In this episode of Blood n Bone, host Paula A. sits down with Dr. David Casarett — palliative care physician, researcher, and author of Undiscovered Country: A Doctor’s Travel Guide to the End of Life. Together, they explore the biology of dying, the ways patients can design their end-of-life experience, and what medicine gets right (and wrong) about death.

Dr. Casarett reframes dying not as a single event, but as a profound journey — one that deserves empathy, curiosity, and conversation. With equal parts science and storytelling, this conversation invites listeners to see death as a vital part of medicine and life itself.

Key Topics:

• The biology of our final hours

• “Death by Design” and how patients can shape their end-of-life experience

• Why death deserves a seat at the healthcare table

• How science and compassion together can transform palliative care

Gaslighting at the Veil: When Medicine Denies the Dying Their Voices

What happens when the systems meant to heal become the ones that silence? This conversation pulls back the curtain on the subtle violences of medical authority—where dying people are dismissed, diminished, or denied their own truth. As a deathwalker, I name the gaslighting at the threshold: the way medicine can strip autonomy, mute grief, and erase the sacred wisdom of those preparing to cross.

This episode is not just about death—it’s about reclaiming voice, dignity, and the right to speak our own exits into being. Tune in for a reckoning at the veil, where silence is broken and sovereignty is restored.

In this episode of Death Talk Unscripted, Paula Adams, a Death Walker, explores the complex themes surrounding death, autonomy, and the experiences of those who are dying. She discusses the perception of time for the dying, the importance of allowing individuals to choose their end-of-life path, and the societal attitudes that often deny them this choice. Through personal anecdotes and philosophical reflections, Paula advocates for a reimagining of death care that honors the wisdom and autonomy of the dying, emphasizing the need for open conversations about death and the sacredness of the dying process.

Takeaways

Death is not an ending, but a transformation.

Dying individuals often wait for their loved ones to be ready.

The perception of time differs for the dying and their families.

Denying autonomy in dying can be seen as patronizing.

The agony of being ready but not allowed to go is a form of suffering.

Time bends around longing in the dying process.

We must advocate for policies that honor choice in death care.

The dying have access to wisdom and clarity that we often overlook.

Communal support can transform the dying experience.

Autonomy and freedom are essential in the dying process.