A New Vision of Our Final Chapter
by Dr. Bob Uslander for Aging Well Magazine
For 25 years, I dedicated my life to the fast-paced world of Emergency Medicine, where I helped countless individuals escape the clutches of death. It was a fulfilling and impactful career, earning me a reputation as a compassionate and knowledgeable physician. However, in 2013, a transformative epiphany led me to a new calling that challenged my understanding of life and death.
This revelation struck me during a celebration of life for a friend in La Jolla, California. As I sat on a bluff overlooking the ocean, a surge of energy coursed through me, awakening my senses. I received a powerful message in that profound moment: “I’m here to help people die.” Given my extensive background in preventing death, this shocking directive wasn’t entirely unexpected.
Years earlier, I had immersed myself briefly in hospice care while helping a friend battle melanoma. That experience lingered in my thoughts, planting seeds of a new purpose aligned with my core values: Connection, Family, Wisdom, Joy, and Freedom.
This newfound path took on a profound personal dimension a short time later as I navigated the final journeys of both my parents.
My Parents’ Story
In the wake of my career transition, my mother’s recurrence of lung cancer unfolded in a whirlwind of doctor’s appointments and treatments that not only weren’t helpful but caused significant complications. Balancing my roles as both a doctor and son, I sometimes found myself secretly wishing she wouldn’t wake up, witnessing her daily struggles taking a toll on her and my father. Despite this, we fulfilled her wish to witness her grandson’s college graduation, albeit through a hospital bed live feed. Opting for hospice care, she died peacefully at home a short time later, surrounded by her family.
This experience granted me profound insights into the anxieties families face during their loved one’s struggles. It underscored the importance of a guide—like myself—to advocate for optimal care, alleviating pain and fear.
Less than a year later, my 81-year-old father’s vibrant life took a shocking and dramatic turn when he was diagnosed with stage 4 lung cancer. Despite a seven-week treatment course and an adventurous trip with his grandson, his return marked a decline, with tests revealing widespread cancer. Embracing his mantra, “It is what it is,” he chose not to pursue further treatment. Assuring him of a pain-free closure, I, as a palliative care and hospice physician, navigated my fears, dedicated to ensuring his “good” death. He died two weeks later.
In the end, surrounded by family, my father’s passing exemplified a perfect death—no fuss, no pain, just love. In his final moments, he became my greatest teacher, demonstrating the power and control of the human spirit. His legacy shapes my commitment to providing families with the gold standard of care as they navigate serious illness and approach life’s end.
My Philosophy
A serious illness doesn’t have to mean the death of the spirit. No matter what stage of an illness a person is at, it is ALWAYS possible to experience a deep sense of peace and innate well-being. I’ve witnessed this time after time in our patients.
Death can—and should—be a beautiful transformation, but having a vision of our final chapter and planning are critically important for allowing this to unfold.
My work involves fostering deep connections with patients and families going through significant health and life challenges and struggles. My team and I guide them in making decisions about their care. Hence, they enjoy the best possible quality of life – and the greatest sense of peace and well-being – while they go through the stages of serious illness, up to and including the taking of their final breath.
In 2017, I joined forces with my now-wife and business partner, Elizabeth Uslander, a skilled spiritual counselor and medical social worker. Together, we embarked on a mission to revolutionize healthcare by bridging gaps to provide whole-person, trauma-informed, and culturally competent care. Our goal is to honor individual and family needs and create a new paradigm—one that ensures agency and dignity for all.
We emphasize the importance of end-of-life planning as a crucial aspect of aging well. Individuals can shape a fulfilling final chapter by understanding all the options, envisioning goals, clarifying intentions, and documenting wishes. Our approach extends beyond physical care, encompassing mental, emotional, and spiritual support for a holistic end-of-life experience.
Though this final chapter signifies an ending, it remains an integral part of living. Everyone deserves unwavering support throughout this journey, ensuring a dignified transition on every level. In championing this cause, we aspire to redefine healthcare, making agency, dignity, and holistic care the cornerstones of a compassionate and fulfilling life until the very end.
Bob Uslander, MD, and Elizabeth Uslander, MSW MTS, are the co-founders of Empowered Endings, a unique model of End-of-Life Care that fills the glaring gaps in traditional Palliative and Hospice Care and emphasizes whole person and family care, including emotional, intellectual, and spiritual health of patients and their loved ones. They are working on their forthcoming book, Permission to Choose. Find them at empoweredendings.com.
