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Hope, Resilience, and Death: A Candid Conversation with Dr. Kathryn Mannix
49 Plays2 years ago
In this heartwarming episode of The Glam Reaper Podcast, your host Jennifer Muldowney sits down with the amazing Dr. Kathryn Mannix, author of the insightful and thought-provoking book 'With The End In Mind.' Together, they delve into the profound wisdom of dying and death that the book captures.
Dr. Mannix's contributions to the realm of palliative care extend far beyond authorship. She is recognized for initiating the first Cognitive Behavioral Therapy (CBT) clinic exclusively dedicated to palliative care patients, potentially a global first. She has also created a 'CBT First Aid' training module designed to empower her fellow healthcare professionals and help them up-skill and improve patient care.
The topic of death often invokes fear and apprehension. However, Dr. Mannix's extensive experience in caring for the dying suggests an alternative perspective, one that portrays death as less frightening and more peaceful than generally perceived. This episode highlights the reasons behind the common fear of dying and discuss potential ways to alleviate such anxieties.
But today's discussion is not just about death and the fears that people associate with it. It’s also a conversation of hope and resilience, as Dr. Mannix also tells stories from her years in palliative care that highlight these qualities. These narratives are proof that love and hope can flourish even in the most challenging circumstances.
Stream this episode and join us for this insightful and inspirational discussion on hope, resilience, and death.
LITTLE NUGGETS OF GOLD:
- Dr. Mannix’s book, With the End in Mind, which reacquaints us with the universal, but deeply personal, process of dying
- Her 30-year career in palliative care and her life’s journey
- How Dr. Katherine's experience in palliative care reveals that the process of dying can be less frightening and more peaceful
- Why most people fear dying
- The beauty of human resilience: Dr. Kathryn’s stories from dark places of hope and love
Resources Mentioned:
With the End in Mind: https://www.amazon.com/End-Mind-Dying-Wisdom-Denial/dp/0316504483
Connect with Dr. Kathryn Mannix:
Facebook: https://www.facebook.com/DrKathrynMannix/
Instagram: https://www.instagram.com/drkathrynmanni
Website: https://withtheendinmind.co.uk/
Connect with Jennifer/The Glam Reaper:
Facebook Page - Muldowney Memorials: https://www.facebook.com/MuldowneyMemorials/
Facebook Page - Rainbow Bridge Memorials: https://www.facebook.com/rainbowbridgememorialsdotcom
Instagram - @muldowneymemorials & @jennifermuldowney
Twitter -
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Transcript
Introduction to Living While Dying
00:00:00
Speaker
But they're stories about how people live while they're dying, aren't they?
00:00:04
Speaker
They're actually stories about living.
00:00:07
Speaker
And I couldn't read the audio book.
00:00:10
Speaker
I couldn't do it.
00:00:11
Speaker
I got an actress to do it.
00:00:13
Speaker
Thank God for Elizabeth Carling.
00:00:14
Speaker
She's absolutely super.
00:00:17
Speaker
Because I couldn't read it without tears.
00:00:21
Speaker
Because it's all about how completely amazing human beings are when it really comes down to it.
00:00:29
Speaker
and what struggles they will make and what things they will do for each other because it turns out that what matters most to us in the end isn't isn't actually death it's love
00:00:51
Speaker
Hi everybody and welcome to another episode of the Glam Reaper podcast.
Guest Introduction: Dr. Catherine Manning
00:00:56
Speaker
I'm your host Jennifer Muldowney aka the Glam Reaper herself and on today's episode I am so excited, totally fangirly, have been a fan of this lady for a long time and you've probably heard me mention her a gazillion times before on social media and I'm so so so excited that she is now my guest on the podcast.
00:01:16
Speaker
It is Dr. Catherine Manning.
00:01:19
Speaker
and she needs probably no further introduction but she has an incredible ted talk she's written books she's a palliative care doctor and i just i love all things that she that comes out of her mouth so i'm really excited to get into this so catherine welcome oh jen thank you so much for inviting me it's so lovely to be with you
00:01:37
Speaker
you're just oh so for anybody who I guess doesn't know um well for me you so you've written more than one book but there's one that stands out for me which is with the end in mind and I I talk about it all the time I know you've just got a new book out that came out sort of during COVID and you'll tell us a little bit about that um
00:02:01
Speaker
It just the book for me.
Impact of Dr. Manning's Book
00:02:03
Speaker
So I work in the funeral space.
00:02:06
Speaker
And because of that, a lot of people assume I'm OK with death and that I'm OK with dying and that, you know, all of the things are are OK.
00:02:16
Speaker
And I'm not necessarily, you know, just because I'm a funeral planner, event planner, but for funerals and I work with people who have passed away and people who are grieving and bereaved.
00:02:29
Speaker
It doesn't mean I'm any more ready for my life to be over or for anything like that.
00:02:34
Speaker
And I actually did always have this fear of what would it be like and reading your book.
00:02:41
Speaker
And I was reading it as a part of research into what I do.
00:02:45
Speaker
It just happened to be one of the books that I actually took out from the library at the time.
00:02:50
Speaker
And I just, I can't recommend it enough to people who are worried about death or about dying because it just gave me such comfort.
00:03:01
Speaker
And I want to hear your take on it.
00:03:03
Speaker
But for me, when I describe people to people, it's...
00:03:09
Speaker
It's there's just a series of breaths and it's it's it's just a letting go of a of a breath is what I kind of took from it.
00:03:17
Speaker
And I actually only reread it again recently.
00:03:20
Speaker
The stories are just so incredible and I get emotional even thinking about some of them.
00:03:26
Speaker
But yeah, it just it just gave me peace, a peace that I'd never know before I read the book.
00:03:32
Speaker
And it's not the easiest book to read because of the topic that's in it.
00:03:36
Speaker
And I'm trying to get I want my mom to read it, but she's she's having difficulty with it because I think a lot of people do.
00:03:42
Speaker
But tell me is what what's your what would you sum up?
00:03:48
Speaker
I guess, dying to be, if somebody said, you know, you have to sum it up.
Comfort in Dying and Grieving
00:03:53
Speaker
Well, I guess what you've just said, that's really lovely.
00:03:57
Speaker
And I guess that for me, that says, well, job done.
00:03:59
Speaker
That book is doing the work that it kind of got sent out into the world to do.
00:04:06
Speaker
And just to pick up your introduction, because it's really interesting that it sounds to me like we're two sides of the same coin where I'm really familiar with the approach into dying.
00:04:18
Speaker
And the more I see of it, the less I fear it, the less I fear it for myself or for the people that I love.
00:04:26
Speaker
And yet I was always very anxious that I wasn't comfortable in the company of bereaved people.
00:04:34
Speaker
You know, in palliative care, you know, you can put me in that room where that person is dying and I know how to be, what to do.
00:04:44
Speaker
I'll notice the person who's hanging back and I'll try to help them to work out what's making them feel reluctant to be closer to this person who they really love, who's about to die.
00:04:54
Speaker
What can we do that helps them to feel engaged and involved enough that they won't wish that they'd acted differently afterwards, you know?
00:05:02
Speaker
Or, you know, if the person perhaps doesn't look comfortable and people should be comfortable as they're dying, it's an important message that we ought to be able to manage symptoms so that people
00:05:13
Speaker
are not having what they imagine is going to be their worst day.
00:05:18
Speaker
And we'll be honest here, you know, it's not going to be your best day, but you will have had worse days that the kind of symptom management that runs alongside understanding that somebody's
00:05:32
Speaker
reaching the end of their life is what palliative care is all about.
00:05:35
Speaker
It's not really about the dying, it's about the comfort.
00:05:39
Speaker
So people should be comfortable and their families should be able to engage and be with them and talk to them and comfort each other around that bed.
00:05:49
Speaker
So I'm strangely at peace in that space.
00:05:55
Speaker
And then the person dies and
00:05:59
Speaker
And then the family is plunged into this space where their life is apparently the same, but this linchpin person.
Grief as Love's Extension
00:06:09
Speaker
is completely missing.
00:06:09
Speaker
And you see this all of the time.
00:06:11
Speaker
And I feel useless.
00:06:14
Speaker
I've got nothing.
00:06:15
Speaker
I'm uncomfortable.
00:06:16
Speaker
I don't know how to be.
00:06:18
Speaker
I haven't got any jobs to do.
00:06:20
Speaker
And I really don't like that.
00:06:21
Speaker
So it's really interesting, isn't it, that I, at that point, hand over to people who say, yeah, okay, I'm comfortable in this space.
00:06:29
Speaker
I get that grieving people
00:06:33
Speaker
can't be made better, that it's not an illness, it's a condition that's part of life, it's part of love and loss, and I can be in that space with them and facilitate them to move through the processes that they've got to observe for registering a death, organising a funeral, all the other things.
00:06:53
Speaker
And then all those people who work in grief and bereavement who are able to hold space, because we know, don't we, that bereavement, grief,
00:07:03
Speaker
It lasts as long as love lasts.
00:07:05
Speaker
And since you would rather hope that the love will last forever, then sadly, that also means that in some shape or form, the grief will also last forever.
00:07:14
Speaker
So I've been doing homework about getting more comfortable on the other side of death.
00:07:18
Speaker
And I love that your book, that your reading of my book has made you more comfortable on my side of death, if you like.
00:07:26
Speaker
Yeah.
00:07:27
Speaker
Isn't that lovely?
00:07:28
Speaker
You know, it's so lovely and it's so fascinating to me because, you know, I've only been doing this.
00:07:34
Speaker
I wasn't born into it or anything.
00:07:36
Speaker
I came through to us through loss myself.
00:07:41
Speaker
But it's been interesting because people often say, I don't know how you do what you do.
00:07:46
Speaker
I just have this feel, whatever you believe in, God, the universe, you know, or there's nothing or whatever it is that your beliefs are.
00:07:53
Speaker
I believe that we're all put here on a path or in a place to do certain things.
00:08:00
Speaker
And this was absolutely my calling, without a doubt.
00:08:05
Speaker
And I don't know how you could do what you do.
00:08:08
Speaker
And I don't know how, like I've often made this comment, I don't know if you've ever seen the movie Bridesmaids.
00:08:14
Speaker
And so and when she's in the car, she has all the puppies in the back.
00:08:17
Speaker
Like that's literally me.
00:08:18
Speaker
If I worked in a pet adoption facility, I'd be like, they're coming home with me.
00:08:22
Speaker
There's no way they're like, you know, I'm just I could not work in a facility with children where they were ill or and I think each of us has this heart of us that that is is here to help.
00:08:37
Speaker
And so it is it's so fascinating that we're coming from two sides of the coin, as you said, and it's
00:08:44
Speaker
And yeah, it's just, I mean, each story in that book, it's such an emotional book.
00:08:49
Speaker
And let me tell you, for anybody who hasn't read it and who's listening, it is an emotional book.
00:08:53
Speaker
It's beautiful, though.
00:08:55
Speaker
And you can pick it up and put it down and do one story at a time.
00:08:59
Speaker
And I just think it's it's such an important book for people who have any sort of a fear and any of my families I work with on the pre planning side where maybe we've done mom's funeral and now they you know, they're super comfortable with me.
00:09:11
Speaker
So they kind of want to plan dad and maybe dad, you know, isn't doing so well.
00:09:17
Speaker
And now they're worried and, you know, they talk to me because you do become part counselor and therapist.
00:09:22
Speaker
And I always recommend your book because I just think it gives such peace because.
00:09:27
Speaker
For me, it nearly wasn't even my own death.
00:09:30
Speaker
I was scared of that, but I was more scared of my parents.
00:09:33
Speaker
And I don't want to get emotional now because they're still alive.
00:09:36
Speaker
But I know that day will come and it's.
00:09:40
Speaker
yeah just to know that they wouldn't and there was even and I'm actually going to read this because I think it's just so beautiful there was um a review you got um about a book um and he just he said you know I got like that he said it took him a long time to read mainly because he had to put it down often to digest it um and he said you know modern society does not talk about death enough
00:10:04
Speaker
we tend to hide from the inevitable rather than understand it.
00:10:08
Speaker
And this book shines a light on what comes to us all.
00:10:11
Speaker
And then he said, which I thought was incredible, on a personal note, it's helped him put to bed something that has been plaguing
Understanding the Dying Process
00:10:17
Speaker
him for a quarter of a century.
00:10:19
Speaker
When he was in hospice, when his mother died, and for 25 years, he thought that she'd been struggling and fighting for breath at the end.
00:10:26
Speaker
And it had haunted him.
00:10:28
Speaker
And now he knows that that's not the case.
00:10:31
Speaker
I mean...
00:10:33
Speaker
that's astonishing isn't it I I cried that that review went up on Amazon just a few weeks ago and I just sat and wept for those 25 tortured years when nobody explained to him at the bedside of his dying mom
00:10:51
Speaker
what he was watching and hearing so you asked me to explain the process and then I diverted into something else so let's just go there for a moment um yeah that's okay this is where my partner okay and this is where everybody gets up and puts the kettle on instead of listening so it's it's not too not too terrible so here's the thing that as we get towards the end of living and go into the process of dying and
00:11:15
Speaker
It's a bodily process, just like all the other bodily processes we've got.
00:11:20
Speaker
So just how a person giving birth for the very first time, their body knows what to do.
00:11:28
Speaker
this process of dying really like giving birth is a series of different changes that happen in more or less the same order in more or less every person and that helps us just like midwives with a woman in labor it helps us to be able to think oh this is where this person is up to now this is where this dying is up to now and so
00:11:49
Speaker
we can and I believe we should and we have a responsibility to talk to the beloved people around that bed and explain exactly what's going on all the way through.
00:12:02
Speaker
Just like a midwife does for the person in labour and their birth partner.
00:12:06
Speaker
They've done all of the prep in advance.
00:12:08
Speaker
They've had the conversations that say, you know, this is what's going to happen and I will ask you to
00:12:13
Speaker
you know, breathe in a particular way or push or not push and you need to listen to what I'm saying.
00:12:20
Speaker
So let's practice it now.
00:12:21
Speaker
And then on Labour Day, people know what to do.
00:12:27
Speaker
I think we should be midwifing death in the same way.
00:12:30
Speaker
Preparation up front.
00:12:32
Speaker
So when we come to that day, we're not telling people for the first time, we're reminding them of stuff we've already talked about.
00:12:39
Speaker
And this is the stuff.
00:12:41
Speaker
Towards the very end of somebody's life, they are coming in and out of unconsciousness.
00:12:46
Speaker
They have no control over that.
00:12:48
Speaker
Some of the time they'll be asleep because sleep recharges our energy batteries and that sleep is really important.
00:12:55
Speaker
So if people feel like, you know, they're really tired all of the time, they're spending quite a lot of time asleep,
00:13:01
Speaker
and there are important conversations to have, have a snooze.
00:13:05
Speaker
Have a snooze first and then try and have that conversation.
00:13:08
Speaker
Otherwise, you might run out of energy halfway through.
00:13:12
Speaker
And as time goes by, people are sleeping for longer, they're awake for less time, and eventually they're just drifting into deep unconsciousness.
00:13:23
Speaker
Once your brain is completely unconscious, there's only two bits of it that seem to still be doing anything.
00:13:31
Speaker
Interestingly, one of those is hearing, that it seems that we can still respond to sound and still hear sound.
00:13:39
Speaker
We don't know how much people can make sense of sound by that stage.
00:13:44
Speaker
But we always tell families to keep talking, play the person's favourite music, let them hear your voices.
00:13:50
Speaker
And we see people just looking calmer when the right voices are in the room.
00:13:58
Speaker
But the other thing, bit of the brain that's doing all the work now is the bit that manages our breathing.
00:14:05
Speaker
Its technical name is the respiratory centre.
00:14:08
Speaker
It's deep down in the back at the bottom of the brain, just above the top of the spinal cord.
00:14:13
Speaker
So it's a really primitive part of the brain.
00:14:17
Speaker
It doesn't do any thinking or reflecting or having ideas.
00:14:20
Speaker
It just drives cycles of breathing.
00:14:24
Speaker
So most of our lives, we don't even think about our breathing.
00:14:29
Speaker
You're thinking about your breathing now, aren't you?
00:14:31
Speaker
Yeah, and everybody who's listening is thinking about their breathing.
00:14:34
Speaker
Okay, so we don't normally think about our breathing.
00:14:37
Speaker
But actually everybody at the moment is managing their breathing.
00:14:42
Speaker
So I'm managing my breathing so that I can breathe in and I've got a microphone just under my chin.
00:14:46
Speaker
So I need to breathe in in a way that doesn't make some terrible noise that terrifies everybody.
00:14:51
Speaker
And I'm breathing in enough that I can breathe out in a controlled way that says a sensible phrase or two before I pause to take the next breath and so on.
00:15:02
Speaker
In the meanwhile, everybody else who's listening is managing their breathing so they're not distracted by noises of their breathing.
00:15:10
Speaker
in the back of their throat.
00:15:11
Speaker
So you know how when there's something coming on the radio, you're waiting for an announcement, you're waiting for a football score, and you almost hold your breath.
00:15:19
Speaker
And that's probably partly so that the noise of our breathing doesn't distract us from hearing the thing that we're waiting to listen to.
00:15:26
Speaker
So we don't think about thinking about our breathing.
00:15:30
Speaker
But we do quite a lot of the time actually manage our breathing without really thinking about it.
00:15:35
Speaker
The unconscious brain, nothing is managing the breathing now.
00:15:40
Speaker
apart from that respiratory centre.
00:15:42
Speaker
So the breathing does something that we wouldn't normally see.
00:15:46
Speaker
These are automatic cycles of breathing.
00:15:49
Speaker
They go from being very deep to gradually more and more and more shallow.
00:15:55
Speaker
They go from being quite fast to gradually slower and slower and slower.
00:16:01
Speaker
Sometimes you might have that fast breathing at a shallow phase.
00:16:08
Speaker
Well, if you see a person you love lying in bed and they're breathing fast, but it's not very deep, if you didn't know any better, you would think that they were fighting for breath, that they were breathless, that they were panting.
00:16:19
Speaker
So the midwives around the deathbed, the death wives, if you like, need to be explaining that this is breathing that we see in people who are deeply unconscious, who are way beyond
00:16:31
Speaker
feeling bodily discomfort.
00:16:33
Speaker
There are other times when the breathing might be slower, but because we can't feel what our body's doing anymore, we might have our vocal cords just a little bit tense.
00:16:45
Speaker
And so you breathe out through your vocal cords and it makes a noise.
00:16:49
Speaker
And it's almost like an out-breath snore, you know, because snoring is normally an in-breath, but it's a kind of...
00:16:58
Speaker
Okay,
Clarifying the 'Death Rattle'
00:16:59
Speaker
what if you haven't heard that before and you love this person?
00:17:03
Speaker
Well, what are they trying to say?
00:17:04
Speaker
Are they distressed?
00:17:05
Speaker
Are they moaning?
00:17:06
Speaker
What's going on?
00:17:07
Speaker
So again, the death whites need to be saying, oh, this breathing, this sound, we see this in deep unconsciousness.
00:17:15
Speaker
And how do I know this person's unconscious?
00:17:17
Speaker
Well, because of another noise they're making.
00:17:19
Speaker
If you think about one of the most sensitive parts of our bodies, the back of your throat.
00:17:24
Speaker
it's been designed so that it protects our airway so if anything touches the back of your throat and you know toast crumb drop a coffee going down the wrong way whatever it is we know immediately we start coughing heaving and retching to clear it so let's just go and have a look at this person on their deathbed deeply unconscious lying on their back and listen to this weird
00:17:49
Speaker
gurgling, rattling noise that their breathing is making from time to time.
00:17:54
Speaker
So it isn't all of the time and it doesn't happen in every person, but it happens often enough that we should be talking about it.
00:18:02
Speaker
This is the sound of air moving in and out of the airway and it's moving through a little bit of liquid.
00:18:10
Speaker
A little bit of liquid is probably about a teaspoon of liquid.
00:18:15
Speaker
And it's lying at the back of the throat and the person isn't coughing, isn't gagging, isn't trying to clear their throat because they can't feel it.
00:18:24
Speaker
And if they can't feel that most sensitive part of their body, they're almost certainly not feeling other discomforts from other bits of their body.
00:18:35
Speaker
So where's that fluid come from?
00:18:37
Speaker
Well, it'll be little bits of saliva from their mouth.
00:18:39
Speaker
It might be the fluid that we've used for cleaning somebody's mouth and keeping it fresh.
00:18:43
Speaker
Might be bits of phlegm that have dribbled down from the back of the nose or been coughed up from the lungs.
00:18:48
Speaker
Sorry, folks.
00:18:49
Speaker
But just, you know, a tiny little bit of fluid making an enormous amount of noise.
00:18:57
Speaker
And the family going, oh my God, what is that noise?
00:19:00
Speaker
That sounds awful.
00:19:01
Speaker
Is he suffering?
00:19:03
Speaker
Is he drowning?
00:19:04
Speaker
Is he drowning?
00:19:05
Speaker
Is his throat closed over?
00:19:07
Speaker
Is he choking because there's stuff down the back of his throat?
00:19:10
Speaker
So no, let's just stop and listen to the noise.
00:19:13
Speaker
It's regular.
00:19:14
Speaker
It's with every breath.
00:19:16
Speaker
The breath is going in.
00:19:17
Speaker
The breath is coming out.
00:19:19
Speaker
Nothing is stopping the breath.
00:19:21
Speaker
The lungs are working.
00:19:22
Speaker
The breathing is happening.
00:19:24
Speaker
The person is deeply unconscious and not clearing their throat.
00:19:29
Speaker
So that death rattle noise that distresses us all so much actually
00:19:35
Speaker
is a sign that this person is deeply, safely unconscious.
00:19:41
Speaker
And instead of us getting all het up about it, really, perhaps we need to be reminding each other that, yeah, dad is making that weird noise.
00:19:51
Speaker
Because actually he's deeply unconscious.
00:19:53
Speaker
He's completely safe.
00:19:54
Speaker
He's way beyond feeling distressed.
00:19:57
Speaker
It's weirding all of us out.
00:19:59
Speaker
Maybe we need to sing.
00:20:00
Speaker
Maybe we need to put the radio on.
00:20:02
Speaker
Maybe we need to play his terrible rock records, whatever, whatever.
00:20:06
Speaker
Maybe we need to make the sound less obvious in the room.
00:20:10
Speaker
But it's not bothering Dad.
00:20:11
Speaker
And we need to remember that it's not bothering Dad.
00:20:15
Speaker
And then during one of those phases, usually when it's slow breathing, possibly when there's long pauses, usually when it's not very deep breathing.
00:20:22
Speaker
But again, you know, there are exceptions to this too.
00:20:27
Speaker
There will be a breath out.
00:20:32
Speaker
that just isn't followed by another breath in.
00:20:34
Speaker
So that's really so not Hollywood, isn't it?
00:20:37
Speaker
The Hollywood last breath comes with special effects and violins, but it also often comes with sitting up, regaining consciousness, telling people where the treasure is buried or which of the children actually wasn't really ever theirs in their first place or, you know, dramatic stuff.
00:20:55
Speaker
Because Hollywood's using dying as a device.
00:20:58
Speaker
It's not really about the dying person.
00:20:59
Speaker
It's about what happens to the people around the bed.
00:21:03
Speaker
But actually, in ordinary dying, almost never does the person suddenly regain consciousness and say something.
00:21:11
Speaker
But very, very rarely they do.
00:21:15
Speaker
Almost never do they open their eyes and smile at everybody.
00:21:19
Speaker
But very rarely.
00:21:20
Speaker
Very occasionally, they do.
00:21:23
Speaker
So if we've got important stuff to say, do not save it for the last Hollywood moment when you think the person's going to suddenly regain consciousness because you're going to be so disappointed like 998 times in a thousand.
Reality vs Hollywood: Dying Moments
00:21:39
Speaker
Let's say what matters while we still can.
00:21:42
Speaker
So if there are people who we love and we think, you know, I really should tell that person, but perhaps I'll wait until they're completely unconscious.
00:21:50
Speaker
Have another think about that.
00:21:53
Speaker
Have another think.
00:21:56
Speaker
I mean, Catherine, I could listen to you all day.
00:21:59
Speaker
I mean, it's just...
00:22:02
Speaker
It's just such a I think it's just such a gift to people.
00:22:08
Speaker
Your book, it's just hearing that it's just.
00:22:14
Speaker
It's such a scary thing.
00:22:15
Speaker
I mean, what is it?
00:22:16
Speaker
They say people are scared, scared of dying and then public speaking is not the two things, you know.
00:22:23
Speaker
So what are we about?
00:22:27
Speaker
fellow dead talkers who work in the death space.
00:22:28
Speaker
I don't know.
00:22:29
Speaker
We're just some anomalies.
00:22:32
Speaker
But I just think it's that breath in.
00:22:36
Speaker
I just, you know, and that's, you know, or the breath out, sorry, and just not the final breath out.
00:22:44
Speaker
I just think it just...
00:22:46
Speaker
It's not Hollywood.
00:22:47
Speaker
It's not, you know, lights, camera action and the violin playing, but it's still just so it's like everything, I guess, how much we overthink everything in our heads and our fears.
00:23:00
Speaker
That's really our fears.
00:23:01
Speaker
I mean, I'm terrified of spiders, terrified.
00:23:04
Speaker
Now, I mean, really, why do you like and I have conversations with them like I initially, you know, if one is in my house, like, why did you come into my house?
00:23:12
Speaker
You know, now I have to kill you and all that sort of stuff.
00:23:14
Speaker
And I have conversations with them.
00:23:15
Speaker
But like, really, if I if I stood outside of myself, my own fear.
00:23:19
Speaker
what has this creature going to do to me you know it's all overthinking it's just that's what our fears are about and I just think your book and because of the way it's divided I think into the stories as well um it's just it does it in a palatable way you know it's it's bearable and it's it brings your emotion and you talk about the different journeys um that that each of the different cases go on and
00:23:44
Speaker
Yeah, I just think it's just so lovely.
00:23:47
Speaker
I think it's just such a gift to give to people that, I mean, it is.
00:23:50
Speaker
It's such a fear of everyone.
00:23:51
Speaker
And I feel more prepared for my own.
00:23:54
Speaker
I feel more prepared for my parents' one.
00:23:57
Speaker
It's, yeah.
00:23:59
Speaker
That is lovely to hear.
00:24:00
Speaker
I mean, there's a reason I chose stories because I could have written a kind of bullet point list, textbooky kind of book.
00:24:09
Speaker
Yeah.
00:24:11
Speaker
And the reason I chose stories was I was thinking back to my grandmother.
00:24:16
Speaker
My grandmother was born in 1900.
00:24:18
Speaker
And so that was handy because we always knew how old she was going to turn in the April of each year because it was the same as the number of the year.
00:24:30
Speaker
And so she was really familiar with dying and death because when she was a teenager and in her 20s, in the 19-teens and the 1920s, you know, she was one of the older girls in a big family and she would have helped when family or friends were so sick that they were dying.
00:24:49
Speaker
The hospital didn't have anything to give to dying people.
00:24:52
Speaker
People died at home and their family and their neighbours tended to them.
00:24:56
Speaker
So she would have been part of that.
00:24:58
Speaker
She would have been shown...
00:24:59
Speaker
what to do and have things explained to her by her own mum and by her aunties.
00:25:05
Speaker
And she almost certainly expected that in time she would pass on all of that knowledge and wisdom to her daughters.
00:25:13
Speaker
Yeah.
00:25:14
Speaker
So what happened?
00:25:16
Speaker
Well, in the 1930s, by the time she was in her mid-30s, one of her children had died of an illness that we routinely immunise children against now, diphtheria.
00:25:28
Speaker
And her husband had died of sepsis when his appendix was.
00:25:33
Speaker
So there she is.
00:25:35
Speaker
She's attended lots of deathbeds.
00:25:37
Speaker
Her child has died.
00:25:39
Speaker
She's a widow.
00:25:39
Speaker
She's got four other children.
00:25:42
Speaker
That's the same experience that women have had about dying and death for hundreds of years.
00:25:49
Speaker
But in the background, there were kind of social improvements going on.
00:25:54
Speaker
In the 20th century, immunisations were starting.
00:26:00
Speaker
The conditions in which people lived were better sanitised.
00:26:04
Speaker
And so the age at which people were dying started to rise.
00:26:10
Speaker
So life expectancy for baby girls born in 1900 in England was 46.
00:26:20
Speaker
By the age of 46, half of those girls were expected to have died.
00:26:25
Speaker
And the other half would be dying over ever so long.
00:26:30
Speaker
So by the time she was 46, the Second World War had just finished, 1946.
00:26:37
Speaker
And two years later, here, the National Health Service started.
00:26:43
Speaker
I became a consultant in palliative medicine in 1995.
00:26:51
Speaker
she was alive to see that.
00:26:55
Speaker
Wow.
00:26:55
Speaker
And a couple of years later, she said to me that she was a little bit worried about what might happen when she was dying.
00:27:02
Speaker
And I thought, okay, this is an interesting conversation that I never expected to have with my nana.
00:27:10
Speaker
So what's the worry then, Nana?
00:27:13
Speaker
You know, I'm not worried about doing the dyeing.
00:27:15
Speaker
I've seen plenty of that.
00:27:16
Speaker
That's okay.
00:27:17
Speaker
I know that's going to be okay.
00:27:19
Speaker
I'm worried about your mum and your auntie and your uncles because I don't think they've ever seen anybody die.
00:27:29
Speaker
And it just came home to me like this kind of thunderclap in my head that in the space of a single generation, that's my parents' generation,
00:27:38
Speaker
The people of, well, for my purposes, England, but actually for our purposes, the whole of the rich industrial nations of the world who have modern healthcare had shifted dying into hospitals because there'd been such fantastic medical advances.
00:28:00
Speaker
You know, antibiotics became available.
00:28:02
Speaker
It would have saved my grandfather's life had they been available.
00:28:05
Speaker
when he was so sick ventilators organ transplantation better anesthetics you could do longer surgery so you could get more done better cancer treatments people weren't dying of things that they used to stay home and die of they were rushed into hospital where a lot of them had their lives saved for the time being of course because we didn't actually cure death
00:28:32
Speaker
But we started to take people sick enough to die into hospital and expect that health services would step up and sort it all out.
00:28:40
Speaker
And of course, they very often did.
00:28:41
Speaker
So that was fantastic.
00:28:44
Speaker
But it also meant that dying didn't happen at home.
00:28:47
Speaker
Family and friends didn't do the looking after, didn't see the stages, didn't witness what was going on.
00:28:54
Speaker
And all of that knowledge and wisdom was lost.
00:28:59
Speaker
So when I was thinking about how my Nana got to understand it, I realized that she got to understand it by watching it and then watching it again and then watching it again.
00:29:09
Speaker
And each time she watched it, she saw what was individual for that person and what was the same each time she saw it.
00:29:17
Speaker
In the same way as when we're looking after women in labor, the stuff that's about this woman, this pregnancy, this labor, this family, and then there's labor, same old, same old.
00:29:28
Speaker
Yeah.
00:29:29
Speaker
So I thought maybe the way to tell people about dying, maybe the way to give the wisdom back is to help people to understand it the way Nana learned to understand it, by just seeing it over and over and over.
00:29:42
Speaker
And also the way that she saw it was she was looking after people because they were alive.
00:29:48
Speaker
They might have been dying, but it was the fact that they were still alive that made people look after them.
00:29:55
Speaker
So those stories, even though
00:30:00
Speaker
all but one ends in a death I think I think all but one person's dead by the end of the book spoiler um yeah I mean I think you kind of you kind of when you're signing up to the book yeah maybe you know that but yeah
00:30:16
Speaker
But they're stories about how people live while they die, aren't they?
00:30:20
Speaker
They're actually stories about living.
00:30:22
Speaker
And I couldn't read the audio book.
00:30:25
Speaker
I couldn't do it.
00:30:27
Speaker
I got an actress to do it.
00:30:28
Speaker
Thank God for Elizabeth Carling.
00:30:30
Speaker
She's absolutely super.
00:30:32
Speaker
Because I couldn't read it without tears.
00:30:37
Speaker
Because it's all about how completely amazing human beings are when it really comes down to it.
00:30:45
Speaker
And what struggles they will make and what things they will do for each other.
00:30:50
Speaker
Because it turns out that what matters most to us in the end isn't actually death.
00:30:55
Speaker
It's love.
00:30:57
Speaker
Yeah.
00:30:59
Speaker
Yeah.
00:31:00
Speaker
And they, you know, when I'm talking to a grieving family that are, you know, it's usually not a grieving family.
00:31:06
Speaker
It's usually one or two of the family members that are really overwhelmed with the grief.
00:31:13
Speaker
And just saying something as simple as.
00:31:16
Speaker
Grief is literally just.
00:31:20
Speaker
showing how much love you had for this person it's just the love has just taken a different form and that's you know as in the love doesn't go away but it's just it's now showing itself in grief and isn't that the most incredible thing in the world to show how much you loved this person and and when i say that
00:31:39
Speaker
It doesn't always mean wailing and crying and, you know, oh, because my sister is crying and my brother is not crying.
00:31:46
Speaker
He must have loved mom enough.
00:31:48
Speaker
That's not what it is.
00:31:50
Speaker
And I actually, this is my TED talk was about it, that it's not about judging.
00:31:54
Speaker
Oh, you're doing it this way.
00:31:55
Speaker
So that's incorrect.
00:31:56
Speaker
Grief is a million things to everyone.
00:32:00
Speaker
It's it's it's anger one minute.
00:32:02
Speaker
It's.
00:32:03
Speaker
frustration the next minute it's breaking down crying it's laughter it's doing it privately it's doing it publicly it's doing it in a group it's doing it solo it's it's a million different things and the sooner we take that judgment oh you're so you're so right I mean I love I love your TED talk and I love your costume because actually I've got a very similar costume obviously it's what I wear all the time too but but it's not a competition is it grief is not a competition
00:32:31
Speaker
Now?
00:32:32
Speaker
Yeah.
00:32:32
Speaker
Yeah.
00:32:33
Speaker
It's no, I have to say since moving to New York, I'm over here nine years now and I'm back and forth.
00:32:40
Speaker
But since moving to New York and working with I'm very blessed in what I do, but I've worked with some notable and some wealthy families and stuff.
00:32:49
Speaker
And sometimes I do.
00:32:52
Speaker
There is that competition of sort of who's crying more and there, you know, for show it can be and sometimes it's for the media and it breaks my heart, to be honest, because it's just, it's not about that.
00:33:05
Speaker
And, you know, there could be one person who's remained stoic in the entire funeral process and they could privately on their own fall apart or...
00:33:17
Speaker
you know laughter it's just it doesn't matter we all just do it completely and utterly differently and yeah like New York is definitely a really interesting place to do what I do because you see so many different
00:33:35
Speaker
facets of humanity honestly I mean you see every city in the world but I feel like here there's just so much extremities and a lot of people wearing their heart and their sleeves or you know showing it it's just it's a very fascinating place but it's yeah I just I think the way you've done you've done the book I think with it the stories are just so beautiful really and truly and I don't I don't want to give any spoilers away but I do want to hear about the second book
00:34:06
Speaker
So if you want to tell our listeners a little bit about that and also what's next.
00:34:10
Speaker
So second, I feel like a serial offender.
00:34:12
Speaker
So I really, I really didn't intend to write another book.
00:34:17
Speaker
I didn't really think I was ever going to write a book at all.
00:34:21
Speaker
Um,
00:34:21
Speaker
But there we are, that happened.
00:34:24
Speaker
And that was an unexpected thing that I wanted to do something about public understanding of dying.
00:34:32
Speaker
I was taking early retirement from my clinical practice to make the space to do something.
00:34:38
Speaker
And I didn't know what the something was going to be.
00:34:39
Speaker
But you'll know this when you're so busy day by day, almost like being a hamster in a wheel, isn't it?
00:34:45
Speaker
How can you stop and look and get your head up and see what you could do differently?
00:34:52
Speaker
So I took early retirement, which was a bit of a scary thing to do.
00:34:56
Speaker
And then in the last week that I was at work, I was phoned at work by the BBC.
00:35:07
Speaker
Now, that doesn't happen to a girl every day.
00:35:11
Speaker
And it was BBC Radio 4, which in the UK is our big, usually current affairs.
00:35:19
Speaker
It's our talk radio station, but it's usually our serious talk.
00:35:22
Speaker
radio station and they wanted me to come and talk to somebody who was terrified of dying and they'd heard that I was an expert on death and it was just a kind of recommendation by a friend thing you know it was one of these extraordinary events anyway since I promised myself that any opportunity that came up even if it was terrifying I was just going to say yes I said yes and was completely terrified but I did this thing and it was a really interesting thing to do
00:35:53
Speaker
And one of the things that we talked about during that interview was how we deal with denial, you know, when people really don't want to face a difficulty.
00:36:03
Speaker
And I told a story about a young woman that's also one of the stories in the book, a young woman who I looked after, first of all, when I was a cancer doctor, and then who came back into my care again when I was a palliative care doctor.
00:36:17
Speaker
And I thought...
00:36:23
Speaker
I then was off work thinking, how can I do this?
00:36:27
Speaker
What can I do?
00:36:29
Speaker
Could I write newspaper articles?
00:36:32
Speaker
What's a podcast?
00:36:34
Speaker
This would be about 2016.
00:36:37
Speaker
And I was contacted by a literary agent, by a book agent, to say, I heard you on the radio.
00:36:46
Speaker
So the broadcast had gone out, of course, because it was recorded as part of the series.
00:36:51
Speaker
I heard you on the radio and you told a story.
00:36:53
Speaker
Have you got any more stories?
00:36:55
Speaker
You know, have I got any more stories?
00:36:58
Speaker
I've got thousands of stories.
00:37:00
Speaker
I said, have you ever thought about writing a book?
00:37:03
Speaker
And just as he said it, I thought, oh, oh, that's how you get stories out into the public domain.
00:37:11
Speaker
You write a book.
00:37:14
Speaker
So he got me a writing contract.
00:37:17
Speaker
That's how the first book came about.
00:37:19
Speaker
So that was already so unlikely.
00:37:22
Speaker
Yeah.
00:37:24
Speaker
And then more unlikely things started to happen.
00:37:27
Speaker
So the first thing was that he got me to write a proposal and he talked to different publishers.
00:37:35
Speaker
And then he got back in touch with me to say, I've got 16 publishers who are interested in your book.
00:37:41
Speaker
OK, so that doesn't happen.
00:37:45
Speaker
And so eventually I chose a publisher who I thought really understood what I was trying to do.
00:37:52
Speaker
And they are giving a percentage of their profits from each book to an end of life charity here in the UK.
00:37:59
Speaker
So my British publishers are doing that.
00:38:01
Speaker
And that's fantastic.
00:38:02
Speaker
And Little Brown in the USA also said, OK, yeah, we will take the same text that you're using in the British publishers.
00:38:09
Speaker
book and we will sell it over here and it's done very well in the USA and Canada as well so and that was it I thought okay my work here is done and then the messages started coming in because the next unlikely thing was that this book became a bestseller
00:38:27
Speaker
You know, it's a book of stories about dying.
Success of Dr. Manning's Book
00:38:30
Speaker
What's going on here?
00:38:31
Speaker
It became a bestseller.
00:38:32
Speaker
It's been translated into 16 languages.
00:38:37
Speaker
It was shortlisted for a literary prize.
00:38:40
Speaker
And it just got more and more and more unlikely.
00:38:43
Speaker
So I've almost got to the stage now where I've stopped being surprised by things because, you know, the next crazy thing is just waiting around the corner.
00:38:53
Speaker
So how fantastic to get that message out there.
00:38:57
Speaker
And of course, the book being successful then leads to other invitations.
00:39:01
Speaker
You meet other lovely people like meeting you.
00:39:03
Speaker
And so it kind of it's like ripples in a pond that just keep on getting wider and wider.
00:39:08
Speaker
But that was it.
00:39:09
Speaker
I've done enough now.
00:39:10
Speaker
That's it.
00:39:10
Speaker
And then the letters started.
00:39:12
Speaker
And some of the letters were the sorts of things that you've been talking about.
00:39:15
Speaker
People have been afraid.
00:39:17
Speaker
who felt by knowing more that they were less afraid, or people who'd been traumatised by not understanding those sounds at the end of life, and suddenly realising that their dear person who they thought had been really suffering and struggling had almost certainly been deeply unconscious, making those unconscious breathing noises.
00:39:37
Speaker
And it doesn't make the grieving any easier, but it takes some of the trauma out of the memory of the events.
00:39:44
Speaker
Hooray.
00:39:45
Speaker
So that's what I'd set out to do.
00:39:47
Speaker
But there was a whole load of other messages that I just hadn't expected, which were about, OK, you've convinced me we have to talk about this stuff.
00:39:58
Speaker
But oh, my good God, how do you start a conversation like that?
00:40:03
Speaker
What if I get into trouble?
00:40:04
Speaker
What if I upset people?
00:40:06
Speaker
What if they don't want to?
00:40:08
Speaker
Or, you know, dear Dr. Mannix, I'm dying and my family won't let me talk about it.
00:40:13
Speaker
What can I do?
00:40:15
Speaker
I only want to talk about my funeral.
00:40:18
Speaker
I only want to talk about my will.
00:40:20
Speaker
I want to tell people that I don't want to go into hospital.
00:40:22
Speaker
I want to tell people I don't want to die in the family home, whatever it was.
00:40:28
Speaker
And I thought, I've got quite a lot to say about conversations and the way we communicate with each other, because clearly I've been enabling that within families for a very long time.
00:40:38
Speaker
And with my cognitive therapy practice, the psychotherapy practice gives me insights into lots of other bits of human life as well.
00:40:45
Speaker
So I went back to my publishers who'd been desperate for another book and I'd be going, no, no, there's no other book.
00:40:51
Speaker
To say, I think there might possibly be another book.
00:40:54
Speaker
Oh, marvelous, marvelous, hooray, hooray.
00:40:58
Speaker
but not about death.
00:41:01
Speaker
You go, okay, that's awkward.
00:41:03
Speaker
Because, you know, you do remember what I write about, yeah.
00:41:07
Speaker
But in fact, I think my editor, my editor in Britain is called Arabella and she's fantastic.
00:41:14
Speaker
And what she said was, don't exclude dying and death, but make it across the lifespan.
00:41:20
Speaker
Give us examples of,
00:41:23
Speaker
of parenting and examples from school and examples from your psychotherapy practice and examples from training people and running your your cancer care service you know make it applicable across the whole of life of course she's absolutely right to do that so all of these letters are about if i can just give this person a really good talking to we can sort it out
00:41:50
Speaker
And I know that you know, and I know that a lot of people who are listening to us know, that actually it isn't about a talking to at all.
00:41:58
Speaker
That the secret of really good conversations is how well we listen to each other.
00:42:03
Speaker
So I knew from the get go that the book was going to be called Listen, because that's the core thing that makes conversations work.
00:42:14
Speaker
And I got the contract to write the book in January of 2020.
00:42:20
Speaker
And I was going to deliver the book in December of 2020.
00:42:27
Speaker
So 12 months to write a book.
00:42:31
Speaker
Yay!
00:42:31
Speaker
Yay!
00:42:34
Speaker
And in the meanwhile, oh my Lord.
00:42:36
Speaker
So my job is to try and distill out
00:42:39
Speaker
these really complicated conversations and what are the essential components of them and how do we get ourselves into a space where we can be alongside a person who's distressed and not interfere but support and just about the time that I thought what I really need to is drill down into the components of these conversations and
00:43:03
Speaker
We were watching COVID sweeping through Italy.
00:43:07
Speaker
It was starting to arrive here in Britain.
00:43:10
Speaker
We were approaching our lockdown.
00:43:13
Speaker
And I thought, I can't just sit at home writing a book.
00:43:19
Speaker
Well, people are dying in their droves and they're being looked after by people who've got no idea how to look after dying people because the people who know how to look after dying people are already doing that.
00:43:29
Speaker
But there are too many dying people.
00:43:32
Speaker
What an extraordinary time.
00:43:33
Speaker
So I went back to the NHS Leeds for Ends of Life Care and said, you've got to give me a job.
00:43:40
Speaker
I can't sit here.
00:43:43
Speaker
And they said, great, could you devise a communication skills framework for people who've never looked after dying people because they're having to phone families, couldn't even meet them?
00:43:53
Speaker
You know, it was all the visiting restrictions.
00:43:56
Speaker
How do they break unwelcome news?
00:43:58
Speaker
How do they explain what's happening?
00:44:00
Speaker
How do they listen to those people's questions?
00:44:02
Speaker
How do they facilitate those conversations?
00:44:06
Speaker
And, you know, some of these were kids who'd been medical students two months ago, registered as newly qualified doctors.
00:44:14
Speaker
Some of them were one of the wards that was looking after people who were dying in our city and people who were not going to be, they didn't have the lung function to be able to benefit from going on a ventilator.
00:44:29
Speaker
So they were already so sick that almost certainly they weren't going to survive.
00:44:34
Speaker
Some of them did, but most of them wouldn't be looked after by nurses that included the nurses that usually were changing the dressings in the outpatient clinics for people who had recent surgeries.
00:44:46
Speaker
you know, completely no experience to bring to this.
00:44:50
Speaker
So it was a fantastic job to be given.
00:44:54
Speaker
And it made me have to dissect those conversations and think about those conversations.
00:45:00
Speaker
So then I went back to work in the National Health Service for another few months, doing staff support and teaching communication skills.
00:45:08
Speaker
So by the time I came back out of that in the autumn, with like four months left to write the book, in fact, I'd been doing the practical work.
00:45:19
Speaker
for the last six or seven months and that had been an absolute boom for me in making me strip away all of the stuff and work out what is it that really matters and it's about attention and kindness and compassion and it's not about the words is it it's about well Maya Angelou said it people will not remember the words you said they will remember the way you made them feel
00:45:47
Speaker
I hate those deals.
00:45:50
Speaker
Now, can I, I mean, I could, as I keep saying, I could talk to you all day, but I know you have a time schedule and I'm sure our listeners as well.
00:46:02
Speaker
On that note and on that book, what would, I'm very much proactive in, and I only just had a morning meeting this morning,
00:46:11
Speaker
And with a group where I'm always trying to encourage people to pre-plan.
00:46:15
Speaker
And even if it's, you know, five things, if you decide burial or cremation, if you decide your funeral song, if you decide, you know, just your top five, you don't have to go through of a PDF that I send out for free to people.
00:46:28
Speaker
I do workshops on it for free.
00:46:30
Speaker
You know, I'm I just think it's so important and it's such a gift to give to your family to put this document together.
00:46:35
Speaker
It's not legally binding, but it just puts your wishes on paper for your family to deal with their grief and not have to deal with the logistics and trying to figure out what would mom want.
00:46:47
Speaker
And so on that in that vein and on your incredible book, what would maybe two things, two or three things that you think you could say to people who want to have that conversation or listening to this and are probably going to get your books, I hope.
00:47:04
Speaker
but that they want to have this pre-planning conversation, what would you, how would you tell them to broach the subject?
00:47:11
Speaker
And it could be a parent who's dying or it could be a perfectly healthy parent.
00:47:14
Speaker
Maybe if we can.
00:47:15
Speaker
Fantastic question.
00:47:16
Speaker
So the first thing is when you know there's a conversation that you want to have, but it feels a little bit daunting.
00:47:23
Speaker
And
Talking About Death with Loved Ones
00:47:24
Speaker
it's kind of a double daunt because it's not just that you've got to have the conversation, it's that you've got to mention the thing that you hardly dare to mention in order to let the other person know that you even want to have the conversation.
00:47:37
Speaker
Yeah.
00:47:38
Speaker
So I would break those into two separate things.
00:47:42
Speaker
And the first thing is just to have just to issue an invitation.
00:47:48
Speaker
Mom, dad.
00:47:51
Speaker
There's this thing that keeps going through my mind.
00:47:53
Speaker
I heard this absolutely brilliant podcast last week or, you know, heard this thing on the radio, saw something on the telly.
00:48:00
Speaker
There's been news on the news channels.
00:48:04
Speaker
It's just got me thinking.
00:48:08
Speaker
When the time comes that I might have to step up and make decisions for you about your health because maybe you're not well enough to make those decisions, or after you've died, unless you're immortal and you haven't told me, I just worry that I might need to know what you want and I just don't have a clue.
00:48:32
Speaker
And it's really worrying me.
00:48:35
Speaker
And if there's some point where you think you could just maybe give that 10, 15 minutes where we could chat about it, it would really make me feel better.
00:48:43
Speaker
And what that's doing is not talking out.
00:48:46
Speaker
It's not taking control.
00:48:48
Speaker
It's keeping our parents parental.
00:48:51
Speaker
rather than infantilizing them.
00:48:53
Speaker
Now, come on now, Mum, you know we need to talk about this.
00:48:56
Speaker
It's being respectful, isn't it, and maintaining the relationship.
00:49:02
Speaker
But it's also using the fact that this parent, or for some of us, it's, you know, dear other older relatives or family friends.
00:49:10
Speaker
I don't know whether they have the same tradition in the United States that we have here, where I've got several aunties who are friends of my parents, but I'm not actually related to them.
00:49:20
Speaker
But I'm definitely going to be involved in stuff towards the end of their lives.
00:49:24
Speaker
They've known me since I was born.
00:49:27
Speaker
So, you know, these are conversations of love and respect.
00:49:32
Speaker
So my first tip is make it an invitation and explain to them how they will be helping you by allowing you to have this conversation with them.
00:49:46
Speaker
And although certainly they will want to help us more than they don't want to have the conversation.
00:49:53
Speaker
So that's the first thing.
00:49:55
Speaker
The next thing is plan when you're going to have it and promise that it won't be for more than 15 minutes and have something really lovely to do.
00:50:03
Speaker
afterwards planned so for me that would be tea and cakes um but it might be just looking through the old family photograph albums or it might be you know taking them out for a drive somewhere or them taking you out somewhere whatever or even go and do it in a cafe somewhere with a lovely view and after 15 minutes you've finished and you're just going to be in the place and enjoying what you're doing
00:50:29
Speaker
And then the most important thing, I think, is you ask your question and you just shut up and listen.
00:50:39
Speaker
Just, it's not about you.
00:50:41
Speaker
Just be quiet.
00:50:43
Speaker
Just be quiet and listen.
00:50:45
Speaker
Absolutely.
00:50:47
Speaker
Respect the ratio.
00:50:49
Speaker
And the thing is that the more we listen, the more astonished we'll be.
00:50:55
Speaker
by how much they've probably already thought about it, the ideas they've got, the people who they actually are underneath that husky parental shell, their inner teenager still lives in there, their inner child still lives in there, that person who changed your diapers is still in there.
00:51:16
Speaker
And they love you, probably.
00:51:19
Speaker
And you love them, probably.
00:51:22
Speaker
And when it's already an awkward relationship, maybe that's the hardest of all.
00:51:27
Speaker
Because then we have to kind of suspend our judgment and forgive their previous mistakes and misdemeanors with us in order to be on the right page for this really, really important conversation.
00:51:42
Speaker
So I call them tender conversations.
00:51:45
Speaker
rather than challenging or difficult and i can take our tenderness instead of our lists or our insistence or our protective you know protective armor just go into it with tenderness and take some tissues because there might be so much love in this conversation that somebody's eyes leak and that's okay
00:52:08
Speaker
Yeah, the lovely.
00:52:10
Speaker
I love that.
00:52:11
Speaker
And it's funny because I whenever I'm asked that question, you and I are so very much aligned.
00:52:18
Speaker
So whenever I'm asked that conversation, I always will sort of say, blame me, you know, like I. Oh, my God, I was at a meeting this morning and they were talking.
00:52:27
Speaker
There was this crazy lady.
00:52:29
Speaker
Her nickname was the Glam Reaper.
00:52:30
Speaker
They were talking about funeral planning.
00:52:32
Speaker
But so what would you do?
00:52:34
Speaker
She did ask, you know, and so and bring it up in a bit of a natural way.
00:52:37
Speaker
But what I loved about what you just told me, which I never and which now I'm kind of going to add in, which I never did was that use that light way to bring it up.
00:52:49
Speaker
But don't don't force the conversation then or don't sort of tackle it at that point, because you don't know where their heads are.
00:52:55
Speaker
They could be in the middle of a task or something or maybe it's dinner or whatever.
00:52:59
Speaker
But use this to invite for it to be a conversation at a later date.
00:53:04
Speaker
And I kind of love that that invitation, because then they can.
00:53:07
Speaker
prepare themselves mentally for it being okay it's going to be 15 minutes we're going to talk about this this is scary for me but it's something that she wants to talk to us about and I think so I kind of I love that and then who doesn't love a treat at the end and the other thing is place your bets about whether they'll stop at 15 minutes because the other thing that you and I both know is that the conversations once you've started
00:53:33
Speaker
are just so much more interesting, joyful, meaningful than you ever could have imagined.
00:53:44
Speaker
So if all you do is 15 minutes, you're winning already, but I bet you'll do more than 15 minutes.
00:53:49
Speaker
100% and I even I only said it at my talk this morning I said if nothing else you find a burial or cremation and their funeral song I guarantee you those two questions will unpeel a million other layers of the onion and they'll start to tell you why they pick that song and it'll just open up this lovely lovely
00:54:08
Speaker
like box of memories I always talk about you know my favorite slash it was a very difficult pre-plan I did with my mom and again she's perfectly healthy and living but we cried we laughed because we were so close but what I realized and this was years ago back when I started but what I realized and it's such an important lesson that I can't iterate enough is that my mom
00:54:32
Speaker
While she's a wonderful mum to me, she's also my brother's mum.
00:54:36
Speaker
She's a wife.
00:54:38
Speaker
She's a best friend.
00:54:39
Speaker
She's a grandmother.
00:54:40
Speaker
She's the person who, you know, is always first in in the grocery store whenever it might be.
00:54:47
Speaker
She's somebody who picks up her library books.
00:54:50
Speaker
She's so many different things to different people other than just my mother.
00:54:55
Speaker
And even a set of twins can have totally different relationships with their mother.
00:54:59
Speaker
Whereas when she dies, it will be left to me.
00:55:02
Speaker
And I would have designed the funeral as my relationship with her.
00:55:06
Speaker
That one way, just me and her.
00:55:09
Speaker
Whereas she's so many other facets.
00:55:10
Speaker
And that's what's so fascinating.
00:55:12
Speaker
And you exactly said it.
00:55:14
Speaker
You know, the one who changed your diapers, the one who picked you up when you cut your knees, the one who brought you to school, whatever it might be.
00:55:20
Speaker
And whatever your relationship is, good or bad with your family, there's still that person who was a teenager once themselves.
00:55:28
Speaker
They were a daughter, you know, a brother, a sister or whatever.
00:55:33
Speaker
They had a life just like you have a life.
00:55:35
Speaker
And it's so important to celebrate that life.
00:55:37
Speaker
It's just, yeah.
00:55:38
Speaker
Oh, Catherine, I could talk to you all, all, all day, literally.
00:55:43
Speaker
But we are going to have to wind it up.
00:55:45
Speaker
And so, oh, my God, please, folks, go out and get not one, but all of her books.
00:55:50
Speaker
And just absorb everything.
00:55:52
Speaker
Follow her on social.
00:55:54
Speaker
Look at the TED Talk.
00:55:56
Speaker
And I mean, Catherine, I would love to have you back maybe another time, maybe when you've written your next book.
00:56:01
Speaker
That would be lovely, wouldn't it?
00:56:02
Speaker
That'd be lovely.
00:56:03
Speaker
I need to get myself over to New York.
00:56:04
Speaker
We need to do it properly in real life next time.
00:56:07
Speaker
Thank you.
00:56:08
Speaker
do you do and maybe there's some sort of a convention or something we can do together because I just I really do and as you said two sides of the point it's just so important both sides and it's just oh I I worship what you do so thank you thank you so much for for being with us today seriously thank you so much for for inviting me and I just I loved that conversation thank you
00:56:41
Speaker
So that was another episode of the Glam Reaper podcast.
00:56:44
Speaker
I really hope you enjoyed that as much as I did making it.
00:56:48
Speaker
It was such a pleasure and such an honour and such a privilege to have Dr. Catherine Mannix on with us to talk about all things palliative care.
00:56:58
Speaker
And she's just an incredible author and beautiful person inside and out.
00:57:02
Speaker
So please check her out.
00:57:04
Speaker
And hopefully if we do really well with this episode, like and subscribe us and share, we can get Catherine back on again.
00:57:11
Speaker
But until next time, we'll talk to you soon.
00:57:13
Speaker
Ciao for now.