Episode 45

August 04, 2023


#45 | Dr. Joseph Stern | Difficulties with Aging

Hosted by

Tony Siebers Bina Colman
#45 | Dr. Joseph Stern | Difficulties with Aging
Parent Projects - Aging In America
#45 | Dr. Joseph Stern | Difficulties with Aging

Aug 04 2023 | 00:56:08


Show Notes



Today, we have neurosurgeon Dr. Joseph Stern with us, sharing his lessons on losing capabilities and capacity while still choosing to maintain vitality and purpose in life.


Dr. Joseph Stern’s Website: www.josephsternmd.com


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00:00 – Intro

01:22 – Welcome to the Show

02:44 – Introduction to Dr. Joseph Stern

05:47 – Dr. Stern’s Call to Action

12:19 – Dr. Stern’s Experience

18:04 – Palliative Care

21:57 – Practical Uses

27:47 – Tips to Help Our Loved Ones

34:45 – CRP Ad

35:56 – Teach Us to Learn Twice

39:59 – Trauma

45:11 – Having Agility

49:35 – Wrap Up

55:33 – Final Thoughts

56:38 – Outro



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Episode Transcript

Speaker 0 00:00:00 We both have been through some very painful things, um, in terms of losing, um, younger sisters. And, and, you know, when I wrote, uh, my book, it wasn't, it wasn't because I wanted to share my own journey. It's because we are all really going through very similar things, and we can learn from each other. We can support each other, we can be kind to each other. And that, that blanket of compassion is ultimately one of the most profoundly helpful things that I can provide as a physician and also as a human being. And it's very relevant in terms of, um, helping someone age Speaker 2 00:00:40 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 guests 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 00:01:04 Well, misery loves company, and so it is hard to get old, but today my company is, uh, is pretty much a blessing for me. I have Dr. Uh, Joseph Stern. Jody Stern is a board certified neurosurgeon at Cone Health in Greensboro, North Carolina. He's also an inventor. He is a published author of his book. Grief Connects Us. He's a nationally recognized grief specialist who's been featured in a variety of major news outlets and other popular podcasts. And I'm blessed to have him with me. Uh, Dr. Stern. Jody, thanks so much for joining us here on the Para Projects Podcast. Speaker 0 00:01:36 Tony, it's a thrill to be here, and I appreciate your, the invitation. Speaker 3 00:01:39 Well, man, it is a, it, it, that might be one of the first times I've heard it be a thrill, especially 'cause we're gonna talk about some things that suck, things that are really, really difficult today, but Right. Man, alive, I really enjoyed our conversations before. Um, if, if you're, if you're new to the show, uh, and you haven't heard before, I mean, we generally, my, our guests and I, we, we start a conversation, we get going, we started 20 minutes ago and <laugh>, then we take a break and we just turn the cameras on and keep going with you. And, uh, and I, it is a thrill. It was a great conversation upfront. You and I have, um, we have very different backgrounds, but we also have some real synergies with how crisis and difficult things have come into our life. And, and, and really led us to a place to be able to understand, you know, that it's okay not to know everything, I think at a, at a bottom line, but really how to start coping with that. And you know, how to make productive things, but, but how to cope with what that looks like. And I, I appreciate you starting to share, you know, some of that with me today and with our audience. Speaker 0 00:02:45 Well, it's, it, you know, I, first of all, I have enormous compassion and empathy for what people are going through. Uh, I think it's very hard to take care of aging parents. And, uh, I think that loss and, um, you know, the loss of autonomy, loss of, uh, independence is really a challenge. So my hat goes off to you, everyone who's in that, it's very hard. It kind of feels isolating sometimes. It feels kind of lonely. So I think that what you're providing with a sense of community and an a place for people to share their experiences, to recognize that these things are going through, they're not alone. That, uh, we are all going through somewhat similar things. Speaker 3 00:03:24 Yeah. Well, you, you, they, they are <laugh> I think you said it when we were talking earlier today, best, right? This, this is something we all are gonna go through, right? Yeah. You remind, uh, uh, all of us die. All of us. Speaker 0 00:03:37 We're all gonna, we're all aging. We're all going to get older, we're all going to die. And we need to kind of, uh, be honest about that and talk with each other about it and make plans and be pretty forthright about it. Speaker 3 00:03:49 Right, right. Well, so let's, uh, let's start, how, how a little bit into your background, um, you know, how, how is it that you come across, um, dealing with or starting to focus such a big segment of your life and helping other families understand the compassion behind having these conversations and working? How did that come about for you? So Speaker 0 00:04:11 This started with my, uh, quite a while ago, about in 2014, my younger sister Victoria developed leukemia and had a bone marrow transplant, and then, uh, died less than a year later. And that kind of shocked me into, uh, an awareness of what it's like to be a patient and how different it feels to be a patient than I thought. I thought I knew what it was like being a doctor and being around people who are dying and going through really tragic and difficult situations. And it turned out I had no idea. Uh, and I also saw what it was like to, uh, lack compassion or to be in systems that are, uh, often transactional and not really focused on caring and, and healing and supporting. Yeah. So then a year and a half after my younger sister Victoria died, she, her husband Pat had a ruptured aneurysm in his brain and went into a coma and also died. Speaker 0 00:05:04 And that orphaned their two children. So I went from a vague awareness, a sense that I was compassionate or that I cared to really realizing just how hard it is to be a patient and to how hard it is to be a family member, what it's like to go through mortal illness, and how really unprepared I was. Uh, so that made me recognize that we need greater compassion in the care we provide and greater support for each other. And that that's really one of the keys of what healthcare should be. A lot of times it's, yeah, you know, you get a treatment, you see a doctor who kind of goes through a procedure, but is not really, um, supporting from the heart or connecting with you in, in a powerful, meaningful way. So that was a real wake up call for me. Um, go, sorry. Speaker 3 00:05:48 Well, I, I was just gonna say, I, I see in addressed in, in, in response to that, I think the medical community has seen that across the border. Maybe it's been just a call to action at some level, and we see this rise of palliative care mm-hmm. <affirmative>, which hasn't quite, it doesn't seem like it's quite found a home in the payer system. Right. Which makes it very problematic here in the United States. But, but, um, but it seems, it seems to start touching some of those, those difficulties there. You have, you've, you ended up touching some level into that as well, right? You started studying the c How, how did you see that coming into play here? Uh, Speaker 0 00:06:22 So I felt a real need to increase, uh, my training in palliative care to get a better sense of how to do that. I went and took a course at Harvard Medical School in palliative care. Yeah. Um, and learning how to better communicate with families and, uh, understand what people are going through. It was very powerful lessons. One of the things I realized, though, is that palliative care is pretty good at providing support. A lot of times it's that we don't really integrate that into the acute care setting. So if you have a neurosurgical crisis and then you make a, you know, family makes a decision, says, well, we, you know, we're not going to pursue further treatment and we're going to do palliative care, or we're gonna do hospice. They make that transition really well. But a lot of times I felt that a lot of those things needed to be given much more early in the course of an illness, that we need that support, we need that, uh, better communication with families. And that a lot of the suffering that happens is because people don't get a really good explanation. They don't feel connected with the treatment team. A lot of the technical things are a focus instead of the emotional, spiritual, psychological things. And those need to really kind of be integrated more meaningfully, much earlier in the care. Speaker 3 00:07:30 Well, and that's a very, that seems to be a very difficult thing to do because of that payer system. Is that, is it is medicine is very transactional focused today, uh, around doing that. You know, you're either a part of the, a Medicaid system or you're part of a Medicare system where you're part of a Plan B system where you're part of a, you know, this healthcare insurance planner, an H M O or P P o, and, and they tend to kind of tell you the networks in which you have to be, and you tend to have to shift between them. Right. Every couple of years. It's hard enough to keep up on your own team, let alone as a, as an adult child, guiding your own parents through what those, you know, where that is. And, and you, and rebuilding, almost having to rebuild that team every time you move into a different payer system, <crosstalk>, I think Speaker 0 00:08:15 It's, it's incredibly, incredibly tough. And, um, and then also meeting a whole, uh, bunch of new, um, practitioners and, and kind of reinventing the wheel each time. Right. So I, I think it's very hard for families, very hard for patients. Speaker 3 00:08:29 Is there a, when, when you're getting instruction, I, I wonder, uh, you know, at a well, that, I mean, that's a, that's a, an elite medical school and a great program from that. And I, I would expect that off someone with your credentials. What is the ti what's, what's the crux of the curriculum the doctors are learning when they're back there? Is it that, is it that bedside manner? Is it that, that soft touch? Is it the vague, the gray space that sits between the technical acute care down to the, okay, we are, you know, the transition into hospice type type environment. What's the crux of what they're, what's what's being taught to doctors today in that segment? So Speaker 0 00:09:08 Most of it is, is listening and communication skills. So a lot less of technical, like how to manage pain. We did talk about pain management, things like that. But a lot of it was, how do I talk to someone? How do I listen to them? How do I interview someone? How do I really hear what they're saying? Also, kind of, uh, we did role playing. We went into small groups and we did role playing where we were the doctor, we were the patient, we were a family member, kind of, uh, you know, where being in someone else's shoes and you get a better sense of, of what it's like. Um, yeah. So I felt that that was very powerful. That's a very powerful set of lessons. Speaker 3 00:09:41 Well, I think those are, okay. Well, so that, that formed a bit of your, I I mean, your platform and understanding what this, um, you know, what to expect perhaps. And, uh, and, you know, we've, we've gotta take our first break here, but when we, when we come back from it, what we're gonna do is we're gonna sit down and we're gonna talk with, with Dr. Jody Stern about what that education and that background and those life experiences led him to understand about what you can and can't do, and what's realistic in helping a family member how to set some positive goals and some in states and get things moving in a particular great direction. And later in the show today, we're gonna talk about what we can be doing to prepare ourselves, because ultimately, we all share that same demise. Stay tuned as we follow up right after this with the Parent Projects podcast. Speaker 3 00:10:33 And welcome back. This week we are talking with Dr. Jody Stern, a board certified neurosurgeon at the Cone Health in, in Greensboro, North Carolina, North Carolina. Uh, uh, Dr. Jody, you know, you've, um, you've spent some time, uh, explaining that background, which is a phenomenal education. You've got this awesome experience that, that works for you. You had this tragic, tragic family situation that really shook and started making changes. You also, you, you had some changes in your own body that led you to start having accepting what was happening to you against life, or starting to change some of your autonomy or the, the direction you were moving. Can you, can you tell us, would you wanna share a little bit about that with us? Speaker 0 00:11:16 Sure. I'm happy to. So, you know, you can see by the gray hair and the, the thinning hair on, on my head that I'm a little bit older and I'm in my early sixties. And what I, um, I was working very full-time as a neurosurgeon and, uh, trying to balance a lot of different things. You know, I was writing full, I wrote a book and, and operating a lot, and I developed problems with my elbow in my dominant arm. And that gradually became extraordinarily painful. And I actually had to stop doing surgery. And so it's one thing to talk about purpose in someone else's life, and then all of a sudden when you're, and, and it was, it was an, a level of awareness of what my sister and her husband went through in her family. But then it takes it a to a whole nother level when it, when it's your own life and you realize, Hmm, I can't really do what I did, and I've gotta make some big changes. Speaker 0 00:12:05 So I am very supportive of how difficult these things, you know, I can sit here and tell you, oh, this is what you need to do, and it's, you know, follow this, uh, checklist. The truth is, it's really difficult and it's, and it's really hard to lose your independence, to lose your sense of purpose. But it's also an opportunity. You know, what I recognized is that, is that I have to stop, uh, operating. That has been what I've done for 30 years, but I also have an opportunity to grow in different ways and to develop in different ways and to be useful and purposeful in different ways. And so, um, you know, one of the things that actually was a kind of fortunate byproduct of that experience was that my father-in-law was dying, uh, from multiple myeloma. When I had to stop work. I basically spent a lot of time with him and his wife, and, uh, helped him die. And I found that to be an enormously meaningful, uh, experience. And I'm really, I'm really proud of being able to be there for him and how that, how that affected me. Uh, and I wouldn't trade that. And I would never have had that opportunity if I had been working in my usual way. You know, I would've come in the evenings and, and, and so it was really a special moment, and I, I'm glad I had it. Speaker 3 00:13:19 Well, and it sounds like you approached that moment out of, uh, out of not a, a conviction of, of, of guilt or fear or obligation out of doing that, but it, you recognized an opportunity to start pouring into something and something you, you wanted to be there and, and wanted to approach through to learn from. Did, did you, is that right? I mean, did you, did you think what, you're going through this, wow, this is gonna change me, this is gonna be something, or do you just stay more focused at what the 50 meter target is right in front of you? Speaker 0 00:13:48 You know, Gary, um, is, was, um, really a wonderful role model and father-in-law for me. And so I felt it was kind of something, I wouldn't say I owed him, but I felt I wanted to, I wanted to give of myself. I also felt it was kind of, um, an opportunity to put the palliative care training to work and see what, see what, um, what good could come of it. Mm-hmm. Um, and I felt that, um, the power, you know, of compassion and empathy and connection is so huge, and stepping into that moment and a willingness to, you know, I, I didn't know where it was gonna go. I didn't know how things were exactly gonna go, but I felt, I felt so fulfilled and, um, that it had, it had meaning for me. So I, I'm really glad I did it. I think I was able to help his wife Margaret a lot. Speaker 0 00:14:40 Um, and, you know, we talked earlier about, well, they were pretty, they were pretty prepared and pretty honest about what was going to be happening. You know, they, they talked about funerals, they talked about end of life wishes. Um, in my own situation, my father is, is 94. He's very independent. Uh, he lives on his own. He's really not interested in moving into a different situation or bringing help into his home. And so sometimes you have to recognize that you can help only as much as someone's willing to let you help them. And, you know, and that's one of the things I learned in palliative care training. If, if someone wants that help and you want, and they want you to, uh, go down that path with them, that's great. If you have those skills and those abilities, and you're interested in sharing them, but they're not really ready to share them, you really can't force it. You know, you can only, you can only do as much as someone's willing to allow you to help them with. Speaker 3 00:15:37 And that is, um, that could be a flex. I, I've learned in my life that sometimes that willingness can be a switch that flips on and off at different times. Sure, sure. Where, where, uh, one moment they're, they're there with you, they're, they're gonna go, and then the next moment just maybe a depression has hit them or something else has happened where that light switch, they've just flipped it off for that moment. And, uh, and I've found that if I push at that particular time, I can damage a relationship as opposed to pulling back and waiting. And maybe at that point in time, just making the room a little safe, like walking around in the dark and making sure that nothing's out there, that anybody's gonna trip on until, you know, the proverbial light switch comes back on, and then we can start moving in another direction that seems to ebb and flow. Is that, is that a, is that a medically, is that, is that something that does tend to happen as, as, as folks get older at a, at a larger scale, being a, a doctor? Is that something you guys talk about in palliative care too? Speaker 0 00:16:34 Sure. I mean, I think that, uh, you know, you need to be able to be as supportive and available as possible. But the it, and I think, you know, I think there's a lot of guilt. There's a lot of fear that kind of goes both ways. Um, I think we need to recognize how this is making us feel and how we start to feel, um, afraid. Um, yeah. And I think we talked earlier about feeling vulnerable or being vulnerable. I think that's really important, you know, to be honest, to be available and, and, and flex in given situations. 'cause people, it's not like a linear path, you know, you're going to just, you know, gradually get sicker on a, on a, on a timeline, and everything is pretty clear. Things change, you know? And, and one of the things that I'm amazed at, uh, from a neurological standpoint is some people feel great some days, you know, say you've had a stroke like one day, some days you may be functioning pretty well, and then other days you do poorly. And so you do need to flex and kind of move through, move with the illness, and, and, and enjoy the, uh, positives, enjoy the up times, and kind of be prepared for the down ones. Speaker 3 00:17:34 Yeah. Or, or maybe even just recognizing that those seasons, the ups and downs are just different experiences. Like you, that's the, the elbows is a, most people look at that and say, well, that's a down, it's a loss of a 30 year career. It's a stop off of all of that. But in the big picture things, when you, you back up, it really ended up being the, you know, a a position of change that opened up the ability for you to understand this other thing or connect in this other way that would not have happened. So, sure. Was it really a down or was it a pivot? Right. Speaker 0 00:18:01 It's, there's a lot, there's a lot of, I mean, honestly, there's a lot of pivoting in life, right? And the thing is, with my, with what my sister's experience and how that changed me, you know, I wouldn't trade that. I, I, I'm sad it happened. I'm, I, but it, but I, I am, I'm glad for the, the opportunities that have come my way, it's sort of up to us, do we take advantage of them? What, how do we, how it's a question of the char character of a person is not what happens to you. It's kind of how you face the adversities that inevitably we all have to face. Speaker 3 00:18:33 Right? Right. And, and ultimately that end adversity, that ends everything, that is something to come to grips with. I think we, we talked a little before, one thing that, um, that I've seen out that I've seen I think you, you had had agreed with, um, prior to the show is that experience, if somebody had a faith, if faith played a role in life, or plays an active role at least that time, or at any time really in their life, I find that that's a time where it starts to come into play. Sure. With one's willingness to start coming, and that, that seems to be something we see maybe on a larger scale too. Speaker 0 00:19:08 I thi I think that's very important. I think that people, um, you enter kind of a more spiritual part of your life. Um, and, and one of the things that's been really interesting for me in all of these processes, in all these changes is, is I have, uh, felt embraced by a larger community. And I have, I have connected with people, I mean, such as yourself in this moment. I, I would never have met you, and I learned from everybody that I'm connecting with. You know, one of the things that I've been doing is working with an organization called One World Surgery, which is in, we're in Honduras and, uh, Dominican Republic, and we provide a free surgical care for people without access to care. And you to take those kind of desire to help desire to connect with people and build something better, to build something that's bigger than our own, um, smaller personal issues. That's, that's a, that's a liberating moment. Speaker 3 00:20:04 Right. Well, and, and it, it can help you get outside your own head. Sure. Uh, and, and maybe even see someplace to go now. Okay. So, so that reminds me of a couple of practical things now to, to jump into the practical one application when helping a family member that is stuck for in move management, where we talk about in, in move management, it tends to be kind of this funnel of life of activity that's got, you know, maybe a 36 month give or take a period of kind of family healthcare or family caregiving where families start to come in. Then you start to get into this decision matrix of are we gonna age in place? Is there gonna be a senior relocation stage of life? Where's that gonna go? Mm-hmm. That, that, that leads into, and then eventually end of life. And the, the earlier we plan for those things and start setting conditions that the, the easier those transitions tend to be to recognize and then work our way through with, um, with helping a loved one, um, move forward who maybe can't get there. Speaker 3 00:21:04 One thing that we recommend, uh, you know, to other families and through others that we're moving, is to put an in-state some type of goal sometime just, just kind of mix it up. So, for instance, in one client that I'd worked with when we did Kinetic Move Management with Senior Moves, um, that it, it was to help her ideate something she still wanted to achieve. So she wasn't overwhelmed by giving up. She had this huge sewing room, incredible amount of bolts of fabric, and all of these things that have to happen from that. In fact, it was, it was, um, it was over so overwhelming for her that she could make other decisions in life. Sure. And most would look at that and go, oh, we just need to get rid of that stuff, because that's an overwhelming from that standpoint. But we came to, when I, when I came to understand what overwhelmed her in it, it was the fact that that room, every single bolt of fabric represented a project that she intended to complete. Speaker 3 00:22:00 Sure. And she came to the realization that she wasn't going to be able to complete all of them. Mm-hmm. <affirmative>, she was paralyzed with the decision of trying to complete of, of where that was gonna go. Right. And so we moved her forward by getting her to understand, well, what are, what are, what is, what are two that you wanna complete? And then we'll focus at the rest of this. And just taking the light off of that and getting them to focus and ideate themselves Sure. In a future state or in that next thing, so that she wasn't, we were moving her out of a condition where she was waiting to die. Right. Instead into finding this, this life of vitality and finding something that she could go achieve and go do. And we didn't know where it was gonna lead off of that. We just knew that, you know, an object that is in motion tends to stay in motion, and an object at rest tends to stay at rest. And we apply that principle, what could you, Speaker 0 00:22:49 You, you can focus on the things that you've lost. Okay. You can look and say, these are the things that I've lost. I used to be this. Right? Yeah. And I used to have capacity. I used to have capabilities, and we're all losing them. You know, we're all getting older. I now wear glasses. I'm not as, you know, um, can't do as many things as I used to. But you can flip the whole conversation and you can say, it's not what I've lost. It's what can I look at all the things I can still do and look at all the things that I can still, that can still give me joy and give me meaning, and give me purpose and gimme a sense of fulfillment. And a lot of it's, you know, connecting with the, with a family member. So when you're, you know, talking about, well, do you get to drive or, you know, losing things, and these are tough decisions, that connection and that, uh, companionship is so important. Speaker 0 00:23:37 And, and the idea that I could maybe do one or two more projects, or I could, you know, with some help, maybe continue to have some joy, to have some purpose, to have some meaning. And you can keep that alive. You know, you can really scale your ambitions and goals and, and still keep that sense of purpose and meaning and joy present and focus in your life. So I don't think, I think you have to really flip the conversation on its head and say, we're not really talking about all that you've lost. We're gonna really focus on what you can still do and what can still bring you pleasure, what can still bring you joy. Speaker 3 00:24:12 I, I love that my kids, um, and because I'm, I'm getting older and my kids pick on me that I've lost, I've lost hair in the back of my head, but I choose to look at it as I can now connect and signal with aliens in space, <laugh>, and, and talk to others when it is just a, a matter of that outlook of what can you get from this change of posture? I, I kid. But, but that is, um, I, I, I love that scaling, that scaling attitude, um, and understanding, okay, well, like, like there's an acceptance there. Years ago, man, what is, if I'm, I'm gonna try to remember her name and I wanna say the last name is Applewhite. Um, she gave a great talk at a national association, a senior move managers, uh, conference years ago, uh, um, that spoke. She moved into looking at things, ideas of like, uh, ageism in particular, but from a concept not as that negative ism side, but more of just, uh, man, do we, we get, let ourselves take a look and say, well, as you get into life, like everything kind of ends. Speaker 3 00:25:21 And she was, she was shocked in the crowd, right? She was like, well, look, sex doesn't go away with age. Right. That, that clearly is flourishing off. And she, when she tackled these really big things that not everybody in the audience was ready to hear, but it was, it was a laugh off of that. But it really put into context that there are a lot of things that does that, that people are gonna do fine. There's a lot that can be done in life at that point in time. It is. I think what's important is what you started with is you can't force this down anyone's throat. Right. They have to, they have to see it. But I, I've said it before, and I'm reminded of a, a mentor I had years ago who said, the difference between a vision and a hallucination is getting other people to see it. Hmm. And, and this might be that, and working with mom, you know, with an older loved one, with mom or with dad or, or an aunt or uncle or other loved one there, what are some tips that we, I mean, what are some things that we can do to help them to see what they can do? And I think scale is gonna play a big role in that, being realistic about, about what they go to, what they go to tackle. Well, Speaker 0 00:26:21 What, so one of the, one of the things that I think we really sell our older, um, you know, uh, family members short, is they have a lot of wisdom. Okay. They have a lot of insight into life and life experience. And it really behooves us all to pay attention to that and to hear what they have to say. And a lot of times, it makes me very sad when I look at older people who just get sort of shunted off away and kind of, you know, living on their own or living in a, in a community where they're own all by themselves, you know? And because people don't recognize and don't value all the insights and all the wisdom that they have to share. Yeah. And so I see so much, uh, really powerful relationships and joy between, um, grandparents and their grandchildren and kind of, you know, learning, um, skills, life lessons. Speaker 0 00:27:14 Uh, and so I think that knowing that, yes, you may be older and maybe need help getting down some steps, or you can't do quite as much as you used to, but boy, do you know a lot about a lot of things that I'm interested in, and I wanna learn from you, and I want, I wanna, I want your insights to help guide me. You know? 'cause one of so many times we do, we make the same mistakes over again. You know? And, and we don't learn from, you can learn from your own mistakes and, and, and not repeat it, but a lot of times you could learn from other people who've gone through a lot of things, have a lot of wisdom, and can share, and can help, help you, help guide you. So I think that knowing that in addition to, um, you know, some, some changes in skills, just that wisdom, that knowledge and, um, the love that they are able to provide is, is huge. Speaker 3 00:28:04 Well, okay, so now, now you just got my brain spinning around this. I, uh, a, a good friend of mine, um, Matt Paxton, he does, uh, for years he had to show hoarders where he was mm-hmm. <affirmative> dealing with a very difficult aspect of it. And today he's got a brilliant, brilliant, brilliant show called Legacy List. I swear to you, I'm not plugged to throw that out there. But, you know, he and I, he was on the show a while ago and we started talking through this. So he's got this exercise that he works through where he gets to you, you go through, he goes through the family and he gets 'em to select outta this whole house when they've gotta make this change. You know, five or so things that they can have an opportunity, they're gonna select and they're gonna learn as much the family. Speaker 3 00:28:48 They're gonna give them an opportunity for the family member to tell everything about this thing. Sure. This moment now, now it connects the dots with a lot of what you were just talking about too, in palliative care. A huge piece of the bedside manner of coaching or being there with somebody else that's walking through this is getting them to trust that you can hear and that you can listen and that you see, and you can, you can pull out of them, right? The, the, the best of what sits out there and set that condition and, you know, act activities like that. I start thinking when somebody is stuck, that's exactly what he uses it to get people stuck, that they'll move that way. Well, when you give them, he's learned, if he gives them the platform Sure. To talk to a veteran's group or to go down to a senior home, or to gather the entire family around, or do it on a television show, sure. They, they get to describe that and they find that fire of, oh, I have value. And everybody around them gets the buy-in for listening, you know, for giving that time and that platform. And so you develop that, that relationship that starts really culminating down to maybe get through a couple of those roadblocks. Um, when you talk about giving them that opportunity to share and that Speaker 0 00:30:03 <crosstalk>, I think that's absolutely, I think that's absolutely true. And I think that, you know, you, if you look at some of the, I'm not a, I'm not an expert on hoarding, but I think a lot of this is, is a desire to still, you know, you, you imbue meaning and physical objects because you're afraid that you're losing, um, you, you're losing your capacities. You kind of, they sort of anchor you. But then if you actually take the time to like, um, talk about why these things are important, or to share your life experiences and, and, and make those profound connections, I think it's easier to guide kind of older people as they die and as they age. But it's also more meaningful. You get more out of it, you get more, uh, return, um, to, on the investment of time and energy. So I think it's, I think it's kind of a win-win for everybody. Speaker 3 00:30:50 I, I agree. We, um, you know, you, you and I, we we're, we're tiptoeing around and we're very cautiously tiptoeing around a topic you and I are gonna talk about a little later in the month. We're gonna do a whole nother segment in grief. Grief has a huge impact in, in this. And I, I, um, I, you know, we'll, in a moment, we, we will take a break and I'm gonna give that opportunity to really highlight what you do, how you talk about that in using grief to connect us. But these, these moments here, these exercises, here, these opportunities, um, to learn from watching somebody, you know, communicate what value they, you know, helping them find that value they still have Sure. Um, with what faculties are there, or finding that value and change instead of just all the downside, right? Just finding one nugget of what might now be possible that wasn't possible before. Speaker 3 00:31:42 Uh, we, I mean, Jody, we, we, we exercise that with our kids since they were little, right? Sure. They, that that bad things happened. But, you know, you're like, oh, well, you know, but look it now you got to do this and you got to do this. And how quickly does that just kind of fade out of our brain? Sure. When it comes down to the other end. And now we are trying to coach a family member through the acceptance of where they're at, at the end of their life. Sure. That's, I, I think that that will be a valuable, um, well, that, that'll be a valuable thing. What I, what I'd like to do is maybe dig into how we do this individually, uh, on the backside of this break. We're gonna take one other break. And during this, I wanna, I wanna highlight, uh, your book, have you explain a bit of what that is. Speaker 3 00:32:23 It's a bit of a teaser for where we're gonna go, and we're gonna talk later in the month of, uh, August, September, uh, about that. But, uh, okay. Stay tuned. Uh, in just a moment. We're gonna be back. We are talking this week with Dr. Jody Stern. We are talking about those difficulties in aging ways to recognize, uh, you know, where that helping our family member recognize that value, that ability to, to engage on their longevity, and to find that next thing, uh, forward. Uh, when we come back, we're gonna talk about ways to put that into our own life. 'cause we have that shared destiny. And, uh, Dr. Jody's gonna break some of this stuff down for us. So stay tuned for the Parent Projects podcast. We'll be right back after this message. Speaker 4 00:33:10 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're 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 00:34:16 Welcome back. This week, uh, we are talking with Dr. Joseph Stern. Uh, Dr. Stern's a again, a board certified neurosurgeon. He's gotten great experiences in life, uh, not just as an inventor as, uh, as a surgeon. He's a published author. Uh, he understands grief, he understands, uh, from a very personal level, uh, how it is that we deal or coach someone through that twilight of their life. And now, Jody, you're gonna sit down with me, and you and I are gonna dig into what I, uh, I kind of referred earlier that Joseph ovarian principle to teach us to learn twice. Um, we're gonna mix some application into our own life since, since none of us are getting off this rock alive. Like it's a, it's a shared, some of us, some of us might. I think it's, it is important to think some of us have more planning to do than others. You know, obviously, some of us will go quickly and won't have that time to really think through that or to, to experience some of those. But for those of us that have that blessing here on earth to, to work and to plan later years and to figure out how to adjust off of those things, what are some of the top things that you've, you've learned in your own life from helping other family members do this? What are some of those, some of those things that really stick out in your brain upfront? Speaker 0 00:35:39 Well, uh, we talked earlier about how, um, I thought that being a doctor would prepare me for all these things, and that I, if I had medical training and understood the pathophysiology of illness and could, you know, kind of navigate disease, that, that somehow would protect me from loss in the sense of, um, uh, loss. And it was a shock to me to discover how little that protected me. Yeah. Um, also, a lot of the defenses that I put in place and that we are taught as doctors are actually, um, kind of counterproductive. So emotional armor, kind of creating distance, trying to, uh, separate ourselves from our experiences. First of all, they don't work. Uh, you really can't avoid these things. And then the, the surprising one was that if you actually lean into grief and you allow yourself to experience, it's a growth opportunity. Speaker 0 00:36:31 And, you know, it's painful to go through. But I, I, and I, I, I would never have, you know, I, I would love for my sister to still be around, but it means it brings kind of joy and meaning to my life. It also gives me a sense of, uh, it, it, it increases my sense of purpose and meaning in my, in my own life. I think a lot of times how lucky I am. And I, I, I was actually at her funeral and, and, uh, I was standing outside on the, on the beach, and I was listening to the ocean, and I was feeling the sun on my face. And I just thought, you know, she will never feel that. But I can. And I do. And there's so many things we take for granted, these wonderful, miraculous things in our lives. And the, the, you know, the other thing is that we, we do get redos, right? Speaker 0 00:37:20 You know, I, I, I have done things wrong or badly as a doctor, as a person, as a father, I, I, you know, I, I, I get an opportunity to correct to, to learn from my mistakes, to try again. Uh, and so I feel that those things, um, having developing emotional agility and the flexibility to recognize, you know, that you, there may be contradictory things going on at the same time, uh, that you don't have to have all the answers, that you have to be available, that you have to be kind, uh, that you, that compassion really is a key feature of being a decent human being, being a decent physician. Um, so these are some of the things I've, I've learned. Speaker 3 00:38:04 You know, you're, when I remember back in the police, uh, academy for me years ago, uh, they talked to his emotional survival. And it is interesting how these things, one thing after another, and being a, a, a, you know, a police officer and a municipal police officer, a long-term just wasn't the fit that God had within my life. Um, but I would tell you fast forward a couple of years, as I'm commanding a team and taking a couple hundred people to Iraq, all of a sudden we start, you know, it, that that training in that bit out of that time in my life is what opened the door for me to understand the importance of emotional survival. I understood the compartmentalization doesn't work again, that armor, is it like <laugh>, if you just, there's something inside armor and it's all rattling around. And so then, then I found myself taking all these folks down range. Speaker 3 00:38:55 And what the military provided for us, right, is, like you had said, that emotional armor, I'm a I'm gonna, I'm a military guy, and it's, uh, because of that constantly, you're constantly studying from the time in an academy all the way through commission. It's still against that. When an injury happens to the body, even inside armor, that armor's gotta be removed. You have to deal with that injury or else it, it prolongs and it festers and it becomes a much bigger problem even within that armor. So just the whole concept was broken. Um, I found a gal by the name, um, Carol Trell. She's a, a doctor that had done research with some of the first folks that had gone down to Iraq. In fact, her book Iraq and Back was something I'd picked up. And I was like, oh, we could start getting in front of this. Speaker 3 00:39:37 Thanks be to God. That experience of that wasn't a good fit of me off of civilian law enforcement. From there at a municipal level, led me to being open because I understood real trauma every day. Like in it deep, neck, deep. It was hard for me. Emotionally, I'm looking at this and it was, it was, you know, especially under your hometown, that's not a fun experience to work through. Sure. And, but that opened the door for me to understand, okay, well, trauma's not something you get to compartmentalize and walk away from. We better find out a way that we are gonna deliver this as we go back and forth so that I can bring all of these soldiers home. And those that did, you know, hopefully every single one of them home. And as they all come home, they don't have those emotional scars that take 'em from us for, for some other reasons. Speaker 3 00:40:23 That, that, that is a pretty, uh, it was a pretty awesome thing. And I, and I, um, I, it really honestly was from me watching other people go through it. Sure. A hundred people go through it at one time, watching 'em try to compartmentalize. It wouldn't fail. Apply this, that would what worked, what didn't work. Everybody was different. Everybody was different. Some tools worked for some, some didn't work for others. You had some, some troops that they just weren't gonna, they weren't gonna play, and you couldn't force 'em to play. And that challenge was just gonna hit them. And to this day, you know, 20 years later, we have discussions when we have connections with them. Some of 'em didn't deal with it for 10, 15 years. Some of 'em still haven't dealt with it. Speaker 0 00:41:06 Well, it come, it comes out and it le it leches out in really kind of often pretty horrible ways, you know? Yeah. I think that the, what I found about the emotional armor is that it's not something you can put on and take off. It's something you wear, and then it, it limits your lived experience all through your life. And so then you realize this is a liability. First of all, it doesn't work. And second, it's, it's, it's not helping me. It's hurting me. Yeah. And, and so then kind of looking and saying, well, okay, what's with, um, medical education that we're not taught how to experience our emotions and, and that their assets, their sources of strength, not weakness, not something that we need to push away. And so then trying to change culture or look and say, well, let's change how we're teaching our young students and, and how we need to bring these, um, these experiences in. Speaker 0 00:41:58 We need to integrate them into our lives. It's okay to be you. You need to learn how to flex between being a neurosurgeon who can sit at someone's bedside and, you know, share really horrible news. Maybe shed a tear with someone, but then also put their game face on, go in and do surgery, you know, cut that person's head open. There's a huge range. Yeah. But people really need the support. They need to know that you care. And we need to be trained how to be able to flex between those extremes. Because that if you're, if you're purely a technician, you're not really gonna be working in the patient's best interests. You're not really gonna be doing what's best for them. You're also kind of selling your short, yourself short on your own lived experience. But then if you're a sponge and all you can do is, you know, find, kind of, feel the pain, then you are not effective either. Speaker 0 00:42:40 So I, I think it's strange that for all of the training that we had in medical school or I hadn in medical school, and we really never touched on any of these things, and these are, these are survival. These are important for survival. I think a lot of times the burnout that people experience is a direct result of them not knowing how to process the emotional experience of their, of their job. You know, that they, they try to push it away or, you know, looking, you say failed marriages and, you know, substance abuse and, and, um, hyper materialism. A lot of ways that people try to kind of finesse them. But, you know, when you actually lean into these experiences, when you actually kind of open your heart, I found that it is a relief. And not only is it a relief, but I'm a better person for it, and I'm a better doctor for it. Speaker 3 00:43:26 It, it takes agility, by the way, is the word that just keeps beating me across the head as, as you were talking there. It is a, a sponge is an agile, a full sponge is not agile. Uh, suit of armor is not agile from that. Right. Right. Can't, neither one of them can work. And both of those images you just, you burn so boldly into my brain. Um, the, it is interesting too that some of those professions, military, the medical clergy, those seem to be the ones that deal with this a lot. The most. They're the ones that people are gonna turn to off of it and probably have some of the least amount of training. Because I, well, I, I don't know that I can say, because there is a lot that has to be consumed and learned today technically Sure. To be proficient and to survive physically in, in the demands and the rigors of, of all of those professions that I think they all share that. Speaker 3 00:44:21 But on the other side, the, um, the, yeah, the, the most important delivery off of here's are they, they've gotta be able to come at it from a healthy spot. So maybe what I'm one, one of the, one of the top things that I, that I can see is we need to come at this from a healthy position. Mm-hmm. <affirmative> individually. We need to understand an emotional it, it's valuable. I, I'm not say we need, it's highly valuable to us to have an emotional intelligence about ourself. Sure. And an emotional sense of survival and a plan, right. For us, not just how we're gonna conduct ourself, but probably like any good plan, who's to my left and right. Who's watching me even when I'm not talking about me. Like, who do I have, who's my battle buddy as I walk through that so that I could process through and go through those things. That sounds like something that would be really valuable when starting to approach even to help someone else if you can't help yourself. Speaker 0 00:45:13 You know, and we talked earlier about how, you know, you're taking care of loved ones who are, who are, who are starting to have trouble and really need your help. And that, that's, um, hard. I think it's oftentimes isolating oftentimes feels lonely. It often frightening. I think one of the reasons it's frightening is 'cause we're thinking, well, are we next? Am I next? You know, what, what happens? What happens with me? And I think this is kind of like a dress rehearsal on how, how do I, how do I approach my inevitable, um, you know, um, changing and aging and, and I'm not trying to be a Pollyanna and say, make it a positive, like happy time because it's hard. But at the same time, there's a lot of value and joy to be had in, in those experiences as well. Speaker 3 00:46:00 Well, there is, there is there, there's, there can be joy in suffering at some level. Sometimes suffering's a real part of our human experience and our human condition from stuff. And also you look at some of the basic components of stuff, right? The, the most valuable things that we have on this planet, the most valuable things in our lives that we can see all are things that are created with heat, with pressure, and with time. Whether it be a diamond out of a piece of coal or, or, or anything that really forms in that way. These seem to be truths of our human, of, of the worldly position that we've got going on here. There's probably some wisdom in being able to accept when we're going through that process. Sure, sure. And, and then start seeking what those nugget, valuable nuggets are gonna Speaker 0 00:46:46 Be. And the change is hard, but you are, I think, of better or stronger, or certainly more nuanced person for having gone through it, you know? And I think we, we share that. And I think probably when we talk again, you know, we both have been through some very painful things, um, in terms of losing, um, younger sisters. And, and, you know, when I wrote, uh, my book, it wasn't, it wasn't because I wanted to share my own journey. It's because we are all really going through very similar things, and we can learn from each other, we can support each other, we can be kind to each other. And that, that blanket of compassion is ultimately one of the most profoundly helpful things that I can provide as a physician and also as a human being. And it's very relevant in terms of, um, helping someone age. Speaker 3 00:47:38 I honestly don't think it could be said better than that <laugh>. Like, I think you just, you bottled that up and, and that was fantastic. I, um, you know, I, I, I want to go back. I want to try to revisit a couple of these things that we've walked through. I love the, you know, tell 'em what you're gonna tell 'em. Tell 'em, tell 'em what you told them. Uh, you know, as, as we got into this and started talking through ways to, to help a family member, it was understanding how to, um, how to recognize what they can and can't do, but how to help scale, uh, the ambition or what the goals are, and setting those goals, putting something out in front of them as we, as we go to tackle that, giving an opportunity to, to share and to pull out, um, to pull out value mm-hmm. Speaker 3 00:48:21 <affirmative> and, uh, to, to, and maybe that, maybe that even, um, helps educate themselves about what they can't do. I think the, the word, if I remember right, the word for education in general comes from Kar, which is to pull from within to pull mm-hmm. Out from that. So allowing a family member to, to educate themselves by seeing what value they still have. Sure. And building that rapport with them by giving 'em that, being somebody who can provide that opportunity for them. They might not think to do that. Provide them at least that. I mean, start with that, to build that rapport and that that bedside manner and that buy-in and maybe even learn something about them along the way of where they have some place to apply. Uh, and you can help plug them in to make the most of what that is. Um, that was in, in responding and, and kind of working at that, there were some of the top things are anything else that I missed in there that you really wanna highlight for responding to a loved one? Speaker 0 00:49:14 So just, just that, um, if you can connect with others, if you can get into situations that are bigger than yourself, um, you know, if you can help, I mean, one of the greatest things to be able to do and to kind of mitigate your own suffering is to, is to help someone else. Yeah. You know, so a lot of times I think that that, um, people who are aging, um, aren't really felt to have the worth that they actually have. And that if they can find avenues for sharing or helping others, or mentoring, um, uh, younger people, that gives them a whole new purpose and sense of, uh, importance. Yeah. Yeah. And, and, and, and, and value. And that, and that young people are, are, are desperate for those kinds of inputs, uh, from people who have lived full and interesting and complicated lives with a lot of experiences. Speaker 3 00:50:05 Y you know, when, when we talked to, we've had a c a number of guests that have come from other cultures around the world that used the, um, the connection between the generational connections worked a little bit differently within their home countries. Sure. Where, where the, where grandma and grandpa raised the kids, while mom and dad were the wage earners and the, they had the strength and they had the, the, you know, they, they were at their peak to be able to be wage earners to, to bring in for the family. And then that would flip around, and it would be the grandkids that would take care of grandma and grandpa as they got older, because mom and dad were still at that focus. And one of these major byproducts that came out of that was this trust of when mom and dad become the grandma and grandpa, they've seen their own children respond previously to their Sure. Speaker 3 00:50:52 To, to their parents. And so there's this trust that's built and there's this communal experience and an exposure Sure. That happens at a younger age. And, and that reminds me, that's probably a valuable thing as well, exposing young people to a healthy lifestyle and death, or exposing young people to death in general. Right. Where that is and not, not on, not on, not on war, not in war. And what you see there, I am, I, I, I am, I'm not a proponent for that. I honestly for is I don't think the human mind personally, truly is really well equipped to handle war and to process war truly. Mm-hmm. Um, and, and I, it's a, it's an, an, it's something, it's an anomaly. It has to be worked through. So exposing our kids do it is, is not, it's not a great idea, but exposing them instead to just to that, to that shared end state can only help prepare. Speaker 0 00:51:48 Well, when you look at, you know, living wills, um, that, you know, at most 30% of people have living, living wills at most, very, most people avoid discussing death and dying. Yeah. Yeah. Um, people d tend to die in hospitals. They tend to die, you know, um, outside of a family context. And we kind of have this perpetuating, um, fear of death unwillingness to, uh, really talk about it, to integrate it into life. And that's just, that's messed up. And, and that's, that's, and that continues to perpetuate one of the things that's really difficult. Like, if you're helping someone age and die and no one's talking about dying, that's really awkward. You know, I, I guess one of the things that, one of the core things that I've learned is that when I feel something, when I feel like I need to do something or like a little light bulb goes off in my head, say, well, why don't you talk about this? Speaker 0 00:52:41 A lot of times in the past I would've just avoided it or kind of said, nah, you know, I got something else to do. I'm busy. You know, uh, you can always find other things to do. But if I actually like, take a little bit of, you know, a deep breath and then kind of jump in, I end up being so glad I did. You know, that, that, if, that, if I, if I'm worried about dying or if I'm worried about talking about it, but I'm a little uncomfortable that I don't avoid it, that I actually go, you know, let's talk about that. What are you, what are your thoughts on that? What are you feeling about that you create these connections that are, are powerful and meaningful for, for you and for that other person? And so I, I guess I would say that we're all in this together. We all are gonna have similar outcomes, and we need to just be straight up with each other and not try to, to finesse it or avoid it or kind of laugh it away or, or, you know, kind of be, um, preoccupied with entertainment and distraction rather than kind of, you know, the meaning comes from really facing and experiencing these things, not from avoiding them or distracting ourselves or finding entertainments to avoid them. Speaker 3 00:53:44 Yeah. Agreed. Agreed. Dr. Joseph Stern, Jody, I really appreciate you joining us today. I think that was a, a wonderful place to open that up to leave that, because I'm tempted now to go into some of the realities of that, which I know we're gonna jump into our Sure. Our next show. And for those of you that, that are looking to join us, make sure to join us the next time. But before you go, um, is there, um, any place if, if people have, if they're looking for information on your, on your book between now and when you and I come on, uh, where, where can people find more information about you, Dr. Stern? Well, Speaker 0 00:54:16 So I have a, I, so I have a website, joseph stern md.com, and you can look at, I've had articles in New York Times and Washington Post, and they're links to those, um, you can look at, at the book. We also have a, um, kind of a quarterly or, or monthly, um, uh, discussion of some of these topics. And those are available. We have newsletters. So I, I'm, I think it's a good place to start to learn about building the community and making, being the change that we want to see. Speaker 3 00:54:46 Yeah. Well, I, I love that. I appreciate you again, sincerely joining us this week and sharing your time, talents, and treasures with us in the audience. Speaker 0 00:54:54 It's been a delight. Thank you. Thank you, Tony. Speaker 2 00:55:00 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 perspectives. 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 00:55:32 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 consulted 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.

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