Read. Talk. Grow.

14. Discovering the loss, pain and beauty at the end of life

Episode Summary

Most of us try not to think about death. But in her novel "We All Want Impossible Things," author Catherine Newman won't let us look away. She takes us by the hand and guides us into the story of two friends as one enters hospice care. There is grief, loss and pain. But as she and Mayo Clinic Dr. Maisha Robinson can also attest, there is also beauty, friendship — and often, laughter — to be found at the end of life.

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Episode Transcription

Dr. Denise Millstine: Welcome to the “Read. Talk. Grow.” podcast, where we explore women’s health topics through books. In the same way that books can transport us to a different time, place or culture.”Read. Talk. Grow.” demonstrates how books can also give a new appreciation for health experiences and provide a platform from which women’s health can be discussed. At “Read. Talk. Grow.”we use books to learn about health conditions in the hopes that we can all lead happier, healthier lives.

I’m your host Dr. Denise Millstine. I’m an assistant professor of medicine at Mayo Clinic in Arizona, where I practice women’s health, internal medicine and integrative medicine. I am always reading and I love discussing books with my patients, my professional colleagues, and now with you.

Our book today is “We All Want Impossible Things” by Catherine Newman, and our topic will be palliative medicine and hospice care. Catherine Newman is a writer who has written a gazillion columns, articles and canned bean recipes for magazines and newspapers. Her essays have been widely anthologized. She’s the author of the memoirs “Waiting for Birdy” and “Catastrophic Happiness,” the middle grade novel “One Mixed Up Night,” and the best selling kids’ life skills books “How to be a Person” and “What Can I Say?”

“We All Want Impossible Things” is her first adult novel. She lives in Amherst, Massachusetts, where she’s a secretary of creative writing at Amherst College, and she has a PhD. Catherine, welcome to the show.

Catherine Newman: Thank you. Thank you so much, Denise.

Dr. Denise Millstine: I’m also excited for our second guest, Dr. Maisha Robinson, who’s an assistant professor in the Department of Neurology at Mayo Clinic in Florida, with a joint appointment in the Department of Internal Medicine. Upon joining the staff of Mayo Clinic, she established the clinic’s first neuropalliative care program, and she currently serves as the chair of the Division of Palliative Medicine and as the program director for the Palliative Medicine Fellowship.Dr. Robinson has spoken nationally and internationally on neuropalliative care. She edited a book titled “Case Studies in Neuropalliative Care,” and she’s a member of the American Board of Internal Medicine Approval Committee on Hospice and Palliative Medicine. Maisha, welcome to the show.

Maisha Robinson: Thank you so much for having me.

Dr. Denise Millstine: Our book today is “We All Want Impossible Things” by Catherine Newman. This is the story of friendship, loss and grief. Edi and Ash are lifelong best friends, and the book opens with Edi in the hospital for treatment of her ovarian cancer, just as her husband and best friend are navigating the news, the time has come to pivot to palliative care.

The book is fiction but is inspired by Catherine’s journey with her own best friend who died from ovarian cancer in 2015. For listeners worried that this book is too sad, stay with us. It is gut wrenching, and I definitely ugly cried my way through it, but I promise it has light and even laugh out loud moments. Catherine, this is such a beautiful book.

Catherine Newman: Thank you.

Dr. Denise Millstine: My story with this book is that I was in an independent bookstore in Dallas, Texas, called Interabang Books, and I was taken by the cover. I read the jacket, and I’m always on the lookout for books that would be appropriate for “Read. Talk. Grow.,” and I thought, “Finally, this is going to be a book about ovarian cancer.”

But of course, once I read “We All Want Impossible Things,” while it does touch on ovarian cancer, it really is the story of navigating hospice care and losing someone who’s very dear to you. You write about Edi’s health as she and her family pivot to this end-of-life care, but you do a really wonderful job of commenting and building the back story for Edi’s ovarian cancer.

I hope you don’t mind, Catherine, if we talk first about how you approach that. I particularly want to talk about one scene where the music therapist, Cedar, is playing a song that’s reminiscent of a different time in Edi’s care, and Ash is remembering their conversation about Edi’s debulking surgery. For those of our listeners who don’t know, this is a common component of ovarian cancer treatment where the tumor that can be taken out or resected is actually resected.

Here’s one of those lighter moments. About the debulking Edi says: “They’re like, what? Taking a little off the top? It’s not the most optimistic name.” Catherine, talk a bit about being a friend to someone being treated for ovarian cancer.

Catherine Newman: It’s a pretty rough road. The debulking that you mention is often the first step in treating ovarian cancer, removing all the disease they can see. That may include the ovaries, that might include adjacent tissue. For me, and this is maybe the segue from ovarian cancer to palliative care, the beginning of understanding how completely unabstract this was going to be, that you hear something like, “Someone dies of cancer,” and it really has, unless you’re in it, really in it, really close to the people, it just feels really abstract, like they die of cancer. It’s like the cancer comes down like a termite tent over a house, and the person sort of disappears.

It’s so bodily. One of the things I was trying to write about was how “body” it is to die from anything. Your consciousness wrestling out of this body that is not able to serve you anymore. I was not trying to say a lot about ovarian cancer in particular, but that was the thing I was trying to say. Just that it was going to be so specific to Millie. What it was that she died of.

Dr. Denise Millstine: I think this is such a good point because we think that when somebody is going through treatment for an advanced cancer, that encompasses their life. But you’re right, there are all these steps and other things go on. Marriages get strained and children are being raised and other friendships. It’s a very complicated time. One that can be pretty mysterious for many people who haven’t lived through it as adjacently as you have.

I really appreciate “We All Want Impossible Things” for taking us into a really difficult moment. Maisha, can you talk a bit about what happens when a woman is being treated for ovarian cancer as an example and the team says it’s time to shift to palliative care or hospice?

Maisha Robinson: One of the things I’d like to really emphasize is that palliative care is really appropriate at any age, and at any stage. So when people are first diagnosed with ovarian cancer, there is an opportunity to engage in palliative care, to think about, how we can really optimize symptoms, how we can take care of the caregivers, the best friends, the husbands, the spouses, the children, the loved ones.

Because really our unit of care for palliative care is not just the patient. How can we start to really emphasize what the goals are and understand those and clarify those and make sure that everything that we are doing that’s part of the medical community is in line with that person’s goals? Then certainly we also talk about the big picture and also advance care planning, which is really making sure we know when the person gets to the end of life, what kind of care, which you want to make sure that we are providing care, from the time of diagnosis through the end of life that is in line with her wishes.

Then we also ask who might she want to help make medical decisions if she can’t make them for herself? I tend to think about palliative care as an integrative approach into the care for somebody that has ovarian cancer. That can be provided any time during the course of treatment. But usually when people get closer to the end of life as a type of palliative care called hospice care, that can really be beneficial, where we have nurses and doctors and social workers, spiritual advisors and aides that can really come in and say, “We’re going to be with you during this time trying to help improve your quality of life and that of your loved ones as well.”

Dr. Denise Millstine: Thank you so much for that. I think it’s such an important point that I just want to restate that palliative care and palliative medicine really can be incorporated at any point, particularly in cancer care, but also in other chronic illnesses as well. As we mentioned in your bio that you actually work in something called neuropalliative care, which is for another set of patients.

Catherine, you start the book with this decision, a tough decision about shifting towards hospice care for Edi and having to decide if she’s going to try to stay close to her husband and her young son, or if she’s going to say goodbye to them and go and be nearby with her best friend. It’s really the first gut wrenching moment where we see Ash and Jude make the decision and then present it to Edi, and she’s like, “No way am I leaving my family.” But then realizes, “Maybe that’s the best thing for me.” Tell us about that scene and how hard that decision is for your characters.

Catherine Newman: I also volunteer in a hospice now, so I come at it from a lot of different places, thinking about what it means to decide that what you want is to be in a hospice. I am preaching to the choir here. I do not need to convert you guys to the beauty of hospice because you are already there.But that shift from the idea of making somebody well, which can be so hard, especially towards the end of life. It’s incredibly hard on the patient. It’s so much pressure. I always felt like my friend was like hosting a party that had gone awry; that there were all these people organized around making her well and she was not getting well.

It was really stressful and a ton of pressure. She really didn’t want to die. I’m not talking about the book here, but then you go into hospice and all the terms shift and the goal is care and clarifying your goal as you have time left. How do you want to spend it? What do you want it to be like? What do you need to get done between now and your passage? There was something so beautiful about that. Even though the premise was so monstrous for all of us, it was just completely surreal that it was giving up, which is how it felt.

People are afraid of hospice care because of that feeling. It is really hard to reorient towards “end of life,” but wow, it was the best thing that could have happened for her and for all of us to die in that place where her care and comfort and goals were at the forefront versus kind of a constant medical intervention. Hospice never woke her up for anything. It sounds like not a big deal, but as anyone who’s been in a hospital knows, people get woken up a lot. It was just a beautiful transition, but also really painful.

Dr. Denise Millstine: In “We All Want Impossible Things,” you do such a great job of creating that setting. Hospice care doesn’t mean we leave you in a quiet room and nobody is checking in on you and there are no services. You have all these people coming and you have the music therapist. You have dogs who belong to other patients. You have a lot of friends and loved ones.

I really liked your scene about constipation, something that perhaps we don’t like to think about or talk about publicly, but this is a huge part of comfort, and you have this fierce nurse who is taking on Edi’s constipation, and that’s such an honest, authentic component of hospice care. Maisha, what am I forgetting? What are the other components of care that we see in a hospice?

Maisha Robinson: You both really touched on some key aspects of hospice care. I’ll step back for a second and just say there often is a significant shift in mindset that has to occur when people transition from what they have been doing, which is usually life-prolonging care. People get diagnosed and they say, “What can I do to keep myself alive?” “What can we do to keep the cancer at bay?” “What can we do to keep things stable?”

Then when you get to some point where the quality of life isn’t acceptable or the treatments that people are receiving aren’t yielding the quality of life that people would find acceptable, people say, “Well, you know, maybe the potential benefit of continuing this cancer-directed therapy is now not outweighed by the potential risks or the cost, not financial, but what does it cost me to continue this, whether it’s time away from home or labs or imaging or other things that may induce some suffering.”

But when people make that decision and they become comfortable with that decision to transition to hospice care, people find all of these benefits, including wonderful people like nurses who are focusing on constipation.

But I think the other beautiful thing about hospice care is that they provide anticipatory guidance, and so what many people really benefit from is that the nursing staff will let you know what is coming down the line. They’re anticipating what is going to happen before it does, and they make sure that you are equipped to deal with it. They are so good at determining what other needs people may have. Some of it may be symptoms other than maybe emotional symptoms. “What does it mean that I’m nearing the end of my life? How does that impact me? How does it impact my family?” People may be worried about the financial aspect of it. “We’re losing income,” or “We might lose the house.”

What does that mean? Or other people have very spiritual concerns: “What is it going to feel like when I transition from this world to the next?” The hospice teams can help with all of that.The physical suffering, the psychological suffering and the spiritual pain as well.

Dr. Denise Millstine: That was such a fantastic answer that incorporated so many of the things that I wanted to make sure we talked about. Edi is the character in your book who is passing away, but Ash very much feels like the protagonist in this novel to me in that she is the caretaker. She is the one that we see grieving after it passes.I really want to talk about being a caregiver and what’s involved. When somebody you care deeply about is in hospice. Can you speak to that, Catherine?

Catherine Newman: One thing that was very true for me, and I think was true for all of my friends’ caregivers, and it’s certainly true for Ash in my novel, not coincidentally, is that it’s like there are these two things where there’s the dying itself, which can be incredibly arduous for everybody. I think in the book, but maybe this was just in my own head, maybe this is not in the book, but it might be in the book, but I was thinking of it as while the person is dying, you’re working really hard to help this person die.

I thought of it as shoveling out this massive hole, like we were working all day doing this thing, and then the person dies and there’s a hole there. Then there is the grief. They’re not actually the same. That surprised me so much. I think I thought that what we were doing was experiencing her loss, but we were not.

We were experiencing her death and then we experienced her loss and they were related, but really different, and that was just a surprise to me. I sort of felt like we got to the end and had done it. The other thing I compared it to is the way you take a birth class when you’re expecting a baby. As if the big thing is the birth, where you’re going, “Oh, I’m going to have a popsicle and my partner’s going to play guitar and there’s going to be a Kumbaya and a this and a that,” and the birth is like a minute, and then you have a baby. It’s like, “Oh my God, why were we distracting ourselves? But it’s really important because it’s that person’s last moments on earth and it matters so incredibly much that their life feels complete. But then you’re just grieving for the rest of time. Not to be really negative. It morphs, but the death for the survivors is really just the beginning of something, and that also really surprised me.

Dr. Denise Millstine: I think one thing we forget and, again here Ash caring for Edi, this is over a month that Edi’s in hospice, and she’s literally wrapped her life around, and her functioning around what’s going on with Edi. There’s a moment where she tries to settle in at home with her family, and she gets a call and they say, “You have to come now,” and that’s how it is. That becomes part of your role or what defines you for that period of being a caregiver, whether it’s hospice or caring for somebody with chronic disease.

When you have that death, that passing, of course you grieve the loss, but you also have this reset of your own function because you’ve defined yourself in a role, or you’ve really arranged your life with this role that is literally nonstop 24-7. Or if you’re part of a team, but it’s still nonstop for when you’re kind of the person who’s on and that hole, I think is something that can be very difficult to see and determine your path to reconfiguring that.

Maisha, no doubt you have a lot of conversations with caregivers and people after somebody they’ve loved has passed. Talk a little bit about what you think is so important from the caregiver side.

Maisha Robinson: We spent a lot of time in medicine focusing on the Edis. Appropriately so. Thinking about our patients. How can we help them live as well as they can? We in palliative care also think about the Ashes because we think about the fact that if we don’t take care of our caregivers, they won’t be there to take care of our patients and their loved ones and the people that they’re spending their time with.

So much of our focus is on how we can provide support to caregivers? I think you put it beautifully when you said that there’s a difference between the death and the loss. Before somebody dies, we start talking about anticipatory grief. People are going through the things that they are losing over the course of the disease, loss of independence, loss of function, loss of job, loss of income, loss of relationships. People are thinking sometimes even about the loss of their own functioning; bowels, things of that nature. But once the person dies, you’re absolutely correct. Then it’s time to really focus on the bereavement support for those that are behind the Ashes. Hospice does an incredible job providing bereavement support, and it can be very healthy for people to meet with a bereavement counselor or talk with their own primary care doctor just about what they’re feeling, and then having some continuity of care.

Hospice will follow people through the first year because you might not know what it’s going to feel like the first birthday or for some people, the first anniversary of a marriage or the first time that Christmas rolls around, or Hanukkah or Thanksgiving, and so having some continuity after the person dies I think is really important.

Dr. Denise Millstine: I think, Catherine, you made a really important point, too, that everybody’s  journey with hospice or losing someone close to them, is their own journey. We’re speaking about two characters in a book, you’re referring to your own life experience. But for our listeners who are going through this, we recognize that everybody’s experience is unique to them and that person with whom they are carrying.

One of the most poignant relationships in the book to me is the relationship between Edi and Dash, her son. Now, we never see them together in the same room, but we know from the beginning that she makes a very difficult decision to put closure on the process for Dash by saying goodbye to him and then going to have her hospice closer to where Ash lives. Talk about that parent child relationship in somebody who is facing “end of life.”

Catherine Newman: I’ll be really curious about what Maisha thinks about this, but I know that with my friend, and I see this in the hospice where I volunteer, it is really, really incredible, and so moving to me how many parents and perhaps more specifically mothers, this is just anecdotal, won’t die with their kids in the room. The number of bereaved kids, and I use kids loosely, I’m talking about 70-year-olds half the time, but the number of bereaved kids at the hospice where we have to say, “Oh, no, no, she waited to die until you ran out for coffee.” They’re like, “I was there for like 70 hours straight, and then I ran out for coffee and I missed it,” and it’s like, “No, no, no, no. Parents are parents.”

It’s so deep. Even people in massive cognitive decline where it doesn’t even seem like they realize who their kids are. There’s a deep parent-ness where you don’t want to die with your kids in the room, and it is so moving to me. My friend did not want to be dying with her kids in the room and she was really torn up about it because of course she was dying. She wanted to spend as much time as possible with her kids, but she could not get on with it if they were there. She had to mother them and really needed to turn towards the process of dying, which was quite arduous for her. She was really young. She didn’t want to die, so it was extra difficult. Maisha, have you noticed that about parents in hospice?

Maisha Robinson: I think you’re absolutely correct, Catherine. We do see that people will hang on as long as they can until a very special loved one leaves and then they will die very peacefully, and the family members, as you mentioned, say, “I can’t believe it happened when I left.” Sometimes I actually prepare people for that because I want them to know you have been here. She knows you have been here, but sometimes that people just want to do it on their own terms in their own way, and they want you to remember them as they were.

Sometimes that can be helpful to people, but I understand that for many family members it can be very challenging to have just stepped away even to use the bathroom, and when they come back their loved one is no longer with us.

Dr. Denise Millstine: There’s so much wisdom in that early conversation with the social worker, Maisha talked a little bit about “anticipatory guidance” in saying to the family in a way this is a gift to the son to say we can say goodbye on our terms, we can say goodbye now. Even though I’ll still be living and we could still message each other or anything, but we know we’re not thinking that we’ll see each other again.

I do think there’s something about that knowledge or lack of knowledge when people say: “I didn’t know that was the last time I would speak” to him or her, and this gift is, as hard as it is, it’s a gift to say this truly is our last touchpoint. This book, Catherine, is so powerful.

I just really think that you have captured the authentic experience of walking through “end of life” with somebody that you care about. I can’t believe you’ve done — I mean, I can believe it because you’re an incredible writer, but what a beautiful book. I really hope our listeners will pick it up and experience it with you.

Catherine Newman: Thank you so much.

Dr. Denise Millstine: Let’s talk about some of the humor because this is messy. One of my friends read this book ahead of me, and I was like, “I don’t have the energy for it.” She’s like, “I laughed out loud.” You add these components and perhaps they’re inspired by your volunteering, but you’ve got a patient in hospice who listens to “Fiddler on the Roof.” You have the man, Junior, who wants his nonexistent haircut to look good. You just add these components of true lights and real life in the hospice setting. Talk a little bit about the process of that. If you just really wanted to give some levity. Tell us.

Catherine Newman: My family calls that shtetl humor. The Jews like to say we didn’t have time to let the bread rise, but we had time to tell a really long joke while we were fleeing across the desert. I feel like that’s cultural to some extent for me, that that’s in my bones and blood.

But I will say at the hospice that we do laugh a lot. A nurse who knows me really well, I was there last night making dinner, feeding people, that’s what I do there. I love, love being there, and this nurse who knows me really well came in and was like: “It’s Ash Wednesday. Do not take a washcloth to that man’s face,” and I was like: “Oh!…” I was about to do that.

Then I had to retire to the kitchen to bend over and laugh because I was really seriously just about to wipe something very meaningful from this guy’s face with a washcloth, because that’s like part of what I do there. So that’s very funny to me. Might not be funny. I really, I don’t know. I think laughing as a coping strategy is not everybody’s coping strategy, and there are many excellent coping strategies, but it was my friend who died who was very, very funny, and we laughed a ton. We laughed a lot, and it did rescue us a little bit.

Dr. Denise Millstine:Maisha, I bet people who haven’t spent much time in hospice would be surprised to walk down a hallway and might have pictured there was going to be soft music and gentle lighting, and while certainly there is some of that, you might also hear old musicals or people sharing it and laughing. You even hear joy in the hallways. Do you agree?

Maisha Robinson: I completely agree. What’s very meaningful, I think, for a lot of people is it tells stories about the person who is nearing the “end of life.” Sometimes I just sit with family members and friends and I learn so much, but so much of it is very comical. They remember old times or funny things the person did, or they’ll remember some corny jokes that they told, or that they enjoyed telling.

We’ll just sit there and smile, and I think just being present and in that moment and realizing the person usually lived a really good life. This is the natural progression, unfortunately or fortunately, for all of us. What people come to terms with, this is the “end of life,” but we just want to be grateful for the life that he or she had. Then I think there are those moments of levity that people can really appreciate.

Dr. Denise Millstine: I want to reemphasize what you just said, that when somebody is dying or in hospice care, the one thing that we can all know to do is to just show up, to be present, to really try not to shy away from talking about it or being there, that, if people are open to you being in their life or caring for the caregiver.

I love in “We All Want Impossible Things” when Ash gets these texts from her friends who are not involved, who say, we can go for a walk, we can grab a coffee, let me buy you a glass of wine if you have time. You’ve even depicted how friends support friends in a way that’s not intrusive but is so meaningful. This idea of “just show up.” Even when it’s hard, even when there’s death and dying involved because, like you said, Maisha, we will all get there at some point.

Catherine Newman: When you were saying that just now, I was thinking about how everybody who’s gone through something has different opinions about what worked best for them. Well, what kind of support worked best for them, and I will say that I am somebody for whom the “I’m bossy” kind of support worked really well.

People who would let me know if I can do anything, but were like, “I’m coming over with this,” or “I’m taking you out for a walk,” and that was a godsend to me, because you often just can’t even organize yourself. Even if you weren’t shy to express a need or a want, which most people are. Even me, and I’m like, really not shy.

Somebody’s like: “Oh, do you want me to bring dinner? And I’m like: “That’s okay.” But the people who were like: “I’m doing this.” It was so helpful and moving to me that that is now the kind of support person I am. I do not say: “Let me know what would be helpful.” “Let me know if…” “Let me know this, that.” There is so much going on. The idea that you have another “to do” thing, which is letting somebody know how to support you. You can’t. You don’t even have it in you. So I really love the: “I’m coming over and cleaning your bathroom. Don’t talk to me about it.”

I just really like really bossy, very hands on, in the nitty gritty, and I find it really helps people not feel like they’re just alone because the alone-ness with something massive in your life, that feeling that the world is going on without you is so strange, and it’s just I loved having friends who just barged into my cry relief. It was really a godsend to me.

Maisha Robinson: You know, Catherine, I think this is very important. I see people all the time that tell me how hesitant they are about accepting the help that people are offering. They say: “Well, you know, Dr. Robinson people are saying, ‘Well, let me know if I can help you.'” That’s it, and then let them know! “Yes, please bring over dinner tomorrow night.” “Oh, it will be great if you go to the grocery store.” “Yes, I have a bathroom that needs to be cleaned. Thank you so much for volunteering.” I encourage people just to write a list out because sometimes people aren’t as comfortable just saying what they’re going to do, but they do say those very big statements about — let me know how I can help.

So I say to people: “Write down some of the things that would be helpful, and then when people call you just go right down that list and give it to them.” I say: “That’s your homework. You have to start accepting the help.”

Catherine Newman: I love that because those websites were so great. We did lots of “Helping Hands.” I don’t know if they’re all the same still, but where you sign up for meals and childcare, and it was amazing because people also really want to help. When you’re the one who wants to help, you believe it, but somehow when people offer to help you, I always say when people allow me to help them, I’m like, “You just allowed me to feel like a total hero. So thank you.” Like I will now smugly go about the rest of my day. Having to clean your bathroom. That it’s like a gift to be allowed in and everybody knows that it feels great.

I wish we could make that last connection to just allowing it. Allowing people to help you is such a gift to them. It is the most intimate, moving expression of friendship that they can offer. There’s not much they can do, but they can do that and want to. So I love those websites where people sign up and do all of it. They sign up for all of it.

Dr. Denise Millstine: Sometimes showing up is just, “Can you just bring me a cup of coffee and give me a hug?” Sometimes it’s not that you want the person to be present, but it can be just so meaningful even to know that they are there. In that after death part you might very much need those extra walks and times to just sit and have a shoulder to cry on or somebody to give you a hug.

There’s so many things that people can give. So for our listeners who don’t know what to do, one approach is to insist you’re coming over to clean the bathroom or bring a coffee or give a hug or make a meal or something to eat. Just to show up is so critically important. Catherine, I want to end by thinking about who you envisioned reading your book when you wrote this and then followed that with Maisha commenting on who you think would benefit from reading a book that depicts hospice in this way.

Catherine Newman: I really wanted to write a book that was both about a really excellent friendship without a lot of conflict in it. It’s the book I want to read where they’re just really good friends. It’s not that complicated. A book that has no antagonist but cancer. If that’s appealing, a slutty friend going through the death of a loved one, I thought, was just like a category of novel that really needed to exist. No, I’m kidding.

People are a little offended by the sluttiness. You’ve been very polite not to mention it too much. I do think the demystifying of death. I did think as I was going through it that I would have loved more of the really nitty gritty, unairbrushed, what it would be like to be with a body that was “giving out” and a friend trapped inside it. I hope that people can read that and find comfort or guidance in that. But also I did want to make people laugh too.

Dr. Denise Millstine: Because you tossed it up there, I’m going to comment on the sexual exploits of our protagonist. I loved that because she is a person and this is not her whole life and this is how she deals with it. It’s okay to be a mess when you’re going through something. That is going to look different for every person.

You probably have no idea what kind of mess you would be until you’ve lived through it. I found it to be so authentic. The reason I didn’t bring it up is because we try to avoid spoilers on this show, although it can be hard. Alright, Maisha, who do you think needs to read “We All Want Impossible Things”?

Maisha Robinson: Everybody needs to read this book. I think, Catherine, what you’re doing is helping to de-stigmatize hospice care. You’re helping us normalize end-of-life care, which is going to be an issue for all of us. When people are able to read this book, they’ll read it in a way that will make them think: “What are the kinds of things I should perhaps be thinking about if or when I get closer to the “end of life?” Should I be thinking about who’s going to take care of me?

Do I have an Ash? Should I be thinking about what the care is going to look like? Do I know what my local resources are? Is there a hospice around? Or for people who are closer to the “end of life,” this may help stimulate some conversation with their families. Anybody I think could benefit from reading this book, and everybody should be reading this book.

Dr. Denise Millstine: You heard it here. Go pick up your copy of “We All Want Impossible Things.” I couldn’t agree more. I think we all need to face these topics. I want to thank you both for an amazing conversation about friendship, about hospice care, about “end of life,” about supporting each other. It has been really an amazing experience. Thank you for being here.

Catherine Newman: Thank you. Thank you both.

Maisha Robinson: Thank you so much.

Dr. Denise Millstine: Thank you for joining us to talk about books and health today on “Read. Talk. Grow.” To continue the conversation and send comments, visit the show notes or email us at readtalkgrow@mayo.edu.

“Read. Talk. Grow.” is a production of Mayo Clinic Press. Our producer is Lisa Speckhard Pasque and our recording engineer is Rick Andresen.

The podcast is for informational purposes only and is not designed to replace the physician’s medical assessment and judgment. Information presented is not intended as medical advice. Please contact a health care professional for medical assistance with specific questions pertaining to your own health needed. Keep reading everyone.