Miller works to give the terminally ill a quality life
Death, like change, is a guaranteed constant in the world.
It’s also Dr. B.J. Miller’s livelihood.
No, he’s not the grim reaper. Nor is he an assassin. He is a palliative care physician who has dedicated his life to propose the rethinking and redesigning for a dignified system that helps the terminally ill live out the remainder of their lives in fulfilling and creative ways.
Palliative care is defined as specialized medical care for people with serious illnesses that focuses on providing patients with relief from the symptoms and stress of the illness and the ultimate goal is to improve quality of life for both the patient and the family, according to Miller.
Miller will discuss his vision when the Park City Institute presents An Evening with Dr. B.J. Miller on Saturday, Jan. 16, at The George S. and Dolores Doré Eccles Center for the Performing Arts.
While many people feel uncomfortable talking about the end of life, Miller welcomes stimulating dialogue.
"We are sitting on the subject of mortality, which is the biggest subject there is," Miller said during a telephone interview with The Park Record from San Francisco. "It gets at what it means to be a human being.
"We are homo sapiens and we know we all will die and we live with the fact that the future in front us will somehow and somewhere go away," he said. "It’s a huge issue and relevant to 100 percent of people who have ever lived. It cuts across culture as well."
In order to instigate the idea of palliative care, Miller knows he has to change the way people think, especially when it comes to how people view healthcare.
"First off, end-of-life is not pathology," he said. "Since we all die, it vexes healthcare, which is centered around diseases and things it can fix. Palliative care is not the stuff built around science, but built around humanities and every discipline that has come around to be."
Changing people’s views is challenging because there are as many views of death as there are people in the world.
"Because it is so highly subjective, it gets at the value system of every individual," he said. "This is why palliative care is so fascinating.
"While medicines help, they depend on the situation," Miller explained. "When it comes to living with an advanced or terminal illness, what medicine has to offer, per se, at most, is distraction or numbness as a rule. But no amount of training in pure medicine teaches how to make the remainder of your patients’ lives meaningful."
That’s where palliative care kicks in.
"The work really is around living our lives in the face of a short time frame," Miller said. "Suddenly the field has this positive and creative potential because when we come to terms that we will die, we may want to live our lives more fully, better or a little more kindly, and not so be hell-bent on delaying our gratification."
Miller got interested in palliative care while he was trying to make sense of his own life and experiences.
As a Princeton undergraduate, a high-voltage electrical shock almost cost him his life and he ended up losing both legs below the knee and half of one arm because of the burns.
"I was just graduating college with a liberal arts degree, but I had these experiences as a patient," he said "So, I wanted to find meaning of my experiences, which seemed right, fertile and applicable."
Medicine seemed to be the place where he could develop a skillset to be of service to others.
"It would also be the place, at least hypothetically, to use all that I have learned from being a patient," he said. "Then palliative care came along and lit up this bridge to the humanities. It was like science in service to the humanities and that made great sense to me."
Throughout his career in palliative care, Miller said he continues to address a couple of misconceptions.
The first stems from the vagueness of the insurance designation.
"Hospice is a Medicare insurance benefit and to be on the benefit of hospice, you have to have six months or less to live and give up other types of care," he said. "Palliative care, on the other hand, is not limited to the insurance designation of hospice."
The second is that people assume that palliative care is a "gloomy, doomy field," according to Miller.
"People think that dying is a depressive subject and all who work in it are morbidly bent," he said. "The reality is that, yes, we are interested in facing the fact that we die, but that’s just a preamble."
Palliative care calls for an integrated life, Miller said.
"That means while doing this work, I have to focus on my own life because the subject matter requires it," he said. "Not every brain surgeon has had brain surgery done on them, but 100 percent of palliative care workers suffer and 100 percent of them will die. So, by working this way, I improve my own life."
Another benefit is finding unique connections with his patients.
"Focusing on this subject, I can spend time thinking of what I have in common with others who I come across that I may never have had the chance to do so," Miller said. "We spend a fair amount of time in isolation due to socio-economic, cultural or matters of convenience, so here’s a subject that brings me into very intimate situations with people who may otherwise seem to have very little in common with me."
Park City Institute presents An Evening with Dr. BJ Miller on Saturday, Jan. 16, at The Eccles Center for the Performing Arts, 1750 Kearns Blvd., at 7:30 p.m. Tickets range from $25 to $75 and are available at The Eccles Center box office by calling 435-655-3114 or by visiting EcclesCenter.org.
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