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A Life & Death Conversation with Dr. Bob Uslander


Nov 15, 2018

Debbie Ziegler's daughter, Brittany Maynard at the age of 29 was diagnosed with a terminal brain tumor she chose to end her life. Her story was controversial and painful. Debbie shares her daughter's journey in life and how she ended hers.

Photo credit: Simon & Schuster

Contact

Debbie Ziegler website – Get a copy of her book, Wild and Precious Life

Note: A Life and Death Conversation is produced for the ear. The optimal experience will come from listening to it. We provide the transcript as a way to easily navigate to a particular section and for those who would like to follow along using the text. We strongly encourage you to listen to the audio which allows you to hear the full emotional impact of the show. A combination of speech recognition software and human transcribers generates transcripts which may contain errors. The corresponding audio should be checked before quoting in print.

Transcript

Dr. Bob: Well, Debbie, thank you. I can't tell you how much I appreciate you coming and spending time. We've had a number of conversations over, since we met, which was probably a year or two ago.

Debbie Ziegler: Yes.

Dr. Bob: I think each time we talk, we get a little bit deeper into the conversations, and I think we both are very aligned in what we're trying to do with our time here.

Debbie Ziegler: Absolutely.

Dr. Bob: Yeah. I would love to use this time for you to share a bit about Brittany so people can really know who Brittany was. I think a lot of people know the name, Brittany Maynard. It's become, in many areas, a household name, and I think certainly in California, and a lot of people think of her as groundbreaking, but they don't really know Brittany. Hopefully, after this, after people hear this, they'll get your book, and they'll learn a lot about Brittany and about her journey, but I'm hoping that you can share a bit about that, because I think it would be really valuable for people to understand who Brittany was, what she did, and then what you've been doing to carry on her legacy and honor her, so ...

Debbie Ziegler: Well, thank you for asking me to speak with you today. Brittany is remembered for the last act of her life, and those last minutes of her life are relived over and over again and spoken of over and over again. She knew they would be, and before she died, she asked me ... She said, "Mama, make sure people remember me for how I lived as much as they remember me for how I died." That is something that I try to honor her by doing, and one of the ways that I honored her was by writing a book about the way she lived, and I titled it Wild and Precious Life because Brittany did live a wild and precious life. She was very much in love with this world, and when she was terminally ill, she would say to me, "The world is so beautiful, Mom. It's just so beautiful, and I'm going to miss it so much."

She did not want to leave this earth. Nothing inside of her desired that, but the fact was that she was terminally ill, and she had a terrible and gigantic brain tumor that had been growing for over a decade. When I look back at Brittany's life, I try to focus on the brain and how marvelous and plastic it was to tolerate the growth of a tumor for 10 years and to, as that tumor slowly grew, her plastic, resilient brain transferred function. I try to remember that. Even when I first find out she was sick, she had already lived a miracle, and it's important to focus that. The miracle I wanted to happen, which, of course, was that she wouldn't die, didn't happen, but a miracle had already happened in that she had lived 10 years with the brain tumor growing.

Dr. Bob: What a beautiful awareness and a gift. It's so interesting because many people don't have that. Many people have a, are diagnosed relatively quickly after something that starts developing because it's created issues that can't be ignored or-

Debbie Ziegler: Yes.

Dr. Bob: ... their plasticity won't happen, and so everything changes from that moment on. Right? They're thrown into the health care system and start having procedures and treatments, and so ... You know that this is a fatal illness, even when it's caught early.

Debbie Ziegler: Yes. I think that one thing that Brittany and I talked about quite frequently is that every person's disease is different, and it annoyed Brittany that people felt that just because their uncle, cousin, niece, had had a brain tumor, that they somehow knew her journey. The same thing happens to, I think, cancer patients with any kind of cancer. We have to remember, as we interface and speak with and try to love these people through their illness, that every body's illness is different.

Just as our bodies are different, our cancer is different. It can be very, very frustrating for a patient to be told, "Oh, well, my aunt did this," or, "My uncle did that." Let's just try to take each patient alone and single and look at their disease and look at their illness separately and try not to bring in all these other judgments based on other stories. Brittany's illness, she had been living with, and the tumor had been growing very slowly, and so that allowed for that plasticity. If a tumor grows in your brain in a quick fashion, a much, much smaller tumor could kill you.

Dr. Bob: Yeah, or in a different position, a different location in the brain.

Debbie Ziegler: This would be the same for other cancers. It would be the same for people with any kind of cancer. Depending on how that cancer, how that tumor's growing, it takes its own cruel path, and so one of my big hot buttons is that we stop and remember that everybody's journey is different, and everybody faces their illness in a different way. The way my daughter faced it was by getting all the information she could get. She was almost an encyclopedia about brain tumors, about the types of cells that make brain tumors, about how those tumors progress in people of certain age groups. She read white papers. She had a good education, so she was lucky enough to be able to read that kind of paper that might put some of us to sleep. She was able to read it and really extract information for it, so when she entered a doctor's office, she was speaking their terminology, and she was very well read, so that is a different kind of patient.

Dr. Bob: Yeah. I would imagine that for certain doctors, that would be a little bit ... I'm not sure if "intimidating" would be the right word, but they're not used to that. They're used to having, to doing the education and kind of doing it on their own terms.
Debbie Ziegler: Yes. There is, and there is this paternal mold of medicine that's been in the United States for a long time where, for many years, we looked at our doctors as sort of an extra father in the family that what he said was how it went. We had this paternal model where we never even asked the doctor, "Well, what are my options," and we didn't have the internet, and we didn't have this quick way to get information. In the case of my daughter, she was actually checking out medical documents online and reading medical documents. We're in a different place, and we're in a different time. We're struggling with this old, paternal medical model, which isn't working for us well anymore.

Then you add on top of that that if a doctor got a scan of Brittany's brain, one doctor said, "I expected her to be wheeled in on a gurney and unable to speak," because the tumor was in that portion of her brain that allows you to speak and vocalize, and it looked like that must, those skill sets must be gone, but because it had grown so slowly, those skillsets had moved, and she was able not only to speak but to speak very articulately. I do think it was a shock, and a little bit more difficult to deal with, with a patient who's very well read and very outspoken. My daughter was, even from a young child, a very purpose-filled person. I remember they observed her playing when they were analyzing whether she was ready for kindergarten, and they wrote in the report that her playing was purpose-filled.

That came back to me as I watched her negotiate her illness, and I thought, "Okay, well, those things that made it difficult to mother her, that purpose-filled, stubborn, willful sort of way, was a wonderful asset to her when she was ill and needed to navigate her illness." People ask me all the time about how Brittany could make a decision like this so confidently, and my answer is that she had the innate personality to question and to, and she also had the educational background that she could absorb the scientific information and accept it on a factual level. The emotional part, matching her ability to be emotionally strong, matching her background to be able to understand the information that is terribly frightening, and which, honestly, I mean, I taught science. I couldn't read it in the beginning. It took me about a month to be able to read about brain tumors. I just couldn't do it. [inaudible 00:11:20].
Dr. Bob: You mean you couldn't do it because it was too difficult emotionally or because it was too, the information was too-

Debbie Ziegler: It was emotionally.

Dr. Bob: Okay.

Debbie Ziegler: I also have a science background, and I taught science, so I could read it, and I could interpret it, but as her mother, having just heard that she had a terminal diagnosis with a brain tumor, emotionally I was unable to read about brain tumors for well over a month. This is a part of what happens to the family of the terminally ill person. Sometimes, they're knocked back into a period of denial where they're unable to look at the truths; they're unable to look at the facts. I think that makes it more difficult in some ways, and yet I'm told by psychologists that denial is something that helps us deal with crisis and eventually move on, as long as we move through it and don't stay in that place. I can testify to the strength of denial, and I can certainly say, from my experience, that it is very important to overcome it if you're going to help your loved one. It's something you must battle through and get to the other side.
Dr. Bob: I think that's so powerful, and, I guess, recognizing that it's happening, being open to recognizing that, and that it's normal, and you don't have to rush yourself through it, because it is a process, but if you're not aware that that's what's happening, then it seems like it's the reality and it's appropriate, and would be much more difficult to get through it and be of support as you ultimately want and need to be, so ...

Debbie Ziegler: Particularly if the patient gets to the point where they are out of denial. Many terminally ill people quietly, but firmly, believe that they have a pretty good handle on how much time they have. Something inside them says it's not going to be more than a few months, but they, if they're surrounded by people who are in denial, they have no one to discuss that with. They have no one to say, "Look, I'm dying." My daughter, because of her youth and because of who she was, said to me in the hospital one night, she was in her bed, and I was climbing on to a gurney next to her, and she said to me, "Mama, you get that I'm dying, don't you? I need you to get this."

It just ripped my heart out, but at the same time, I realized, "Oh, my goodness. I have to look at this. I have to turn around. I have to stop running and pretending that I can find some miraculous doctor in some other country," which is what I was dreaming of at that point. "I have to turn around and look at my child who is telling me, 'I'm dying.' I have to be with her in that moment." I'm telling you, it's hard, and I'm also telling you it's really important for the patient, really important for the patient to be able to say, "The people that love me get it. They get it. I'm dying, and they get it."

Dr. Bob: "And stop wasting my time." Right? "I'm-"

Debbie Ziegler: Yes.

Dr. Bob: "Be here with me, because we don't have a lot of time for what we need to do."

Debbie Ziegler: In her case, she wanted us to listen to what her desire was for the rest of her life, what it was going to look like, because being told that she had about six months to live, Brittany immediately sprang into her list of, she had a bucket list of places she wanted to visit. She had a list of people she wanted to talk to before she died. She had a list of accomplishments that she wanted to be able to be a part of, which included, in the beginning, she wanted to write some articles.

She decided she wanted to write articles because the medication she was on to keep the pressure in her cranium down from this gigantic tumor causing this pressure, she was taking a lot of steroids, strong steroid medication, and steroid medication at that level has some pretty gnarly side effects. It makes you get this round, very full face, which they refer to in medicine as a moon face. Brittany thought, "All right, because I don't want anybody taking pictures of my moon face, and that way, I can write an article and still have an impact and advocate for other terminally ill patients, but I won't be seen."

Then as it turned out, and as many people know, that is not the path that it took, and she was asked to have her photograph taken, and then she was asked to be filmed, and then she was asked to be interviewed. All of this was done when Brittany didn't look like Brittany anymore, and she cried, and she said, "I just see cancer in that face. That doesn't look like my face. That looks like the face of cancer." I know what a sacrifice she made to do this for people.

We talked about how it was normal at 29 to feel feelings of vanity, yeah, a little bit, as you're a woman and you don't want to look bad, and how she was going to overcome that. Of course, as her mother, I kept saying, "You're so beautiful, Brittany. You are still beautiful. It's just a different beautiful." She would be like, "Oh, Mama, you're my mom," but I just want people who are ill to know that those last six months that my daughter had were some of the most productive month of her life.

She had a sense of urgency and joy. In between sadness and terror, there were these moments of great joy and satisfaction, as we walked through a particular place in nature that spoke to her. She'd call me, "Mama, come and look. Come and look at the banana slug. Come and look at the starfish. Come and ... " We shared those moments of joy because she faced her illness, and she was not going to waste that time. That required decision-making. That required saying, "No," to some treatments that she felt, after reading about them, we're not going to buy her any significant amount of time, and while she did those treatments and did not receive significant time, the treatment itself was going to deteriorate her lifestyle.

Her quality of life was very important to her, and she said, "If I'm not getting any measurable upside here in the way of extended life, then I need to be looking at the quality of the little life that I have left," and so she remained focused on that, and she remained strong in the face of some pretty persuasive and, in some cases, almost bullying that went on in the medical system of, "You must do chemotherapy. You must start it on Monday." Even her oncologist, after doing DNA testing, told Brittany, "You aren't a good candidate for chemo." She said, "Your DNA, your markers, are indicating that you're not a good candidate. There's a very, very small percentage of chance that chemo would do you any good, and there is some chance that chemo could actually make your tumor grow faster because you have a glioblastoma now."

Dr. Bob: Certainly, it would deteriorate her quality of life, which she knew, and yet still there were physicians who were part of her team who were pushing her.

Debbie Ziegler: Definitely pushing that. She stayed with her oncologist, who she felt understood chemo the best more than the surgeon, and she said, "Your own hospital just wrote a paper about chemo not always being the right answer for the brain tumor patient, and so I'm saying, 'No.' I know that you know this within these halls, and I'm not going to do it. It doesn't have enough of a possibility of upside for me, and it has a definite downside that's very well known. The symptoms that will take away my ability to do some things that are very important to me," one of being that she wanted to travel to Alaska, and she wanted to ride in a helicopter in Alaska and land on a glacier. She wanted to go on a dog sled and cross a glacier. She wanted to move in a dog sled on a glacier that was moving on a planet that was moving in a solar system that was moving. We wanted to be moving in time and space, and we did it.

Dr. Bob: That's wonderful. That's awesome. Debbie, at what point, at what point after the diagnosis, did the whole concept of medical aid in dying come into her awareness and start becoming a bit of a focus?
Debbie Ziegler: For Brittany, her focus on aid and dying came much more quickly than anyone else in her family, because, at Berkeley, she had been in a psychology class where they had had a discussion about end-of-life options. Her class had heatedly argued about end-of-life options, and so Brittany had already thought about this, discussed it, and, quite frankly, been a participant in a conversation at a high level. As soon as she was told, and she did ask directly, none of her family could or would, because we were all in denial, she's the one that forced the conversation and said, "Is this brain tumor going to kill me? Is this a terminal brain tumor?"

She was told, "Yes, it is terminal. At this point, until we have tested this cell structure, we don't know how long, but we do know this is what you will die of." As soon as they told her that, she began discussing end-of-life options. She did not know how long her life would be, but she did know that the tumor was going to take her life, and she knew enough from her science background of the course of action that a brain tumor takes that she knew she wanted to be looking into other options rather than just following a natural course.

Dr. Bob: How fortuitous for her, not maybe fortuitous at all, but that she had had, been exposed to it.

Debbie Ziegler: Yes.

Dr. Bob: Not a lot of 28, 29-year-olds are-

Debbie Ziegler: No.

Dr. Bob: ... and so it could have been a very different process, and path had that not happened.

Debbie Ziegler: The way she introduced the topic into conversation was, I think she was trying to spare us until she could discuss it with her parents, but she said to the doctor, "How can I get transferred into the Oregon medical system?" That, of course, to everyone in the room, seemed like an odd question, and in the back of my mind, because I am a science teacher and, of course, had read articles, I thought, "Oregon. Oh, my goodness. I know why she's talking about Oregon." I couldn't have told you the details, but I knew that it had to do with the right to die, and I knew what she was talking about the very first time she mentioned it. I knew where she was going.

Within seconds, there were two people in the room. I'm sure the doctor knew what she was talking about, although he chose, at that moment in time, to not recognize it, to say, "Well, why would you want to do that? You're in a fine medical system here in California." It wasn't until days later that we had open conversations about why she was interested in Oregon. Of course, since that time, California has passed an End of Life Option bill. I feel that that is my daughter's legacy. I believe that it was her story of having to move out of California in order to die, in order to die peacefully, that touched a lot of hearts and made history in California. I smile when I think of our End of Life Option Act because, in my heart, it's Brittany's act.

Dr. Bob: Well, it was Brittany's act, but she couldn't have done it without you. Right? You-

Debbie Ziegler: She-

Dr. Bob: You were her partner in that.

Debbie Ziegler: She had help, and she had many, many volunteers who loved her, who loved her spunk, her feistiness, her story, who immediately gravitated towards supporting her. I have had letters written from all over the world, from all over the world. I now speak with people in an ongoing relationship, some of whom I have met face to face now, and some of whom I haven't, from countries all over the world about Brittany, and some of these faithful people write me every time it's her birthday, every anniversary of her death, every anniversary of the bill being passed, and they tell me how much my daughter means to them, and that they live in a place where there is no law, and that she stands for hope to them, that she stands for hope that one day, all of humanity will treat each other with love and kindness and will not be so afraid of death.

It's such a beautiful legacy that it helps me accept that she's gone. She's gone physically from me. Those first few years, grief was so difficult, and I've met so many grieving people, and as I was grieving, I would literally be knocked down to my knees sometimes. I'd be crying on my knees in the hall, or in the living room, or in the kitchen, or one time in a park, another time in a store, like a T.J. Maxx. Here's this lady down on her knees, crying. I would always smile through my tears and know that Brittany would be saying, "Get up. Get up, right now, because you're on your knees crying. It means there's something that needs to be done. Look around. See what needs to be done."

The first time, I got up, and I thought, "Oh, my goodness. I just opened an email about how dire the blood shortage was," so I went and donated blood, and now I try to donate blood twice a year in Brittany's name. I pick times of the year when that is hardest for me. I pick the times of year when I know the grief is going to wash over me again. Times, holidays, her birthday, the day of her death, the beginning of the year. I pick times to do the donations when I know that giving blood is going to be this beautiful gift that's going to lift me out of my sorrow. Then I look around and see other things that need to be done. I see an elderly person that needs a visitor or flowers. I see a friend who needs a visit who is fighting breast cancer.

When I go into my worst grief, I always hear her saying, "Get up and look around. There must be something you need to do." That is one of the ways I've dealt with grief is by getting up and looking around.

Dr. Bob: And doing what, and doing what is-

Debbie Ziegler: And doing something-

Dr. Bob: ... right there, immediate, in your awareness.

Debbie Ziegler: Yes.

Dr. Bob: I'm going to, so can we stay with this for a moment?

Debbie Ziegler: Yes.

Dr. Bob: I know that I've been with you, and you've shared some of your other tools, tips, ways of working through the grief.

Debbie Ziegler: Grief, yes.

Dr. Bob: I think I would love for you to share if you're up for it, a couple more, just a little bit more about how you've managed to work through your grief or work with your grief as a guide here for some of our listeners.

Debbie Ziegler: Well, in the beginning, I have to admit that grief was like, it was a black ocean sucking me under, and I thought, "If I don't do something, I'm not going to make it." I really, first of all, I admitted this to the people I loved who began searching for things that might help me. My sister came to me with a treatment that's called ... I don't know the letters for it. I think it's PTSD, but it's an eye treatment.

Dr. Bob: Oh, EMDR?

Debbie Ziegler: EMDR.

Dr. Bob: Emotional freedom release, yeah.

Debbie Ziegler: It is EMDR, and it's rapid eye movement treatment. Because I told people, "I can't talk my way through this. Talk therapy is not going to be enough. I can't do this." This is a scientific treatment where you are asked to follow a light with your eyes. I was probably the most skeptical person on earth that it would help me, but it did, and rather rapidly. It took me out of this circular, negative thinking that I had. I had a few broken records that revolved around Brittany's illness and Brittany's death, and those records would come on and play over and over again, and this treatment of causing my eyes to move while I thought about this, or while I thought about a very stressful day or the actual day of her death, while I thought or discussed about that, my eyes were moving, and it causes your brain to use both sides, the right and left, and your own brain helps you heal and stop that broken record from playing. That is one treatment that I feel very strongly about.

I also used the treatment of touch, of various therapies that have to do with massage and different types of massage, to kind of work the tightness that was in my muscles. After being with Brittany and anticipating her death for six months, there was a lot of muscle difficulty, and so I used that. I also have a sister-in-law who sent me ... I also have a sister-in-law who sent me various scents, an aromatherapist, and she sent me a mister. She sent this to us before Brittany died, and Brittany used it all the time to help her try to sleep. That was a difficult part of the last month of her life was getting any sleep, so both she and I used aromatherapy, which is another thing that I sort of, as a scientist, was sort of like, "How can I possibly help?" Yet-

Dr. Bob: It did.

Debbie Ziegler: It did. In fact-

Dr. Bob: Undeniably.

Debbie Ziegler: ... my daughter said the two therapies that helped her the most, she said, "Look at all the doctors we've been to, Mom. Look at all the specialists, the high-paid brain surgeons, neurologists, oncologists," and she said, "Look what I'm down to in the last weeks of my life. I'm down to massage and aromatherapy, and these are the two things that soothe me and help me." She used them right up to the end, and she developed a relationship with her masseuse, and she developed a relationship with my sister-in-law, who sent the aromatherapy. Along with these treatments came this human touch and caring that's so important.

Dr. Bob: You're singing my tune. I mean, those are the things, of course, that we try to, and it's just, I didn't know that about Brittany's-

Debbie Ziegler: [inaudible 00:35:07].

Dr. Bob: ... about what brought her comfort, so it was really, it's, I guess, confirmation, more confirmation about how incredibly valuable these therapies and are ... Not to throw out every other treatment that is being offered through the traditional medical system, because sometimes those are very important, but the value of some of these-

Debbie Ziegler: Simpler-

Dr. Bob: ... high-touch-

Debbie Ziegler: ... natural-

Dr. Bob: Yeah. No side effects. What are the side effects of massage therapy? I'm so happy to hear that that was comforting for her, and also for you, afterward.

Debbie Ziegler: It was, and we would go together, and friends would send her massage gift certificates. It was a way for them to reach out to her and to give her some solace. We had a special place that we went to and a special group of women who knew her and knew our story, and so it was a safe place that felt safe to go to, and ...

Dr. Bob: And that connection. Right? The connection that she made, which was not, didn't revolve around her illness.

Debbie Ziegler: No.

Dr. Bob: It wasn't going to get a treatment or for someone to check and see how she's progressing. It was a human connection, which people at all stages need, and when we can provide that, it normalizes things. It enhances the feelings of well-being, so this is another pretty powerful reminder of that.

Debbie Ziegler: The people that worked in the area that we went to, which was Portland, Oregon, we went to a place there, they never questioned her. They never argued with her. They just said, "How are you today? Where do you feel that ... Do you have places that we need to concentrate on? Do you have places where you have some knots in your shoulders, you just want ... How much pressure?" It was all about, "What feels good to you, Brittany, today? Because we just want to send you out of here feeling a little bit better than you came in." There was no lofty goal to cure cancer. There was no lofty goal to fix this girl who had this gigantic brain tumor. It was just, "From where you start to where you leave, we promise you're going to feel a little bit better."

Dr. Bob: In that moment.

Debbie Ziegler: And she did.

Dr. Bob: Yeah.

Debbie Ziegler: And she did.

Dr. Bob: That's wonderful.

Debbie Ziegler: Yeah. That's a beautiful thing.

Dr. Bob: We talked a bit about some of the ways that you moved through grief, which I'm sure part of that was what you, basically what's become your life's work as well.

Debbie Ziegler: That was very fulfilling. To be able to testify was very fulfilling, and I felt that my testimony came from a place that was a little bit extraordinary in that, as Brittany's mother, this was not my first choice. This was not; I did not readily gravitate to this end-of-life option idea. I stayed in denial for a period of time. I had to work through this in my head. I had to analyze some childhood beliefs that I grew up with in Texas, so when I spoke with senators face to face, or representatives face to face, and they were reticent, or they had some childhood religious beliefs that were kind of interfering with their ability to even hear Brittany's story, I could relate to them, and I told them that.

I told them, "I was you. I was you. The look on your face, my poor daughter had to see. I see you avoiding this subject. I see you turning away from death. I see you turning away from this idea. My daughter had to watch me do that, and that must have been so hard for her to have her own mother not be able to discuss it, to be in denial for a period of time." I felt that my testimony was from a place of, a commonplace that we had, and I felt that in some cases, minds were able to change, or people were able to look inside and say, "Hey, maybe I do need to look at this a little, from a little bit of a different angle."

I felt that that was an important truth that I could share was that I didn't start out all gung-ho about this. I knew what she was talking about, and it scared me to death. It really did. It's an important common ground that we had. Then as I went on and spoke in different environments and different countries, I recently came back from Africa, where I spoke at a conference there where people from 23 different countries met in Africa to discuss our human right worldwide to die peacefully when we are terminally ill, to seek a peaceful death. It was very empowering to meet these people who are; literally, you could almost feel the room vibrating with the love and excitement that these people have about making the end of someone's life more tolerable.

Coming back from something like that is just, infuses me more with energy and confidence, and inspires me that this is important work, and that I believe that sharing the hardest parts of how it happened and the hardest parts of what we went through in the public eye and as a family who really didn't have very much of a help and assistance ... In fact, we kind of had to claw our way into a situation where my daughter could use the law. I feel like telling those hard parts and just kind of opening my kimono and letting people see the pain, that maybe they will have confidence when, and if, something happens in their own family, that they can say, "Oh, I read about this one time, and you know what? She was in denial, too. That's what I'm in. I'm in denial. I recognize this."

Maybe it will help someone get out of denial. Maybe it will help someone not feel so alone. Maybe it will help someone support a patient and say, "What do you think? You are the one who's dying. Let's make a plan, your plan, your plan, because this is your life, and I want to hear what you want to do." Maybe it will help someone look into the patient's eyes instead of running out of the room and making phone calls to try to make something that can never happen. I just, I think that if we don't tell our story and share the humanness of dying, that we're not going to move forward. The more we keep hiding and not talking about it, the less likely we are to be able to face the end of life, which should be a beautiful time.

My daughter showed me that. She showed me that, "Yeah, Mom, it's not always beautiful, because I'm 29, and I'm pissed off that I'm dying, but in between being pissed off, I want to live, and I want to experience joy, and I want to go places, and I want to meet people that I haven't seen in a while, and I want to finish things. I want to feel that I've finished some jobs and some relationships and before I go." She wanted a plan, and I think a dying person's plan, no matter what it is, because it may not be what you, as their relative, want it to be, but their plan is really all they have, and so let's support that plan. Let's talk about that plan and what it's going to look like, and how are we going to get it put in place.

I think people don't plan. They wait too late. A hospice is called, sometimes, too late. People end up saying, "Oh, I want to use the End of Life Option Act," but it's too late. They haven't left themselves enough time to get the prescription, to write the letters, to wait for the waiting period. The more we can normalize this and discuss this with our families, with our loved ones, with our friends, the more they can plan and make a good plan, and we can help them put that plan into place, but it's not our job to make the plan for them. It's not our job to get in there and say, "Oh, you need to do this, and you need to do that." We need to stop. After they've been told, "You have a terminal illness," we need to slow down a little minute, and we need to absorb that information with them, and then we need to listen. "What do you want to do? How do you want to live these last months?" It can be beautiful.

Dr. Bob: And, "How do you want to die?"

Debbie Ziegler: Yes. "How do you want to die?"

Dr. Bob: "How do you want to die?" Wow. Okay. I think we came to a beautiful place to pause. You and I are not done with our conversations.

Debbie Ziegler: No.

Dr. Bob: By a long shot.

Debbie Ziegler: California's not finished with this conversation, and I think we're committed to-

Dr. Bob: Co-create it.

Debbie Ziegler: ... making the best of this that we can.

Dr. Bob: Yeah. There's a lot of work to be done. There's a lot of lives to support, and so we will have, you and I will have more conversations, and I would love ... I know we talked a bit about what came out of this conference in South Africa. Another podcast devoted to that would be wonderful-

Debbie Ziegler: That would be great.

Dr. Bob: ... because that would be very educational for people to see what's going on in the rest of the world and what we have to aspire to. Can you share how people can read more about the story and get more information about you and Brittany?

Debbie Ziegler: Oh, the book I wrote about Brittany was published by Simon & Schuster, and it is available on all the major online vehicles that you can buy books, I mean, every single one. Amazon, all the bookstores. The title is Wild and Precious Life. I hope that when you read it, it will make you want to live a wild and precious life, because we just have this little bit of time, and we might as well make it wild and precious. I'm Deborah Ziegler, Brittany Maynard's mother. My greatest achievement in my life, my daughter, who I love dearly, was a great model of living a wild and precious life. I would urge you to read her story and benefit from it.

Dr. Bob: Yeah. I agree. I second that wholeheartedly. It's a wonderful story. It's hard to read, at times, for sure, but it is a, it's well worth it, and I think you'll gain some really great insights. Thank you for writing it. Thank you for all that you do. Thank you for being here. It's an honor.

Debbie Ziegler: Thank you.