Ep 55: The Last Breath, Interview by Dr. Delia Chiaramonte

Dare to Dream Physician Resources:

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Dr. Delia Chiaramonte and Institute for Integrative Palliative Medicine Resources:

The Institute for Integrative Palliative Medicine
https://integrativepalliative.com/

The Integrative Palliative Podcast
https://integrativepalliativepodcast.com/

Integrative Palliative Medicine Interest Facebook Group
https://www.facebook.com/groups/931224730912640

Dr. Delia Chiaramonte on LinkedIn
https://www.linkedin.com/in/deliachiaramonte/

Dr. Delia Chiaramonte on Twitter
https://twitter.com/DrChiaramonte

Transcript

Dr. Gray 0:00

Welcome back to another episode of the dare to dream physician podcast. I'm so glad you're tuning in today. This week is part two in a multipart series where I share my experience and my reflections as I spent the last 40 days of my dad's life with him. And what, what I'm so grateful for is that this was part of my life plan. I didn't realize how important it was to me at the time when I went through the process of life planning was when I first verbalized that I really wanted to be there for my parents at the end of their life. And. I'm so grateful that a year and a half later, I was able to honor that desire. I was able to honor my father, but also just really honor that desire that I had and live in alignment with what's important to me. So that I would not be regretting anything in the future. This is part two where I am being interviewed by Dr. Dalia Kira Monte of the integrative palliative podcast. Dr. Dalia is just a wonderful host, a very wise palliative care physician, and don't worry. We're gonna have more episodes with her. I can't wait to share this one. So let's dive in.

Dr. Weili Gray 1:19

Yeah. And so much of that is being nonjudgmental. Yes. You know, you may have a feeling. You may observe it and you know, you're UN you may be uncomfortable with it, but, but just giving it space, creating the space for that and letting it sit and, and not thinking this is good, or this is bad. I think unconsciously, I would just assume that anything that was uncomfortable or potentially painful was bad. I think

Dr. Delia Chiaramonte 1:44

we were, we're all kind of raised that way. We don't learn skills in dealing with scary and uncomfortable things. And that sometimes you just have to notice them, as you said, without saying, oh my God, why do I feel this way? Or I shouldn't feel this way, or I have to stop feeling this way immediately. Just, this is what's happening for me right now. And I'm just gonna sit within until it passes. And it also, when you sit in that space more often, it makes you more tolerant of other people. Oh, that person's just agitated today or they're just cranky today and it doesn't have to be like, why are they always cranky? And why do people do this to me? And what if they're like this forever? And just be like, well, right now that's where they are and that's

Dr. Weili Gray 2:22

okay. Oh, I cannot emphasize how important that is now to me as a physician. Because every day, I mean, especi I'm sure. Especially in palliative care, but you know, just every day and even as a sleep physician, which is like the least, you know, stressful field um, as far as, you know, the, the, the problems that we encounter, but I come across people who are in pain, who are in distress, who are angry at something and just practicing mindfulness, practicing, active listening, and, and giving them space. Yeah. Not judging, you know, whatever their feelings are that come up or whatever feelings that they may be reflecting at me. Yeah. It brings so much more, well, first of all, um, most of the time I find when, when I do that, I, I can. Grow such a, um, a much deeper connection with the patient. Right. Because even if they come in angry yeah. And I just sit there and I give them some space and I'm, I'm not talking about like 10 minutes, but you know, just even two minutes Yeah. And, and, and, and just, they can feel that, that you're not judging them. They can feel that, that you're giving them space and listening. And, and it's such a deeper connection, um, that, that I can build with the patient. And it's so satisfying because, and, and also, I don't take anything personally.

3:37

Right.

Dr. Weili Gray 3:37

Even if they're angry at me, And I know, well, I didn't even do anything I, I, I, I feel sorry for them, right. I, I can empathize with, wow, they're so distrustful of the medical system or whatever it is, or people in an authority that, you know, they're angry at everybody,

Dr. Delia Chiaramonte 3:53

we call that healing, healing presence. There there's a, I have a podcast episode on that. Maybe you should listen to that one. Cause you, you practice it clearly you practice it and learning healing presence and bringing it to the clinical encounter is not just good for the patient. It's also good for us. It makes us healed and it makes our job more satisfying and less stressful.

Dr. Weili Gray 4:13

Mm. I love it. Yeah. And, and so I actually, there is a really good example of this and, and I've talked to you about this too. My dad, um, did not. Want to talk about dying. And my dad did not want to accept that he was dying. He didn't wanna see himself as dying. Yeah. And that became kind of difficult, um, when this is, when he was fairly weak, um, and he was hospitalized, he had, he had wonderful doctors, outpatient who were taking care of him long term. They knew him really well. And I think it, they worked really, really well with him. And as far as, you know, symptoms and, they were doing a really good job, um, with, with that part of his medical care. But he went into the hospital, um, one of his many hospitalizations and one of the hospitalists who I'm sure was well, meaning that, who didn't know him very well. I think, you know, had met him for the first time. She. Felt really strongly that he should be on hospice. And, and so I think she talked to him about it and he didn't want it. And then she was like, well, maybe there's a language bearer. So let me get an interpreter on the, I don't know what's on the phone or in person, but let me get an interpreter and, um, and talk to him about again. Oh boy. And she got the interpreter and he's like, no, I don't want this. And, um, and, and then she, I mean, she worked really hard at this because she, then she, called his doctors, called my mom. And basically, was trying to convince everybody to kind of be on board with that. He needs to be on hospice. And so anyway, I mean, I, I, I think. I mean I'm I wasn't there. So, you know, I, I can't say exactly how this progressed. I would just say that in the end that didn't work out very well. And at that time, he, he, he did end up being on hospice for a very, you know, I think just like less than a day, but then he had to leave hospice because he needed IV antibiotics and, um, you know, hospice couldn't provide that. And, you know, he was already on, I think, like five days of it. And so he, couldn't not he had to go back to, so he had to leave hospice after being in it for a couple of hours when, when my, when my mom and, and him learned that he couldn't be on continue the, the treatment, um, by the way, that's probably not the best time to be going hospice. Yeah, no,

Dr. Delia Chiaramonte 6:27

but one of the funny things I think in palliative care is sometimes it's the palliative care doctors who. Arguing for the patient not to be on hospice because not all people who are close to the end of their life should be on hospice. If they don't want to, if they want to have aggressive, potentially life prolonging care till the last second, then that's their prerogative in this country. And they should be allowed to have it. And that's inconsistent with a hospice philosophy. And so they shouldn't have hospice. Mm. So it's not about like, yes, you, I'm looking at you and you should have it. It's about here's your medical reality. What do you want? Let's talk about it together and see if this is something that would be helpful for you. And

Dr. Weili Gray 7:04

I think that is a very. Sophisticated and sort of mature approach. And, and I would say, I mean, even earlier in my career, as you know, early in my training, in my career as a physician, I'm, I don't know if I would've been able to do that on, I mean, just to be completely honest. I mean, I, I think when I was like in residency sometimes, I was trained as an anesthesiology resident, you know, sometimes I, I take care of patients and I'm like, wow, like why are they getting all of these things? Right. I mean, it's, it's my own judgment. It's my own sort of, yeah. You know, my own interpretation of what's happening and, and being able to sort of. Distance yourself from your own, your own assessment and judgment of, the patient's choices. Um, I, I, I think it takes a lot of maturity and a lot of skill.

Dr. Delia Chiaramonte 7:53

You just have to learn it though. You just have to learn it. I didn't know it either until I was in palliative care, but it's a skill set that you can learn. It's part of why I'm out here pushing palliative care because primary palliative care is done by every physician and other healthcare providers too. Right? Right. It's just like primary cardiology. You get your blood pressure managed in your family. Doctor's office. Every physician pretty much is managing some amount of pain. So just cuz there's a specialty in, it doesn't mean that everybody shouldn't be doing it and knowledgeable about it. And this is one of those things that you can't just look at someone and say, that's a hospice patient. It's about putting together their personal goals and their medical reality. And if his goal was to not think about or talk about the fact that he's dying and he wanted potentially life prolonging care, it doesn't matter what the hospital thinks it's not appropriate for him.

Dr. Weili Gray 8:41

Yeah. And, and I think it was really only being there and, and seeing what's happening with my dad that really helped me understand and practice that. Yeah. You know, now going forward to, to be able to truly embrace that approach. Um, because I saw like, I, because I understood my dad, you know, I knew that this was who he was and it was absolutely true that this is what he wanted. Yeah. And he, I, you know, he's, he's my dad, so it it's so, so it's, it brings this other layer to, to my understanding. And I, I think that, um, That, you know, ultimately it worked out for him. He actually ended up enrolling in hospice. He didn't even enroll. He, there, there was a point, you know, when he couldn't even swallow anymore. Mainly my mom and I were worried that, well, he can swallow his pills. Like, is he gonna be comfortable? Right. And that's actually when we decided to enroll him in hospice. Um, right. And, and I think that was the right thing for him. I I'm, so I told you, I mean, on a Wednesday morning, um, the hospice nurse came by and, admitted him to hospice home hospice and, and, um, 9:00 AM and then, two around 2:00 PM was when he passed. So he basically was in hospice for one day. Yeah. Um, and, and I am. So grateful for the one day. I mean, it was the perfect timing for him. I'm, I'm so grateful for that one day that he was on hospice. Was it helpful? What was helpful? It, it was so helpful. Great. First of all, I sort of had this feeling that, you know, for, for the few days before then that, you know, some, this is there's something happening fairly quickly. And, and I, I knew that I needed, like, I, I actually can't. So I was doing telehealth clinic for a lot of the time that I was down there. You know, I'm grateful that I was able to do that with my practice. I wasn't doing it every day. So like, let's say, you know, I think that week I had only one full day of telehealth clinic and it happened to be on a day when I was worried about him declining pretty quickly. And I. What if this was, you know, the last day my dad was conscious, one part of my mind was thinking I just have one full day of clinic. I already did the others. Like if I just get this out of the way I'm done for the week, um, the other part of me wondered, you know, what, if this was last day of being conscious, right? What would I regret? Not being able to have those hours with him. And so actually woke up at 4:00 AM and I couldn't go back to sleep. And I thought about that. I asked that myself, that question, and I said, no, it's, it's clear. I need to, I need to cancel that clinic, which by the way, I never canceled clinic. That's I, I think in the seven years that I was an attending, I think I canceled it three times. And one of those times was the week before to bring my dad to the hospital. so I, um, so it was kind of a big deal in my mind. Yeah. But also not a big deal when I asked myself that question, I'm like, of course, this is a no brainer, so there's

Dr. Delia Chiaramonte 11:25

another one, right. You could have said, well, I can't cancel.

Dr. Weili Gray 11:29

And I did say that for a very, very long time in my head.

Dr. Delia Chiaramonte 11:31

Yeah. But then you did it. Right. You canceled it. Yeah.

Dr. Weili Gray 11:34

Good for you. And so, so, right. So that was the Tuesday. And then I was so grateful to spend, uh, that day. Um, and, and again, I mean, he was asleep most of the time and this is the other thing I think that's, that's hard, when you're a family member, who has a busy work schedule and you come and visit your loved one from far away. Um, a lot of the times he was sleeping. Yeah. That's great. Right. And so I, I just, I actually, and I was really tired cuz I was, we COVID came through the house. So that was the other traumatic thing that's so terrible. Oh my gosh. Yeah. So I, I was getting over that and I was, I had this COVID fatigue and so I was tired. And so I'm like, well, if I'm gonna take a nap, I'll just take a nap. And at that point I was, you know, I was past the, the whole thing where I, well, actually my dad also had COVID so that was another story. But anyway, at that time we weren't attempting to quarantine or anything. And so I was like, Um, I, I, I would just take a nap right next to him on the couch. You know, he's on this hospital bed in the living room and I'm just gonna take a nap on the couch. I'm still in the same room as my dad's. That's awesome.

Dr. Delia Chiaramonte 12:36

That's huge. That's huge. It's just being there. You don't have to be standing over his bed, looking at him the whole time. Just being present, just being nearby is so valuable. So

Dr. Weili Gray 12:47

important. Yeah. So a lot of the time was quite anti-climatic, you know, there wasn't like me having deep part to heart conversations with him or anything like that, but it was just, it was just being there and that is the whole

Dr. Delia Chiaramonte 13:00

thing. So grateful it is. It's just being, there is the whole thing I'm

Dr. Weili Gray 13:04

so grateful. And so, so he let's see. So that Tuesday when I canceled clinic, yeah, he was asleep most of the day, but he, there was this moment where, I sat next to him and, I had my kids there and my cousin who, who was visiting, but who was leaving that day? Um, we all sat next to my dad. And first we kind of just gathered around him. He was, he was asleep most of the time, but because my cousin was leaving, we're like, well, let's pray for him. So we did that. We all just, um, we all just sort of, you know what, um, he would wake up every once in a while. And then we, we would, just say one sentence to him, he'll. He would nod and go back to sleep. And it was just such a sweet moment. And, um, at one point he woke up and my aunt was using her iPhone to, to take a video of my, my cousin and my, my five year old daughter. And my dad thought that she was taking like a picture of everybody. So he smiled. Oh, like he, wow. So he looked at the iPhone and he smiled and, and I said, Hey, look, he's awake. And he thinks we're taking a picture. So everyone gather around so we can, you know, just get a picture with, um,

14:12

goong

Dr. Weili Gray 14:12

is what we call him. That's grandfather in Chinese. And, um, and so all the kids ran right next to him. And so we got this picture. So my aunt, you know, wow, switched from the video to the picture and, and she snapped this picture and my dad was smiling. Oh, um, that gives me chills.

Dr. Delia Chiaramonte 14:28

Oh my gosh.

Dr. Weili Gray 14:30

I know it was such an amazing moment. And, and that was the last photo that we have of him.

Dr. Delia Chiaramonte 14:35

Oh, my gosh, it brings tears to my eyes. Wow. See, that's why you just have to be there. Yeah. You just, cuz you never know

Dr. Weili Gray 14:45

you, you don't. And, and I used to say that like I would visit him, um, the last, you know, even the last visit, um, from a couple of months ago we would visit and he was asleep most of the day, but I told my kids I'm like, well, even though it seems like if he's asleep most of the day, then I could go and do whatever I did. But if, if I'm like hiding in the basement, doing something, what if he wakes up for, back then he would wake up for an hour or two hours at the time. I'm like, what if I missed that one or two hours? yeah. So, so, so yeah, and, and I know at the end of his life and you know, the, the second to last day of his life, it was what if I missed that? It was probably like five seconds.

Dr. Delia Chiaramonte 15:22

Yeah. Yeah. Oh, what a beautiful gift.

Dr. Weili Gray 15:25

and, um, and so, so yes, the last day was, when he enrolled in hospice and here's the thing, because my dad didn't really wanna talk about dying. We, we couldn't ask him about, what are your wishes for burial? Like, you know, even talk about, I mean, most of the time we were busy taking care, giving him care and, taking care of the other logistics So when, when my mom, you know, saw that he stopped breathing, she got me from another room. And, um, you know, the really crazy thing is even though like intellectually you're like, yeah, of course, like my dad was going to die. Like I was afraid, afraid of that, like five years ago. Yeah. Um, but when, and seeing him decline so much, I was there with him for the last 40 days of his life. Wow.

Dr. Delia Chiaramonte 16:07

What a gift you gave to him really? And to yourself and to your kids,

Dr. Weili Gray 16:12

the, the natural course of dying. Is not linear. Right? So there were times where he would, he would rally and he would get better. I remember the last time he could go up the stairs, you know, his room is, his bedroom is on the second floor, but he couldn't go up anymore. And he kept saying like, I wanna go up there, but he just, he didn't have the strength, you know, go. And then the last time he could go to the bathroom on the first floor by himself. But then, but then we're like, yeah, you can't really walk anymore. You know, we'll help you and, and do this. And he's like, oh no, no, no, I'm gonna do it. And he, he did, you know, one night and, and so it's like this, you're like, well, is he really declining? But then if you look at the big picture, you know, the average line yeah. Was declining, but then there are ups and downs. And so during that 40 days, I mean, it was challenging cuz that I just sort of, because I was clear in what I wanted, um, I was like, yeah, I'm just gonna be there. I can't leave, you know, he's um, right. he's, he's, he's not well, but, but the rest of my family and even the other, his sister who came, um, to, to help him with the caregiving, you know, I think a lot of people started getting antsy cuz they were like, well, you know, we're yeah, we're getting tired being here, like we're away from home and um, it it's it's so I, I would say. That just being okay with uncertainty, because, you know, at one point I did wonder I'm like, actually I had planned to go back to Vermont, just, just, just for a week, cuz I'm like, well, my dad seems to be okay. I've been here with him for like 30 plus days. I'm just gonna go back to Vermont and, actually was scheduled to meet with, uh, Dr. Unna. Oh, wow. For a day. in Vermont. And this is, someone who I highly admire and who I had actually anticipated, meeting in Vermont, even a year ago, we had planned this day where she was coming to town, so, wow. So anyway, there are so, so many things that would've pulled me away. But in the end, just imagine like on that last day, and actually he died on the day that I was supposed to meet with her in Vermont. Right. Yeah. Wow. And, and so, so just being, so was I disappointed? So first I got COVID so then I'm like, well, I can't go to Vermont cause I can't meet anybody. and I was super disappointed. And, but then I thought, well, you know, that means I'm supposed to be here. like, that means I wasn't supposed to leave and sure enough, it turned out that that was actually the day that, that he passed. Wow. Yeah. And so just being O okay with that uncertainty, because cuz you don't know when people, you don't know when, when, when that last day will be

Dr. Delia Chiaramonte 18:31

right. You don't and, and the truth is none of us know. Yeah. As in. We're assuming he turned out to be right. That he would pass before you, but you don't know that right? There are plenty of young people who die all the time in car crashes and have unexpected things. None of us know. And we shouldn't take that fact to make us feel scared, but rather to make us be like we talked about before in the moment as best you can, like, am I living the moment that I would wanna live one coming to the. Even if it's unpleasant or uncomfortable just being in it, cuz it just is like, it's okay to be restless. It's okay to think, oh my gosh, I've been here 39 days for goodness sake. like that's okay. It doesn't mean every minute has to be happy, but really coming back to how you started it's it is a life planning thing. Like it even would've been okay for you to go to Vermont. If you recognize that. If I go to Vermont and he passes while I'm gone, it's okay. Because I was here and I said all the things I needed to say, so it would be okay. Right. And if that's, if that is the place that you're in, then it's fine to leave. Right. If the place you're in is, oh my God. If I, if I'm in Vermont and he dies, I will never get over it. Then you shouldn't go

Dr. Weili Gray 19:40

to Vermont. Yeah. And that's that that's, those are the questions. It's such a simple question. but I, I think it, it brings so much clarity. Yeah. And so the last day when he enrolled in hospice and then, I mean the hospice nurse, you know, she came at nine, but I think she left around like 11 or 12 and then he passed at two. Wow. And one of the questions that my mom had asked the hospice nurse was, you know, well, what happens when he takes his last breath and it was such a good question and, and ended up being very, very relevant that day. So I'm so grateful that that, first of all, she answered, she, my mom asked that question and then she answered and she says, oh yeah, that's easy. Just call, call the hospice line. This is the other thing that I'm so grateful for is. Even that last day and you know, after he passed it, it would've been, if I was not comfortable with my feelings, it would've been so easy to just even that day focus on the logistics, right? Yeah. Like who do you call? You know, how, and then, oh, what funeral home do we choose? Um, all these logistics. Yeah. Through the self development work that I've been doing, I came to the point where I knew that the most important thing was just to focus. The feelings and the, sort of the, what was going on kind of spiritually and you know, that, that non, um, the non-rational part of, um, of being, and then, and then for me, like, I was still able to take care of the logistics. Like I was the one who called the, the, well, the social worker from hospice also came by, which was so helpful because we had no idea, you know, we didn't know anything about funeral homes. I didn't even know. You know the difference between like a cremation service and a funeral home and all the stuff that they all the vocabulary. I mean, speaking of jargon, right. All the vocabulary. Yeah. Around funeral planning and all of this is total Greek to me. Yeah. And I actually said that to the, to the person on the funeral home. I'm like, they're like, blah, blah, blah. Does he wanna a cremation, blah, you know, an embalmment? I'm like, I, I, this is all Greek to me. can you just explain this in regular words? um, but, but it was so helpful to have, you know, hospice, the nurse who came in to pronounce his death. And even on the last day, we were so grateful to have hospice. That's

Dr. Delia Chiaramonte 21:47

wonderful. So it sounds like they kind of shepherded you through that completely unknown experience. What do you do when someone has just passed has just

Dr. Weili Gray 21:55

died in your house? Yeah. Cuz they didn't teach me that in medical school. No, they don't teach

Dr. Delia Chiaramonte 21:58

you that they don't teach you that. But one of the things that strikes me in your story is that your kids were in the house, right? Yeah. And, and what. A blessing that is, and that may seem insane for me to say, because people often try to shield children from death, but it's an education, right? The reason you don't know anything about it is because no one ever teaches us anything about it, which is insane when you think about it, because a hundred percent of us are going to face this one way or another. And so just showing your children that this is a part of life, and this is how you handle yourself. When someone you love is getting close to the end of their, of their life. And you, you gave them an education that this is just part of life, which is a huge blessing. Yeah.

Dr. Weili Gray 22:41

And. And I always explain to my kids, like, you know, we're visiting go go because he's sick. He's really weak. You know, he's really frail. And then I would say kids, when you give him the opportunity, they just they're. So in the moment, yeah. You know, they they're, they're not judging what's happening. They're not trying to control what's happening. You know that, I mean, most of the time my kids were just kind of playing in the living room, you know, where my dad was good yeah. But that's, and then if he woke, yeah. And if he woke up, they may say hi to him, or, back when my dad was still able to eat, um, my dad, one of the FA he, he, he didn't, eat a lot, but one of the things, if you asked him, if you wanted to, like, if, if I asked my dad, do you wanna eat ice cream? He's like, oh yeah. That was the one thing he would always say yes to, until he couldn't swallow anymore. And so the kids enjoy eating ice cream with him. And so they're, and, and so they. Didn't have this like, looming idea that yeah. Okay. He's going to die. Right. Um, and what happened was when, when the hospice nurse came by, when she examined him, he, she noticed that his hands, his extremities were modeled. And, um, and, and I, that, that was new. And so when she saw that, you know, she sat us down and she said, um, he's actively dying. You know, he may only. Probably one to two days to live. Just, I, I, I didn't wanna be like the doctor in the family and, you know, and also I wasn't really qualified because this is not my specialty. So I sort of in like internally, I had these ideas of, the timing and what's happening, but it was really helpful when, when the hospice nurse sat us down and said, whoa, I mean, even that was news to me, cuz I was, I didn't know that. Okay. It's one to two days, I just knew it was coming soon. And um, and so that was the first time my mom heard that, oh, he is actively dying. Like this is happening really soon. And then after the hospice nurse left, I took my kids downstairs because when she said that, I'm like, oh, okay, this is helpful to have this timing. I sat them down and, told them what was happening. And so that was really, really helpful too. And at first when I sat them down, they're like, so like we know that because I, I was like, well, you know how goong is doing and how he's been weak. And they're like, yeah, we know that yeah. And this is my five year old saying this too. And she's like, yeah, why are you saying this? We know. And I was like, well, what the nurse told us is that he is actively dying and he only has maybe one to two days left to live. And so I was able to sit my kids. So my kids are 12, eight, and five. And so I was able to sit them down and they saw me cry a lot. well, my five year old is the most verbal and kind of open with her feelings. And, and so she said, she said, oh, I didn't know that. Now I'm sad. That was like her first response when I told her about, the dying and, and she said really, and, um, and I said, yeah, we can, we can spend more, you can go upstairs and, watch him and just, enjoy that time with him. And, yeah, so she was grateful that, um, that we talked about it and I think all my kids were. So when it happened, it happened very shortly after. That was probably, I think I talked to them for maybe. 30 minutes or something. So, and so very shortly after that, that was like maybe around one 30 when I talked to them. And then they came upstairs and they had a zoom session, um, with our babysitter on, on the other room. And then very shortly after that my dad passed. So, so it was good that, you know, I was able to, they were like, wait, but what happened so quickly? yeah, I would say the kids handled it really well. Now, if I anxious and irritable, I think they would've noticed. I, I think that, when they see me being more at peace and just, you know, calm about the whole process, right. Just from the time we, we started, I, I think that also they internalized that, or, you know, they, they feel that you, you

Dr. Delia Chiaramonte 26:31

prepared them and you gave them words around it, as opposed to just whatever, you know, fears or feelings came up when you stuff them in the other room. And don't let them see so good for you. If, if you could look back on the whole experience, is there a, a thing or an idea or a particular meaning that comes to you? Like what, what did this experience of being with your dad mean for you?

Dr. Weili Gray 26:55

Wow. I would say that to, to trust ourselves. When, I mean, this is part of the life planning reflections too. When you, even if it's a very soft voice first, give yourself the opportunity to reflect and to, um, just, just that to go through the process of what what's really important to you in your life. Cause it doesn't have to be this, you know, it could be anything. And even if it's a very soft voice that comes up like, oh this, I mean, it's almost an afterthought for me, like to be there for the, with, with my parents at the end of their life. Cuz I, I think the reason why was because I saw so many obstacles to that, like I work, I live far away, you know? And so to give yourself that opportunity to, to voice these things and then to trust that this is important and then just know that there is something so special about the end of life. It's so enriching to the rest of our life. I'm usually like a very cerebral and rational person and allowing myself the time and the space to process what's happening to experience what's happening on a heart level. Yeah, I think it really, it really enriched my life. It, it sort of, and, and it enriched me as a person. It really helped me grow as a person. And it even, you know, like when you think about the person you love, I mean, we all have flaws, right? Like I have a lot of flaws and where there are things that my dad did that annoyed me all the time. Um, and you know, there were like, nobody's perfect, but you know, seeing him at the end of his life, it really helped me get a big picture and, and focus on the things that are really important. And, you know, sometimes the little things that kind of annoy us about our loved ones, like it's so easy to amplify that in our, in our minds, um, in the moment when, when it's happening. But actually my dad was really good at doing that. Like he didn't sweat the small stuff, so, and, and just to, to honor that person, to, to remember their essence, to, to focus on, you know, what, what, what, what I loved about my dad and, and it's not necessarily, it's not like, being naive and looking at the world through rose color lenses. Um, I mean, although there's nothing wrong with that, I think that's a great approach. Um, but it's, it's really just, um, looking at the big view and, and not being so affected by the little things or, or like I was saying before, like before in my life, I, I felt like I was the victim, of my work and things like that. It's like, if I really look at a big picture view of my life, there's so many things I'm grateful for. There's so many things. That are important to me. Like that one little thing is really not important and that's actually why now I am. I'm, I'm still at the same job that I was when I was unhappy and I'm happier than ever. And I love what I do. And so it's, it's just going through life, focusing on the things that are really important and key. Um, and, and that some of the stuff that we focus so much energy on is really not worth our energy.

Dr. Delia Chiaramonte 29:58

A hundred percent. I'm actually writing a book on this topic at the moment, which in my mind is tentatively called flowers in the poop, because that's what I often talk to patients about, which is, not saying everything's great, but saying, this is hard. And I don't like this. But, and then shifting your focus to something that's going well, either internally or in your life or the relationships or the meeting you have in your life or the beautiful day or your air conditioning on a hot day, you know, just sort of choosing where to put your focus makes a huge difference in how we feel. Mm.

Dr. Weili Gray 30:35

Oh, I, well, I'm first. This is the first

30:37

time

Dr. Weili Gray 30:37

I'm hearing that you're writing a book. So that's really exciting. I, I can't wait. I'll definitely read that. It it's such a good perspective, cuz really we all have limited time and like you said, there's no guarantees, right? Like I could have died before my dad, even though, he was in his seventies and had metastatic cancer. There's, there's nothing that we can take for granted. And when, when we have that view, it, it helps us get the most out of every. It

Dr. Delia Chiaramonte 31:05

does it's it's not, uh, pull the blankets over your head kind of feeling it's the utter opposite, which is if that's true, then I shouldn't mess up today. And I shouldn't focus on stupid things that don't matter. And if you know, you didn't get invited to that thing, or you, your pants are tight now, or your oven broke or whatever, you know, who cares because really it's kind of awe inducing that we're on this planet anyway. And birth is awe inducing, but so is death. It's the whole thing is pretty bizarre and amazing and miraculous, and we don't totally understand it. And so having those book ends of our life, you know, birth being an awesome experience, but death also, same thing like on the planet off the planet is pretty amazing. And it's a moment of awe and it that's the sense I got from you too, hearing your story and that with the time that you spent with your dad, it's powerful.

Dr. Weili Gray 32:00

It really was. And I'm just. As you're saying that I'm just picturing the moment I I'm. I'm so grateful that I was there with him for the last 40 days, you know, up until the moment he died. I saw, I didn't see him taking technically his last breath, but I saw like an agonal breath cause when my mom's like, Hey, come in, come in. I, I went and I'm like, he had already stopped breathing, but he took an agonal breath and it was just so meaningful to me to, to be there with someone who I love and, and just see them at the very end of their life. And it is, it really brings so much perspective. You, you just have, I mean, you, it's almost cliche in the mindfulness world, you know, where like focused on the breath, focus on the breath. Right. But it, there, there is going to be a last breath and, and it's like, we it's, it's almost surreal that that will happen one day. But I, I saw that with my dad. It's

Dr. Delia Chiaramonte 32:55

powerful. And what we can do with it is to use it, to do exactly what you talked about at the beginning, which is make sure that the life that we're living right now is the one we're happy about. You know, that we're, we're spending our time on this planet, the way we really want to, with the people we want to contributing the way that feels meaningful to us and not worrying about stupid stuff. I love it. So that's everybody's homework. I always give, uh, a piece of homework at the end of the podcast, but I think that's. That's the homework for everybody this week is just intentionally, even with a little bit of awe to focus on the things that really matter. And I'll add a little bit of what you said too, which is to pay attention to that little bubbling up insight that you might have trust and an idea that you might have or feeling that you might have. That's trying to get your attention. Just take a moment to focus on what that might be and see if that leads your life a little closer to the direction that you want it to. Thank you so much whale for joining us and for sharing this incredible story. This, this fills my heart, this conversation. Thank you so much

Dr. Weili Gray 34:05

for being here. Thank you. Thank you for what, what you offered me, during this difficult and enriching time in my life. And, and for what you do.

Dr. Gray 34:22

That wraps up the two part interview where Dr. Dalia, Kira Monty interviews me on her podcast, as I talk about my experience spending the last 40 days of my father's life with him. the following two weeks, we're gonna be switching seats and I'm gonna be interviewing her so she can share her expertise as a palliative care physician and how we can get the most. As we spend time with our loved ones who's facing a serious illness or a life threatening. you can find Dr. Karara Monte and I encourage you to find Dr. Karara Monte. She will share more about what she does in the future episodes, but you can go right now to our website, www dot integrative, palliative.com. She offers classes in CME and integrative palliative care medicine. She also offers one on one counseling for physicians with loved ones who are facing a serious or life threatening illness. And I, I cannot recommend her highly enough. Thank you for tuning into my podcast. I am really excited to share next week's episode with you. So please tune in. I'll see you next week.