Speaker 0 00:00:01 Kind of both. I mean, you know, people come in in all different ways. Some, sometimes people come in in a crisis, and, uh, you don't have a lot of time. I think that honestly, it doesn't really take a lot of time. If you're available and you are willing to, um, be vulnerable or to connect with people, those connections happen immediately, very, very rapidly.
Speaker 2 00:00:23 As our parents grow older, it can be difficult to guide them through their golden years, while still respecting their autonomy and fitting it into our already complex lives. Welcome to the Parent Projects Podcast, where our guest share practical wisdom to tackle the issues that impact adult children of aging parents. I'm Tony Sievers. Thanks for joining us today.
Speaker 3 00:00:46 Hey, everybody. Welcome, uh, back this week, uh, we're welcoming back into the show, Dr. Jody Stern, who is becoming a fast friend for me. Uh, we are an unlikely bunch talking about something today that we generally, in our professions don't talk about, and we're, we're, we're trying to kind of compartmentalize and maybe set that away, which is all the more reason why I think where we're gonna go with the conversation's gonna be something interesting. Dr. Sterns, a board certified neurosurgeon. Uh, he's an inventor. He is a published author. We're gonna talk a little bit about his book. Grief Connects Us, which is an amazing, amazing, um, uncovering in a, in a story of his own journey, uh, about his losses and how he saw that from the eyes of a trained physician and what that looks like. So, welcome us in, uh, or I'm gonna welcome him back in, uh, Dr. Stern. Jody, how are you today?
Speaker 0 00:01:39 I'm very well, Tony. Thanks. Thanks a lot for having me. Well, it's great to be
Speaker 3 00:01:42 Here. It, it is awesome to always have you back onto the show. You are, um, you're, you're brilliant in your capabilities to harness some challenging situations, uh, from your personal life. Be able to put that perspective from what you learned professionally in that, and you communicate it really clearly down to folks. So, I'm excited to get to, to dig into a bit of this challenge when people are, are talking of families that have grief and how they start working their way through it. So, thanks for breaking that down.
Speaker 0 00:02:13 It's, it's really a pleasure. I'll, I'll tell you, I kind of, um, this wasn't an intentional journey, you know, and I think maybe you'd say the same, which is I, um, came to this, uh, through, uh, illness and loss in my own life. First, my, uh, younger sister Victoria, uh, had, uh, developed leukemia, a very aggressive kind of leukemia. When she was 52, I was 54, and then she had a bone marrow transplant, uh, which her son was the donor for. And then, uh, she died less than a year later, and she wrote a journal of her illness. She said she wanted it to be a one act play of surviving leukemia. Instead, it became a testament for, uh, her, uh, dealing with illness and, and what she had to go through. And so I wrote, uh, uh, a book incorporating her journal. Then while I was still writing it, her husband, a year and a half later, uh, pat died of a ruptured aneurysm in his brain, and he was in a coma for a week.
Speaker 0 00:03:11 And I had to put off my neurosurgeon hat and become a family member, but it was a neurosurgical catastrophe. So I knew everything really well, but from a very different perspective. Ah, and then we had to let him, um, uh, go and, um, orphaning their two children. And it was such a devastating experience. Far, far more for them than for me. But it was so profoundly shaking. And, uh, so I, I kind of felt compelled to write this book. And one of the things that I learned was that this experience that I went through is not unique. It was just my experience. But everybody has similar painful journeys. They go through, uh, horrible losses. We all tend to, uh, try to deal with grief. I, um, interviewed in the book, uh, physicians and patients, and talked with them about their own experiences, and they gave me strength and a feeling of, uh, that I wasn't isolated.
Speaker 0 00:04:08 I wasn't alone. That we all have a similar language, that we, we are connected. And then in the, uh, latter part of the book, I tried to put forward some ideas of how we could do a better job as, uh, health systems, uh, how we can be kinder to each other, kinder to ourselves, more supportive, uh, and, and, uh, that compassion really needs to be the foundation of what we do as, as in medicine and, and in caring for other patients and people. Um, and after that, I went and, and, uh, got training in palliative medicine to get a better idea of what, you know, learn the skills that I was advocating for. So it's been a real life altering life, uh, changing journey for me. Uh, and we talked before, um, about how, you know, I wouldn't, I I, it was awful. And I, I wish it had never happened, and yet it has taken, these experiences have taken me to a place that I, um, I I'm, I'm a better person or a different person having gone through them.
Speaker 3 00:05:08 Well, and you have that, you, you, you thrive in that and help other other folks thrive in that, because you have a perspective that allowed you that need, you know, allowed you to see what needed to be shared. I think for a lot of people, including, including myself, uh, you know, there is the, the military aspect where we came through. I, you know, one thing that that really resonates in hearing your story, and I can't help but, you know, draw somewhat, uh, of, of similarities in how prof, just from a a matter of professionally, I was trained classically to work one way for an emotional survival. And I had a, a bump in the road, honestly, with, with a little bit of law enforcement that led me to understand this was even important. And I say a bump in the road, because I don't think that was part of the whole training plan for the military get go.
Speaker 3 00:05:55 That that wasn't, that wouldn't have have been where it was going to go, but it just, man, it wouldn't leave me. Once I had learned it and I had heard it, then it just kind of buzzed around and it stuck out there. Um, it was itself something that, that, you know, I, it, it wasn't something I would've seen as a great success of my life. It was like this little side quest. Uh, and, and I didn't know that I understood the value of that until later when I ended up having, you know, and I lost my sister. We've talked about that last year, coming up on a year now, this month. And in that, that may be one of the, truly one of the first times that I could not only working through and, and counseling maybe a the family of a, of a fallen soldier or some other group of per, you know, persons.
Speaker 3 00:06:42 There was someone at the end of life. Now, I'd had family members die at natural end of life. But just the shock and awe left behind her adult children that she left behind as well of, you know, 18 and 22. Man, these are big shifts of things that led me to just sit back and go, okay, well, what do I, what do I think I understand about what this is doing to me? What's the impact on me as I'm coming through? And I guess maybe one of the first things, uh, to dive into as we set this up outside of knowing where we both kind of come from and that we've decided we're gonna have this conversation regardless, um, is situational awareness. You know, what's the maybe maybe laying kind of some of the grounding of, of some concepts that you learned throughout your experience or you see out there, you know, what are, what is, what is grief? Is this just a thing that happens to us every time? You know, it's just gonna pop up every time something bad happens. Is it something that sits out there? And underlying what, what have you learned from your experiences that, that we should be thinking about there?
Speaker 0 00:07:43 Well, uh, first of all, you know, grief can be really bad, catastrophic things like people dying, um, you know, loved ones, um, losing loved ones. But I think to a degree, we, we deal with grief on a regular basis in our lives, you know, whether it's disappointments or losses. And we all have, uh, this is sort of what creates the color in our life. This is what, uh, you know, we talked about, well, is this cause sadness or cause joy? The truth is, grief is what allows us to experience joy, you know, and, and successfully moving through grief or allowing ourselves to experience it. A lot of times we tend to try to cover it up, you know, bury it and say, you know, I'm gonna go through this, um, cat catastrophic event. You know, for me it's, you know, a patient dies, or, and for you, we talked about, you know, soldier falls.
Speaker 0 00:08:34 You've still gotta go through the, the, the action. You can't step back and, and, and allow yourself to experience it. But if you don't experience it, if you don't allow yourself to, uh, get through it and to incorporate it, to integrate it into yourself, then you, you, you sort of damage yourself. You create these, um, these walled off areas of yourself. And if you never really work through the grief that we go through, it's actually, I think it's very toxic, and it's very, it's very unhealthy and unhelpful. So, one of the things I think that I wanted to establish in this book is that, you know, I have gone through grief. I've had some training as a physician, I understand some about disease. I've really not had enough training in terms of managing grief and, and going through it, you know, personally and how to, how to, how to incorporate it in my life.
Speaker 0 00:09:23 And I think that's one of the things that we need to do a better job in medical education. Mm-hmm. <affirmative>. But when patients are coming to me, or when people are, you know, experiencing loss or are afraid and feel alone and feel unsupported, and that they, they, that they, that this is a very isolating experience. I think it's really important to kind of hold their hand and to realize, and to, and to bring them in and say, you know, I understand what you're going through. I've been through something like this. You know, and you don't need to go through your own story. But it, knowing that, that I have gone through this, that I have, that I have an understanding of what other people are going through, I think is a powerful, uh, healing part of being a doctor, and also being a, a decent human being.
Speaker 0 00:10:10 And we, we talked before about how we need to have a lot more kindness for each other, kindness for we're all suffering. Uh, we all are going through these losses. And, uh, we're all fearful. I mean, ultimately, we're talking a lot about we caring for parents who are aging, but then behind them, there's us. And you look and you go, I'm seeing things I don't really like. And I know, like, I'm looking at my hair and saying, it's going away. <laugh>, you know, <laugh>, I'm getting older, and these are inevitable. We're all going to, we're all going to, uh, get sick. We're all going to die. Right? We need to support each other. We need to be kind to each other. And, and, and we need to connect with each other. And so, I think one of the things we als also talked about is that we also need to prepare.
Speaker 0 00:10:57 So when wet, uh, are facing mortal illness or, or, you know, loss of capabilities, that's the time we need to start talking with our loved ones about what's going on and about what we want and what we want, how we want to be cared for. And having these conversations. 'cause there's a lot of times that our tendency is to be afraid to pull back, to put on a, you know, a, a, a wall, the armor, the emotional armor we talked about. Right? And I think you have to put that down. I don't think it really helps. Uh, and in the short term, yes, if you're in a battlefield, you can't, you know, uh, fall apart. But if you, if you never fall apart, uh, then you really never, uh, get through it.
Speaker 3 00:11:36 Well, and the reason I,
Speaker 0 00:11:37 I'm, I'm, I, I wanna ask you, is that sound right? 'cause you're, you're the guy who's gone through
Speaker 3 00:11:42 That. Yeah. You, you know, I, I would say you don't ever not fall down from that. There's just, it's just a matter of, um, man, there's some other, other phrases that I've heard. Uh, you know, maybe in, when you're dealing with a, with a parent project sometimes, or if you're professionally guiding a family through something, one common saying is, if you don't know where the family's get involved, gonna get involved, you probably won't, like where the family's gonna get involved for your project. Grief works a lot like that. It is a i and I think you just laid a good groundwork against it. It, it is a, it's just a real thing because it's a part of, it's not just a massive loss of somebody falling down there. It could be a fact of you got, uh, command you weren't expecting off of that. You are a part away from your family.
Speaker 3 00:12:26 You are watching two soldiers make a mistake and something that they're doing. And, and it's just really disappointing to watch that thing happen within their life. Or, you know, like grief comes from disappointments and letdowns at some side. There's, there's different levels of where those things are at, but they all come into play. And, and, and so I would say you, you're right. You have to, there's a tactical mission that needs to be accomplished. And, and compartmentalization can provide for that in a military perspective. It can tell us, okay, until this is complete, that's where that is. But as soon as you've completed, the closest thing we, we, we really had was, um, you complete and you have actions on the objective. Once you get to what your objective are, it is you, you complete these things that needed to be done, gather what needs to be gathered, make that assessment from that all.
Speaker 3 00:13:15 Then you package all of that up, and you move on to what the next thing is, and you reconstitute. First thing you need, you park all your vehicles back in, you gas everything back up. You put new ammunition with it, and you set yourself up back everything in so that you are prepared to go immediately again, when you're called back on part of reconstitution is allowing, like that steam to blow out, or where this, this pressure release valve. I, you know, I, I don't, I don't talk about this a lot, but one thing that really concerned me a lot in, uh, in, in Iraq in particular, was I remember coming off, we'd, we'd come off and, um, you know, out, out of, out of moving someplace or, or have some challenges, you come put the trucks away and everybody would head down, uh, in what was really common at that point in time.
Speaker 3 00:14:00 They'd play video games. They'd, they'd go down and they'd have a big television, and they'd jump into a Call of Duty, and they'd run the same route that we just ran. Wow. And they'd be doing it on the video game, like within 20 minutes of coming off and having a significant emotional event happening off of that. Right. And you're, I remember walking past the room and being like, man, this <laugh>, we're gonna have to unpack this someplace because I don't know. And maybe that is unpacking that, right? That's allowing them to slow down for that moment, because at the moment, you weren't allowed to process where that was. And that gives 'em that opportunity to do that. So, uh, I think that, that, that grief is, if you're really taking, we call situational awareness in the military. If you're being situationally aware of what you're walking into, whether it's a pair project or it's a surgery, maybe, or, or, you know, a mission or, or, or a small tactical mission you're working through, uh, you've gotta have that awareness of what's going on with everyone around you. And what I love what you said here was that, that touch of connections, what can come out of some of that connection, kindness is a great way to start a connection. Um, mercy is a great way to start a connection, authenticity. Mm-hmm. <affirmative>, it's a phenomenal way to start a connection, particularly when emotions are raw and tingling. I found in, in, you know, in my career and in life. Um, I, does that resonate with you, or is that with your experiences?
Speaker 0 00:15:29 Absolutely. Absolutely. And I, I, the other thing I think, um, this is one of the things that I also was have been writing about, is that we really, as physicians are not really trained in how to manage these things. And, you know, one of the things I was advocating for is emotional agility, which is you have to be able to flex between a lot of different experiences, and you have to have contradictory things occurring at the same time, you know? And so for me, I have, I have the, uh, battle readiness, you know, that I go and do a, uh, an intense surgery, and I have to be very focused. I also have to be emotionally connected to that patient and the family and navigate those things. So I think that takes a lot of training. I also think that takes that people who can do that are ultimately the doctors or the people you want to be with, because they're, they're, they are, I guess you'd say, they are the leaders.
Speaker 0 00:16:17 They're, they're, if you, if you deal with people who get kind of, uh, sidetracked with, um, distractions and don't master those areas, you know, I don't think you can really do a good job if you're never emotionally available to a patient. Um, but also, if you're only emotionally available, you gotta walk the line. You gotta be able to have all of those skills. So I think it, it's a real challenge, but ultimately, if you're able to do that, I think that's where you find, um, joy satisfaction. Um, and, and real meaning, you know, and when I look on my career and I look at, it's not, it's not the, um, the really crazy technical surgeries that I have done that stand out for me. It's the people that I have helped and kind of held their hand and walked them through illness or been available to them. And it's those, it's those, um, meaningful relationships and connections that I most value and that really, that really stand out for me.
Speaker 3 00:17:17 Do does a lot of those connections in those interactions that stand out in your mind, were they, um, were they opportunities to connect prior to an inciting event of the surgery? Or would you say maybe afterwards? Uh,
Speaker 0 00:17:31 Kind of both. I mean, you know, people come in in all different ways. Some, sometimes people come in a crisis and, uh, you don't have a lot of time. I think that, honestly, it doesn't really take a lot of time. If you're available and you are willing to, um, be vulnerable or to connect with people, those connections happen immediately, very, very rapidly. But then some of the things that have just, you know, uh, I remember, uh, there, there was a guy, he had a, a hemorrhage in his brain was about to die. Um, we did surgery on his brain, and he, he came back, um, uh, to my office, like months. We really thought he was gonna die. He came back months later, um, walking, talking, you know, not fully recovered, but so much better. And just to be a part of that, or to be able to kind of, uh, witness that, that was, that's so powerful.
Speaker 0 00:18:20 So I guess that's not a, uh, maybe it's a grief that, um, uh, there's grief and loss, you know, for him, he had, uh, loss of capabilities and wasn't able to go back to his job that he used to do. Right. But at the same time, he had, he had his life and, and he had his family. And so I, I think that in, in dealing with grief and loss, there's also, um, there can be, um, some, uh, maybe some peace or maybe some, um, acceptance. Some, uh, you know, maybe a new beginning, you know? So there's, there's a lot of, like, for example, we talked before. Yeah. So I, um, yeah. I have had personally so, uh, had an injury to my arm, to my dominant arm where I've had to stop doing surgery. Right. And that has been a huge loss for me. Uh, but it's also, and so I would say I've experienced grief in, in, in dealing with that. And yet having kind of worked through that, it is now a tremendous opportunity. You know, I'm sitting here talking with you. I'm writing books, I'm, I am exploring, I think, ways that we need to change or, or do things differently. And I think that has meaning and value. So, so when one door closes, maybe another one can open.
Speaker 3 00:19:36 So when, and I, I think more than just open, uh, one thing that I, I, I take that a step further and state that every door closing has shaped me moving into the direction I, like, literally, uh, needed to move within mm-hmm. <affirmative>, a hundred percent, a hundred percent of what's happened to me is what's formed my ability to tackle what's in front of me. Um, and, and one of those things changing would've dramatically impacted that. Mm-hmm. <affirmative>. And so, in, in finding that value, I mean, we've, we've talked, uh, previously having an understanding of purpose behind things. I think there's, there's this, I wish I could remember exactly who said it, but it's something along the lines of when people understand why they can deal with a whole lot of how, or something mm-hmm. <affirmative> Sure. Right. Into those, into those areas, um, that, that why seems to be something that's like carved into the heart of mankind, <laugh> of constantly.
Speaker 3 00:20:33 Where would that sit? Where would that come from? And what I've noticed in, in, in my experiences in life, and then now over into the parent project stuff, is those that have come to understand a why someplace or have come, become comfortable with that some level of, of transubstantiation is, or some level of higher power, or mm-hmm. <affirmative>, or that, whether it's they, they believe in a God, or they believe in just something that's bigger out there, that there's gonna be a purpose maybe allowed them to, to find that path of, of hope in, uh, in suffering or something from that standpoint. Uh, how does that, how, how does seeing, how, how does something like that play out with what you've seen?
Speaker 0 00:21:11 Well, I think that, um, there's a definitely a spiritual component of all of these, um, experiences. And I think that some people who have faith or who have, um, belief also seemed to have a lot of, um, uh, get to acceptance, maybe EAs more easily. But I think that it's not a prerequisite. You don't have to have a, a a, uh, established religion. I think that you can, um, recognizing that, uh, there are forces greater than yourself, right? Recognizing that we're bigger than just merely being, uh, individuals, um, connecting with each other. And I think, um, walking with each other, uh, recognizing that we are, um, there's a, we're in a world that's bigger than just ourselves, I think allows me to get to a, a level of peace and acceptance that I find reassuring.
Speaker 3 00:22:06 Yeah. And, and so working, you know, here's, you were talking about connecting with families before and, and, and, and after surgery and things, I, one thing that came to to mind asking these conversations is they may unfold for you. I, I, I've had a couple of surgeries now, uh, never a brain surgery. Uh, but about how long, from the moment in which you are tactically doing, I'm gonna use the word tactically, but you're doing the surgery, you're in that moment and working from what that is, where maybe you've, you're at the height of compartmentalization to stay focused and what it is, how long, generally is it before you then have to go have some level of com some conversation with somebody that is with, you know, that follow-up conversation? We see, I, I, I've been on the table. I haven't been standing out in that waiting room, but I know my, my wife had said someone could, you know, a surgeon came right out afterwards and talked. That seems like it's a pretty, like, expected to be a pretty quick gap of time for you to, you mean
Speaker 0 00:23:04 Switching, flexing from one, from one role to the other? It's,
Speaker 3 00:23:08 I mean, yeah. With, well, and it's interesting. You see, you, you even say one role to the other because reality is like, we, the, the family's not seeing it that way. Right? Right. It's just seen as it's the role that's, that's, that's the expectation of you. So what does, how long does of time does that, is that, is that really that quick of a training? I mean, it's like, you completely,
Speaker 0 00:23:26 Well, I mean, in, in a brain surgery, they can take hours, they can be, um, fairly, uh, short. Um, usually a brain surgery is at least a few hours. Okay. Um, but, you know, then you have to do a lot of routine tasks like, you know, um, dictate, uh, write notes, check a patient afterwards, then go, you know, it's at least a half hour or so before you go and talk to a family member. Okay. But it's more, it's more, I think it's less amount of time and more kind of, um, psychological space, you know, being, um, being able, uh, I, I think I talked about this in, in my book and in, in an article, but I, when I, uh, when I was training, I went out and talked with a family member after a brain, a really complicated brain surgery. And I kind of missed the opportunity to, to speak honestly, about what was going on, because it was a pretty devastating, um, tumor.
Speaker 0 00:24:15 And I always felt, uh, badly about that because I really didn't allow myself to be, you know, honest and, and, um, and, um, uh, really explain what was going on later after I went through with my sister and brother-in-law, that really changed. And, and I think maybe it's some emotional maturity. Maybe it's some age, maybe it's, you know, having some losses myself, but I'm much more comfortable sitting down, talking, holding hands, you know, saying really what's going on or what, what, what this all means. Yeah. Um, but it's daunting to step into that, um, reality and, and be vulnerable and be honest and connect with people. But it's important. It's, it's kind of it, if you don't do it, it really sticks with you. And if you do do it, you can make a huge difference, almost as much as, as the technical part of taking on a tumor.
Speaker 3 00:25:08 Yeah. Well, it, it, and I agree even from the other side, being able to walk through and, and process those other people that are impacted, you know, long term, I, I have been, I've stood on the, well, yeah. I've, I've stood on the tarmac at that backside as a somebody's come home Right. And sat with the, with the family, uh, and escorted through that, that week, um, at a ver at a very personal connection. Right. To understand what that feels like and how it works. And, and that opportunity where you touch in, um, I, I, I wanna kind of jump back. My mind was, was thinking back, I, I'm always looking for these great opportunities in which we can take time to step back and prepare ourselves or, or better, like, where can we change direction if we're moving in the wrong direction? Or where can we give ourselves a good opportunity to, to put better practices in play?
Speaker 3 00:25:58 You talk about, um, when you come outta surgery, you then go through, you have some transcription that happens. You're making your notes, you're working off of that in a very similar way. When we come on, as soon as you come off the trail, you're immediately as, as an officer, I'm sitting down and I'm processing, I'm filing my reports, this is what I walked through. Same thing in law enforcement. Right. As soon as you've been through that, you sit down, you walk through, you write your reports, you get out a lot of stuff. You're actually trained also at that time to, to know, like with formal training that, um, you have to process that in a very deliberate way. Because if you received, or you walked into that maybe you're responding to a, an accident or a car accident or, or, or a loss, your brain is going to perceive things very differently mm-hmm.
Speaker 3 00:26:45 <affirmative> in the first couple of moments. And it might actually remember things a little bit differently over Sure. Different prolonged. Okay. I'm glad that makes sense to you because Sure, sure. Other than just hearing it told to us and then living through it and experiencing and going, oh my gosh, I literally remember this differently the first 15 minutes than I did the next 15 minutes after that. Sure, sure. And then even the next day as I came back, I'm like, oh, it's like that, that this other color come in. Kind of came into that. I digress. Mm-hmm. <affirmative>, uh, that moment though, we both have that moment that's built into the schedule after ex going through something where maybe grief could happen or where something trauma difficult has happened, um, in high intensity to process mm-hmm. <affirmative>, could we build something into that time? Does that, is it maybe as soon as you've, you've seen, or you've, you've recognized that that event has happened and you are working with somebody that may be in grief, giving your space that time to, to pop out and to begin processing it at your own level instead of running right into trying to process.
Speaker 3 00:27:52 Is there, is there something in there? I'm thinking there might be a, a nugget of Well,
Speaker 0 00:27:55 Well, I think, you know, um, my, um, son is in medical school right now, and, um, he is, uh, and, uh, I've talked to a number of medical students. I, I, um, um, teach them in the medical humanities, um, program at, uh, university of North Carolina, chapel Hill. And, um, they have described how, you know, they're like the first death that they've, uh, encountered. There really wasn't time or a built-in, um, moment to process or to help people process it. And if you're a doctor, and you may have done this for 20 years, that may not be disruptive to you 'cause you've gone through this a lot, but it can be terribly traumatic or disruptive for a student. So we need to really build in some, um, time to process, time to adapt, time to kind of work through what's happened. And I think if we don't, uh, if we don't allow ourselves to do that, we really, it really is a disservice.
Speaker 0 00:28:59 And I think the, the message to the student is kind of, I gotta get my act together. I gotta put the wall back up. I got more to do. You get the same thing in the military, you know, I've gotta go out and run another mission, and you try to push that stuff away, and it doesn't go away, you know? So I think that part of, uh, managing grief is giving it its time. Allowing ourselves that time to kind of think things through, to process them. I have found, uh, writing to be really helpful, uh, and taking the time to think, think things through. Um, if you don't do that, and if you don't allow yourself the time to kind of go through those, there's no, there's no way to finesse it. There's no way to kind of just, um, avoid it or somehow, you know, push it away and pretend it didn't happen. I, that I think, think is very damaging.
Speaker 3 00:29:42 Yeah. Well, and, and I think, uh, it being pragmatic, I think many people will come into where they discover that there's a, this big situation that's gonna cause grief to work from that. And chances are, they're very quickly going to have something else to have to deal with. Mm-hmm. <affirmative>. Um, and so they're not gonna get to fully process off of that. I, I love the journaling idea. I stink at writing. I wish I, I really want to fact, if I could pick what I would do in the world, I, I would write, I, I, I love the idea of it. I just can't do it. But, uh, I record, you're
Speaker 0 00:30:15 Doing a, you're doing a podcast. I,
Speaker 3 00:30:16 I know I've learned, I
Speaker 0 00:30:17 Can record. You found your, you find, you find your path, <laugh>.
Speaker 3 00:30:21 Yeah.
Speaker 0 00:30:21 And I, the other thing, I think the other thing I think is interesting is that I, is that there, a lot of these things are not really linear. Right. You know, you don't have, you don't have, um, a grief moment, you know, an intense moment, get through the grief, then you're onto the next. And, you know, like if you take X amount of time, it'll all be fine. Uh, we experience and re relive our grief over and over again. Right. And I, I feel that a lot of times, the hurts or the damage or the things that we never really kind of got through or process, they keep coming back, you know? Um, and, and so, uh, <laugh>, you know, one of the things that, um, I learned from that experience with that, uh, family that I felt I didn't do a good job is, is I, I didn't get a do over with that family, but I, I had a chance to do it Right. Um, the next time, you know, so, so I feel like, you know, this is all part of life. Learning how to, how to go through these experiences, managing them, and then, and then growing from them and, and realizing that they're gonna come back and they'll, they'll revisit themselves. Um, and that all, you know, just by being available, by being, um, open, uh, and supportive and humble, maybe, I think it's, it, it is, it is really powerful, really helpful.
Speaker 3 00:31:38 I, yeah. I, I, I think you're, um, more, more than helpful. I think it, it, it's, it's something that is you, in some levels, you'll have a responsibility if you feel compelled to lead someone through a situation, um, or you've got that level of responsibility here. I think you have to build in some protection for yourself that makes you at least take stock of, okay, so, so now it's, I can't deal with this right now. Chances are it's gonna impact me someplace. Where's it gonna impact me? Keeping your eyes open to it. I wanna, um, you know, when we come back, uh, we're gonna, we're gonna take a quick commercial break, and when we come back, uh, we we're, we're gonna continue our conversation with Dr. Jody Stern. We're talking about working with people in grief. Um, and, and again, when we come off of that, let's talk about preparing, having these discussions sooner than later. Preparing yourself to come into that, uh, here on the Parent Projects podcast, stay tuned. We'll be right back.
Speaker 4 00:32:42 Hello, my name is Joseph Stern. I'm a neurosurgeon and author of Grief Connects Us. My book Bridges the gap between patients and their doctors, and invites us to open our hearts and improve our communication and gain mutual understanding and appreciation. If you're going through your own grief, or if you're a family member of someone who has died and are grieving, or if you're facing illness yourself, or wanting to plan for your future, instead of reacting after the fact, then this book is for you. If you are a medical student or nursing student, or a physician or nurse, this book is for you. I provide readers with tools to enable them to get through their own grief and to grow in the process.
Speaker 3 00:33:49 And welcome back again. This week we're sitting down with Dr. Jody Stern. We're talking about working with people in grief. Uh, Dr. Stern, you've, um, you, you've, obviously, you've written the book on it. You are, uh, you're brilliant. You are literally a brain surgeon as it comes up. The, the humility with which you tackle grief is commendable. And I'm not just throwing that up to butter you up for this one. Um, one thing you've made really clear when you and I have talked before is it's important to talk about the processing and preparing ahead of time if you can, if you can prepare for the conversations you're gonna go into. I mean, we, we, we talked about maybe even, are there ways we can do that in these little gaps or windows between major events and discussing them to, to prep for that conversation, um, in, in preparing for a discussion, what's something that helps you prepare for a difficult discussion that you're gonna have with somebody?
Speaker 0 00:34:47 Well, first, I, I think I, I kind of reach out to your audience, uh, because, you know, I'm thinking about a lot of people who are struggling with, you know, um, logistics of aging parents and having to downsize or having to, you know, change their, um, living situation. There's so many big, um, kind of frightening topics that are kind of looming out there. And I think that it's, um, it's scary to bring them up. It's scary to kind of lean right into them and say, you know, let's talk about this and let's, you know, talk about, um, what you, your, your death, how, how your death, what your death might look like, or what you want, what you value, you know, um, your funeral, your, uh, living will. All these things. You know, the fact is, if, and it's, while it's scary to do that, it is really scarier to not do it.
Speaker 0 00:35:41 Um, and by kind of passing the buck or just sort of saying, I'm not gonna do it. We lose an opportunity to kind of make, um, a big difference and to, uh, take the, have some courage, you know, to plan and to discuss those things. I will tell you that the difference between patients and family members who have living wills and advanced directives and have talked about all these things and, and those who have not, is really huge in, you know, I think in our country it's about 30% of people that have actually done this. So a lot of your audience, you know, um, it's really worth it, uh, for them. And, you know, it's one of these things that we say, kind of leaning into a difficult situation, or, or, or being emotionally honest or available. I, it's scary to do it. I'm so glad every time I do it, if I don't do it, I feel bad.
Speaker 0 00:36:33 And I think this is the same. I mean, and I'll tell you also, you know, I've got an aging, uh, aging parents. I face this, it's really hard. Um, but ultimately it's very rewarding. And also it's very comforting. So I think that when you've had these discussions and we've gone through the trouble of having the documentation and the kind of, you know, really discussed all these topics, you know, um, it actually, it actually takes a load off. So it's, it's, you think that kind of going into it is, is, is, um, scary and, you know, upsetting, but the reality is, it is a little upsetting upfront. It's a whole lot of relief for everybody down the road. And I also think the other thing is that if you, if you do that with your parent, uh, you're also in a position to do that for yourself, you know?
Speaker 0 00:37:22 And I think that's hugely important too. You know, so as I am dealing with, uh, aging parents, I, I recognize, I, I don't wanna beat this into the ground 'cause I said this before, but I, I recognize I'm kind of next in line. You know, I'm, you're kind of filling into that, you're stepping into that spot. All of these things. I do not wanna burden my kids with having to make these decisions. You know, when Pat was in the coma, he had a living will, but he was locked in a safe deposit box, and so we couldn't get access to it. So we had to make all these, uh, decisions, uh, almost blind. And it would've been so much easier if that had been out there, um, and available to us. So I think that really, we owe it to ourselves. We owe it to our family members.
Speaker 0 00:38:06 We owe it, uh, to our kids to have these discussions to do, to make these plans, to take the initiative. Um, and ultimately, I would just say that when it's, it's hard to kind of take on lib, uh, deliberately take on discomfort, disquiet, um, you feel ill at ease. You're asking questions that are awkward. It's painful, it's upsetting. It may cause tears. But, you know, not having the discussion is not going to prevent what's coming, because we are all aging. We are all going to die, and we should all prepare. And then I think it's a whole lot easier if we have this awareness and this preparation. It's a, it's a, it's a gift to the medical team that's taking care of your family member because they're, they have some support, they have some guidelines. Um, it's a whole lot easier for that person. And the trouble is, you know, was, uh, interesting for me, I mean, I, interesting is probably not the right word, but it was my sister, when she, uh, was dying, she, her bone marrow transplant, uh, didn't take, and her platelet count dropped and her cancer came back.
Speaker 0 00:39:19 But she was conscious, uh, throughout the whole time. Then she had a cardiac arrest and, and died kind of suddenly. But she was able to kind of, uh, steer things along. The problem was she wasn't willing to talk about the idea that she might die. She thought that if she was gonna die, um, if she said that it was gonna make it happen. So she missed that opportunity to say goodbye to her kids and to, and to make some plans. And I think that was, that was sad and very difficult. My, uh, brother-in-law had the opposite where he was healthy and then had a hemorrhage, and he was in a coma, and he never woke up. So we, you know, we didn't have the opportunity to talk to him about what was going on. We had to make decisions for him. And, and I think it's really hard if you are a family member, to take, when, when people have to make those decisions, they have to make the decision that says, not what I want.
Speaker 0 00:40:14 Right? I don't want my loved one to die. It's what I'm representing this person's interests. Right. Right. So that's a very selfless and difficult position to put yourself in where you say, well, I want you to stick around, but I think it wouldn't be fair for you to continue in, in what may be a, you know, hopeless, uh, situation and let you go. But it's a whole lot easier if you have some of that grounding, and you've had those discussions. And, and, and we are able to, to make decisions. 'cause a lot of times, a lot of the treatments in the in-hospital deaths are not really, um, they're not ideal. You know, they can be, uh, prolonged. There can be, you really want to kind of, um, minimize suffering as much as possible. And it's, so it's really helpful to have those conversations in advance when you can, you know, and you talk about, uh, people with dementia, right.
Speaker 0 00:41:09 You know, if you, if you wait too long, you really can't have those discussions, you know? Right. And, and it's very hard for me as a, a surgeon, I saw this just all the time. You know, people come in, in the middle of the night with a hemorrhage in their brain and no family around and no guidance. And I have to make decisions with limited information. And then you say, well, if the person was in a nursing home and they were not, you know, really independent, you know, the, the default position may be, I've gotta do the surgery. 'cause if I don't do the surgery, then they're gonna die. But if I do the surgery, am I really doing that person or that family a favor? You know, putting them back in a maybe more debilitated state. And I don't, I don't have the ability to make all those decisions myself without guidance. And it's one thing if you have, you know, it all spelled out or people have had these discussions, so they already have gone through these things and have made those decisions. It's very different if it happens at three in the morning and it's a crisis and you have no time to, um, to, you know, reflect or to have a, you know, kind of considered conversation. Yeah. Would, I would say that people need to just kind of jump in and be willing to do this.
Speaker 3 00:42:21 Uh, the, the other is that sometimes that is, especially, you know, maybe in dementia or something like that, it's a long goodbye. Mm-hmm. <affirmative>, there is a prolonged period of grief that you're working through. And so you might be dealing with that very quick decision. You're, you're in such a rhythm of this long rhythm where it sits, and then all of a sudden there's this inciting incident that happens.
Speaker 0 00:42:40 Right. Right. That
Speaker 3 00:42:41 Demands attention and focus against all these other things that have happened. And it is, it is not the best time to depend on memory. Sure, sure. It's not the best time to work from that. Right. And so that preparation,
Speaker 0 00:42:53 You know, if someone, someone is losing their faculties, you know, the time to talk about that is as soon as possible, you know, as soon as possible. Because, because you don't know what's coming and you don't know what, how much capacity they'll have or how much they'll be able to understand things. Yeah. Yeah. And it's really hard. I think one of the things that I think is really difficult is if you don't have these discussions, then you carry a burden of guilt, um, of, well, I made a decision, but maybe it was the wrong one. And, um, you know, I wish I hadn't done this. Or, you know, what, if things had been done, it had been different. And I think people are very afraid of, of making the wrong choice and feeling guilty or, or, or responsible. And I think so, so having these discussions and having these, um, advanced directives takes a, takes some of the burden off. Yeah. You know, it's all, you've, you've gone through this. The person has said what they want or what they would want, what they would wish for.
Speaker 3 00:43:53 And, and I think sometimes that, that difficulty. So we, we, we look at, um, we look at what I've, I, I'm a military guy, I like acronyms, right? So all of the issues or these, uh, these, these taught these issues that tend to drive or make it difficult. If I'm having, if you're having a hard time having this conversation outta a loved one, an aging loved one, your, your mom or your dad, your aunt, whoever it is that's aging off of that side, oftentimes being able to speak into a recognize or understanding upfront when you're showing kindness to them. Mm-hmm. <affirmative>, um, top, top things that we've at least seen in the parent project realm so far, uh, autonomy, uh, legacy, and then then loss. These are the, these three things that sit out there. So it's, you know, uh, the loss losing, they've lost mom's lost dad, dad's loss mom.
Speaker 3 00:44:38 It's a shift of, of life, of responsibility of those types of things. It's changed the dynamic of what's going on along with just loss. The same thing that we will eventually also face just when you lose, when you hit that inevitable end of life, which we all share, uh, legacy from that, how someone's gonna be remembered. Uh, that is, I, we see a lot in men. Mm-hmm. <affirmative> sometimes. And not that women, it doesn't impact 'em the same way, but men especially want to be remembered in how that is. I, I think there's something that's built in a someplace of, of how we, how, how that comes down to shoot. Uh, my youngest kids are already challenging me for my, you know, my lands and titles. So I think there's definitely <laugh> something, something that's a part of, how will I be remembered when I go?
Speaker 3 00:45:22 And then, uh, you know, ton uh, their autonomy, the ability to go to handle things on your own and to make your own. You might, and beyond making own decisions and decision making, but carrying them out and working from that concept. And so when, uh, in defeating that, if, if you see or you recognize, uh, you know, a family member off of that, things that I know we've worked through as a, as in, in the senior move management world and, and in other, and just really around, around this, this, um, this industry is leaning into being able to, we call it a leaning culture, ways to help them, what that is, help them get more autonomy, make that the goal of that first goal in order to calm everything down and establish that trust, which is probably there someplace, blow the dust off of it.
Speaker 3 00:46:10 And I'm gonna help you with autonomy off of this or the legacy, you know, I talk to me about how you want to be remembered from that. Mm-hmm. <affirmative> acknowledging, you know, here's an easy one. You're not gonna barrier yourself. You can't barrier yourself. No one's been able to pull that off yet. If you've figured it out, let me know. But outside of that, I'm gonna have to have that responsibility, and I wanna do that in the way you wanna be remembered. Walk me through that. So just, just to have me from that. And it's okay if we get emotional while doing it, but I really just need to understand that so that I don't have to be figuring that out, you know, at four o'clock in the morning when I'm struggling from losing you the night before and, and, you know, and trying to put it together.
Speaker 0 00:46:51 I think that, you know, how you, um, first of all, I think one of, one of listeners are, they're to be commended because they're, they care and they're, they're invested in their parents' wellbeing, and they want the, the best for them. And I think you can say, you can, um, phrase or, or shape all these arguments or these discussions out of, with pos with out of a positive, uh, basis and out of love. And what is really hardest is when people are isolated or alone or unsupported. Um, and so the fact that you're there and the fact that you're trying to kind of tackle these things is huge. But you're actually right. You can start it at, you start the conversation as, you know, oh, we're gonna talk about death. Right. That's a negative. So, but maybe you flip it and say, Hey, you know, let's talk about how you wanna be remembered or, or what, what you want to live on after you are physically dead.
Speaker 0 00:47:50 And, and, and how can we honor you and your wishes so that you are, you know, we, we, we, we care for you and we care for your memory, and we, and we care about you, we honor you. You know, and it's a, it's so, it's an act of love. It's an act of support. It's an act of kindness. It's that connection and, and fighting the isolation and the loneliness. Because when we don't talk about these things, it doesn't make 'em go away. It, you just bury 'em in you. And, and, and that's a, that's a net negative. And that's scarier than facing it. Well,
Speaker 3 00:48:26 You leave it to be guessed at later, and that is <crosstalk>
Speaker 0 00:48:29 And we'll never do as good a job as if I'm taking care of you. And you're, you're in a coma, I'm guessing. Right? Right. If you, if you've led me, you know, and given me some, um, points of, uh, how to, how to manage things, I'm gonna do a much better job for you.
Speaker 3 00:48:45 Right. Which is, yeah. Right. And, and you're guessing, you just, you're only increasing our biggest, our biggest fear, which is failing at that or mm-hmm. <affirmative> not delivering what it's, what it, what we could be doing or should be doing, or the best version. So I'd love that. Love, um, love. Let me love that you brought up the word love within that kindness, showing kindness, showing love. Um, okay. So those are fluffy things. These are not things that surgeons and soldiers talk.
Speaker 0 00:49:15 Not, not, not soldiers.
Speaker 3 00:49:17 This is not, this is not that. But um, but I,
Speaker 0 00:49:21 When you, when you, when you said, I just, um, I, you know, I watched your interview with the, uh, the hoarding expert.
Speaker 3 00:49:28 Oh, Matt. And it was Matt Paxton probably,
Speaker 0 00:49:30 Right? Yeah. And it was fascinating to me because I never really understood it. But then when you start to recognize is, you know, people are, are, are, they're craving relevance, and they're cra craving meaning, and they, and they're, and they, it's just almost irrational sense that if I just keep everything, I'll still matter. Right. And what he did was say, well, let's choose a few things that you've, that, that are important to you. And, and, and tell us the story, you know, include us in your life and tell us about what those, why those are meaningful. Well, it's the same thing about advanced directives. It's just, I mean, the, the form is not the, the form is a, is a legal thing, but the, but the conversation is what matters, you know? Right. It's having, taking the time, um, and being kind and, and, and it is a positive gesture.
Speaker 0 00:50:17 It's a, it's a gesture of love. It's a gesture of support. It's a gesture of, of, um, saying that you matter and that I'm, and that I'm, yes, I'm afraid to talk about these things, but I'm willing because it's important because I love you and care enough about you, that I want you to be your end to be as, as peaceful and as, um, as, um, I guess pleasant as possible, you know? Right. So I, I think you can easily put a positive spin on it, but the opposite of just sort of saying, ah, you know, you're gonna, you're gonna pack your house full of stuff, and we're not, and we're just gonna deal with that. Not manage it. It's the same thing. You know, how do we handle our emotional baggage and, and our, and our our fears.
Speaker 3 00:51:00 Yeah. The, those are, well, you just, you, you sparked going back now, a couple years, one of my first, one of our first episodes dealt with, dealt with how to say goodbye. Um, in, in dealing with that, and, and we were working through, uh, the, the guests or the, in the, in the articles we were working through, uh, she was talking about letting, um, telling her like six or seven year old child who was dying of, of cancer, letting them go mm-hmm. <affirmative>, right. And, and giving these magic words, what are the magic words? What do you say to somebody that's passing and working off of all that, which is in, its, I mean, you just, you think of a child, <laugh> just, it just grabs you from that standpoint. But speaking into, um, the same terms of what you're, you're talking, what the understanding of what she had was letting them know one, uh, you're, you're not gonna hurt anymore.
Speaker 0 00:51:55 Right.
Speaker 3 00:51:55 You're not gonna hurt anymore from this point ever. That's not gonna be something you ever, you ever have to deal with. Um, and another key portion off of that was saying, and we're gonna be okay. Right?
Speaker 0 00:52:06 We're
Speaker 3 00:52:06 Good. We're, we're gonna be fine off of this side. What was really fascinating against what she had to say was that the way she processed it on the backside was turning all of that backwards and then internalizing those same words back off of where this was as, as words of comfort into the situation. Mm-hmm. <affirmative> sure. In her process. But, um, you know, giving, again, I guess maybe, you know, also giving time what we were talking about when you come outta that major event before you go in, is a doctor maybe, and have that conversation or before, you know, we write that, that time to write the report and to work through in a process and think through that. I, I'm reminded also in approaching somebody with a difficult conversation, giving them a kind of a heads up. Mm-hmm. <affirmative>, uh, in the military, they say generals never like to be surprised.
Speaker 3 00:52:53 Do I have a surprise? General? Right. You're gonna, you're gonna tell them what you're gonna tell them. You're gonna give them time to set up for that. Then you get to go in there and tell 'em what you're gonna tell 'em. Then afterwards, you tell 'em what you told them. <laugh>, that, that <laugh>, that, that, that approach has, has fared pretty darn well for me. Um, right. As I, as I've had to work through some people giving them that time and, and then using, you know, the, the kindness, the mercy, the love, those things, what that really, it's empathy. Mm-hmm. <affirmative>, it's me giving that, that that's practically trying to apply some level of empathy to read them. Right. They need time to process this, to get to it. It doesn't mean it goes away forever. And there will be some people who just shut down, confused mind, says no, and they're gonna try to avoid that.
Speaker 3 00:53:35 Right. I think that would've let you, that's always actually, let me be able to, well, sometimes I just think through, well, is that what I needed to talk about? Maybe that wasn't what I needed to talk about, but this and this and this. I need to talk about those things. Right. And so when can I get approach up? I'm like, Hey, I'm gonna throw this. I'm gonna throw this one out. Right? But I really do need to talk on this and this and this, and, and, you know, we've let that out and prepped it. Well, how does that play out with your experience?
Speaker 0 00:54:01 Well, I, I think that, you know, this, the bargaining, um, I think it's hard when, um, when people lose their autonomy, as you said, you know, they lose their dr uh, driving privileges and, and they feel like they're being kind of whittled away or chipped away. And I think, you know, so small victories are, are, are, have a lot of meaning. You know, you say, okay, there's five topics we need to talk about. We're gonna, you know, you don't wanna talk about these two, let's talk about three of them, you know, is it's a give and take, you know, and the other thing is there's you, you can revisit it, um, you know, more than once. So, so I think that, um, uh, I definitely, it's definitely, I think the empathy part is huge. And I think the recognition of how scary it feels to lose that autonomy to, uh, you know, the whole idea of moving into a, you know, assisted living or, you know, and, and what, what comes with that? What, what, what huge, um, you know, it's, there's a lot of legal paperwork and decision making and, and logistics, but there's also a lot of emotional, you know, uh, freight that comes with it. It's, it's a, it's a big deal. Yeah.
Speaker 0 00:55:11 Yeah. But I think, I think if, if, uh, your listeners realize that, you know, pat themselves on the back and think, well, you know, I'm, I'm here. I'm supporting. I'm, I care. That's a lot of, that's a lot of what's important,
Speaker 3 00:55:24 Uh, with, with, without a doubt. And, and truly to the, to the man or the woman in the arena. Uh, it matters that you show up. It matters that you're here. And my my hope is that our conversation today in, in our experiences here ne neither one of us being experts in grief, right? But to just lay out, um, how we had to find our way through, off of this being ones that weren't supposed to focus on <laugh>. It's a real thing. It's not going away. And I hope that that helps. And I I appreciate that. Go ahead.
Speaker 0 00:55:51 Yeah. As, as do I, and I, I find it fascinating talking to you about kind of the, the military part of it, and, you know, uh, I think that the wisdom I've gained, I, I'm, I'm, I'm very grateful, uh, for, and, and I also need the help in facing very tough situations.
Speaker 3 00:56:08 Wow. Uh, you're a true, you're a true friend of the show, and to me, I really appreciate it. I love having you on here. Again, I look forward to having you back again. Uh, hey, talk to us about where to, uh, to go to see, uh, grief Connects us, especially if somebody's in the medical profession off of that, or if, if they're a family where that especially might be speaking in, and there may be a great opportunity, but, um, where, where can people get, find more about, uh, the book that you have out right now and the other stuff that you're doing? So
Speaker 0 00:56:32 I think if you go to my website, which is joseph stern md.com, it's got a lot of resources. You can buy the book, uh, through Amazon or independent, uh, booksellers. Um, and there are links there. There's also, there are also links to, I have, uh, several articles in the New York Times, and then also The Washington Post and other, other, um, journal articles, a Ted Talk, a bunch of talks. So that's, and we also have a newsletter, uh, and, um, which kind of tries to create a community where people can get resources and support each other. And so I think that's a, that's an important part as well. So that's a good place to
Speaker 3 00:57:07 Go. Yeah. Love that. Can also
Speaker 0 00:57:09 Contact me, um, by email through that website as well, if
Speaker 3 00:57:13 You'll Great. Great. And we are gonna put all that by the way down below in the show notes. So make sure that you check in against that. And if you're looking at this, whether you're on social media, feed of this and YouTube, or if you're out on the website, you can find
[email protected]. And a lot of these resources as well, we'll be linking back through throughout the site because it is, it is gold. And, uh, and boy, I can't tell you again, Jody, thank you so much for sharing your time, talents, and treasures with us and the parent projects audience. Thank you,
Speaker 0 00:57:39 Tony. Thanks for what you're doing. I think you're making a big difference.
Speaker 3 00:57:42 Thanks be to God. Thanks, man.
Speaker 2 00:57:48 Well, that's it for the team this week, and thanks for joining us. If you've enjoyed the content, remember to subscribe and to share this episode on the app that you're using right now. Your reviews and your comments, they really help us expand our reach as well as our perspective. So if you have time, also drop us a note. Let us know how we're doing for tips and tools to clarify your parent project, simplify communication with your stakeholders, and verify the professionals that you choose. You can find us on YouTube, follow us on Instagram and Facebook. Thanks again for trusting us. Until our next episode, behold and be held.
Speaker 5 00:58:20 Thank you for listening to this Parent Projects podcast production. To access our show notes, resources, or forums, join us on your favorite social media platform or go to parent projects.com. This show is for informational and educational purposes only. Before making any decisions, consult a professional credential in your local area. This show is copyrighted by Family Media and Technology Group, incorporated and parent projects l l c. Written permissions must be granted before syndication or rebroadcast.
