Cycle of Health
End-Of-Life Doula | An Interview with Jim Brulé
Clip: Season 19 Episode 2 | 17m 53sVideo has Closed Captions
Dr. Rich speaks with Jim Brulé, an end-of-life doula.
Dr. Rich speaks with Jim Brulé, a death doula, about the unique role he plays in end-of-life care
Problems playing video? | Closed Captioning Feedback
Problems playing video? | Closed Captioning Feedback
Cycle of Health is a local public television program presented by WCNY
Cycle of Health
End-Of-Life Doula | An Interview with Jim Brulé
Clip: Season 19 Episode 2 | 17m 53sVideo has Closed Captions
Dr. Rich speaks with Jim Brulé, a death doula, about the unique role he plays in end-of-life care
Problems playing video? | Closed Captioning Feedback
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Checkup From the Neck-Up
Dr. Rich O'Neill hosts Checkup From the Neck-Up, a monthly podcast about mental and physical health.Providing Support for PBS.org
Learn Moreabout PBS online sponsorshipJim.
Who?
Who are you?
Tell us who you are.
My name is Jim Brulé.
And I'm in this context.
I'm adapter.
I work with people and families who are towards the end of life.
I'm also a transformational storyteller, so I. I work with stories as a vehicle for healing.
us what a death tool actually does.
A deat tool is someone who accompanies a person as they'r reaching the end of their life.
One who works with the family or caregivers before, during, and after the person dies.
And also someone who help people who are ready to struggle with their own mortality.
Maybe not in the face of any particular imminent demise, but have said, gee, this is something I've had a struggle with.
So I do all of those things.
So when I was preparing to meet you, I was thinking, well there are probably kind of two broad categories of people you work with.
People like me who are thinking, oh, well, you know, mayb maybe I'm going to die someday.
It could.
It's it's possible that I migh die someday and, and but have.
No, no, you know, no diagnosis and no more or less end point in sight.
And people, who are more quickly approaching with some kind of end point.
Yes.
Is that.
That's pretty much the case.
You know, I have a number of clients who are in that first group who have said, gee, you know, maybe it's time I start thinking about this.
They might hav had someone close to them die, or they just might be, in that frame of mind.
So that's some really good work to be able to do.
it's, that we're doing this because two weeks ago, a high school buddy of mine, really close friend died.
Unexpectedly.
And, so I was it's on my mind and it's, you know people around you start to die and you start to think, well, wait a minute, this is actually going to happen, you know, and what what do you do with people like me.
How do you approac working with somebody like me.
Well the first thing I do is listen, you know, because if somebody comes to me that means they're not just meeting me on the street, you know, they, they're coming for reasons I try and understand what it i that has brought them to this.
In general.
People in this culture are terrified of death.
And so a lot of it is just kind of acclimating them to the notion that they are mortal, and, that there are ways of livin that actually, by appreciating the fact that you're mortal your life becomes much brighter.
How do you work with people who are closer to death?
Well, the first thing to say is it's a lot like being a birthday or being a death door.
People are transitioning from one state to another.
Their families are.
And most of what they're facing is fear and ignorance.
So there's a lot of education that goes on.
What does my body go through as I die?
What happens to my mind?
What forms do I need to sign?
You know, how do I protect myself?
How do I help my family?
The will, the will.
Now, I'm not a lawyer.
I don't do anything legal in that sense.
But I can point them in the direction of resources that they might need if they're not completing that work.
So it's a lot of education, but then it's also how do I manage my fears and my family's fears as I'm going through this.
So there's a lot of grief you know, kind of pre grief work as well as after the person passes working with family.
So you get the regulatory legal stuff out of the way.
And then you can focus on the emotional aspects of dying and accept they're interwoven.
So for example, people will say I want to have someone be my health care proxy.
And there's a form to fill out.
But all that does is it gives a person the ability to speak for you.
Well if they don't know what you want they can't really speak for you.
So a lot of it is eliciting from them.
What is it that you want.
And how can we help this person understand what you want?
Because you can't predict everything.
So you're really these things are opportunities for people to have a conversation with you and with them.
Absolutely.
And with the other people in their lives about what do they want to happen, and yet how things are going to happen in what they want after they pass.
Jim, one of the things that's so remarkable about you is your easy laugh.
Does humor play a role in your work?
Oh, it it has.
It's part of who I am.
It's part of how I work with folks.
Sometimes peopl get really stuck on something, and I find a bit of humor or even a bit of absurdity is something that'll just help them get unstuck and move forward.
So, yeah, it's part of everything.
Yeah.
there's, there's an old, Jewish, kind of midrash, the stor that says the way you should be walking around in lif is with a note in each pocket.
One note that says the world was created just for you.
And the other is you're nothing but dust.
So a little bit of the absurd there.
Yeah.
Yeah, I get that.
does storytelling to people tell the story of their life to you?
Or how did how does that work?
Well, first of all stories are part of who we are.
Yeah.
And so story and especially for me as a storyteller that enters into it directly.
Sometimes it's stories I tell that might be folklore or something like that, which are ways of letting people open u without having to speak directly about what they're worried about.
So you're telling the stor somehow brushes up against that, right?
Yes.
I also have techniques for people to start to tell their own story, in short, anecdotes that can be then told to their family or to their community as a way of living on.
So that's another kind of storytelling that I'm engaged with.
Tell me to say that again.
I'm sorry I didn't.
Okay.
So I have I call it legacy storytelling.
It's a way of people recognizin what's really important to them.
And telling little anecdotes about moments in their lives where that was obvious.
And those are short enough that someone else can repeat them.
Oh.
And so if I tell you my stor and you tell it to someone else, well then I'm kind of living on.
And that's true.
Yeah.
And so that's a, that's a very powerful thing that I do as well.
So you work with people to sort of figure out, what do they want to tell other peopl that people will remember?
Yes.
Not th not the thing in the obituary.
It's not the eulogy.
You know, honestly, that's not very useful.
It's a it's a great document to have, bu it doesn't tell you who you are.
Yeah.
Yeah.
You want the story that, people tell at the week.
That's great.
Where are you?
Here.
Where people are, remember.
What is this.
It's only when he did that.
That's right.
That's right.
In fact, I'll.
I'll just say, I work a lot with the indigenous world.
And the Lakota have a notion of who is a person.
And the word they have is knock, knock, which means a swarm, a swarm a swarm, and a person is a swarm of stories, of the stories we tell ourselves, the stories we tell to others, the stories we listen to and the the stories that are told about us when we're not there.
And that's who we are.
And so I try and contribute to that knowledge, to, to hel people expand their, their self.
That's a grea I love that a swarm of stories.
Yeah.
Yeah.
I'm imagining that you might work quite a bi with people who are dying alone.
Yes.
Yes.
They don't have a family.
They don't have a family.
They may have very few support services.
And so helping them identify either a community or an agency that can help them through is part of what I do as well.
What kind of agencies are there to help people with dying?
Well, here in Syracuse, there there's hospice, which is a wonderful organization that is completely under-resourced.
So they don't have actually they can't do a whole lot for people.
They do what they can.
What are they actually doing?
Well, they'll provide a nurse that might visit you once a week.
A chaplain who's on call.
But really, what they'll do is provide you with medical equipment.
That's kind of the limit of what they can do these days.
There's Francis house, which is a wonderful end of life, home.
It's the.
It's called an omega home.
It's your last home.
And that's the place where you go to spend the last weeks of your life.
And that's a tremendous place.
But again, it doesn't have the resources it needs to even serve the number of peopl it's equipped to to, to serve.
So you're dying.
You go to this house to be with people, all the people who are dying there.
They can hold up to 18 people.
Oh, wow.
Yeah.
So you have a, like a community.
Like a community.
And I know that's touching.
It's wonderful.
Oh, yeah.
How does one find a death to, That's a real challenge.
One of the problems is tha death doulas are not licensed.
And so there aren' any kind of formal organizations that one can approach and say, who's who's a good death?
There are two, there' the National End of Life doula alliance and the Internationa End of Life Doula Association.
And they both maintain, lists of people who are death tolls.
There's a wonderful organization here in Syracuse called Community Living Advocates.
And this is a organization that manages all kinds of services for elderly folks.
And so there's a number of us who are on their rolls.
What's your website called.
It's loving transition.com.
Loving transition.com.
Yeah.
And that's my death website.
So I've I get the number of people who come through that website as well.
I know in New York they just passed a la for medical assistance in dying.
the acronym is made in May ID.
And there are several states now that have made laws.
New York is the most recent.
And they all have something in common.
They're variations.
But they basically sa if you have a terminal disease and you're expected to die within six months, if you are completely coherent, you can't be in a fog.
You have to be declared competent.
You have to be examined by tw physicians and a psychologist.
I mean there's a huge set o guardrails around around this.
And if you're capable of self administering the medicine then you, you can request this be provided in New York.
There's a I think a 72 hour waiting period.
You can't just walk in and have it done.
So you you get a physician, two physicians approval and a psychologist to approve and then you get th prescription for the medication.
Yeah.
72 hours, 72 hours later, you get the medication.
So you have a little pause.
Time to think.
Maybe.
Maybe this wasn't a great idea.
Or maybe it was.
Maybe it was.
And I'll say I've worked with people who are from other states who've who've chosen this.
And one of th interesting things about it is that of all the people who are approved for it, about a third of them never use it.
So that's one interesting thing.
But in each of the cases that I've been involved with, the person had some tremendously painful existence.
And this, this made perfect sense for them to be able to, to leave on their own terms.
One of them died two days before she took the medicine.
Just on her own, which i another phenomenon we see.
So.
Yeah.
Do you work with people around unfinished business in their lives?
How could I not?
I mean we all have unfinished business.
Yeah.
So that's part of it?
Absolutely.
But part of it is also how do I want to transform that into a new mission?
Or a new a new story?
And so, Yes.
what are the things people regret the most?
As they look back on their life?
A lot of the time, what people regret is a relationship that broke that they didn't have the chance to repair, resolve or or make peace with.
I find there's very few times where people say, gee I wish I had earned more money.
That that sort of thing.
It's there, but it's it's not, central.
Can't take it with you, can't take it with you.
And by that point, people realize it.
But there is regret over unfinished business between close, close people.
And sometimes there's, you know, nothing to be done about that except come to come to peace with it.
That would be part of grieving.
Yeah.
How did you start doing?
How did you start doing this work?
It's, you know that's a it's a tricky question.
It's kind of like when somebody asked Picasso how long it took him to paint a painting.
He said, all my life.
So there's there's been a component of this, for as long as I can remember.
I lost my mother when I was in my early 40s and that was a big deal for me.
But I had already witnessed a lot of death by that point.
But it was tha that kind of propelled me into saying, boy, I've got an ability to help with this.
I'd like to pursue it.
It didn't happen immediately, but it colored what I did and it was really.
Oh, I want to say a decade or so ag that I took all the coursework and all this stuff that one does to become a death doula and and made it a part of my active practice.
in our culture grief is something to be cured.
And it's not, grief is a companion.
And anyone who's had, any kind of immeasurable grief, and that's most of us, will do much better if they say this grief was a teacher for me, and it's now my companion, and I now walk with it.
What can I learn from it?
That's a lovely way to think about it.
Yeah.
What is it protect me from?
Because grief is strong.
It's a strong companion.
And if we learn how to walk with it, our lives get even more wonderful.
But we carry around the pain of the loss, whatever it is.
It's part of who we are.
Yeah, it's part of that story swarm that we've got.
It's a new member.
my father passed away about almost 40 years ago and I'm still sad about that.
And and also I celebrat some of the things who he was.
Sure.
And the same for my mother.
And oddly, as I get closer to my own death, I think more about them.
Sure.
And I never anticipated that.
I didn't think, you know, I would be thinking more about them right, now than I did years ago.
How are you preparing for your own death?
Well, a lot of ways.
I mean, it's it's front and center with me.
Part of it is, I say I got about ten years of good life left.
Yeah.
Maybe another five beyond that.
And how do I want to spend that?
What do I want to do.
And, you know I think a lot.
So it, you know, I'm about to leave for Morocco, for ten days of storytelling in the Atlas Mountains.
And I wouldn't have done that if I hadn't said, gee, you know, I've got a limited amount of time.
What do I really want to do?
And it's not so much of a bucket list as following my heart.
So you're lettin your learning emerge from you.
What is it i how you want to spend your time.
Absolutely.
Well thank yo for spending this time with us.
A real pleasure to meet you Jim and work with you.
Thank you.
Thank you very much.
Preview: Living With With A Terminal Diagnosis
Video has Closed Captions
Preview: S19 Ep2 | 30s | Dr. Rich and a panel of experts discuss knowing your options when facing a terminal diagnosis. (30s)
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