How to Die Well / Lydia Dugdale (From the Archives)

Why don’t more doctors talk about death? Dr. Lydia Dugdale has been asking this question since she was a medical student. She is the Silberberg Professor of Medicine and directs the Center for Clinical Medical Ethics, and two books on how we die, including "The Lost Art of Dying." "Most medical professionals today are very unpracticed at talking to patients about their mortality," she says. Not only unpracticed, but even themselves afraid. In this bonus clip from Episode 232 with Macie Bridge, Dugdale traces the path from that early perplexity on the wards to the *ars moriendi*, the medieval art of dying, grounded in the idea that dying is part of living, so if you want to die well you have to live well. Lydia comments on the emergence of palliative care and the way it let physicians hand conversations about death to specialists; the doctor who inherited the priest's old place at the threshold between life and death; the death anxiety clinicians carry without examining; virtue as preparation for dying, and community as the other half of living well; the unrepresented patients of New York City who die alone; and a grumpy old man, hospitalized for 20 years, who wept when she read aloud what she had written about him. Episode Highlights - “Most medical professionals today are very unpracticed at talking to patients about their mortality.” - “we are really the intermediaries between life and death, I'm not saying we're priests, but that used to be the role of the priest. And so it is now the role of the physician. - “If you want to die well, you have to live well.” - We have to be all in or we end up like all of these patients here in New York City who have no one that I can reach out to as they're dying. - “He started weeping and he said, someone finally saw me. Someone finally saw me. I've been in this hospital for 20 years and I didn't think anyone ever saw me.” About Lydia Dugdale Lydia Dugdale is a physician and medical ethicist who has spent fifteen years asking why medicine finds death so hard to talk about. She is the Silberberg Professor of Medicine at Columbia, directs the Columbia Center for Clinical Medical Ethics, and co-directs clinical ethics at NewYork-Presbyterian Milstein Hospital, where she still sees patients. She edited "Dying in the Twenty-First Century" and wrote "The Lost Art of Dying," a modern ars moriendi. She trained at the University of Chicago and Yale-New Haven Hospital, holds a master's in ethics from Yale Divinity School, and in 2025 founded the nonprofit Heal the Nation. Helpful Links and Resources - “Dying Alone,” the full Episode 232 with Lydia Dugdale and Macie Bridge: https://faith.yale.edu/media/dying-alone - Lydia Dugdale's website: https://lydiadugdale.com/ - The Lost Art of Dying: Reviving Forgotten Wisdom, Lydia Dugdale's book: https://www.harpercollins.com/products/the-lost-art-of-dying-ls-dugdale - Dying in the Twenty-First Century, edited by Lydia Dugdale: https://mitpress.mit.edu/9780262534598/dying-in-the-twenty-first-century/ - Columbia Center for Clinical Medical Ethics, which Dugdale directs: https://www.vagelos.columbia.edu/departments-centers/columbia-center-clinical-medical-ethics - Columbia Center for Clinical Medical Ethics on X: https://x.com/columbia_ccme - Ars moriendi, the medieval art of dying, at the Morgan Library and Museum: https://www.themorgan.org/blog/new-acquisition-ars-moriendi-blockbook - Ars moriendi block book, 1475, at the Library of Congress: https://www.loc.gov/item/2021666798/ - Lydia Dugdale at the Yale Center for Faith and Culture: https://faith.yale.edu/people/lydia-dugdale-md Show Notes - Death anxiety in medicine - Why doctors avoid frank conversations about mortality - Palliative care's arrival as a discipline, and what it made possible - Real gains in symptom relief for the sick and the dying - The unintended cost: death conversations outsourced to specialists - Clinicians as intermediaries between life and death - The priest's old place at the threshold, now the physician's - Nurses at the bedside, doctors calling the shots on treatment - Existential questions physicians have never worked through - A colleague who would never tell a patient they were dying, out of her own fear of death - Digging into how other times and places handled mortality - Ars moriendi: the medieval genre on the preparation for death - Illustrated editions made for people who could not read - Fifteen years and two books spent reviving the art of dying - Living well as the precondition of dying well - Virtue as preparation: hope, patience, joy against bitterness and despair - The role of community in dying well - New York's unrepresented patients, dying alone - A reader estranged from his adult children who committed to years of repair after the book - Relationship as ongoing work: rupture, forgiveness, iron sharpening iron - A long-hospitalized patient nobody wanted assigned to their team - Modeling care for young doctors, and being verbally destroyed in front of them - Loneliness of the neighbor, the colleague, the checkout person - Practice as the only way to get better at it #ForTheLifeOfTheWorld #LydiaDugdale #TheLostArtOfDying #ArsMoriendi #MedicalEthics #DyingWell #Loneliness #EndOfLifeCare Production Notes - This podcast featured Lydia Dugdale - Edited and Produced by Evan Rosa - Hosted by Evan Rosa - Production Assistance by Noah Senthil - 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