In Conversation with an End-of-Life Specialist

The Last Lesson: A Conversation with Dr. Ken Gorczyca

Dr. Ken Gorczyca has been sitting with death since he was eight years old. His guinea pig, Squeaky, died, and no one helped him. No ritual, no guidance. So he put her in a shoebox, added flowers, dug a hole in the backyard, and figured it out on his own. He didn't know it then, but that was the beginning. Ken graduated from veterinary school in 1983 and moved to San Francisco — straight into the center of the AIDS pandemic.  His very first client was a physician asking whether people with HIV should give up their pets. Ken said no.  He co-founded Pets Are Wonderful Support, the first organization dedicated to keeping people with AIDS and their animals together. He lost 300 clients. Dozens of friends. And when he finally took the end-of-life doula course at UVM decades later — yes, the same program I went through, and yes, Ken was one of my instructors — he recognized something: we were all death doulas. We just didn't have the name for it yet. When he turned 65, he went into the desert with one question: What's next? What came back was this work. In the last four years, he's been present for the deaths of roughly 2,000 animals — dogs, cats, bunnies, rats — in homes, in living rooms, in the spaces where a life was actually lived. He rings a bell. He tells the story. He smudges. He closes with a poem. Not because it's required, but because he believes — deeply, unwaveringly — that at the end of life, medicine and spirit can't be separated. In this conversation, Ken and I talk about what families most need when they're scared and don't know what to expect.  About why he spends 20 minutes asking families to tell him everything — the adoption story, the name story, whether their dog ever stole the turkey off the table — before anything else happens.  About disenfranchised grief, and why the loss of an animal is real grief, not a lesser version.  About what it means to let go. And about what he's come to believe: that an animal's death is the last lesson they teach you. "Their passing," he said, "is really their last lesson. They're teaching you about death." This one stays with you. RESOURCES MENTIONED IN THIS EPISODE: Ken and our guests touched on something that doesn't get talked about enough: what happens to your pet when you die — or when you're dying and can't care for them anymore. Here are a few places to start. Pet Advance Directives — Just like a human advance directive, a pet advance directive lets you document your wishes for your animal's care if you're no longer able to make decisions. Mine needs updating. Maybe yours does too. https://tinyurl.com/PetAdvanceDirective [https://tinyurl.com/PetAdvanceDirective] Pet Trusts — A pet trust is a legally enforceable arrangement that sets aside funds and names a caretaker for your animal after your death. Unlike leaving a pet to someone informally, a trust gives your wishes legal teeth. Your estate planning attorney can help, or search your state bar association for resources specific to where you live. https://tinyurl.com/PetTrustsPrimer [https://tinyurl.com/PetTrustsPrimer] Pet Quality of Life Scale https://tinyurl.com/PetQualityOfLifeScale [https://tinyurl.com/PetQualityOfLifeScale] My Grandfather's Cat — mygrandfatherscat.ca [https://www.mygrandfatherscat.ca/] — A free Canadian charity that helps seniors and terminally ill people find second forever homes for their pets. No shelters, no foster systems — their animal stays home until the very last day, then moves directly to a new forever family. Canada-only for now, but a model worth knowing and sharing. A Gentle Rest — agentlerest.com [https://agentlerest.com/] — Dr. Ari Rozycki's in-home euthanasia practice in the San Francisco Bay Area, where Ken Gorczyca is part of the team. If you're in the Bay Area, or simply want to see what this work can look like at its best, it's worth a visit. About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack [https://patriciamsears.substack.com/subscribe] for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

When I Die, I'm Really Going to Miss Mint Jelly — In Conversation with Diane Button

What do we reach for when time gets short? Not the accomplishments. Not the carefully managed image. Something simpler. Something we wish we'd said out loud sooner. This conversation is for anyone who has been putting off a conversation they know they need to have. Which is most of us. The conversation doesn't have to be perfect. It just has to start. Guest: Diane Button End-of-Life Doula | Author | Educator | Founder, Bay Area ELDA UVM End-of-Life Doula Certificate Program Instructor What we talk about in this episode: The mint jelly story — how a grandfather's final meal and a single sentence launched Diane's career in end-of-life work. The doula bag — what happened when Diane showed up to Floyd Barker's house with 100 questions on a clipboard and a bag full of supplies, and never opened either one. The vigil plan — why asking someone what they want their final hours to look like is one of the most important conversations you can have, and why the answers will surprise you. The gap — what it actually costs people when advance directives go unsigned, relationships go unhealed, and words go unsaid. From someone who has watched it happen. The Final Checklist — six questions Diane distilled from a hundred. She asks them of her clients. She asks them of herself. Every month. They will stop you cold. Death is just one day — why Diane calls herself an end-of-life doula, not a death doula, and why that distinction matters more than it might seem. The six questions: 1. Who matters most? 2. What matters most? 3. What is left unsaid? 4. What is left undone? 5. What are you worrying about when you're lying awake at night? 6. What brings you joy in the daytime? Diane's book: What Matters Most by Diane Button — find it on Trish's curated booklist for end-of-life reading at Graceful Transitions: 👉 https://bookshop.org/lists/for-graceful-transitions-an-end-of-life-doula-a-curated-booklist [https://bookshop.org/lists/for-graceful-transitions-an-end-of-life-doula-a-curated-booklist] The voice changes in this episode are due to 'operator error,' and I had to re-record 8 minutes as a result. I am learning a lot about editing and polishing. Onward with CHEERS and sincere appreciation. About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack [https://patriciamsears.substack.com/subscribe] for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

Street Wisdom at the Threshold: What 35 Years of Bedside Ministry Taught Me About Dying Well

What does it take to stand in a room where someone is drawing their last breaths — with no clinical training, no script, and no way to fix it? Pastor Larry Wall has been doing exactly that for 35 years. As the founding pastor of Newport Church of God in Vermont's Northeast Kingdom and the visionary behind the Living Waters Hospice House, Pastor Larry brings something most bedside training programs don't cover: street wisdom, spiritual discernment, and an unshakable belief that death done well can be sacred and beautiful. In this conversation, we go deep: * What terminal breathing actually looks and sounds like — and why families are rarely prepared for it * The 3 AM phone call that changed everything: Pastor Larry's first death vigil, what he did wrong, and what grace showed him instead * Why dying people "hold on" — and the surprising question that unlocked a peaceful death within 10 minutes * The profound difference between spirituality and religion at the end of life (and why it matters more than you think) * How advance directives do more than protect the dying — they protect the living from an impossible burden * The hymn Pastor Larry sings at the bedside when someone can't let go * Perspectives from London to San Antonio: Graceful Lifers John Goodey and Kathy Hamilton on children, hospice, and a mariachi band at a 95th birthday that brought a room to tears * Graceful Lifers are paid subscribers to https://patriciamsears.substack.com [https://patriciamsears.substack.com]/ and/or alumni of Graceful Transitions Legacy Leaders Guide [https://linktr.ee/pmsears] cohorts or Living Fully and Dying Prepared workshops. Graceful Lifer John Goodey — a former London headteacher — also shares the story of the groundbreaking intergenerational program he helped launch at St. Christopher's Hospice in Southeast London, where 9-year-olds partnered with dying patients to create art and exchange life stories. That program has since spread to every continent. If it moves you as much as it moved us, here's where to learn more: * The St. Christopher's Schools Project (the original program, running since 2005): https://musicandartsinaction.net/index.php/maia/article/view/stchristophersschoolsproject [https://musicandartsinaction.net/index.php/maia/article/view/stchristophersschoolsproject] * Studio DöBra (the Swedish intergenerational arts initiative inspired by St. Christopher's): https://www.döbra.se/en/projects/studio-dobra/ [https://www.döbra.se/en/projects/studio-dobra/] This episode is also a window into what Living Waters Hospice House [https://www.livingwatershospicehouse.org/] is being built to be — a place where laughter is medicine, love is the bottom line, and no one dies alone. Living Waters Hospice House is actively seeking community support. To learn more, reach out to Graceful Transitions. Interested in planning your own legacy before the crisis arrives?  Join Trish for a free Legacy Leaders Guide Taster Session: https://tinyurl.com/LLG-FreeTasterSession-Register [https://tinyurl.com/LLG-FreeTasterSession-Register] About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack [https://patriciamsears.substack.com/subscribe] for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

Dealing the Cards on Death: How Lisa Pahl Is Getting Families to Have the Conversations That Matter

What if talking about death could actually be fun?  Lisa Pahl, licensed clinical social worker, hospice veteran of 18 years, and CEO and co-founder of The Death Deck, believes that humor and the right questions can open doors that fear keeps shut. In this conversation, Lisa shares how a friendship forged through loss led her and co-founder Lori to create a suite of conversation tools — The Death Deck and The End of Life Deck. Lisa collaborated with Compassion & Choices to create the brand new Dementia Deck. All 3 decks are designed to help families have the conversations they keep putting off.  Whether it's what to do with your passwords, who's taking the dog, or how you'd want to show up for loved ones after you're gone, these cards meet people exactly where they are. Patricia and Lisa explore the surprising power of humor and silence in end-of-life work, what families argue about most at the bedside, why your partner might not be the best choice for your healthcare proxy, and the critical — often unknown — decisional moments that shape how we die with dementia. This episode is both practical and deeply human. You'll come away with a new appreciation for why starting the conversation now, before a crisis forces the issue, is one of the most loving things you can do for the people you'll someday leave behind. You'll hear about: The story behind The Death Deck and how grief sparked its creation, why dementia tops the list of what people fear most, what families don't know they can choose when a loved one has dementia, how to think carefully about your healthcare proxy, and what it means to truly honor someone's wishes when the pressure is on. Find the decks: thedeathdeck.com About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack [https://patriciamsears.substack.com/subscribe] for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

When Loss Isn't Death: Jenny Filush-Glaze on Validating Every Kind of Grief

Grief counselor Jenny Filush-Glaze joins us to discuss the losses that don't come with funerals but hurt just as deeply — from chronic illness to broken relationships. After her own alpha-gal syndrome diagnosis, Jenny brings both clinical expertise and lived experience to conversations about youth grief, permission to feel, and why "at least no one died" is one of the most damaging things we can say. With 15 years in hospice care and current work as a school-based therapist, Jenny shares insights on how children actually grieve versus how adults think they should, why we rank grief (and what that costs us), and how to create spaces where all feelings are valid. Her journey from treating ambiguous loss to living it offers rare perspective on navigating life-altering change. Whether you're supporting someone through loss or navigating your own grief, this conversation provides both validation and practical guidance for honoring every kind of loss. CONNECT WITH TRISH (aka Patricia M Sears): * All links: ⁠linktr.ee/pmsears⁠ [https://linktr.ee/pmsears] * Graceful Lifers: ⁠patriciamsears.substack.com⁠ [https://patriciamsears.substack.com/] * LinkedIn: ⁠The Threshold newsletter⁠ [https://www.linkedin.com/newsletters/7402419035591843840/] CONNECT WITH JENNY: * Books on Amazon: "⁠Grief and Alpha Gal: The Mind and Body Connection⁠ [https://a.co/d/5pZgEYU]" & "⁠Grief Talks 2⁠ [https://www.linkedin.com/newsletters/7402419035591843840/]" * Facebook: ⁠Alpha-Gal Grief Girl [https://www.facebook.com/groups/824675736929995] About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, UVM-certified End-of-Life Doula and founder of Graceful Transitions in Vermont's Northeast Kingdom. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers. Join the Graceful Lifers community at Substack [https://patriciamsears.substack.com/subscribe] for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.