame, the anger, like the uncertainty is overwhelming. And it seems that if we look at that as a case, maybe collectively as a group of people, we, we have this fear of death, so we try to hide it on some level. I know that my grandmother was, she went away to a home and she lived on this machine for years. And it was like she was already gone on some level. What, what, are we facing like a collective, hey, let's let's put this in the background and not talk about it,

I don't have to worry about it. Do you think that on some level we're doing that? Well, of course. I mean, you're, you've, once again, you nailed it. I mean, we are extraordinarily frightened to face the facts. And, you know, you got to have some sympathy for people who, for everyone, because it is the scariest, most horrifying realization in life that your life may end. And, you know, it happened, because we're so frightened to talk about it or think about it,

it tends to happen behind closed doors. Unlike in other societies and back in the past when death was part of life, it's not anymore. Even in hospice, it happens, you know, at home or in a hospital room and the doors are closed. And people who are close to the person who is dying may be gathered around but they're just there often at the last minute you know and then they disperse again and go about their lives and because it's so managed death is so it's become a medical problem and it's managed so closely and usually in the hospital that we don't get a chance to bring it into life and and make it part of being alive and so it's natural that everybody he's horrified and scared because it's never talked about. It's never, it's never a part of

day-to-day discussion other than like when you get to be my age, you talk about your friends who have died. And I have a lot of friends who are no longer with us. I have a group of very close friends. We're on Zoom every Sunday. People I've known for 50 years. We just were close back then and we still are. We talk about it. But even, even in that, setting, you know, it takes some effort to get a discussion going about what really goes on when people get to the end of life. It's very forbidding. And it's not until we have a conversation like you and I are having here that we can begin to normalize it a bit, you know, make it so that people understand that it's something we all face. It's natural. And not only that, when you

experience enough of it like I have in my career, you realize it's not the end of life and the processes that lead up to it are not scary at all. And people don't suffer the way you would imagine that they do. Now, some people do. And unfortunately, it's when that happens, it's often because nobody ever talked about it. And it's a shock when it happens. It shouldn't be. when it's handled in a more reasonable way where you have some time to prepare and get used to the idea and have time to adjust. It's a process of emotional and physical adjustment. It's not only not scary and horrible, we can manage the pain. We know how to do that.

It's often a process where people really learn. and commonly they'll say afterwards or even during when it's going on they'll say i've never experienced anything like this this this uh you know i would never have wished for this to happen but this has been one of the most important experiences in my life i've really learned and experienced things i never imagined and that's before death now what happens after death that we're learning more and more. I mean, resuscitation and,

and, you know, resuscitation science and critical care, we're so good at that now that we're bringing a lot of people back from cardiac arrest. And there's more and more near-death experiences compared to what there used to be. Now we're hearing more and more of stories of what may well happen

after we die. And talk about a learning experience. If you read enough of the, those accounts, just reading them, reading what people report they've experienced when they die and are brought back what they experience as they have left their body and then return, that's healing in itself. In fact, it's really healing. I'd recommend that people look more at the recent data and the recent reports, and there's more and more books now coming out since there was a flurry in the 1970s, there's more coming out now. If you want to heal your fear of death,

one good way to do it is to look into what we're discovering now about what people experience after they die, because we have more and more reliable reports about that now that we're actually studying it scientifically. Yeah, I've read some of those reports, and I work a lot in the psychedelic community. And, you know, there is, I've spoken with lots of people who have been through PTSD. My son died when, on his first day of life, and I've taken large amounts of psychedelics. And there's something that I think resembles a near-death experience at a high enough dose of psychedelics where you realize that you're part of something bigger than you can imagine. It's ineffable, but you can feel it through your senses at a level that.

that is celebratory and scary. I think there's a great, there's a great book called, um, the terror before the sacred. And like that, just that, that saying alone,

the terror before the sacred speaks to the ideas of dying. Like you're terrified in front of something so beautiful because you know it's wonderful. There's no words for it on some level. But I, I know in your book, you, you have researched the idea of psychedelics and,

and these near death experiences. And I'm one, Can you speak to any cases that you know of where maybe people found themselves in palliative care and have used psychedelics or read some of these near-death experiences and it helped them kind of ease their transition on some level? Yeah. In fact, there's a chapter of my book that's devoted to this. I was taking notes there because I hadn't heard about that book. I'm going to read it now. That's great. But, you know, the, I was lucky enough. I mean, I went to college in the late 60s and early 70s when psychedelics were just, you know, coming on the scene before they were made illegal. And I had a lot of experience with them. And I never regarded LSD and psilocybin and, you know, the real strong psychedelics.

I never regarded them as party drugs. lot of my friends did. I had really deep respect for that experience and I learned a lot. In fact, I describe one of my own experiences in the book. It's not a long, you know, book length description, but I try to portray what the experience is like in a psychedelic experience. And, you know, You mentioned, George, that at high doses, it's a very special experience. And there are many, many features that that experience has in common with near-death experiences. In fact, there are research scales, questionnaires that have been developed for both psychedelic experiences and near-death experiences. and a lot of the questions that are asked are similar on both of those scales,

because the experiences are very similar. And it's almost as if what we experience when we're in our bodies, where all we have, the only way we can gain any information about anything is through our senses, our five senses, and what our mind does as it interprets the signals that we get from our environment, that's all we have to know anything about anything in our universe. And if you think about it, science is only, it limits itself just to that information. If it's not sensible, if it's not something that you can see or hear,

or data that you can gain through instruments that do nothing other than amplify our senses. That's it. For the last 400 years, you know, since the European Enlightenment, that's the only thing that's regarded as reality. And that's fine. Look at what we're doing with it. I mean, we've got some serious challenges around the environment and all that. but the progress that we've made is phenomenal.

And yet, the data that we're now getting through psychedelic studies and near-death studies make it look a lot like what we find through our senses is only part of what's actually there. There's a larger reality that we can't sense with any instruments, although I don't want to get into it now or it would take forever, but there are signals and data that we get through our instruments that make us wonder. But, you know, really, what reality actually encompasses may be a lot higher frequency information than what we can sense with any of our instruments or our own five senses. And, you know, it looks as though with a large enough dose of psychedelics, or in a near-death experience, we're experiencing a greater reality than anything we can

possibly know when we're in a body. And in our current cultural prejudice, anything that we regard as real. Because, I mean, if you're going to be honest with yourself, you have to admit that unless you have experience and spirituality, you regard certain things as real and things outside that group of, you know, that pot of experience is kind of woo-woo or it's mumbo-jumbo or suspect. It's, you just don't regard it as real because we've all become very scientific now, whether we know it or not. But the psychedelic experience takes us outside that. And one thing that near-death experiences and psychedelic experience have in common is that people who come back from those will say, you know something?

What I experienced there that I can't see now anymore, now that I'm back in my regular brain, you know, what I experienced there was more than anything I've experienced in my life so far in my brain. body that almost everyone will say something like that. And it's, you know, if you have experienced either of those things, you'll say the same thing because there's another level of reality that's at least as real and maybe more than what we experience as we're here in a body. So why are we here? Is there a reincarnation? I don't know.

There's pretty good evidence that there certainly could be, but we just don't know. the only windows we have on that world at this point that are subject to any kind of rigorous study are psychedelic experiences and near-death experiences. And what we're learning through those windows, I think, are that you look through that window and you can see that there's a whole lot more to reality than what we can see and accept while we're alive in a body. Yeah, it's well said. I get goosebumps hearing it and thinking about it.

And it's interesting when you, when sometimes science dismisses the psychedelic experience, but it's the most repeatable thing. You think scientists will love it. It's the most repeatable thing possible. Here's 10 dried grams. You will have an, you will have an experience.

If you try it, it's a repeatable thing. And I, sometimes I wonder, I know it's not for everybody. and I realize that the long-term ramifications of people that may have different psychological issues or something like that. There's real problems there. But on some level, it allows for a more meaningful life.

And it gives you the courage to maybe face these things you're doing that are a problem. Like, I hate my job. I hate this relationship. Sometimes a near-death experience or a high dose will give you the courage to realize, like, look, I'm dying. I should start living. Do you think that maybe on some level, maybe on some level society doesn't want that? Like, hey, we don't need these people living. We need them going to these jobs and doing these things.

Is that too far out there? Oh, no, not at all. I think that's what I think that mindset that you're detailing there, namely that psychics are dangerous because they make us really look at the life that we have here and what's accepted as, what's acceptable isn't enough. You know, there's more. Yep. You know, and if you look back, if you went through the 60s, you'll remember that when LSD hit,

Timothy Leary said, you know, turn on, tune in, drop out. Yep. And the dropout part scared a lot of people. And, you know, I think that's why they were outlawed because it, psychedelics were looked at as extraordinarily irresponsible, you know, agents of irresponsibility, you know, people were going to drop out and a lot of people did. I mean, face facts. Some of us went on and built careers and did what we did in our lives inspired by that

experience. Others did not. or even, you know, did things that were destructive. But now, I mean, what's really interesting about the scientific study now of psychedelics is Roland Griffith's work. He just died a year or two ago. Roland Griffiths was the pioneer in psychedelic research not only back then but now. And his was the first well-done, rigorous study that showed that psychedelic, administered under the right circumstances with people who knew what they were doing,

you know, in the right set of expectations on the right setting, you know, 40% of people who have terminal cancer have terrible anxiety related to it. But he took a number of those people and others with cancer that weren't suffering from horrible anxiety, He gave them psychedelics and studied their reactions, not only when they took the drug, but afterwards and for some length of time afterwards and for some until they died. And what he found was that in about 80% of cases, people who were terrified at the fact that they had cancer and they were going to die, they could not deal with it emotionally. About 80% of those people lost their fear.

And they said when they came back from the, and again, I write an example story in my book, you know, people commonly will come down from the peak of the psychedelic experience while they're in the therapist's office because therapists are present for these experiences when they're done in a managed setting. And, you know, after an hour or two. or three they'll come start coming down and they'll take off their headphones with the music and they'll take off their eye shade or blindfold and they'll now say okay i get it thank you and they've lost their fear because what they saw when they were there and this is the same for people who've gone through near-death experiences what they saw revealed to them that there's nothing to be afraid of not only that when you get beyond the body and you see what reality really is and who you really are and come back thinking that was more real than what I experience when I'm in my body.

What you experience is that the whole universe is entirely reasonable. Everything is basically made built out of love, which sounds corny until you actually experience it. You can't, words don't convey the reality of it. And they'll say, you know, I'm totally safe and I never understood. I never realized that. No matter what happens to me, I'm completely safe. And 80% of people have that reaction. And most all people who come back from near death experiences who remember them, a lot of people don't.

But the ones who do, almost all of them lose their fear of death. And in fact, they envy people who have died because what they experienced on the other side was so much more fulfilling and real and loving and accepting and safe than being here in a body, which is not a safe experience once you get to go through both of those. Yeah, it's almost as if, and it's been written about in the literature for as long as you want to look back, is this idea of the divine. Or if you look, I'm a big fan of the medieval mystics. And one of the guests I normally have on my podcast is Dr. David Solomon, who's an expert in, you know, Julian of Norwich and Thomas Aquinas and all of these incredible mystics. And there's a great manuscript called the Cloud of Unknowing. And some of these medieval mystics are explaining this near-death experience through the light or the lens of divinity. And there's almost a conversation happening there.

And the way you explain people coming back and being like, oh, wow, I see what's happening. It's almost as if you get to have communion with something bigger than that. Do you think, like, perhaps if we can let go of our fear of death and embrace this idea that there's something bigger, that we can begin to evolve and have more of a connection with this spiritual nature that could sort of awaken more people. Absolutely. I mean, the answer is, in capital letters, yes. I think you're, I think you're, I think you're exactly right spot on there. I think divinity, God, whatever you want to call it.

I mean, people who come back, people who die and are revived commonly report that they meet with a being that's composed of light. Some of the entities that they meet look like they're still in bodies, but that differs from person to person. I think it amounts to how you're conditioned to see things and people. but most people report that they meet a being who is all-powerful, all-knowing, and many report as they come into contact and enter into a connection with that being that suddenly they know what that being knows. They know everything. Now, anybody who's ever taken psychedelics understands that when you come

back down from that experience, you forget 90% of what you realized when you were there. It's very, very frustrating. And that's just the way, what happens with brains. But I think divinity or God, our concept of God that has come to us through religion stems directly from experiences that visionaries had, either when they were under the influence, of maybe a psychedelic substance back then, or just had that experience spontaneously. Some people, in fact, some of the ancient mystics are known to have had epilepsy, and there's a certain type of temporal lobe epilepsy where people will have exactly these

experiences, you know, mystical, divine experiences. And what happens in that form of epilepsy is that the seizure, originates in a part of the brain that paralyzes the other parts of your brain that are rational and probably serve as a filter to keep you normal and engaged in your life on this earth. Those centers get paralyzed temporarily during the seizure, and they unmask this other experience that may always be there, but we don't get to experience it because the part of the brain that, forms our concept of our self that we're in the midst of all the time as soon as we wake up,

not so much in dreams, but even in dreams that sense of self is kind of preserved. If that sense of self is paralyzed, which is one thing psychedelics do and certain kinds of seizures, we may be seeing and sensing and knowing a reality that's there all the time. And it's just masked or filtered out by that part of the brain that evolved to make sure we succeed on this earth. You know, it's a very practical part of the brain, and it's very domineering. You can't experience anything but that sense of yourself and who you are while you're awake, because if we hadn't evolved that way, we wouldn't have survived. to survive through evolution, assuming you aren't one of those people that thinks the Earth was formed 6,000 years ago, and we didn't really evolve.

I mean, if you're a student of evolution, you know, you understand that we could not have become the species that we are with the ability to understand, predict, control, our environment for better or for worse, without a brain that filtered out all the stuff that would have really distracted us from being in tune with our environment at all times. So any threats that came along, we dealt with them. You know, that part of the brain, what I think we don't realize most of the time, 99.9% of the time is that part of the brain that is ruling our consciousness is a filter. And it's filtering out the rest of reality, which is a greater reality than we can know as long as we're in that mental space that that part of the brain produces. And we think that's us. The joke's on us when we come near the end of life or we have a psychedelic experience

because we discover, wait a second, that's not all there is. And you can, if you do the right kind of meditation, you can hit the edge, at least, of that experience while you're still here. and I think that's time well spent. Yeah. Is that part of the reason why you wrote the book? Was there like a sense of responsibility to tell people about what you've been part of and the things you've noticed? Honestly, the reason I wrote the book, I wanted ever since that third year in medical school, almost 50 years ago, I wanted to write a book. But it's a good thing I didn't because the book that I would have written back then would have been a very,

very angry, upset piece of work. I was so upset at how we treated people who were seriously ill. I got very disillusioned in medical school about our lack of communication. We lacked so many things in medicine, and honestly, in many ways we still do. That really made me angry. I didn't write about that, which was good. I wound up writing a lot of papers and other more academic stuff. But when I got to where I was retired from that work, I thought to myself, okay, it's time to write that book I always wanted to write. And why do I want to write it? I spent a while thinking about it. And to answer your question, the reason why I wound up writing it was I came to understand that there was something about dying, about the end of life, where I could work with people.

and I knew that all the time no matter what, they were okay and they were going to be okay. I just, at some level, I just knew that. And that's a handy feeling to have inside when you're working with somebody who is like in horrible pain or horrible fear or both. Because, you know, when I would, teach hospice staff, I would say, you know, you always have to remember that courage is contagious,

meaning that if you understand that people are always safe, no matter how tormented they feel they are, they are always safe and they're always going to be okay, no matter what happens. And in hospice, believe me, I mean, you're in somebody's home and it's chaos. and screaming and, you know, there are some unbelievably difficult circumstances. And if you can always know somewhere deep inside that, hey, you know what, everyone's going to be okay. All you have to do is feel that and become aware of it. And everyone else calms down because you don't have to say a word and you do not want to lecture people or say anything about this because as soon as you put words to it,

it takes the power of it away. You just want to be it. And if you can be it, it looks like courage. And it is a certain form of courage if you know everything is going to be okay. And people get that you're feeling that without you're saying anything about it. And they begin to catch that kind of courage themselves. And pretty soon you're having a nice conversation instead of a screaming match and things calm down.

So the reason I wrote the book was I didn't understand why I felt that way. And I decided I got to write a book so I can learn myself, because that's what happens when you write a book. I can bring out in the writing what it is that leads me to feel that way. You know, why did I always feel everything was okay? What is that about? And that's where the book came from. and you know i i don't know if i i explained it to myself i don't know if anyone else reading the book can pick it up because it's a very individual thing that that feeling and that experience it's

spiritual but um that's that's why i finally sat down and and spent the time to write the book i'm glad you did and thank you for explaining that on some level and when i hear you explain it It almost sounds like an invitation to a right of passage or an invitation to a ritual on some level. Like when we look to the different traditions, we see that the rituals or the right of passage from some, like an elder passing down wisdom to someone. And you realize that this person who is on the edge of another world has wisdom that a younger generation hasn't even thought of yet. And on some level, like I'm hopeful that we can see a return to that. And I think your book is an invitation to that on some level. Like wouldn't that bridge the gap between this sort of divide we have where we send our elders to a home and our kids to school and then this person goes and works?

What if we had the elders giving this gift of wisdom through a ceremony, like this gift to give through a right of passage? I think that could be a real big bridge. Do you have any hope for that? Yeah, you know, I think that's starting to happen. And I, you know, one thing that has distressed me a little bit is like the baby boomers, my generation. I'm in the vanguard of the baby boomers. You know, people born right after World War II and for a few years after that, it's the biggest cohort, the biggest population group in American history is baby boomers. It's a huge group of people.

And we, baby boomers, are now beginning to die. that this generation is entering a period of what ought to be preparation for the end of life. Does anybody talk about that? No. I mean, I don't hear it widely discussed. It comes up, but it doesn't come up in those terms. It doesn't come up in the way that I think it ought to, which is, you know, the largest population group in American history is about to die.

let's give that a little airtime. What does that mean? I mean, and one thing I think it does mean, and I think this actually is happening, is, you know, we're a knowledge culture for sure. I mean, scientific knowledge and lots of other kinds of knowledge or kind of dominate our culture. But we're starting, I hope, to graduate a little toward being a wisdom culture,

where some of the experience and thought and wisdom that's been developed by people who are now in that age group that's about to depart, some of that wisdom could be imparted, and I think it is by some of us or we're trying to impart it to others, because you don't want to just, you know, you can't take it with you, but you don't want to just, you don't want to just throw. it on the funeral pyre and burn it, I mean, why not, why not talk about it? And I, that is, I didn't think about that actually when I was writing the book. I, I didn't intend to do that, but the book certainly could be part of that movement, you know, to impart some of the things that we've learned so that people can read them and just think about them. To be on, to be on. honest, I don't think my book is for everybody. I have a lot of people who have read it and they'll say,

I found this book really difficult. I have others. Others, one of them happens to be a maternity nurse, who she's retired now, but she's delivered thousands of babies. And she read it cover to cover in a couple of days and said, I felt like I was meditating the whole time I read this book. And it was easy for her. Others will read it and they'll say well you know the stories were great but then you get into the second part and I'm not sure I really get it. It was hard for me

and I think that's the way it is with spirituality and especially with writing about spirituality. I think that's why it's always been a cult. You know the true spiritual message has always been regarded as

a cult meaning it's hidden. It's hidden in the words. It's It's in there somewhere, but God knows how you're ever going to understand it. And I think it really depends on who's reading, the attention they devote to it, and the spirit that they bring to it as they're reading it. I just think it really varies from person to person, which is great. That's the way it, that's the way it is. Yeah.

It's, we're coming up on an hour. Did you need to take a soft break for a moment and then we can get back at it? I'm fine. I've got a cup of coffee here and I'm doing great. Okay, fantastic. I'm glad I, I echo your sentiment with the baby boomers. Like I come from my mom is the oldest of eight and you know, it's interesting to see a lot of the messaging that was given to the baby boomers about he who with the, he who dies with the most toys wins. And there's this idea. idea of people wanting to live forever and this, this sort of explosion in longevity treatments. And, you know, it's, I can't help but shake the fact, like, if you want to live forever,

depart the wisdom you have and you will remain forever in the lives of the people that love you, and you be revered. But I'm not at that age yet. So it's easy for me to say, like, I haven't really faced, okay, this, here I am at 75 or 80 or 69. But I do see this, this sort of, this sort of of running away and it scares me as a generation Xer. I'm like, there's so much wisdom here and I see so many people running for the hills. Like on some level it sees like all these wars and all this political chaos seems to be the echoes of unrealized dreams of a certain class of people. Is that too far out there? No, I don't think that's too far out at all.

I'm probably going to blast. Oh, Ernest Becker won the Pulitzer. a surprise for a book called The Denial of Death. And he had written several books prior to that, but he tried to put everything he knew together in this one book. And it's remarkable. But basically, you can sum it up in one sentence. And it is that all of civilization, all of our achievements basically amount to a rabid,

overwhelming urge to not admit that we're going to die, to not ever think about it, to not ever feel about it, and instead to go out there and instead of being with it, to do and to accomplish. And everything we've accomplished is in response to that mortal terror that we feel when we kind of slow down and realize, say wait a second this isn't going to go on forever what am i what am i doing here you know that that so i i think um you can he did make a good case for the fact that uh that our um fervor

to accomplish and achieve uh may come from a place that we're not really aware of which is you know for some people it's like hey you You know, I got to build a monument here because, you know, when I'm dead, I want people to remember me. Or, you know, I'm going to go out there and make as much money as I can possibly make because then I'll be secure. Someday, these feelings that I have deep down, this insecurity that I have and I don't know where it's coming from, I don't know what it is, but I'm not going to think about it. I'm going to go out there and I'm going to achieve. and like you say the most toys, you know, the biggest IRA, whatever it gives you security.

I think there's a lot to that. And, you know, of course, we don't want to turn off achievement or criticize it. But I think that if it were, if our achieve, if our urge to achieve were tempered, by our awareness that, you know, we're here for a limited time. And we have, yes, we have a job to do, but we may not really know what it's about until we get quiet and go down deep inside and really take a look at who am I and what is my purpose.

Why am I here? You know, am I paying attention to the things that really matter. And it's not until you get really quiet. You can call it meditation if you want or contemplation. That maybe some of those things can get a little clearer. The, you know, the dust or the mud can settle out. And we can get clearer on some of those really important questions.

So, yeah, I do think that there's a lot of sound and fury out there that comes from a little bit desperation that we're not really even aware of and and as far as all the political turmoil and disagreements and hatred and all the other things that are surfacing right now i don't know i i think that there are those who say that we come here in order to work through certain issues that that are fundamental to life on this planet. And being alive here is the only way to work through them, because being alive in a body is the only way. It's so ironic.

Incarnating into a body is the only way to become limited enough that you have to make choices. If you listen to the stories of people who have died and come back can relate their near-death experiences, most of them will talk about how perfect and beautiful and loving that other reality is after death. Well, it's not like that here. Yeah.

And it's, you know, you're compelled to settle down and deal with your life on this planet. You can't not do that or you don't survive. Or you're an outcast. I mean, there are people who don't do that. But they don't get to participate in the back and forth that you get and the conflict and competition. And you don't get to really get deep into the issues that you must work through, not just react to, but work through to the other side when you're a human being here on this planet. And there's something that's very valuable about being compelled to do that if you want to make it at the other end of life and feel like, well, okay, you know, maybe I did what I came here to do.

I mean, maybe I can't ever accomplish everything I came here to do. Maybe nobody does. But I did the best I could do with what I was given. And some of us are given more than others. and how responsible can I be with the gifts that I've been given? You know, and I think that's what people may think about, many of them when they get to the end. And, you know, it might be a decent, you know, interesting exercise to think about that sooner than when you get to the point

where you've got nothing else to face anymore. Yeah, it's, it's, that's fascinating. Because I was just the idea of surrender was on the tip of my tongue and how we can take this idea of surrender and apply it to our lives. But I think you covered that right there very well. Like realizing you're here for a limited time and you have this much left or but isn't it a wonderful gift if you can understand the idea of surrender? Well, let's let's I'm going to, you know, wave that white flag and run away like a child. Are you going to fight? But maybe someone means something different.

Let me talk about a deeper aspect of surrender here for a second. I think there's when you, I mean, if you choose to engage in meditation, which I tried to do for much of my life and failed, it's, I've got the kind of mind where it's very hard to turn it off. It's only late in life that I finally have kind of found ways to get beneath or get deeper than my mind. And, you know, one thing that has helped is my mind, and this is a little bit of a paradox, my mind realized at one point that everything my mind can conceive of is not, really ultimate reality. There's nothing my mind can conceive of that in the ultimate sense is actually real,

because my mind is just reflecting and giving me reactions on what I've experienced in the past and all that. And if you sit for some length of time and just allow whatever thoughts come into your mind to be there and don't fight them, don't try to push them away, don't think to your Oh man, I'm thinking again, oh, geez, how can I shut my, you know, how can I shut this? I mean, you just allow whatever thoughts are there to be in your awareness because your awareness can only hold one thought at a time. That's how it works.

You know, you just look at it and observe it like Vipassana meditation teaches you how to do. But then you go beyond that and you say, okay, this is not real. this thought that I have, no matter how profound or how full of truth or how full of whatever, fear, doesn't matter, this is not it. And it's kind of akin to there's a form of yoga called, I think, Neti Neti or Janana Yoga where it's translated as not this, not that. In other words, whatever it is, that isn't it. Whatever it is, you're looking at or thinking of, that's not it. And you just follow that discipline until your mind finally says, all right, well, if nothing, if none of this stuff is real, I'm just going to go ahead and stop for a while. And then you get a chance to sit in the middle of nothing but just being aware.

You get to experience your own awareness. And it's tricky. I point this out in the book. It tricked me for a long time. If you say to yourself, wow, I'm experiencing being aware, well, you just popped out. You're not experiencing now. You're thinking about it again. So you've got to realize that's not real either, you know, that thought I just had,

that's not real either. And just drop it. And that, going back to that word you just used, surrender, I think that form of letting go is fundamental to all deep spirituality, all spiritual traditions. You know, what Jesus did when he said to his disciples, look, man, I'm not going to be with you forever. You know, my end is coming soon.

you guys, you know, stay awake with me tonight, and none of them could. They all went to sleep. What did he do while he stayed awake all night? He talked about, I'm going to be with my father. Well, that's just what's in the Bible. That's what was translated from the original Aramaic or whatever the language was. And I think what Buddha realized in his 40 days under the Bodhi tree and where he finally got to where Jesus went to on those nights was a place of emptiness because it's only when you

reach that place that you begin to feel the reality that and this is the ultimate irony the reality that physics is now talking about where empty space has a huge energy potential the emptiest vacuum between the galaxies where there's no matter, no energy to speak of. I mean, there's a bit, and it's where reality probably originally came from. There's virtual particles popping into existence and back out of existence all the time. And there's actually very powerful energy density in a complete vacuum. that's the process of creation. Even physics now is telling us that where there is nothing, there is something, always.

There are things popping into existence, and then there are particles of matter and anti-matter, popping into existence and then re-annihilating each other. And this is happening, no matter where you are, it's always going on. And when you're empty, when you're in an empty place and your mind finally stops, in the book I, on purpose, listed a lot of different instances where my mind stopped. And it was only when my mind stopped that I, that I hit a place where I realized, wait a second, when my mind stops, I begin to know who I really am. There's a secret there that you're never going to express fully in words because in that space there aren't any.

There's just emptiness. And yet, it's not really empty. It's not nothing. It's where everything comes from. It's where all our, it's below our unconscious mind or above it, who knows where it is, but it's a place where creation emerges. And it's where our own self emerges. The self that we think we are, that's not who you really are.

Who you really, really are is that place where you're nothing. You are a zero. and Zen Buddhism, it gets pretty close to that. That's the object of their meditation is emptiness. And I think there's really something to that. And as you were saying a few minutes ago, when we're busy in our lives, we are cramming everything we can get into every moment. Where's the emptiness?

Well, it's still there. It's just you don't get to touch it and feel it and be. in it. And talk about healing. I mean, healing, healing is a process where you engage in being in that space as much as you can when you're engaged in a relationship with someone else who's hurting or who needs help in some way. You're in that empty space, leaving yourself out. And then as whatever comes up, you just respond. You don't react. You respond in as deep a way as you can, but as much as you can maintain that emptiness inside yourself, the more, I think, healing you can be, and the more you can heal yourself. That's a place where, that's a place where all healing comes from,

because it's the place where you're really authentically who you actually are. It makes me. It doesn't have to make sense. Don't worry about it. Yeah. It reminds me of death, you know, and people that are close to death get to see the emptiness of the other,

which they get to see for the first time in somebody else. And once you're aware of something, you can't not ever not be aware of it again on some level. Like, broadening up consciousness it's oh i see this thing and the only word to describe it is ineffernable you know what i mean you can't describe it you can sense it you can it's it's life changing at some level yeah you can and and uh the funny what what you i mean you just have to laugh about it but uh when when you find that place i mean for me anyway um i whenever i've had

revelations that really meant something or whenever I found that place, I always have the same reaction. It's like, I already knew this. I already knew this. What was I so exercised about? You know, this has always been here and I already knew it. I just forgot. You know, the most important, most profound realizations that we have, if they're the important, the important, the important ones, you're always going to say to yourself on some level, it might not be consciously, but you're going to have this feeling like, wait a second, I knew this already. Why did I, why did I lose this or what happened to it? Where did it go? Why is it only coming back now? Those are important questions because you can't stay in touch. You can't be in this world

and truly authentically respond to the people and the events that you come upon and stay in that place. I mean, maybe there are saints or maybe Jesus, who know, maybe Buddha could. I don't know, but I find that I cannot stay totally in that place. But, and I think you just touched on this a second ago, once you encounter it, you know, never lose it. It's always there. And you always have, it's easier to find next time. You have some little tendril of your awareness that's connected to it. And I think over time you can strengthen that connection or that passageway or that portal to the place that is real that you can't describe and you can't really ever understand because that's all with your mind. It's just there. And

you just can accept it and you can find it again sometimes it's very difficult i often often have a lot of trouble getting back in touch with it it's i mean but that's just who i am maybe it's because that's so challenging for me um that it's so important to me maybe that's the answer to why i wrote the book i mean uh it was very important to me to understand where does this kind of come from, you know, who am I and why is it so important to me? What is it about that that seems to me to be so critical? Nobody else seems to care about it that much, you know, at least when I was at work in the hospital. So it's a mystery and it's critically important, I think, to encounter it, but it's also one of the hardest things to do when you're here in a body on this planet to do.

And maybe that's part of what's behind the importance of coming here, that it's such a challenge. If you can crack this nut, you're really onto something in this life, I think. Yeah, yeah. it's slippery you catch glimpses of it and i think you're you mentioned earlier that your book's not for everybody but it is for the people maybe it's maybe your book becomes a moment of clarity for someone like the nurse that was delivering babies you know what i mean like our stories serve as that tendril to connect us to those spots for others like it just i can't help but shake the idea of the the non-local consciousness or the connection that happens through stories

like this. Yeah. You know, the stories and the other stuff that's in the book, I, you know, it was so hard for me to write a book because for so long I wanted to write a book that would mean something to people who read it. And that kept me from ever writing a book. I finally had to get, I finally had to get to the place where, and I published it with a small publisher. and we had sort of a support group of fellow authors who were all writing books with this publisher and we would get together online and on Zoom every month or so

and talk about the problems that we were having in writing our books. And somebody said at one point, you know, one of the exercises you do when you write a book is it's helpful to ask yourself, who is my ideal reader? and if you can really get very specific about who that ideal reader is, and for many people it's like a particular person they have in their mind. It might not be a real person, but particular age, particular profession, blah, blah, blah,

you know, somebody very specific, and then they write for that person, and that's how many authors write really good books. They know who their readers are. Somebody said one day, well, you know, maybe your idea, reader is yourself at an earlier age. And a light bulb went on in my head when I heard that because I said to myself, damn, this is like, my book needs to be for that confused kid that I was when I was in medical school when things just blew up for me.

And I, and I, again, it's, it's chapter one in the book. where I really was confused and disillusioned and upset. That's who I'll write the book for. So who knows, if time, maybe time doesn't exist as we know it, and maybe this book, maybe in some sense that'll give comfort to me

when I was back there. And looking back, and there's a story or two in the book about other things that happen to me in my training, who knows, maybe back then I was receiving what I wrote later in my life in the book. You can't ever know if that's true or not. But I can see where, you know, maybe there's a kind of a cycle here that I wasn't aware of at that time. That's, it's mind-blowing to think about.

That's, it was necessary, all of it. It was all necessary. Yeah. You know, I can't. Just a few moments ago, you said, I had to laugh. And you have a wonderful laugh. And I'm curious, what role does a sense of humor have as you approach the end of life? Or when you see people in palliative care, how do you see the role of a sense of humor?

Oh, George. Another really, really good, good question. That's a great question because I've often, Often, I don't know about, certainly not in every case, but because there are some cases where things are really dire and laughing would be really out of line. But in most of the cases where I've been in very tense family meetings where big decisions had to be made about taking somebody off a ventilator or, you know, momentous decisions that you know are going to affect people for the rest of their lives. The last thing you would think is that you'd be wanting to laugh in the middle of one of those meetings. And yet, almost always, there come moments where you can make a comment that's entirely appropriate. And yet it cracks everybody up.

And it actually, I have a couple little sayings that I keep to myself. But one of them is one of our, as human beings, one of our ultimate. spiritual tasks is to crack each other up. Because I think having a sense of humor, maybe it's cosmic humor, I don't know. Yeah. You know, to be able to laugh at the right moment about a very serious situation,

not only is really appropriate, it kind of makes things whole. You know, there is no situation, or very few anyway, that are so heavy and so critical that you can't introduce a comment that is unexpected. I mean, that's what a lot of laughter comes from, something that happens that just came out of left field that nobody ever expected, and it's so out there that it's funny, and yet it makes sense. I mean, and I can't even think of a of an example right now, but it's just happened so often that I think a sense of humor is essential. Because maybe it's part of that, that, you know, contagious

courage we were talking about. If you can, if you can say something that's funny or enough that's just out of line enough or inappropriate enough or out of left field enough to crack somebody up, that means that you are engaged in the situation in a way that's human and that's you got your feet on the ground and you know you're making sense of something that I mean so many of these situations that you meet in and say in the hospital where things are you got to make you know there is no good answer you just you know you got to pick the least bad way to go those situations are so human that it's often really appropriate to round everything out by, you know, just having a laugh about it. Because in a cosmic sense, it's funny. I mean, it may sound weird. But the situation that we're in on this planet and these bodies is hilarious.

in a sense. It's hilarious. And it's if you take it so seriously that you can't laugh, then you're, you've only got one side of yourself involved. So yeah, I think a sense of humor is critical. One of my favorite philosophers that I always go back and listen to is Alan Watts. And I'm reminded of this segment where he talks about, I forgot who he was quoting or what it was, but it was something along the lines of. Once you reach enlightenment, all that's left to do is to have a good laugh.

It's just like this great joke. You know, it just puts everything in perspective on some level. And Dr. Stewart, I feel like we just scratched the surface here. I hope we can come back and have more of these conversations. And I have a lot of ideas that I would like to talk to you about off the air for a moment. And do hang on briefly afterwards.

But before I let you go, where can people find you? What do you have coming up and what are you most excited about? Well, I don't have anything really big and important scheduled right now. I'm really enjoying your podcast. I mean, this is a great one. You have thought through and you're wondering about, I mean, I always feel like, you know, the secret to life or the important things in life, it's not important to find the answer. Because if you think you're, found the answer, that's another thing that's not real, okay? It's out of your, it's out of your mind, and therefore you're out of your mind if you think that you have found the answer, because that's not what this is about. It's about the questions. You know, one question leads to another, and it's through questions that we reach a place that's really important.

And so this has been a great time. talking to you because your questions are fantastic. You know, that you've put your finger on a lot of really important points, not by saying what they are, but by asking the questions. So I really want to thank you for a great, a great event here. Thank you for that. I hope it's the first of many. I really feel like there's some really interesting topics that we could move into. But I want anyone within the sound of our voice, whether you're listening live today, whether you're listening tomorrow or 10 years from today. Go down to the show notes and check out Dr. Stewart's book. It's a cool read. I think that you'll learn a lot from it. And go down to the links and ask some

questions and reach out and let us know what you might want to hear about in a future conversation. So Dr. Stewart, hang on briefly afterwards, but to everybody that's taken a moment to be with us today, thank you. Thank you very much from the bottom of my heart. I hope that you are asking big questions in your life. And I hope that you are willing to understand that laughter plays a good role and that the end of life may be your first step in living your best life. So that's all we got for today, ladies and gentlemen. Have a beautiful day. Aloha.