Dying Alone: Terminal Loneliness, Modern Medicine, and Contemplative Solitude / Lydia Dugdale (SOLO Part 5)

Living alone may be difficult, but what about dying alone? Physicians and nurses are the new priests accompanying people as they face death. But the experience of nursing homes, assisted living, and palliative wards are often some of the loneliest spaces in human culture. “He said, ‘Someone finally saw me. I’ve been in this hospital for 20 years and I didn’t think anyone ever saw me.’” This episode is part 5 of a series, SOLO, which explores the theological, moral, and psychological dimensions of loneliness, solitude, and being alone. In this episode, Columbia physician and medical ethicist Lydia Dugdale joins Macie Bridge to reflect on loneliness, solitude, and what it means to die—and live—well. Drawing from her clinical work in New York City and the years of research and experience that went into her book The Lost Art of Dying, Dugdale exposes a crisis of unrepresented patients dying alone, the loss of communal care, and medicine’s discomfort with mortality. She recalls the medieval Ars Moriendi tradition, where dying was intentionally communal, and explores how virtue and community sustain a good death. Together they discuss solitude as restorative rather than fearful, loneliness as a modern epidemic, and the sacred responsibility of seeing one another deeply. With stories from her patients and her own reflections on family, COVID isolation, and faith, Dugdale illuminates how medicine, mortality, and moral imagination converge on one truth: to die well, we must learn to live well … together. Helpful Links and Resources - The Lost Art of Dying: Reviving Forgotten Wisdom by Lydia S. Dugdale https://www.harpercollins.com/products/the-lost-art-of-dying-ls-dugdale?variant=40081791942690 - Pew Research Center Study on Loneliness (2025) https://www.pewresearch.org/2025/01/16/emotional-well-being/ - Harvard Study of Adult Development on Loneliness https://www.adultdevelopmentstudy.org/ Episode Highlights 1. “If you want to die well, you have to live well.” 2. “Community doesn’t appear out of nowhere at the bedside.” 3. “He said, ‘Someone finally saw me. I’ve been in this hospital for 20 years and I didn’t think anyone ever saw me.’” 4. “We are social creatures. Human beings are meant to be in relationship.” 5. “Solitude, just like rest or Sabbath, is something all of us need.” About Lydia Dugdale Lydia S. Dugdale, MD, MAR is a physician and medical ethicist at Columbia University, where she serves as Professor of Medicine and Director of the Center for Clinical Medical Ethics. She is the author of The Lost Art of Dying: Reviving Forgotten Wisdom and a leading voice on virtue ethics, mortality, and human flourishing in medicine. Show Notes Loneliness, Solitude, and the City - New York’s “unrepresented” patients—those who have no one to make decisions for them. - The phenomenon of people “surrounded but unseen” in urban life. - “I have a loving family … but I never see them.” Medicine and the Pandemic - Loneliness intensified during COVID-19: patients dying alone under strict hospital restrictions. - Dugdale’s reflections on balancing social responsibility with human connection. - “We are social creatures. Human beings are meant to be in relationship.” Technology, Fear, and the Online Shadow Community - Post-pandemic isolation worsened by online echo chambers. - One in five adults reports loneliness—back to pre-pandemic levels. The Lost Art of Dying - Medieval Ars Moriendi: learning to die well by living well. - Virtue and community as the foundation for a good death. - “If you don’t want to die an impatient, bitter, despairing old fool, then you need to practice hope and patience and joy.” Modern Medicine’s Fear of Death - Physicians unpracticed—and afraid—to talk about mortality. - “Doctors themselves are afraid to talk about death.” - How palliative care both helps and distances doctors from mortality. Community and Mortality - The man who reconnected with his estranged children after reading The Lost Art of Dying. - “He said, ‘I want my kids there when I die.’” - Living well so that dying isn’t lonely. Programs of Connection and the Body of Christ - Volunteer models, day programs, and mutual care as small restorations of community. - “The more we commit to others, the more others commit back to us.” Solitude and the Human Spirit - Distinguishing solitude, loneliness, and social isolation. - Solitude as restorative and necessary: “All of us need solitude. It’s a kind of rest.” - The contemplative life as vital for engagement with the world. Death, Autonomy, and Community - The limits of “my death, my choice.” - The communal role in death: “We should have folks at our deathbeds.” - Medieval parish customs of accompanying the dying. Seeing and Being Seen - A patient long thought impossible to care for says, “Someone finally saw me.” - Seeing others deeply as moral and spiritual work. - “How can we see each other and connect in a meaningful way?” Production Notes - This podcast featured Lydia Dugdale - Interview by Macie Bridge - Edited and Produced by Evan Rosa - Hosted by Evan Rosa - Production Assistance by Alexa Rollow, Emily Brookfield, and Hope Chun - A Production of the Yale Center for Faith & Culture at Yale Divinity School https://faith.yale.edu/about - Support For the Life of the World podcast by giving to the Yale Center for Faith & Culture: https://faith.yale.edu/give