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Audacious: David Meyers Interview Transcript

Audacious with Chion Wolf
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Chion Wolf 0:00

Hey there, I'm Chion Wolf. And this is a special extended version of my conversation with Dr. David Myers. After five years of living with glioblastoma, a brain tumor, he's nearing the end of his life. He talks about what matters most to him, he gives advice for those of us who aren't so willing to ponder death deeply, and he shares how he wants to be remembered. But let's back up. When did he first know that something was wrong?

Dr. David Meyers 0:25

A couple of weeks, maybe three weeks before I was actually diagnosed, I noticed I could hear myself walking. And that was a new experience. And I looked at it and thought, this might be my new dress shoes that I was wearing a lot that week and... maybe I was just still getting used to them. And I had a big conference coming up. So I just ignored it for a while. And I went to the conference. And I heard myself walking through the corridors of the airport with those very echoey floors. It's like, Yeah, this is something. But again, I was focused on the conference. And during an afternoon off, I went swimming - it was in the southwest. And I couldn't do the breaststroke kick. And that might not be surprising for everybody. But I was a competitive breaststroker when I was in high school. So this really made me wake up and say this isn't normal. And when I came home, I sat down and tried to do a self diagnosis. I'm a physician, and realized, this wasn't my foot. This wasn't my leg. This had to be in my brain. This was a nervous system condition. I came down to the conclusion that it was one of three bad things. It was either ALS - Lou Gehrig's disease - a new case of multiple sclerosis, which tends to happen in middle age. So I was a candidate for that... Or a brain tumor. And the next morning, I went to see my primary care physician, and he first thought, maybe I pulled something, maybe it is the new shoes. Why don't we give it another couple of weeks. And I didn't accept that. I pushed back. I used doctor-speak to him to tell him what some of my symptoms were and why they thought I need more testing. And he eventually agreed. And that day, we got a CT scan. And CT scan showed a shadow in my brain, which helped convince him that this really was something. So he sent me to see a neurologist who quickly got an MRI. He was more worrie d after seeing the MRI and got a more advanced kind of MRI the next night - this is Friday night - and called me over the weekend. Said I've got some bad news. It is a brain tumor. And it's probably a malignant brain tumor. And I was actually prepared for that. I wasn't surprised. But I was deeply saddened because I had plans for my life. I wanted to see my son grow up, I wanted to grow old with my wife, I love my work. And I had many more things I wanted to accomplish before I retired. And in that moment, everything changed. I realized I wasn't going to have that kind of time.

Chion Wolf 3:01

What kind of time did they estimate you'd have?

Dr. David Meyers 3:05

Doctors are very squirrely, sometimes. It took a little longer to get inside my brain and get some of the tissue and prove that this was a aggressive form of brain cancer known as glioblastoma. And they didn't really want to tell me exactly how much but I knew how to look that up. The prognosis was a little over a year. Some people die much sooner, and some who, on average, after there for more than six to nine months,

Chion Wolf 3:36

And it's coming up on five years.

Dr. David Meyers 3:38

It is. I am incredibly fortunate, and there's no exact reason why. I got great medical care, I had a very talented surgeon who removed far more of the tumor than we were expecting. And that probably helped. I have a genetic malformation in my tumor. And normally, that's a bad thing. But in this case, it was a good thing that my brain was more... The tumor was more responsive to medications, chemotherapy and radiation. But mostly, I was just lucky.

Chion Wolf 4:09

At any point, did somebody say you should get your affairs in order prepare to die?

Dr. David Meyers 4:17

No, I don't actually remember that. But I knew that. And so the moment I came home from the hospital, I felt this intense urge to put things in order to do things like make a will, and make sure our backyard was mowed. Like, as if that's the most important thing! But just check off these lists of things that I wanted to leave my son and wife in a good place. And so for the first few months after my surgery, that's what I did. And there was some anxiety until I had finished it and then I actually had a deep sense of peace. At that point.

Chion Wolf 4:52

What were some of the things that you really wanted to make sure that you did in your remaining time, however long that would be?

Dr. David Meyers 4:54

While there were those anxiety-producing things like having a durable power of attorney so that when I wasn't able to make decisions, my wife would be able to care for me, I wanted to investigate hospices in the area with my wife and pick which one we would use. But then there were the things that gave me my life meaning, and there were two parts to that. And one is connection with other people. So I really wanted to be able to say goodbye and see people tell them how much I love them, and then included family and friends. And the other part is that my work gives me great meaning, and I know I'm very lucky to have a job that I really believe makes a difference in the world. But I was in a position where I had a lot of projects that reported to me. And so it was really important to me early on, to make sure that those were all taken care of, where the team had a plan for what to do after I left. And again, once that was done, I continued to work because it gave me such meaning. But I did it at a different pace. And in more short-term projects, things that I could start and either wouldn't matter if they didn't get finished or would continue on after I was gone.

Chion Wolf 6:12

Will you tell me about the sweater you knit for your son?

Dr. David Meyers 6:16

Yeah, I'm happy to do that. After having this incredibly lucky, long, extended period, my tumor, as expected, came back. And so for the last few months, I guess, now it's been six months, I've been dealing with recurrent cancer. And very few people are as lucky, and people say to me, Well, maybe it can happen again. And I don't think that's going to happen. But as you mentioned, I'm a knitter, it's been one of my hobbies for a long time. And amusingly, it was my son who taught me to knit after his mother taught me to knit, so it's a family hobby. When I was first in the hospital and going through chemotherapy, and specifically going through radiation, I did very small knitting projects to give to friends and family, when I realized I might have a little bit more time in those early months. I knit something a little bit more complicated for my mother and something for my wife, and I gave to them, I gifted it to them. But I couldn't decide what to do for my son. And I really wanted to knit him a sweater. Something that would hold him and wrap around him when I was gone. But knitting a sweater is a big project! And for me, even though I'm experienced, I'm a very slow knitter. I thought it'll take about a year to do this. And I didn't think I had a year left. And now... I hadn't finished it, by the time my recurrence, I was really worried I never would finish it, which was a life lesson that if you don't start, you'll never get finished. So I started before my diagnose my rediagnosis. And I finished it afterwards, even when I was going through shaky hands and things. But I had the deep belief that even if I didn't finish it, either my son or my wife could do that. And that would even add more love into the finished sweater. And the good news is the sweater did get finished. And I was able to give it to Abe at the holidays this year.

Chion Wolf 8:09

I'm gonna jump around a little bit. When you first got your diagnosis of glioblastoma, you had to tell people, not only your family, but your co-workers, your friends, everybody who mattered. I'd like to hear what that was like, and also what that did for you - or to you - to go through that over and over again. and in different ways that you did.

Dr. David Meyers 8:37

In the very beginning, even before I had my definitive diagnosis, my wife and I decided that we wanted to be open, and not hide any of what was happening. To be open and transparent and honest about what was happening to me. And that's not a decision everybody would make. And I respect other people's choices in this. And I know there are some people who couldn't do that because of fear of job loss, loss of insurance or rejection from their families. But for us, this has worked really, really well. It's meant on a small side that when I meet people, I don't have to say, did we tell them? Did we not tell them? And play that game. But I think on a deeper level, it's meant that I'm not hiding any part of myself. That if you don't talk openly and honestly about something this important to what's happening to me, it would put a distance between me and the people I loved, or my friends or even my coworkers. And so being open and honest really helped me connect to the seriousness of this. The difficulty of it. Our culture doesn't like talking about dying. It's opened up a dialogue with many, many different people. Close friends and even distant people have really appreciated and I've gotten to know because of this. So I think for us, it was definitely the right decision.

Chion Wolf 9:56

Were there any moments you had when you would tell somebody, and all of a sudden, you had to comfort them?

Dr. David Meyers 10:03

Yes, unfortunately, sometimes that does happen. And that's part of being connected with people. And it also sometimes gives me the feeling that I still have value. That I'm not only being cared for. That I can still reciprocate. And when you have cancer, that can sometimes feel good too. There are times, like, ahh, enough of this! I don't want to comfort other people. But most of the time, they're being honest. When somebody is able to be honest with me that they're having difficulty thinking about me being gone, or my diagnosis, or even saying it's not fair, which we can talk about later - That's not my favorite expression - The ability to work through that with them... I appreciate that they trusted me enough to be honest.

Chion Wolf 10:50

So what do you say when someone says, what you're going through... It's not fair.

Dr. David Meyers 10:55

Depends how well I know them. But mostly, it's a form of who said life is fair? Life isn't fair. And if not me, it was going to be somebody else. Why should I expect... and I've had a really privileged and lucky life. So maybe it was my turn. But the most important thing is, cancer is never fair. That's not the way to think about life. It's the hand I was dealt, and let's see what we can do with it.

Chion Wolf 11:21

What do we know about glioblastoma? Is it just wrong brain wrong time, if that's the right way to put it?

Dr. David Meyers 11:29

I'm guessing there are scientists who know more about the causes of glioblastoma, and my doctors, partly because I'm a scientist and the doctor often offered me studies to read about and learn about, and I really appreciated that, and I would often skim them. My wife devoured them. She might know more about this. In general, I don't think we know much about what are the underlying causes. But sometimes, it's helpful to realize that our cells are always growing and mutating. And that's actually what creates the diversity of life, why we have plants and animals. It all comes from mutations. The fact that we're living at all, we're here at all, is a miracle. So that some of those cells sometimes go into weird things, and some of those weird things we can recognize something we call cancer... That's part of what life is. And my cancer cells, I also realized, are part of me. It's not an alien that we have to rip out and kill. It's not some foreign invader. It's my own body that just grew in the wrong way.

Chion Wolf 12:34

As a physician, you're used to helping people figure themselves out, solve problems, treat illnesses, and a thousand other things that go along with just that one job. And now you are... It sounds like you are utterly yourself, as you've always been, and a physician for yourself. Have you found, or do you think, that this work as a physician is informing the way you... Physician yourself?

Dr. David Meyers 13:04

Well, there's a lot there. First, thank you for that definition of a physician. That's one of the loveliest ways I've heard it described. Because you're right, a physician can do many things, and each person gets their own... You have to respond to as them and what they need. I was a practicing physician about 20 years ago, and moved more into research and policy and helping make the healthcare system better. And I think that is the aspect that I've taken most into my diagnosis. I love watching how, in the healthcare system, and how care is delivered to me, what's working and what's not working. And one of my favorite stories is that when I was in the pre-op area and about to go into surgery, the charge nurse for the operating room called everybody together. They all became quiet suddenly. And they went around and around my bed and said, I'm the surgeon, I will direct the surgery. I'm the fellow, I will assist in the surgery. I'm the nurse anesthesiologist, I give the anesthesia. And they gave their names and introduced themselves to each other. And what that was doing - it's called a pause - is reducing the chances there'll be mistakes in the operating room. I was so grateful that they were doing that, because it meant I would have the safer surgery. But I was also ecstatic. I almost wanted to get out of bed and call people, because that's the work we do in my agency. The fact that we're doing a pause... It was my agency that proved this improved safety! So I got to see it as a patient. That's not what you asked though. I want to correct something though, at first. I don't try to be my own doctor. I did a little bit at the beginning. I am not a neuro oncologist. I'm not a radiation oncologist. I'm not a surgeon. I was very comfortable with the people I chose to be part of the team with me to get my care. I listened. I'm still active. I make the decisions, but rely on their advice. So when I'm being cared for, I'm a patient. When I'm back in my office, I might be a physician. But here, I wanted to be a patient. The other thing - other than the excitement of getting to see safety procedures used around me - I don't know... I mean, I really don't know how most Americans who don't have themselves or someone in their family, who's in medical field, how they can deal with our fragmented system. All the things, getting the records from one place to another, or dealing with the billing of the insurance company, or having somebody explain things to you... This experience has reminded me of all the work we do at my agency to make care more patient-centered. And how fragmented our current healthcare system is. As a physician, it was eye-opening to see that again. I mean, I knew it intellectually. To experience it was one of the most important lessons I've learned,

Chion Wolf 16:02

If you had a magic wand you could wave over the entire system and change one big chunk of it... What would it be?

Dr. David Meyers 16:10

Oh, there are lots of things. I know where I'd like us to end up. And that's with a system that looks at Whole Person Care. That sees us as physical, mental, spiritual, emotional beings, and builds the healthcare system around that fact. And for those people. In the interim, when I only get to do one thing that I think would help, is to change the financial incentives underlying our healthcare system. I think the way we pay for health care in America built the system we have, and we can't get a new system until we change some of those incent financial incentives.

Chion Wolf 16:52

What do you think those odds are?

Dr. David Meyers 16:55

Sometimes change happens slowly and incrementally. And sometimes people just get fed up enough that it can happen very, very quickly. I'm hopeful that the American people will, as so many of us experience problems, will feel empowered enough to demand change. And it'll happen very, very quickly. There's some signs that it is changing. We need more of them, and we need more people speaking up to have the healthcare system we deserve.

Chion Wolf 17:26

How the past five years affected your marriage?

Dr. David Meyers 17:31

Short answer is that it's deepened our love and our connection to each other. Slightly longer answer: The year before I was diagnosed, in fact, almost exactly a year before I was diagnosed, my wife was diagnosed with aggressive breast cancer. And we were just coming out of that experience. And for me, it was a chance... I had been a caregiver in the doctor's sense of caregiver. But I've not been a caregiver and this sense of providing support to somebody in the home to somebody I loved. My wife and I used to discuss while she was going through her treatments, is it harder to be the patient or the caregiver? And I don't think we ever answered that question fully. My wife thought it was harder to be the caregiver and I wasn't sure. I watched her be in pain and throw up and be fatigued and have brain fog. And I wasn't sure. So one year later, I'm diagnosed with terminal brain cancer. We went from bad to worse, and our roles flipped. I was the person needing caring-for and she was the person providing that care. And during this period, I've decided that I definitely believe it's harder to be a caregiver. All she does for me has just deepened my love. She wouldn't be doing those things, though, if we weren't built on the solid foundation of our relationship. And all these fears and sadness and physical needs, like getting up in the middle of night, tell me to go to the bathroom, making it possible for me to get out of the house and see friends during COVID... All the efforts that she's done have actually brought us closer together emotionally. I've realized... I'm sorry, I think I got confused in the middle of that. But I hope it makes sense. We're actually writing a memoir together on the experience of how health and healthcare has affected our marriage. And what's wonderful about that is that it's also bringing us closer together, having to verbalize what we're feeling, and share that with each other, and edit each other, and remind each other of stories we had forgotten. It's just been a glorious experience. I'm not sure I'll be able to finish my part of the book. I think she will have to take it the last stretch. But all the work we've done on it. It's just been a gift.

Chion Wolf 19:48

Do you have a title yet?

Dr. David Meyers 19:50

In book publishing, you don't get to pick your title, right? They pick it for you. But our working title ourselves is This Mortal Coil. And that's both a Shakespeare reference - we're both Shakespeare geeks - But also a recognition that life goes around in circles, and you're not in the same place, but that it changes. That works for us.

Chion Wolf 20:17

So what are your days like now? Like, how are you feeling today? And and how are you?

Dr. David Meyers 20:23

Thank you so much for asking. In the wonderful grace period between my first diagnosis and after I finished the treatments and thought I didn't have enough time, I had a long period of time where I was feeling pretty good and was able to continue working, and going out, and going to art museums and like, theater and like, music, concerts, seeing friends, near and far. That was such a gift. And then COVID hit. And being somebody with a compromised immune system in COVID... I mean, for all of us, COVID changed our lives, and it shut it down. But those bonus years -what I can think about as bonus years - I sort of feel a bit cheated! I was getting extra time, but I had to spend it in my house. The silver lining was that colleges closed down. So my college-aged son came home, and I got to spend extra time with him. So that was a small bonus. But overall, COVID really left me feeling a bit cheated. But how do I feel now? We still have COVID. And now my immune system is even weaker than it was before because I'm back on chemotherapy. But I'm still working full time. I'm really committed, not for any other reason than I'm just committed to trying to make the healthcare system safer, more equitable, higher quality, more patient-centered for all Americans. And I'm using my own experiences. Now, to drive deeper into that work helping my agency... For example, think about end-of-life care, and how do we make sure that that's patient centered and equitable, and everybody has access to hospice? So I, most days, get up and sit and do telework, like we had been doing for years before. But it's also because of Zoom. I have connections with the people I work with like that. In the evenings, my wife generally cooks dinner, I can no longer help with that. And we do something quiet together on the couch. I could be reading out loud to each other or watching a British BBC production of something. Maybe just talking. It often is writing. I'm slowly watching my functional decline, I'm losing strength - and control, really not strength - in the left side of my body. So I went from walking, to using a cane, and now I use a walker. Someday soon, I'll be in a wheelchair. There are also some thinking difficulties. Speaking fluently, word-finding difficulties. All of that is getting slightly worse every day. But most days, I'm I feel pretty good.

Chion Wolf 22:54

You said you're still on chemotherapy. At what point do you say, no more chemotherapy?

Dr. David Meyers 23:02

That's a great question. I actually just said that. It just got to that point. And that was partly because we asked my doctors for the evidence that this chemotherapy for six months after radiation, what's the evidence for it? And while I'm sure many people would look at the evidence and come to different conclusions... After reviewing it myself, I decided there's not much extra benefit from four months to six months, and I've been on it for about four and a half months. And while it wasn't horrible, it did slow me down a bit. It did weaken my immune system. And then I had to travel and get blood tests frequently. And it gave me wicked constipation.

Chion Wolf 23:41

That's no fun.

Dr. David Meyers 23:42

Yeah, at this point, I was like, I see the end, I know my end is coming, is chemotherapy and its potential giving me a few more extra weeks or maybe a month, worth the inconveniences it's causing me now? And I told my team, and I talked with them about this. And they said that decision to stop chemotherapy is reasonable. And so they're supporting me in doing that.

Chion Wolf 24:15

How much time do you expect you have?

Dr. David Meyers 24:18

Still almost anything is possible. But some things are more probable than others. It's possible that I will die very quickly, two, three weeks. It's possible that I'll be very lucky and live for another nine months or a year. It's far more likely that'll live three to six months we're in now, and so that's when my wife and I are thinking about how to make the most meaning and the most value. The most joy in that timeframe. Which is one of the reasons why I'm like, I don't want constipation anymore!

Chion Wolf 24:56

It's like you've had almost five years to... I don't wanna say practice for this final era... But in a way you have. How do you think this final era of yours will be different than the years leading up to it, when you knew it was sort of imminent, but not sure... But now you are. How's it different?

Dr. David Meyers 25:16

The period I'm in now is very similar to where I was relatively soon after treatment, my first treatment. And you're right, after I got through that, and saw things were continuing, that I was doing well... It sort of reverted back to normal life, not thinking about death all the time. I don't think about death all the time now, but almost any decision I make, it's part of it. And I live day to day with a deep sadness, that doesn't go away. That doesn't mean I can't experience joy and connection and frustration and all the other emotions, I do. Surprise! But sadness is always there. And one of the things that helps me, and I expect, I will take advantage of more, is hospice care. Americans are really afraid of death. We do almost everything we can to avoid even talking about it. And at this point, I'm not afraid to talk about it. And hospice care is one of the things that I think helps families, patients, people have less fear about that. For me, the reason I'm going to go into hospice is because I expect I will lose cognitive function, I will keep losing physical function, and they're going to help me manage that. And as I lose the ability to feed myself or wash myself... It's very possible to get agitated, either because I'm recognizing the losses, or just because of the way the brain reacts when the cancer advances. And they'll be able to help with medications, if necessary, and functional equipment to make life easier. But more importantly to me, or maybe, as important to me, is that hospice will look after my wife and son, and make this transition easier for them. Both explaining about what's happening, counseling them on the normality of the grief they're feeling before I die - which we call anticipatory grief - and helping prepare them for... Be there for them in those first weeks after I die. So I'm a big proponent of hospice care. And I don't think I've ever been this close to enrolling.

Chion Wolf 27:20

What has been funny about all this? Have you been able to find any humor?

Dr. David Meyers 27:27

I have. I don't look sick. So sometimes people are talking with me, and they forget. And in a way, I find that reassuring and lovely. But I was startled one time when somebody said, so what are you planning to do after you retire? And I could have cried. But I actually laughed. And we talked about that.

Chion Wolf 27:53

Yeah, that sort of levity doesn't feel necessarily like a given. But when that arrives, it's kind of beautiful. I mean, you think about the absurdity of even existing in the first place. It's nice when a little absurdity is woven into the end, too!

Dr. David Meyers 28:08

And to be able to still see that and enjoy it.

Chion Wolf 28:14

We often lightheartedly kick around ideas about what we'd like our surroundings to be when we die, like... Maybe I'll be wearing this, or eating this, or doing this, or feeling this, or hearing this, or smelling this... What are some of those things, in an ideal world, that you would experience in your final moments of cognition and feeling here on the planet Earth?

Dr. David Meyers 28:44

Some of the things that have been most important to me during my life, I'd like to have at that moment. The first is connection with other people, that deep sense of connection that we get only from the relations with other people. So in my final moments, or final moments of being aware, I think you're wise to point out, I'd like to be surrounded by, or with certainly my wife, my son, perhaps other people as well, that have meant a lot to me. The second is music. And we've been building a final moments playlist of music that has meant a lot to us over our lives. Specifically my wife and I, and my son has added some songs. My friends have demanded some songs be on the list. And I expect that'll be played for a long time while I can hear it, after I can hear it, and after I'm gone. Those are two parts that I look forward to. Before that, there should be some dark chocolate.

Chion Wolf 29:43

What percentage are we talking?

Dr. David Meyers 29:45

Oh, high. 75, 85, 88...

Chion Wolf 29:48

Any flavoring?

Dr. David Meyers 29:49

Nope! Unadulterated, please.

Chion Wolf 29:53

I like whiskey, and if you were to offer me like... cinnamon-flavored whiskey that's a no, that's not happening

Dr. David Meyers 30:00


Chion Wolf 30:01

Bring on the Lagavulin, I'll taste that! Um... do you have? God, I hate asking this question, but I... Words are obviously so important. And you read about famous last words, right? What do you think you'd like your last words to be?

Dr. David Meyers 30:23

Before I answer that, I'm just gonna take a sidestep and say, there's a trope almost, for people with cancer, that they write letters while they're still here to get read by their loved ones and their friends after they die, in which they expressed what was important, why they loved them, what they think about them, why they're such special people. And I found that to be too much pressure on those specific words. So instead, I decided that I want to do that while I'm still here. And while I'm alive, and they can hear it directly from me, so I speak those words to them. And I never miss an opportunity to say, I love you. And that sort of surprises people, friends, when I say I love you. So one way I could imagine my last words to be are I love you. Maybe right before that, it's my son and my closest friends, is, be kind. That's my wish. to each other, to all beings.

Chion Wolf 31:32

I keep thinking like, this is elementary, you know, they taught us this in kindergarten: Love. Why do you think it is that we need something like our imminent deaths to really hammer home what we've known to be true the whole time? Which is just to be loving?

Dr. David Meyers 31:56

I think I said I love you frequently to my wife and son, because that was culturally acceptable. But it wasn't to say it to your friends. And so perhaps approaching death gave me the freedom to be able to say, and then for people to hear it. I'm not held to the same social standards, I get a pass because I'm dying. Why many of us lose that ability that we were taught and you know, the joy that kids can experience their ability to love the policeman on the corner, or the bus driver, and my son was in love with the bus driver... I don't know why we lose that. But I'm glad I got it back.

Chion Wolf 32:44

It's not uncommon for people to fear death. Makes sense. For many of us, even those who have religious beliefs that promise an afterlife, even in those convictions are still at times feelings of doubt. And so there is fear. Are you afraid? What do you feel?

Dr. David Meyers 33:08

No, not really. I had some fears or... Anxiety is a better word about the dying process. In a way, glioblastoma is the cancer you don't want to get because it's 100% terminal. On the other hand, it's not associated with the terrible bone pain for most people, the vomiting, a lot of the things that we associate with cancer. So in that way, I'm lucky. But still, the dying process is scary. And especially those ideas of losing the ability to know the people I love and recognize friends and become... Actually glioblastoma is associated with personality changes. So to become agitated, or mean, or violent. And that's why I'm glad that there is hospice, because I now have confidence that I'll be cared for, and that the people I love will be cared for. And we'll get through this together. So I'm not even fearful about anymore.

Chion Wolf 34:08

What do you think happens after you die? Maybe a better question is what do you hope happens after we die?

Dr. David Meyers 34:19

For me, the best answer to what I think happens after I die, or we die, is actually sort of surprisingly said by Keanu Reeves when he was being interviewed on TV. And he said to the interviewer's question, what do you think happens after we die? The people who love us will miss us. And that's really what I feel. I recently have friend, a mentor, actually, who is now a friend, sent me some poems, and we discussed them. And they said, as part of our conversation, I realized I'm becoming less mystical as I get close scared to death. I think it's because I'm trying to be brutally honest with myself. And that, for me, many of the mystical beliefs that I had, are ways of comforting myself, but I didn't fully believe. And so as I tried to become more honest. And seeing death this close, it's helping me do that. And re-examining some of those beliefs and letting go. I fully support, I fully recognize, I fully embrace that other people have different feelings about mystical thoughts, and take real comfort in it and have strong beliefs. And I don't deny them, I don't want to deny them or in any way dishonor those beliefs. But for me, I'm finding my truth, and my truth... It's about making connections now. Leaving those mystical beliefs behind has helped me refocus on what I want now in life, which is being in love with people, making deeper connections with those people I love while I have the time, and doing meaningful work, leaving a better world for my family and those who come after. And so, not thinking about the afterlife, or what happens after we die has helped me be a better person now, or get more meaning out of whatever time I have left.

Chion Wolf 36:31

What would you like done with your body after you die?

Dr. David Meyers 36:34

When I was a first-year medical student, one of the transformative experiences that I got to have... So with a group of three of my classmates, we were privileged to dissect a human cadaver. And when I went into medicine, the part that I was most excited about was the ability to help people thrive within the context of their goals, their community, their families. It was the relationship part of medicine. I was good at science, good enough to get into medical school. But that didn't fascinate me the way trying to understand people and help people understand and for me to understand the context of illness, and the social context of illness. Going into the anatomy lab brought balance. It was the most fascinating experience, and one that very few people actually get to experience. It was really a privilege. Learning about and seeing and touching the insides of another person, I learned how the cardiovascular system, the circulatory system and the nervous system, our bones, all work together to make us work. Around that same time that I was getting to experience anatomy, I found a study partner. And we would meet every night for dinner, and then sit down with our books. And I picked a study partner that was not in medical school. Medical school can be so all-encompassing, it takes over your life. And you think everything revolves around medicine. And my partner was a humanities grad student. And we'd sit for several hours doing our own studying. And then one of us almost every night would say, Oh, that's interesting! Or I don't get this, or I don't agree with this... And we talk about pre-Civil War south in the US, or why this nerve splits into five branches. And we'd switch books and read for a while, and then go back to our own studies. And it was a really good choice on my part to have the humanities graduate student help me remember there are other ways of knowing the world. As I approached my first anatomy exam, it's about 11:30, at night, one night, and we had keys, they gave us 24/7 access to the cadaver. I realized I wasn't learning anything from the books and the pictures, I needed to go see the cadaver and touch and feel and examine. And so I got up and I said, I need to go to the anatomy lab. And on the spur of the moment, I said, Do you want to come? Because she had heard me talk about this cadaver every night for the past two months. And to my surprise, and I was quite pleased, she said yes. And as we walked over to the anatomy lab, we talked about what it was gonna be like, and what the experience was. And I have to backtrack a moment: Very early on, when we were first making our first cuts in the cadaver, and getting to know the cadaver, we were dissecting an older woman. And I actually asked our group to name the cadaver to help remind us that she had had a life, that she was a person, she had a story, and we might not know all of it. But we should respect that. And given her age and the time I was in medical school, we picked a time-appropriate name, and we called her Mabel. And just gave her the name label and so on. What I actually asked my study partner to do was, come meet Mabel, could I introduce her? When we got into the room, she was very brave. And I was so impressed with her curiosity, and her respect for my cadaver. And we spent two hours in the anatomy lab, me explaining the parts. And I actually gave her a pair of forceps. And she got to dissect a little in a way that my anatomy partners would not have minded. And at about two o'clock, we went home together on the shuttle, or each to our own homes on the shuttle. And I passed the exam, and several weeks later, actually, we realized we wanted to be more than friends. And then we started dating. And a few years later, we got married. So that's where I met my wife. And we look back on our relationship and realize it was built on curiosity. And our first date was in an anatomy lab. Since graduating medical school, I've realized that Mabel has been one of my greatest teachers. I carried her with me as I met patients, and I tried to understand what was happening inside of them. And I remembered Mabel's arthritis in her left shoulder. And what that looked like, and what that must have felt like, when I was talking to patients with arthritis. And the stomach scars that she had, and what kind of surgeries she had, and how heart failure changes the shape of one's heart. I learned these from her. And it was a gift to me. She helped me become a healer. So now that I'm approaching the end of my life, I've decided to donate my body to an anatomy lab, actually where I finished my medical training. And my hope is that future generations of students becoming physicians will use me as their teacher. I don't know what they'll want to name me... Given my age, it'll probably be Michael or Steve. But David, I guess is a choice... And that they will become better healers, better physicians, because of their ability to dissect me. So it's in honor of Mabel that I'm doing this. But I also think it's in honor of my wife. My love for her, my curiosity, and what Mabel gave us... I don't think any other medical students will necessarily get married, because cadavers. But who knows? That would be that would be a wonderful extra gift. That's my plan.

Chion Wolf 42:33

I imagine you'd like to die at home?

Dr. David Meyers 42:35

Very much. Unless something extremely unusual happens. My son was born at home. And I'd like to die at home, because the body might want to go to the medical school. So they have certain requirements, but it's not immediate. So I will probably lay here for a bit. And I hope that many people I love will be here, you know, while I'm dying. And as I die.

Chion Wolf 43:00

When I hear you say the words, while I'm dying, as I die... I hear it loudly. Because it's like, when I use those words, it's far off, you know? And for you, it's imminent. So when you say, as I die, when I die, are you used to saying it like... What goes through your whole body when you say those words?

Dr. David Meyers 43:29

I'm not afraid of dying. I think it's a mistake that Americans make that we come up with all these euphemisms. When I pass, when my time comes, that's not heading... So in the same way that I'm interested in honesty, as I approached death, being able to use the word die and dead and in my own context, has been helpful. It helps keep the fear away. When I was first diagnosed, a mentor sent me an a link to an app that he had been using. Called We Croak. It's a cute name. But it's based on a Buddhist tradition, a Tibetan Buddhist tradition, of contemplating one's own death five times a day, And it randomly would send me a text to say, Think about death! And it would give a quote, sometimes from a poet, sometimes from a scientist, sometimes from a celebrity. And that was a useful practice early on. It helped me become more comfortable with this. I don't do that anymore. I still meditate some most days. But again, that helps normalize, and it's sort of funny that even physicians don't like to think about it. Maybe it's because physicians often see death as the enemy. I would argue... Not argue, I can just say, I believe strongly that physicians are not here to fight death. We're here to help people heal when we can, and relieve suffering when we can, make meaning when we can, have people thrive to their own abilities... It's not about them. One of the things I found surprising is when I looked into donating my body to anatomy lab, physicians, which I thought would be more likely to donate their bodies, actually are lower than the average. I've been pondering that for a long time, I still don't have a good answer as to why that might be.

Chion Wolf 45:32

To the point about remembering death five times a day, I have one of those little light-up boards, and you can slide letters into them. And going through my own hard stuff in the past couple years, I've been changing that message, trying to find one that... You know, I see it every day when I walk out of my bedroom before I walk downstairs, it's in this window, and I always see it, and I want it to be meaningful. And right now, and for a long time, it said, just passing through. And we all know it. And that's the frustrating thing about... Almost everything we talk about, about love and kindness, and truth and honesty, and compassion and grace... And we're just passing through! Like, it's all stuff we've known the whole time. But it's almost like we don't think it can be that simple. But the truth is, it is! And it sounds like the closer you get to knowing that your end is imminent, the more things just get pared down to the stuff we've already known the whole time. I'm very frustrated with the fact that we need reminding all the time. And in all these ways. I don't know.

Dr. David Meyers 46:45

That was beautiful. I think there's some value in Maslow's hierarchy of needs. A concept not everybody knows about, but it basically says that the foundational set of needs that people have to get are air, food, shelter, warmth. Without those things, you can't move up. And the very top of the pyramid when you have all your other needs met, is this contemplation and moving towards enlightenment. Really engaging with big thinking, culture, art... I believe that while there's much to be said for that way of thinking, all of us have all of these needs that all the time. What you pointed out is, I think, one of the reasons we forget about the top. Even though we have those needs, we want to do those things, is because we get caught up in the mundane. In our natural, evolutionary tendency to make sure we have food and make sure we have shelter, makes us think when we're doing unimportant things that they are the important things. And we forget about what's really important. And I fully agree. I had a terminal diagnosis four and a half years ago, with an expected lifespan average of 15 months. And I lived through that. And then I kept living and was, odd as it sounds to say this, it was a gift. It allowed me to stay focused on and start pushing some of those less-important things away. I wish I could say I did it better. That I didn't get petty, that I didn't get needy, that I was able to stay focused on those things like kindness and compassion and love. And really, our most meaningful thing is connection. I wasn't perfect at it. But it really did help me stay more focused on that. And now that I have this recurrence - rates are four to six months - I'm already a little ahead of that. So I've been very lucky twice. But this one has definitely made it easier to focus on those important things.

Chion Wolf 48:56

You said you meditate.

Dr. David Meyers 48:58

I do!

Chion Wolf 48:59

How do you meditate?

Dr. David Meyers 49:00

I've tried a number, or, a least a few schools. Mindfulness Meditation has worked the best for me. I appreciate doing metta meditations, which is not meta as in Facebook, or the multiverse. It's loving kindness meditations, compassion meditations. It's easy to love the people we love. It's easy to express kindness and want good things for them. The practice as I continued to do it, expanded the sphere of people. People that I didn't know but had seen the ability to have compassion, and realize they might be having a bad day, or I didn't know what else was happening in their life... And to wish them good things. Fulfillment, peace... To have gratitude for them. Getting to the people who get under your skin, or the people that do bad things in the world - That's harder. But it helped me more with my humility, with my ability to see a more broader scope to the world, and realize I don't know everything, and the world would be better if we all wanted good things for all people. That's what I believe. So that meditation is the one I think I do the most often.

Chion Wolf 50:15

I remember when I learned of metta and yeah, it was so easy to wish wonderful things like... My producer, Jessica, is somebody I immediately default to. She's so kind, and loving and sincere. And she's very easy to wish love for. I have a lot of people I feel that way about. And then, like, the mail person and a clerk behind the counter, cool, cool, cool. And then you get to the people who've done some real damage. And it's so tempting to see them as two-dimensional, and that sort of grace... I'd like to think that I've never done anything so awful that someone would see me that way. But just in case, I'd like to not be seen as two dimensional, if I ever do some make some mistakes and some selfish calls, you know. But yeah, I do find that the first time I tried metta and got to that point where I pictured the people who would hurt me... The resistance was informative.

Dr. David Meyers 51:18

Exactly. It takes practice, yeah.

Chion Wolf 51:23

But you can get there! There was one time I even said thank you to them, just to see how it would feel. Thank you. Thank you. Thank you, thank you. And even though it was a feeling that was hard to describe, and hard to digest, I'm glad that I practiced it. Thank you, I think you've reminded me to practice it some more.

Dr. David Meyers 51:46

Sometimes when I think about meditation and the time I'm spending on it, it feels like trying to escape. I'm still trying to balance these out. It's the idea of not engaging with the world, of clearing your thoughts or spending six hours a day meditating... Feels like not building real connections, not contributing to making the world. When we all work together, it's a better thing. And so it's a balancing between these two, because, as we said earlier, or you said earlier, sometimes it feels like we can't remember the important things, kindness, compassion, connection. And maybe taking a time-out helps us get back to those things and stop worrying about the little things that are not important. On the other hand, too much of it may mean we're not actually engaging with those hard things.

Chion Wolf 52:40

You also remind me, there was a Ram Dass quote, If you think you're so enlightened, spend a week with your family. It's lovely. Not your family of course!

Dr. David Meyers 52:49

Oh, I have a wonderful relationship with my wife. Deeply passionate, deeply... I hope, deeply respectful. We get under each other's skin really easily. And we do things, we say things to each other, that we would never say to people outside. The people we're closest to are the ones we let out the bad stuff to, I think. So you have to be honest, and you have to apologize, and you have to keep working at it. I haven't read Michelle Obama's book, but I've heard some of her interviews when she talks about, you have to put the work in. It's true, we pretend that everything is ideal and that dying has just brought out all these butterflies and fireworks and stuff like that or moving towards death. There's not heavenly music playing. It's hard.

Chion Wolf 53:41

I think about what it's felt like to talk with you. I have always been interested in death. I think it's important to talk about it, and think about it and ponder it. There's a part of me that feels like we both share this ultimate end, it's just... You know, that your time is more limited. And at the same time, like, I could have a stroke the moment we end this Zoom call. I'd like to hear about how talking about this creates this sort of dual awareness.

Dr. David Meyers 54:16

Speaking with lots of friends my age, and they're going through the same thing, and in my many of my friends are similar age, I have older and younger friends too. But a lot of them I think, are in my general age range. And I'm going to be one of the first of our group of friends to die. I know that now. And it's helping them transition into a deeper meaningful... Thinking about themselves as, whoa, I'm mortal! One of the things that I've realized though, is while it is true, and I can say none of us know when we're gonna die, the probability of a healthy, middle-aged person dying within the next 24 hours is tiny. The potential of them thinking about that they could die... What do they want to do with their time? Not in terms of how much money that you want to save for retirement - and I do think people should think about their futures - but about how they treat other people. And do you call your mother? Do you get that pet and give them love? Do you plant a tree? Do you go to the art museum? Or do you just sit on the couch for hours and hours?

Chion Wolf 55:22

Scrolling Reddit?

Dr. David Meyers 55:23

Yeah, exactly. What value does that give and is that what you want your last day to have been? That's sort of where I ended up.

Chion Wolf 55:33

How do you hope to be remembered?

Dr. David Meyers 55:37

Someone who's kind. Someone who supported those around them. And through my work, made a difference. Made the world a slightly better place.

Chion Wolf 55:51

I like don't want to hang up with you.

Dr. David Meyers 55:54

I was gonna say, I'm always here for you, but that it's probably not what I can say anymore! But I do hope to listen to your show more. This has been so valuable. it's been lovely.

Chion Wolf 56:04


Dr. David Meyers 56:06

And when you signed your thing, your friend? Making new friends is so important to me right now. So I'm glad to count you as one of them.

Chion Wolf 56:15

It's an honor. Thank you. I'm sending you so much love. And I'm so appreciative of you spending this most precious time with me. And... just thank you.

Dr. David Meyers 56:30

It's been valuable for me too. Thank you. Be well.

Chion Wolf 56:34

After I recorded with David, I asked him which song should we use to end his episode. And he wrote, “Dancing was one of my great joys. After my diagnosis and treatment, I've been unable to dance like I used to. Recently I rested my arms on Hannah's shoulders, and we swayed together to Peter Gabriel's version of the Book of Love in our tiny kitchen. I cried tears of both joy and sadness, as Hannah helped me.“

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