BJ Miller, M.D.: How understanding death leads to a better life

**Peter Attia** (0:11)
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Now, without further delay, here's today's episode.
I guess this week is Dr. BJ Miller. BJ is a hospice and palliative care specialist. We talk a lot about what that means, but the reason I wanted to speak with BJ is I've been really thinking a lot about better understanding what end of life means and how understanding the end of life could help us better understand, frankly, what we want out of life. And by an amazing coincidence, BJ and I met very, very briefly many years ago in medical school, although I don't think he remembers it. But when I saw him again giving a TED Talk several years ago, I immediately realized, hey, that's the guy I met at a party, you know, 20 some odd years ago, and became really interested in his work and then reached back out to him and said, hey, would you be interested to sit down and talk about this? And so in this discussion, we talk a lot about his personal story because you can't really avoid it. And frankly, his personal story is a big part of why he ultimately chose the life path he did, which is doing something that many of us, including people who go into medicine, would find just too difficult to do, which is basically help patients die as a means to reach this combination of their life. We get into all sorts of things, the difference between death and dying, the difference between palliative care and hospice, the differences between loss and regret, what the medical system that we're a part of is good at and what it's not so great at. We talk about what really happens at the end of life. How enlightened or transcendent is it? And he tells a number of stories that are quite moving about patients and also from his own life. And finally, we conclude with a discussion on both the hastening of death and also what he's most optimistic about, including the use of psychedelics.
This is another one of those episodes that I think people at the surface might think, gosh, I don't really have an interest in that. I would encourage you to push through that. I think it's natural to find this topic unpalatable. And I think that's exactly why people need to listen to this. So without further delay, please enjoy my conversation with BJ Miller.
Hey, BJ, it's a real honor to be sitting down with you, even though we're not in person together.

**B.J. Miller** (3:08)
Thank you, Peter. I appreciate you having me, but I'm looking forward to this.

**Peter Attia** (3:12)
Now, I don't know if you remember this. In fact, you can't have remembered this because I'm not memorable in the way that you are, but we've met a few times at parties in medical school.

**B.J. Miller** (3:24)
No shit.

**Peter Attia** (3:25)
You went to UCSF and I went to Stanford.
And I don't know if we were the same class, but we were pretty close. What year did you matriculate at UCSF?

**B.J. Miller** (3:34)
97

**Peter Attia** (3:36)
So we were the same class. And I don't recall you guys ever coming down to Palo Alto, but we sure as hell went up to San Francisco a lot.

**B.J. Miller** (3:45)
For social reasons or for school?

**Peter Attia** (3:47)
No, just for social reasons.

**B.J. Miller** (3:49)
Oh yeah. Yeah, yeah.

**Peter Attia** (3:50)
We just had friends in common and stuff like that. And so it's almost 25 years ago. And I remember one of the things that stood out was you had a dog, right?

**B.J. Miller** (3:59)
Uh-huh. Yep.

**Peter Attia** (4:01)
What was your dog's name? I don't remember.

**B.J. Miller** (4:03)
His name was Vermont, like the state.
Yeah. I'm so psyched you remember him, Peter. He was a huge part of my life. I can tell you that's beautiful.

**Peter Attia** (4:14)
So I will admit something, BJ which is that I never had the nerve to come up to you and say, hey, what happened because it wasn't subtle, right?