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What really matters at the end of life | BJ Miller | TED
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Well, we all need a reason to wake up.
For me, it just took 11,000 volts.
I know you're too polite to ask,
so I will tell you.
One night, sophomore year of college,
just back from Thanksgiving holiday,
a few of my friends and I were horsing around,
and we decided to climb atop a parked commuter train.
It was just sitting there, with the wires that run overhead.
Somehow, that seemed like a great idea at the time.
We'd certainly done stupider things.
I scurried up the ladder on the back,
and when I stood up,
the electrical current entered my arm,
blew down and out my feet, and that was that.
Would you believe that watch still works?
Takes a licking!
(Laughter)
My father wears it now in solidarity.
That night began my formal relationship with death -- my death --
and it also began my long run as a patient.
It's a good word.
It means one who suffers.
So I guess we're all patients.
Now, the American health care system
has more than its fair share of dysfunction --
to match its brilliance, to be sure.
I'm a physician now, a hospice and palliative medicine doc,
so I've seen care from both sides.
And believe me: almost everyone who goes into healthcare
really means well -- I mean, truly.
But we who work in it are also unwitting agents
for a system that too often does not serve.
Why?
Well, there's actually a pretty easy answer to that question,
and it explains a lot:
because healthcare was designed with diseases, not people, at its center.
Which is to say, of course, it was badly designed.
And nowhere are the effects of bad design more heartbreaking
or the opportunity for good design more compelling
than at the end of life,
where things are so distilled and concentrated.
There are no do-overs.
My purpose today is to reach out across disciplines
and invite design thinking into this big conversation.
That is, to bring intention and creativity
to the experience of dying.
We have a monumental opportunity in front of us,
before one of the few universal issues
as individuals as well as a civil society:
to rethink and redesign how it is we die.
So let's begin at the end.
For most people, the scariest thing about death isn't being dead,
it's dying, suffering.
It's a key distinction.
To get underneath this, it can be very helpful
to tease out suffering which is necessary as it is,
from suffering we can change.
The former is a natural, essential part of life, part of the deal,
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