Unfortunately, dying well is not a given. As a palliative care physician, my work is to help support people in health crises. I talk about their future so that they can experience more control in an uncontrollable situation. Most often, however, I witness how late these conversations occur and the stress they place on families to make difficult decisions quickly when deep conversations have never happened.

Even when advance directives have been completed, the job is not done if it is not followed by a real dialogue surrounding the available choices. Believe me when I say that when you are at your sickest is not when you want to start.