When we are young and we’re in the car with our folks, we often ask, “are we there yet?” When we’re traveling, we will ask the person who's taking us, “are we there yet?” We are anxious to be ”there,” to arrive so we can get on with whatever is next.

When we are dealing with a serious illness or perhaps facing the end of someone’s life, we are much less likely to ask that question. We fear what is next - how will I know what to do? How will I know if I can handle it? There is indeed a lot of uncertainty. These fears frequently lead us to become angry if it’s suggested to have a palliative conversation. The assumption is that the news is all bad and out of our control and is going to usher in a new knowledge that we simply do not want to think about. Often the assumption is: I can’t face this. It can be frightening and baffling. It can also be an opportunity to understand the reality of what is happening, to ask questions about what is to come and to make decisions, hopefully long before a crisis occurs. And it can be a time of healing.

My goal, my passion, in doing this work, having participated in many, many palliative conversations, in several medical settings, is for people to learn how to have the big talks, the hard conversations. We can and we must have these conversations so that we can learn what we don't know, understand where we are going and the decisions that need to be made along the way.

There are many journeys when it comes to health. The journey may be an illness. Or the journey may be an unexpected medical event that has simply taken our breath away. Chronic or temporary. Life-altering. These are a few of the situations that can stop us in our tracks. But we can learn to be with news. We can learn how to navigate the emotional, psychological, and spiritual landmines that we fear. And when we do so, we give ourselves and our loved ones the gift of presence. Therein lies the healing.

At some point, you may have to have to make big decisions about your health or the health of someone you love. You may have already been in this situation and felt paralyzed or unprepared to make decisions. That may be part of the grief that you feel. Maybe that process went very different from the way you expected. As you are reading this, you may be thinking, “I want to learn how to do this better next time, for myself or my partner or my friend or a loved one.”

People often say, “I am not ready,” Well, let’s get you ready…

Please tune in every week for new threads on palliative care. Feel free to submit questions you might have. This space is intended to expand not only an understanding of palliative care but to also learn how to have these hard conversations.