Lacking a coherent view of how people might live successfully all the way to their very end, we have allowed our fates to be controlled by the imperatives of medicine, technology, and strangers.

Dr. Atul Gawande, Being Mortal

[Editor’s note: Please read the amazing followup stories submitted by viewers here]

To anyone who cares for patients, or for those with loved ones who’ve faced the end of life, this statement rings tragic and true. Strip away the political posturing and nonsensical talk of death panels and the like, and we’re left with a stark truth: that we too often fail to have those difficult but crucial discussions about dying, and this failure leads to untold human suffering and billions in squandered resources. We are failing as caregivers, we are failing as family members, and we are failing as individuals—failing to simply have a conversation that ensures that we direct our own destiny. Plainly put, we need to talk about dying.

  • As patients, death and dying are often the last things we want to discuss and think about. We need to get over it. Who do you want making decisions for you at the most crucial juncture in your life? A set of strangers? Or do you want to control your own care? We need to think about and discuss the types of interventions we’d accept, and more importantly, what we’re willing to sacrifice in the process of reaching our goals of care. We then have to tell our loved ones and care team our wishes, and pick a surrogate to make decisions if we can’t. If we fail at this, we risk unnecessary suffering on a scale that is tough to imagine, while putting our families through a preventable ordeal of guilt and indecision. Here’s one set of resources to get you started.
  • As healthcare providers, we need to do better at starting these tough conversations, often over multiple visits, and preferably in the outpatient world while there’s relatively clear thinking and no imminent crisis. Having more time per patient, as in Turntable Health‘s relationship-based care model, doesn’t hurt either, but upcoming reimbursement changes should help incentivize these crucial discussions. We’ve all seen what happens if we fail at this.

Need help breaking the ice? Here’s Ain’t The Way To Die, based on the Eminem and Rihanna masterpiece Love The Way You Lie. It’s the first video we’ve made that is not funny—well, that is not funny on purpose, in any case. We initially planned to use blatant comedy to break down taboos around the process of dying, but some intense personal stories from our Facebook fans made it clear that this topic required an unprecedented level of gravity.

So Dr. Harry and I wrote lyrics that ultimately sprang from our own experiences caring for patients, young and old, at the end of their lives. Devin Moore blew us away by completely reimagining the instrumental track and laying down such insanely epic vocals that Rihanna herself might need to pull out her Um-b-rell-a. And medical peeps will recognize those tones at the end as actual ventilator sounds, triggering the appropriate PTSD response…

But the clincher? Storyworks productions. They were doing a documentary tentatively called “Wake Up” that featured ZDoggMD and his shadowy real-world alter ego, Dr. Zubin Damania. Hearing the audio track, they immediately offered to shoot the music video as part of the documentary! So now we have a true Hollywood-level production thanks to their amazing contributions.

There’s too many people to thank on this one, so please check the credits in the video. But well-deserved shout outs go to Dr. Michael Fratkin of Resolution Care for his inspiration and feedback, Variables of Light for some pinch-hit videography, and Ellen Goodman and The Conversation Project for helping to light the way.

And a special thanks to Medicare, for finally agreeing to reimburse physicians for conversations about end-of-life care. Tough break, Sarah Palin.

You only die once. Do it on your own terms.



Get ZDoggMD to come speak and perform this song live. Let’s spread the message together!


Just gonna stand there and watch me burn
End of life and all my wishes go unheard
They just prolong me and don’t ask why
It’s not right because this ain’t the way to die, ain’t the way to die


I can’t tell you what I really want
You can only guess what it feels like
And right now it’s a steel knife in my windpipe
I can’t breathe but ya still fight ‘cause ya can fight
Long as the wrong’s done right—protocol’s tight

High off of drugs, try to sedate
I’m like a pincushion, I hate it, the more I suffer
I suffocate
And right before I’m about to die, you resuscitate me
You think you’ve saved me, and I hate it, wait…

Let me go, I’m leaving you—no I ain’t
Tube is out, you put it right back, here we go again
It’s so insane, ’cause though you think it’s good, I’m so in pain
I’m more machine than man now, I’m Anakin

But no advanced directive, I feel so ashamed
And, crap, who’s that nurse? I don’t even know her name
You lay hands on me, to prolong my life again
I guess you must think that this is livin’…

Just gonna stand there and watch me burn
End of life and all my wishes go unheard
They just prolong me and don’t ask why
It’s my right to choose the way that I should die


You ever love somebody so much, you can barely see when you with ‘em
That they, lay sick and dying but you just don’t wanna let ‘em
Be at peace cause you miss ‘em already and they ain’t gone, beep beep, the ventilator alarms
I swore I’d never harm ‘em, never do nothing to hurt ‘em
Hippocratic oath “primum non nocere” now I’m forced just to torture ‘em
They push full code, no one knows what his wishes were
His sister heard him say once, “I don’t wanna be a vegetable”
But no one agrees in the family his caregiver Kate wants him comfort care but Aunt Claire lives so far away
That her guilt eats her like cancer so she answers, “Wait! I think he’ll wake”
Maam, you ain’t even in the state!
Palliate, relieve pain, get him home, explain
Critical care? Just hypocritical when it’s so insane
But they insist I shock his heart again so I persist
Guess that’s why they say that love is pain.

Just gonna stand there and watch me burn
End of life and all my wishes go unheard
They just prolong me and don’t ask why
It’s my right to choose the way that I should die, the way that I should die