Ep 12: Facing the End: Purpose, Presence & End-of-Life Coaching with Phil Cass

In this episode of The PLA Podcast, host Dr. Stephanie Costa sits down with PLA founder Phil Cass for a deeply personal and thought-provoking conversation about his recent journey into end-of-life coaching.

After decades of leadership, coaching, and service to physicians, Phil shares how a silent retreat, personal loss, and his own health scare led him to explore a new purpose: supporting individuals and families as they face death. Now trained as an end-of-life-coach, Phil reflects on the power of presence, listening, and reducing fear at life’s most vulnerable moments.

Together, they explore how conversations about death can bring clarity, connection, and even joy, and why so many people already hold deep insight into what a “good death” and a meaningful life look like. Phil also offers practical reflections on preparing for the end, from writing ethical wills to having honest conversations with loved ones, and shares how this work continues to shape his own approach to living fully.

Registration is open for the next class of the Physicians Leadership Academy at the Columbus Medical Association. Designed FOR physicians BY physicians and led by globally recognized faculty and coaches, PLA is a transformational, research-backed program to help you build the skills to thrive in today’s ever-evolving healthcare landscape. Learn more at physiciansleadershipacademy.org.

Produced by the Columbus Medical Association

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Transcript

This transcript was automatically generated and may contain errors 

[00:00:00] Welcome to the PLA podcast. This podcast was created to help graduates of the Physicians Leadership Academy at the Columbus Medical Association stay connected to the PLA teachings, mindset, and community. If you're not familiar with the Physicians Leadership Academy, check out our website, www.physiciansleadershipacademy.org, and consider filling out an application for this next, session that starts in September of 2026.

Welcome, and thank you for your curiosity, and please enjoy the learning today. I'm Stephanie Costa, director of alumni programming at the PLA, and today I'm excited to have a conversation with someone who's dear to all of us, Phil Cass. Most of us know Phil and his love of physicians. Phil has a PhD in counseling, and many of us know [00:01:00] that he was a former CEO of the ADAMH Board in Columbus, Ohio, and CEO of the Columbus Medical Association.

He created the Physicians Leadership Academy and continues to pour all that he has into it, um, to, to continue to make an impact for physicians throughout central Ohio. Today, I wanna talk to Phil about a new pursuit that he has. Uh, so Phil, welcome to the podcast, and I'm curious to sit down and, and learn a little bit more about this recent endeavor of yours.

Steph, thanks for the invitation, and, uh, I'm looking forward to this conversation. Yeah. Well, most of the people in the PLA or who know you well know your coaching skill set, but most people are probably not aware of your recent calling to obtain some more specific training in coaching. Uh, can you tell us about [00:02:00] that?

Steph, I think, um, you and per- perhaps many of the people who have been through the PLA know I do an annual retreat every year. Um, I go away for a week and sit in s- silence and solitariness and contemplate things. And a few years ago, I was really aware that... felt like there were a number of things that were coming to an end, that were bringing some closure in my life.

Uh, and I, on the retreat, decided I was just gonna sit with a question about what next. And when I came out of that retreat, it was very cl- I didn't know what it was going to be, but it was very clear. There was, like, this message out of the retreat saying, "Yeah, well, you got some other work to do." And actually, I was kinda angry at that point.

I was like, "What?" I'm 76 years old at that time. Why do I have to have another purpose? Why do I... Haven't I done enough? And it was like, "No, there's more to do." And I [00:03:00] decided not to try to answer the question what the purpose was, but just to see what emerged. What happened was, um, in the same year, right after that retreat, or shortly after that retreat, I found that my best friend here in Columbus, um, had Parkinson's disease, and it was really, uh, advancing quickly.

Um, and then my best friend and oldest friend, uh, was dying in California. And all of a sudden, I'm like, "Huh, this is interesting." I'm finding myself- Really connecting with them and spending a lot of time. In the California case, I talked with my friend every week until he died, and, and my friend here, I spent, well, at least two or three times a week with him until he passed away.

And then it was kind of like, "Huh, this is interesting that I've been wondering what, what's coming next," and I'm, I'm with these people and [00:04:00] spending time with them and their families and, um, just really being present, but also in some kind of ways because of my counseling and such coaching, I found myself helping.

And then a physician friend asked me if his... This person's parents were struggling with a diagnosis and asked me if I'd sit down with the parents and, and spend some time, and I did quite a bit actually. It was at that point that I said, "What do you need to understand more," coming out of this retreat about purpose?

You're getting banged, or your, your friends are passing away. You're being asked to be, uh, uh, consulting and speaking with people who are passing away. I think there's something here, and it felt right. Yeah. So it was like this discovery of next steps for me that came from not thinking, just letting things happen, and what started to happen was death was happening.

And I, [00:05:00] you know, remember this time in your life and, and, you know, a time where you yourself were grieving, yet you were giving so generously of yourself to your friends and, f- um, and family and, um, y- you know, still having awareness as Phil Cass would have during, um, what could be seen as such a, a painful experience.

And this is such an important concept and, and one that we teach in the Leadership Academy, slowing down, becoming aware, and finding out what's there. And our friend Jim Marsden will tell us to explore the why and the who, and suspend thinking about the how, um, resisting our urge to figure things out. And so you alluded to this a little bit about how you were having this awareness, but can you speak to, to this in, in how you used this [00:06:00] concept to kind of work through this, this awareness?

Yeah. Um- The particularly the, Jim's point about, um, the how, that's exactly what coming out of that retreat, I decided I am not gonna even touch that. That's planning. And, uh, and I think most of us know when we really start to do planning, we're in trouble, and I decided to suspend planning and just see what emerged.

So that was very much in line with what Jim teaches. The why part of it, I translate in my case to purpose, and I don't bel- I don't believe that we're on this earth that have one purpose. Maybe some people, but most of us, I think our purpose emerges over time. And, um, I'm at a point in my life where let's...

I'm not... I don't kid myself. Uh, I'm in [00:07:00] absolutely the winter of my life and, um, and so is there a purpose that emerges at that phase of my life? And I didn't expect as I came out of the retreat, I thought that the purpose would e- emerge had more to do with the quality of, of letting go, not something further emerging.

But a new why came, a new purpose came, um, to my surprise. And then the other part, the who, and Steph, you know this, and I've said this to the academy over the years. I, because of my own battle with cancer years ago, um, I made the decision that I was going to fall in love with as many people as I could before I die.

And so the who for me was pretty, pretty big. It was people that... Any person I came in contact with was important to me. Um, and so the [00:08:00] combination of purpose, falling in love with people, deciding not to plan and let happen, let come, were all part of what's emerged for me. Yeah. So Jim's teaching were very, was very helpful.

Yeah. So what happened next? How did you explore this? It's even gotten more intense, Stef, because, uh, last August I had, um, a situation where I g- I, I have a lymphatic left leg from the cancer that I had years ago, um, that got infected. And at the same time, unknownst, unbeknownst to me, I didn't know that I had COVID.

So I had about... I was, had COVID and an infection in my leg. All that went septic. And so I had sepsis and I had never, um, been not awake other than when I've had surgeries. And, uh, I was unconscious for about eight hours. Um, [00:09:00] and came to the realization somehow in my life I'd always imagined, I think because of cancer, that I would know when I was going to die.

And I had this encounter with, wait a minute, who are you kidding? You may well not know you're gonna die, and that was an example of it. I was gone out of it. My blood pressure was dropping, my kidney function was dropping. It could've happened that night, absolutely. So the combination of all those things, and in my own experience at that time with, with, with death just reinforced, um...

and my own meditation reinforced the notion that I needed to do some things about l- not just assuming that I knew because of my coaching and counseling how to work with death. I needed to get some certification. So I did. I signed up and, and did a, I think it was an eight-week course, uh, online, uh, meditation course.

Uh, excuse me, um, uh, coaching. W- it, it was a, a death doula. Uh, I, I've [00:10:00] preferred to call it end-of-life coaching, but it was a death doula certificate that I have. Um, yeah. And it was very, it was helpful. There, I, there were parts of the training I wasn't satisfied with. I think there's some other training I want to do.

But, um, yeah. So I'm, I am certified in the jargon, a death d- doula. In my words, an end-of-life coach. Yeah. End-of-life coach sounds better to me too, even somebody who is familiar with doulas in that birthing space. But, um, I'm just kind of curious though, you know, having gone through coaching training and, um, w- how do you do the training online?

Is it you practice coaching each other, or was it all just downloading of information? Yeah, in this particular case it was downloading, and that's what was unsatisfying to me. There's a book that I read that, uh, the title of the book is Briefly, Perfectly Human. Uh, the author's [00:11:00] Alua, A-L-U-A, Arthur. I love the book.

She does, um, like three or four day retreat seminar kind of things, um, for people. I'm gonna try and do that in the next year. Uh, I th- from reading her book, I think she is doing exactly what I think I need. Um, and so, uh, I think there's further training coming down the road, and I think it'll be hopefully with her.

So observing how you- Teach in the Leadership Academy and knowing that you're a coach and kind of those coaching principles, um, it must have been a little frustrating, uh, being in a learning environment where it was a download of information. But I'm curious, did your coaching background help you take in that information in a positive way?

Yeah. Yeah. I think, as you know as a coach yourself, [00:12:00] our biggest thing we do is listen and, and suspend judgment, right? We have to listen to people, and we have to suspend judgment, and I had to do the same thing with this course. Even though it didn't feel satisfying at first, I needed to listen, 'cause people have spent time.

I'm quite certain, I know that there was a lot of work put into this certification, and so I needed to listen and learn from it and suspend my, my own tendency to judge, especially on things like this where I, I've done a lot of work, a lot of planning. Um, yeah, so listening and suspending judgment, I really just try to employ what we know as coaches is essential.

Um, and I, and I, so I did. I, I got, I got lots out of the course, just not exactly what I expected. Yeah. Yeah. So you had mentioned this book briefly, Perfectly Human, and that the author runs workshops. What is it that you're [00:13:00] hoping to gain from that?

So I have spent, uh, I, as you know and others, I had cancer when I was 31, and so my contemplation of death has been deep, long. It's informed my entire life, but it's been solar, so- sol- so- solely me. Um, what I'm looking for is, uh, an experience with others that are willing to be open and talk about death, their own and other, other people's deaths.

Um, I'm missing that. I... It's been very solo thing for me, and so I want to explore this subject with others and learn from others, 'cause I'm sure there's lots of things that I, in my own contemplation, that I'm missing. So yeah, that's the big thing. I wanna talk with others. Well, and we know [00:14:00] community is so important, y- y- you know, in, in all of our aspects of, of life and, and I would see that this would be particularly important.

Um, so how has it been going? You mentioned, three situations where you were able to assist. Have you, um, and I know you haven't hung a shingle up that says, "Hey, I'm an end of life coach." Um, but you've been talking about it and mentioning it to people. Have you done much work since you did the training?

One of the things that happens when one is diagnosed with cancer is you suddenly become part of an unwanted fraternity or sorority, and what that means is that, uh, uh, either people find you for some reason, that you become a, what I refer to as a strange attractor, uh, that people wanna talk about. Other people will say, "You know, I'll talk to Phil about that."[00:15:00] 

So there's people that just come into my life, particularly because of my f- my experience with cancer, that, um, now for me, I've shifted from w- let's have this conversation to maybe there's some coaching that I can actually be of help. And so I find that just because of the circle of people and my own life experiences, I'm c- coming...

And I'm, I'm of that age too, right? I've got friends who are passing. And yeah, so there's just a lot of opportunities for me to be able to engage with this and, and both practice, uh, a- and help. Yeah. So what do you find to be the most fulfilling part of this work?

Reducing fear, my own and others, um, is [00:16:00] probably the biggest thing I, I have found that, um

Most people who are faced with death already have started to figure stuff out. And what they're most in need of, because people don't wanna talk about it, people wanna talk about what they need to do to live. People don't wanna talk about the, their death, and so they live with this fear, and they live in isolation.

And so for me, helping people to reduce their fear helps me reduce my own fear. Sure. And-

Allows them to not be alone. And I can't think of anything that's more sad than being alone when one is facing their own death. And so yeah so for me it's about helping people and seeing the reduction in fear, [00:17:00] seeing them start to smile just, just because they started to talk. Yeah. They start to smile, and they're not alone sometimes just naming that fear helps give you perspective.

You know, talking about it with another person, particularly someone who's a coach, um, and, and helping you see that, state that fear and see it from another perspective, it then becomes less scary. And I'll tell you, Steph, that this, this, what I'm going to say now may sound a little weird or odd, but my experience when I have been with these f- folks that I'm close to, but also where I've been asked to be of assistance, I come away from those experiences feeling joy.

Sure. It is so hard to talk about death, but I'm willing to do that. I'm pretty comfortable with talking [00:18:00] about death. And when I see people smile and I see their fear reduced, I, I feel joyous. And, uh, that's part of what wraps back to my purpose and caring about people and all of that. Um, yeah, there's this we- this weird thing that happens for me when I can invo- in- you know, be involved with folks around de- their death.

It brings joy to my life. Yeah. So I feel like it's weird to say, but it's true. No, but I could see that because you realize in that moment that you've helped someone in a very specific and unique way that most people don't have the comfort or skill set to, to, you know, be in that space and provide that kind of support.

So yeah, that has got to be very fulfilling. Is there anything about the work that has surprised you? [00:19:00] It's been interesting to me, Steph. One of, two of my favorite questions is, um, what, what w- what could you imagine is your good death, and what could you imagine happen, needs to happen between now and then where you feel like you've left a, led a good life?

What's been surprising to me is people have an answer for that. I kept thinking when I first started out that talking with people that it would be like, "Phil, let me think about that and get back to you." That's not what's happened. When I ask that question, w- how can you, what, what do you imagine to be a good death, almost everybody has an answer And that surprised me.

And the same thing with, and what between now and then is a good life, people have an answer. I was surprised, and yet, you know, when I think about it, I think that the thing people struggle with most is being a- alone and being, being afraid to [00:20:00] talk about it. People... As soon as people want to talk about it, people, other people want to label them as being morbid.

"Don't talk about that. You need to be talk... and focused on you got- getting better. You gotta..." And they want to reveal themselves. They've already been doing the work in some respects. And, um, I'm sure this is not true for everyone, but for many they've done some work on it already, and I'm really just allowing them to surface it where sometimes with their loved ones it's not easy to do because it's labeled morbid.

Yeah, so that's been a big surprise to me, how much they already know. And it's delightful. I'm like hearing their story, I'm like, "All right, you've really thought some of this through." So are there common themes as people talk about, what, what they want to do between now and- Yeah ... that good death?

Yes, there are common themes, and I think they're, uh, they're [00:21:00] similar to what we probably already know. The biggest one is, "I wanna be surrounded by my loved ones." That's, that, that's the biggie. But I wanna be surrounded by my loved ones in a not... In a... And I'm hoping that they'll be in a non-judgmental way.

They'll let me, let me go the way I wanna go. So yeah, surrounded by loved ones. Um- serene kind of settings. I would just wanna be in nature. I wanna be able to read. I'd love to have my family around me. Um, nature, a lot of people talk about wanting to spend their, some of their last days in nature. Uh, there's a reconnecting in m- what I see is a, a reconnecting with our roots.

We're part of everything. We've never been separate from each other, nor are we separate from nature. And so people want to go back to, that's my sense, or [00:22:00] reconnect with their nature and with the people they love. Yeah. Yeah. You had mentioned that, you know, sometimes if people wanna talk about their death, their family sees it as morbid.

I can't imagine how helpful it is not just to that person who's nearing the end of their life, but for you to spend time with their family members or for them to at least hear parts of the conversation, it would really demonstrate to these family members and the person at end of life how to have conversations, how to talk about death in a way that is meaningful and not, dancing around the elephant in the room.

So important. For family members particularly. Sometimes the only thing they've really heard about their loved one's impending death is in a doctor's office. Um, [00:23:00] and they'll be told, "This is terminal. This is not gonna go the way you want it to go." But it's also, a- and I think physicians do the best they can, but you're all working in 15 minute increments, right?

Right. This isn't a 15 minute thing. And so some of the family members, all they've ever heard is, "This isn't gonna go well. We're gonna... It's gonna be an end of life." Physicians spend time with me as the best they could But there's a lot there to unpack. And so, um, I think that one of the things that, that an end of life coach can do is to take it from what the physician's able to do, uh, to help people to unpack the whole thing.

You had mentioned physicians, and of course many people listening to this are physicians. Uh, you know, the reality is most people do not think regularly about their own death and, and what they desire. Um, [00:24:00] I think in particular though, because of the work physicians generally are aware of death, how fragile life can be, and how end of life can come at any time.

And I think we've all seen people who are nearing their end of life and are at peace, and others who are fearful and unsettled. Um, Phil, can you share how you are now approaching your own death because of your end of life coaching training from working with folks who are near- nearing the end of their lives?

Yeah. Um, this has been, as I said, I, I, having been diagnosed on as early as I was, couple years after I was diagnosed I thought I had it back. This recent experience with the sepsis, um- I'm not afraid. I don't [00:25:00] think I'm afraid of death. The day of, I may be f- I may be answering that differently. But at this point, I'm, don't feel like I'm particularly afraid of death, and I'm willing to look at that in the eye.

For myself, you know, my, my oldest daughter had Hodgkin's, and I kind of, I went through that with her, too. And we... It's interesting, because she and I are kind of, uh, both in the same sorority, fr- fraternity. Um, so I continue to contemplate, um, the issue of death without trying to be morbid about it myself.

The other things I've, I've tried to do is I, I realize that many people who are, um, approaching death feel like things haven't been ordered enough in their life. And so I've really tried to. I've done all the legal stuff and, and, uh, on a practical level, even with my kids, 'cause I just... I have two daughters.

Uh, I have [00:26:00] thrown out tons and tons of stuff. I've made boxes for both my daughters of things that maybe they'll want after I'm gone, and I've told them both, "The boxes are there. Go through them. Throw the s- throw the stuff out if it doesn't mean anything to you." But I've, I've prepared that stuff. The other thing I've done, um, is I've written an ethical will Not just my legal will.

There's a rabbi who has produced a book that is, it's the 12 questions your loved ones will wanna know when you're gone. And I've used that book to write... I've written my answers to the 12 questions, which comprise, make up an ethical will. There have been people that have said, "Phil, you need to write, you need to write a book."

Eh, it's not me. I'm not gonna write a book. But I did write an ethical will. The other thing that has happened is, um, my youngest daughter... When I had the sepsis in [00:27:00] August, it scared my family more than I realized. And my youngest daughter said to me several months later, she said, "Dad, would you do me a favor?

And in, in the years that you're s- that you still have in your life, will you every year write me a letter and just stick it away with your will? I don't wanna read it now, but I want a letter there, letters there, hopefully as many as I can give you, um, to read when you're gone." And then I talked to my oldest daughter and I said here's what your sister asked me to do."

And I said, "I'm asking you because I don't want a situation in which when I'm gone, she's got 10 letters there and you don't have any." And so she said, "Yeah, I want them too." So I have written letters now to both daughters and my granddaughter. Um, and I'm gonna do that every year that I'm, that I'm still on this earth.

That, um, is what they desire, right? I'm gonna be gone. What do they need? And what [00:28:00] they need is, um- To hear from me, and I'm gonna... And I'm doing that. So there's things like that that I'm doing, writing letters, my ethical will, and then the, just the practical stuff of getting rid of junk and... 'Cause they don't want...

I've had to clean up after people die. It's not fun, and so I don't want them to go through that. And so I, with the exception of my books and some of the tchotchke stuff I have around that they'll have to go through, there's not gonna be a lot they're gonna have to do. And they, even to the point where I know for my two daughters, when I, that day comes, it's gonna be hard for them.

So I- I've listed my son-in-law. He knows where everything is now. "When I pass, here's where everything is. They won't remember. You have to remember." Yeah. I've re- I've really planned. And, um, my wife and I have bought plots in a green [00:29:00] cemetery. We're gonna be buried in a green cemetery, which I'm, which I am pleased that we've done.

Yeah. So- You shared that with me, but can you just speak to what a green cemetery is? Yeah, yeah. So there aren't many in Ohio. It's becoming a bigger thing. I think there's only two in Ohio. We bought our plot at, uh, uh, Ethan Cocosyn Nature Preserve near Kenyon College, where I went to school. Um, they bought a, uh, a small little golf course, and they've turned it into a nature preserve At the same time, it's a nature preserve, it's a green cemetery, which means that when you're buried there, you have to, um, either be buried in a shroud, be buried in, if you're going to be, uh, cremated in a, a biodegradable container.

You can be buried in a, a, a wicker casket. But bottom line, you have to... It's, it's dust to dust, earth to earth, [00:30:00] and there's no metal, there's no stuff keeping that from happening. And so, uh, somehow I got into a conversation recently with, with my kids, and it was... We were talking about life after death, and I said to them, "Well, you know, I am going to be alive after I die."

And they looked at me like, "What are you...?" I said, "Well, we've chosen a green cemetery. There's flowers. They've planted wildflowers over everything. There'll come a day where my DNA is gonna be part of that, so, s- part of those wildflowers." Um, and I said, "So if you really understand n- nature to nature, I'll be back."

Yeah. Your carbon will be out there. There you go. Well, I love the idea of the letter-writing, and I, I think I want to do that for my sons. But, um, for people listening to this podcast, um, [00:31:00] any advice that you have for people who might be supporting someone who's approaching their death or, um, how they might wanna approach their own death?

In terms of the, the first and n- being with loved ones, it goes back to what I said at the beginning, Steph. It's, it's, it's as complicated and not as complicated as listening and suspending. We gotta just try to be able to listen and suspend judgment, which requires us to be able to listen to ourselves about our own life and our own death, and also suspend judgment about that, about the morb- morbid- or the morbidness of it, um, is critical.

So yeah, I think listening, asking questions, understanding that they already [00:32:00] under-- they already are, are processing this stuff. This is... We sometimes we think that, that people who are dying, and I suspect some do, they try to not pay attention to it at all. I'm sure there are lots of people like that, but there are lots of people who've actually, when they've understand what's happening to them, are already starting to answer their questions.

And what they need most of all is somebody to listen to their contemplation and listen to their desire and not be judged as being, um, not fighting the, the disease, not fighting something. And in fact, being able to speak their truth about death is probably helps in terms of life enhancement too while you're on this earth Yeah.

Yeah, having that awareness that each day is a gift and, y- you can't make any assumptions. Um, it, it does [00:33:00] change how you approach each day and the people in it. Definitely. You know, I, I, as I said, I've ... I, I have contemplated and wondered does one have to go through some kind of a health crisis to come to some reflections about death?

I hope not. But, um, but clearly in my case, uh, it has been, it has informed my entire life. Uh, I have made almost all my decisions based upon knowing that there's an end, and what is my purpose then if there's an end? So it's informed that. Um-

When I thought they, when they thought I had my cancer, the cancer back when I was younger, um, and I was doing a con- my s- second contemplation on my own death, for some reason at that point I imagined life after my death, two years after my death, and [00:34:00] I was like, "Oh, shit." They're okay. My kids and my family, my wife were, yeah, on my birthday, on Christmas they would miss me, but they got on with their life, which is what we want at one level, and another level we all want everybody to always remember us, too.

Sure. And I came away from that going, "Phil, you're important, but you're not that important." And that combination of understanding importance and not importance has also been part of what's been my path, um, to

Figure out how to let go when it's time to let go. Um, whether it's in different phases of my life or as I, I'm hoping on that day that I'll be able to let go. I don't know yet. I may be the biggest [00:35:00] I may be the biggest pain in the world when that day comes. I don't know That's my hope. Yeah. Yeah, that's great.

Um, if anyone were interested, you know, they hear your words and they say, "Wow, you know, I think I would really like to support people in their end of life journey," or, gosh, you know, what's coming up for me, I'm supporting my own mom through the end of her life. And, um, you know, if people wanted to, to learn more or get a little bit training in being a death doula or as you and I are preferring to call it, an end of life coach, um, I mean, it may not even be formal training, but if people want to learn more...

You mentioned a book. You had mentioned the training. Um, what would you... What advice would you have for them? Yeah, I'm, I am certain that there's got to be, or I'm sure there are, [00:36:00] because I, when I got the training, I looked at a lot of different online opportunities. So I'm sure if you get into Googling those sub- you'll find all kinds of things.

I found that book, Briefly Perfectly Human, to be really helpful. Um, and I guess, you know, uh, it's, and it's not a thousand page book, it's a relatively small book, um, to be really helpful. So I would, I would commend people to pick it up, take a look. Highly readable. It's really the woman's story that led her to becoming a doula.

Um, that's, it's profound. Yeah. Yeah. Good. As we wrap things up, any last words for the listeners?

嗯 Just the fact that we're doing this podcast [00:37:00] is a, is meaningful, I think, because we don't wanna talk about this. And so to the degree that we are talking about this, and the degree to which people can grapple with their own death, and that's the first requirement. I know that. I know that in my soul. I can do what I'm doing now 'cause I've grappled with this for a long time Grappling with it with ourselves is the first step.

Yeah And then finding some people to talk with about it that at least initially don't find it to be morbid, um Because I have found that, uh, there are circumstances where I will talk... I'll get asked some of these questions, and I'll start to talk about it, and people will shut it off immediately. Yeah.

Yeah. And I get it. I get it, but it's not what people need, and it's not what we need. [00:38:00] My life, Steph, and, you know, my life has been rich. It's been a very rich life, and I, I believe that a bunch of that richness comes from this contemplation that there is an end. And so this notion of living and how we do that is short, and we gotta get on with it, um, and do it, and live our life the way we're meant to live it.

And, and you know, that's what we do in the academy. We really try to help people become even more aware of who they are as human beings and what their path is. Um, and I think it's just enhanced when we understand there's a... When we really understand there's an end, and it's not just a, a thinking thing, but we actually know in our gut that there's an end, and it's okay.

It's part of what, what this is, right? It's gonna happen. And I would think [00:39:00] just, you know, having awareness of that- Kind of pushing yourself to go there, just the gratitude that would come up, for all of the, you know, you talk about your rich life. I mean, it's, it's just, I don't know, I'm filled with gratitude and, and think about all of the people in my life, uh, when I think about my own death.

Um, so yeah, there's, there's- And the other part of it I will s- say to you too, 'cause I've, I have contemplated this a lot, that the act of dying, at least for now from my contemplation, is not that scary. When I go there, when I let myself go there, it's not that scary. Painful when you let the loved ones come into the picture.

Not gonna deny that. But At this point, my contemplation of what the end of the actual m- moment is doesn't feel that scary anymore. And I know we [00:40:00] have our friends who have come through the academy that are, you know, hospice and palliative docs, and gosh, there's so many resources to help, you know, family, people, um, get through that, th- that last part of, of life that, um, you're not alone.

Uh, so- You know, we had a palliative care physician in last year's class as well as this year's class, and I remember talking with the one from last year and her saying to me, "You know, Phil, the one thing I never hear on the deathbed is people saying, 'I wish I'd spent more time in the office.'" Right. Yeah. Well, and, and, you know, as I'm, I'm closing this up, I'm realizing this podcast episode is not just for physicians, and I would welcome people to share this recording with not just their colleagues, but friends, family members. Um, you know, it may be a way to start having the conversation in your own family.[00:41:00] 

Um, so please feel free to forward it to, uh, people in your life. But Phil, thanks so much for sharing all of this. Um, you're always just such a fountain of, of wisdom and love and generosity, and we appreciate you so much. Um, and you, the listener, thanks so much for joining us today. If you're curious about the Physicians Leadership Academy, um, hop on over to our website at physiciansleadershipacademy.org.

We are currently accepting applications for the next class beginning in September of 2026. If you're curious about the personal transformation that can occur through the Physicians Leadership Academy, do something amazing for yourself and fill out an application on the PLA website.