Recorded live August 19, 2026

Dr. Karen Wyatt is a hospice physician, spiritual teacher, and author of What Really Matters: 7 Lessons for Living from the Stories of the Dying, along with The Journey from Ego to Soul, Stories from the Dark Night, and Wild and Holy: A Journey Through Grief, Guilt, and Grace in Italy. 

She is the founder and host of the End-of-Life University podcast, now nearly 560 episodes deep, where she has spent over a decade in conversation with leaders in death and dying. 

Known for weaving clinical experience with spiritual wisdom, Karen teaches that facing mortality is a doorway to living well, not the opposite of it.

Website: eoluniversity.com
Books: available on Bookshop.org and wherever you buy books

Episode Description

Dr. Karen Wyatt has sat at hundreds of bedsides and recorded nearly 560 episodes of her own podcast, and she says the biggest lesson still traces back to something her father taught her by a stream before she ever wore a white coat.

We talk about the story behind that lesson, and about a moment with a resistant patient that turned on nothing more than a shared childhood memory neither of them saw coming. 

One of our Graceful Lifers, Steve, joined the live Q&A with a memory of his own, and it stopped Karen mid-sentence.

Karen also walks through a piece of Aramaic scholarship that reframed one of the most quoted lines in the Christian tradition for her, and what it changed about how she sits with people who are suffering. 

We get into forgiveness, into what she is still figuring out even now, and into a ritual she has started keeping with the ocean since a recent move pulled her away from the mountains she'd called home her whole life.

This one runs deep. Bring something to write with.

Links mentioned in this episode:

• Karen's podcast, End-of-Life University: eoluniversity.com
• Karen's books, including What Really Matters: 7 Lessons for Living from the Stories of the Dying

In this conversation:

• The stream-side lesson her father taught her without either of them realizing it
• Why "listening" became the skill she had to relearn after years of clinical questioning
• The hollyhock doll moment that broke through with a resistant patient
• Forgiveness as the theme she didn't expect to find at nearly every bedside
• Reframing death's "PR problem," and what it means to see it as light instead of darkness
• The Aramaic reading of Jesus's last words that changed how she understands suffering and purpose
• Her recent move from the mountains to the coast, and what impermanence is teaching her now
• Nature journaling as a way of grieving one landscape while learning to love another
• Karen's answers to the six closing questions, including what she still hasn't figured out

A Graceful Lifer named Steve joined the live Q&A and shared his own childhood memory of a stream finding its way around rocks in the mountains with his father. That exchange became one of the most quoted moments of the hour.

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About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers.

Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

What does it feel like when everything is finally said?

Darnell Lamont Walker knows. He's been in those rooms — the ones where a sweet surrender settles over everyone, where people say it was hard, but it was beautiful — and the ones where nothing was said, which he describes as summertime in the south, humid, wearing a blanket. He knows the difference in the air.

Darnell is a death doula, Emmy-nominated writer, fifth-year faculty at Esalen Institute, and author of Never Can Say Goodbye — a book Trish recommends you listen to on Audible, in his own voice, turned all the way up.

In this conversation, Darnell and Trish go deep on what it means to die empty — to leave nothing inside that should have been written, said, or done. 

They talk about the object exercise he uses at Esalen to unlock storytelling and unblock creativity, why grief and laughter move through the same room, and what well-meaning adults get wrong when children ask about death.

Seven to eight million children in the US have experienced the death of a parent, sibling, or close friend — most without a single honest conversation. 

Darnell talks about small goodbyes: the end of summer, the pet that didn't make it, the best friend moving away. These aren't interruptions to childhood. They're the practice runs we forget to honor — and the tools we forget to give.

He also answers six questions Trish wrote specifically for him, including the song he wants timed so the last note hits with his last breath, and what a world where children grow up fluent in loss actually looks like.

"It looks like we've gotten rid of loneliness."

In this episode:

• The object exercise — how a memory trail always arrives at a person and a moment of aliveness
• Why grief is the sequel to love, not the punishment for it
• What adults get wrong when children ask about death — and the one language shift that changes everything
• "Humid summertime wearing a blanket" vs. "sweet surrender" — the difference in the air
• Red Dust by James Vincent McMorrow — and why the timing has to be perfect

Get Darnell's book: Never Can Say Goodbye — and if you listen on Audible, turn it all the way up.

Ready to start your own conversation? Start the Conversation — July 23rd

In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, End-of-Life Navigator and founder of Graceful Transitions. New episodes drop monthly. Graceful Lifers are in the room live — join the community at linktr.ee/pmsears

About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers.

Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

Barbara Karnes, RN, started her hospice nursing work in the 1970s — before hospice was even a word most Americans knew. She didn't join a movement. She helped build it. And more than fifty years later, she is still writing, still teaching, and still asking the field harder questions.

In this conversation, Barbara and Patricia talk about what it actually takes to walk with someone toward the end of life. 

Barbara's answer might surprise you. End-of-life work, she says, is far more about social, interactive people skills than it is about the medical. The medical model focuses on disease. End-of-life care focuses on the person who happens to have one.

If there's one thing she'd want every family to understand — one sentence she'd leave behind — it's this:

90% of end-of-life care is about knowledge.

It's about educating people in regard to what is actually happening. Because when families have that understanding and that resource, something shifts. They are less fearful. And the experience becomes something more sacred.

Dying isn't pretty, Barbara says plainly. Neither is giving birth. There's labor on both ends of life's journey. Mom is working hard to get out of her body — and that's what it looks like. That's not something going wrong. That's the work.

Barbara also shares the 3 a.m. phone call that led to Gone From My Sight, why she's still a social worker at heart, what surprised her most when she cared for her own husband, and what she wants people to feel in the room when she is the one dying.

This is a conversation about what it means to really show up — for the people we love, and for ourselves.

About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers.

Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

Dr. Ken Gorczyca has been sitting with death since he was eight years old. His guinea pig, Squeaky, died, and no one helped him. No ritual, no guidance. So he put her in a shoebox, added flowers, dug a hole in the backyard, and figured it out on his own. He didn't know it then, but that was the beginning.

Ken graduated from veterinary school in 1983 and moved to San Francisco — straight into the center of the AIDS pandemic. 

His very first client was a physician asking whether people with HIV should give up their pets. Ken said no. 

He co-founded Pets Are Wonderful Support, the first organization dedicated to keeping people with AIDS and their animals together. He lost 300 clients. Dozens of friends. And when he finally took the end-of-life doula course at UVM decades later — yes, the same program I went through, and yes, Ken was one of my instructors — he recognized something: we were all death doulas. We just didn't have the name for it yet.

When he turned 65, he went into the desert with one question: What's next? What came back was this work. In the last four years, he's been present for the deaths of roughly 2,000 animals — dogs, cats, bunnies, rats — in homes, in living rooms, in the spaces where a life was actually lived. He rings a bell. He tells the story. He smudges. He closes with a poem. Not because it's required, but because he believes — deeply, unwaveringly — that at the end of life, medicine and spirit can't be separated.

In this conversation, Ken and I talk about what families most need when they're scared and don't know what to expect. 

About why he spends 20 minutes asking families to tell him everything — the adoption story, the name story, whether their dog ever stole the turkey off the table — before anything else happens. 

About disenfranchised grief, and why the loss of an animal is real grief, not a lesser version. 

About what it means to let go. And about what he's come to believe: that an animal's death is the last lesson they teach you.

"Their passing," he said, "is really their last lesson. They're teaching you about death."

This one stays with you.

RESOURCES MENTIONED IN THIS EPISODE:

Ken and our guests touched on something that doesn't get talked about enough: what happens to your pet when you die — or when you're dying and can't care for them anymore. Here are a few places to start.

Pet Advance Directives — Just like a human advance directive, a pet advance directive lets you document your wishes for your animal's care if you're no longer able to make decisions. Mine needs updating. Maybe yours does too.
https://tinyurl.com/PetAdvanceDirective

Pet Trusts — A pet trust is a legally enforceable arrangement that sets aside funds and names a caretaker for your animal after your death. Unlike leaving a pet to someone informally, a trust gives your wishes legal teeth. Your estate planning attorney can help, or search your state bar association for resources specific to where you live.
https://tinyurl.com/PetTrustsPrimer

Pet Quality of Life Scale
https://tinyurl.com/PetQualityOfLifeScale

My Grandfather's Cat — mygrandfatherscat.ca — A free Canadian charity that helps seniors and terminally ill people find second forever homes for their pets. No shelters, no foster systems — their animal stays home until the very last day, then moves directly to a new forever family. Canada-only for now, but a model worth knowing and sharing.

A Gentle Rest — agentlerest.com — Dr. Ari Rozycki's in-home euthanasia practice in the San Francisco Bay Area, where Ken Gorczyca is part of the team. If you're in the Bay Area, or simply want to see what this work can look like at its best, it's worth a visit.

About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers.

Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

What do we reach for when time gets short? Not the accomplishments. Not the carefully managed image. Something simpler. Something we wish we'd said out loud sooner.

This conversation is for anyone who has been putting off a conversation they know they need to have. Which is most of us.

The conversation doesn't have to be perfect. It just has to start.

Guest: Diane Button End-of-Life Doula | Author | Educator | Founder, Bay Area ELDA UVM End-of-Life Doula Certificate Program Instructor

What we talk about in this episode:

The mint jelly story — how a grandfather's final meal and a single sentence launched Diane's career in end-of-life work.

The doula bag — what happened when Diane showed up to Floyd Barker's house with 100 questions on a clipboard and a bag full of supplies, and never opened either one.

The vigil plan — why asking someone what they want their final hours to look like is one of the most important conversations you can have, and why the answers will surprise you.

The gap — what it actually costs people when advance directives go unsigned, relationships go unhealed, and words go unsaid. From someone who has watched it happen.

The Final Checklist — six questions Diane distilled from a hundred. She asks them of her clients. She asks them of herself. Every month. They will stop you cold.

Death is just one day — why Diane calls herself an end-of-life doula, not a death doula, and why that distinction matters more than it might seem.

The six questions:

1. Who matters most?
2. What matters most?
3. What is left unsaid?
4. What is left undone?
5. What are you worrying about when you're lying awake at night?
6. What brings you joy in the daytime?

Diane's book: What Matters Most by Diane Button — find it on Trish's curated booklist for end-of-life reading at Graceful Transitions: 👉 https://bookshop.org/lists/for-graceful-transitions-an-end-of-life-doula-a-curated-booklist

The voice changes in this episode are due to 'operator error,' and I had to re-record 8 minutes as a result. I am learning a lot about editing and polishing. Onward with CHEERS and sincere appreciation.

About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers.

Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

What does it take to stand in a room where someone is drawing their last breaths — with no clinical training, no script, and no way to fix it?

Pastor Larry Wall has been doing exactly that for 35 years.

As the founding pastor of Newport Church of God in Vermont's Northeast Kingdom and the visionary behind the Living Waters Hospice House, Pastor Larry brings something most bedside training programs don't cover: street wisdom, spiritual discernment, and an unshakable belief that death done well can be sacred and beautiful.

In this conversation, we go deep:

• What terminal breathing actually looks and sounds like — and why families are rarely prepared for it
• The 3 AM phone call that changed everything: Pastor Larry's first death vigil, what he did wrong, and what grace showed him instead
• Why dying people "hold on" — and the surprising question that unlocked a peaceful death within 10 minutes
• The profound difference between spirituality and religion at the end of life (and why it matters more than you think)
• How advance directives do more than protect the dying — they protect the living from an impossible burden
• The hymn Pastor Larry sings at the bedside when someone can't let go
• Perspectives from London to San Antonio: Graceful Lifers John Goodey and Kathy Hamilton on children, hospice, and a mariachi band at a 95th birthday that brought a room to tears

* Graceful Lifers are paid subscribers to https://patriciamsears.substack.com/ and/or alumni of Graceful Transitions Legacy Leaders Guide cohorts or Living Fully and Dying Prepared workshops.

Graceful Lifer John Goodey — a former London headteacher — also shares the story of the groundbreaking intergenerational program he helped launch at St. Christopher's Hospice in Southeast London, where 9-year-olds partnered with dying patients to create art and exchange life stories. That program has since spread to every continent. If it moves you as much as it moved us, here's where to learn more:

• The St. Christopher's Schools Project (the original program, running since 2005): https://musicandartsinaction.net/index.php/maia/article/view/stchristophersschoolsproject
• Studio DöBra (the Swedish intergenerational arts initiative inspired by St. Christopher's): https://www.döbra.se/en/projects/studio-dobra/

This episode is also a window into what Living Waters Hospice House is being built to be — a place where laughter is medicine, love is the bottom line, and no one dies alone.

Living Waters Hospice House is actively seeking community support. To learn more, reach out to Graceful Transitions.

Interested in planning your own legacy before the crisis arrives? 

Join Trish for a free Legacy Leaders Guide Taster Session: https://tinyurl.com/LLG-FreeTasterSession-Register

About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers.

Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

What if talking about death could actually be fun? 

Lisa Pahl, licensed clinical social worker, hospice veteran of 18 years, and CEO and co-founder of The Death Deck, believes that humor and the right questions can open doors that fear keeps shut.

In this conversation, Lisa shares how a friendship forged through loss led her and co-founder Lori to create a suite of conversation tools — The Death Deck and The End of Life Deck. Lisa collaborated with Compassion & Choices to create the brand new Dementia Deck. All 3 decks are designed to help families have the conversations they keep putting off. 

Whether it's what to do with your passwords, who's taking the dog, or how you'd want to show up for loved ones after you're gone, these cards meet people exactly where they are.

Patricia and Lisa explore the surprising power of humor and silence in end-of-life work, what families argue about most at the bedside, why your partner might not be the best choice for your healthcare proxy, and the critical — often unknown — decisional moments that shape how we die with dementia.

This episode is both practical and deeply human. You'll come away with a new appreciation for why starting the conversation now, before a crisis forces the issue, is one of the most loving things you can do for the people you'll someday leave behind.

You'll hear about: The story behind The Death Deck and how grief sparked its creation, why dementia tops the list of what people fear most, what families don't know they can choose when a loved one has dementia, how to think carefully about your healthcare proxy, and what it means to truly honor someone's wishes when the pressure is on.

Find the decks: thedeathdeck.com

About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers.

Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

Grief counselor Jenny Filush-Glaze joins us to discuss the losses that don't come with funerals but hurt just as deeply — from chronic illness to broken relationships. After her own alpha-gal syndrome diagnosis, Jenny brings both clinical expertise and lived experience to conversations about youth grief, permission to feel, and why "at least no one died" is one of the most damaging things we can say.

With 15 years in hospice care and current work as a school-based therapist, Jenny shares insights on how children actually grieve versus how adults think they should, why we rank grief (and what that costs us), and how to create spaces where all feelings are valid. Her journey from treating ambiguous loss to living it offers rare perspective on navigating life-altering change.

Whether you're supporting someone through loss or navigating your own grief, this conversation provides both validation and practical guidance for honoring every kind of loss.

CONNECT WITH TRISH (aka Patricia M Sears):

• All links: ⁠linktr.ee/pmsears⁠
• Graceful Lifers: ⁠patriciamsears.substack.com⁠
• LinkedIn: ⁠The Threshold newsletter⁠

CONNECT WITH JENNY:

• Books on Amazon: "⁠Grief and Alpha Gal: The Mind and Body Connection⁠" & "⁠Grief Talks 2⁠"
• Facebook: ⁠Alpha-Gal Grief Girl

About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers.

Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

We live in a culture that prizes eloquence and timing - say the right thing at the right moment, or don't say it at all.

But Gabrielle Elise Jimenez, author of The Conversation, knows something most people don't: the "perfect" deathbed conversation doesn't exist, and waiting for it might mean never speaking at all. 

In this tender exchange, Gabby reveals why showing up imperfectly matters more than showing up polished, and how becoming someone's voice when they can no longer speak might be the most profound gift we can offer. 

We explore what happens when hard conversations finally break open, why the messiness of grief deserves our full attention, and how presence - not perfection - creates the healing we're all seeking.

Subscribe to Gabby's website to find treasures in her blog, workshops, and books. CHEERS

About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers.

Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears

In this National Hospice Month episode, the Second Season's first episode, host Patricia M Sears of Graceful Transitions speaks with Lori Rizzo, a certified end-of-life doula and dementia practitioner from Compassionate Crossings, about the urgent need to reduce stigma around dementia and transform how we support families navigating this journey. 

With nearly 7 million Americans living with dementia and 12 million providing unpaid care—often quietly and exhausted—Lori shares practical guidance on early conversations, person-centered care approaches, and how communities can step up to support the "circle of care" surrounding someone with dementia. 

From understanding the importance of getting tested early to learning how to visit a loved one with dementia, this conversation offers hope and actionable tools for families facing one of healthcare's most isolating challenges. 

Whether you're planning ahead, supporting aging parents, or helping a loved one through this transition, this episode provides the compassionate framework to talk about dementia the way we talk about heart disease or diabetes—openly, without shame, and with dignity.

Resources that Lori mentioned in our conversation and others she's sharing:

• Dementia Minds - ⁠https://dementiaminds.org/⁠ Support groups are for persons living with dementia or mild cognitive impairment (MCI).

Training and tips for caregivers: 

• Positive Approach to Care (Teepa Snow) ⁠https://teepasnow.com/⁠ Caregiver training ⁠Free videos on Youtube https://www.youtube.com/channel/UCSXrEX7LkWOmfTaV6u1C7wQ'⁠
• Adria Thompson - ⁠https://www.belightcare.com/⁠ Speech Pathologist.Offers a ton of short videos and more! Follow on Facebook, Instagram, and YouTube

Caregiver Resources 

• Daughterhood offers a free, virtual dementia support group, “Circles,” that empowers family caregivers with emotional and practical support throughout the caregiving journey.⁠https://daughterhood.org/⁠
• GUIDE (Guiding an Improved Dementia Experience) Model - Medicare coverage for a comprehensive package of care coordination and care management for people with dementia, along with support for qualifying caregivers, including education and respite services. ⁠https://www.cms.gov/priorities/innovation/innovation-models/guide⁠
• Alzheimer's Association ⁠https://www.alz.org/⁠
• Alzheimer's Foundation of America ⁠https://alzfdn.org/⁠

Conversation and Advance Care Directives 

• The Conversation Project - Starter guide for caregivers of people with dementia: ⁠https://theconversationproject.org/wp-content/uploads/2020/12/DementiaGuide.pdf⁠
• Compassion and Choices Dementia Values and Priorities Tool: ⁠https://compassionandchoices.org/dementia-values-tool/⁠

About the podcast: In Conversation with an End-of-Life Specialist is hosted by Patricia (Trish) Sears, an End-of-Life Navigator and founder of Graceful Transitions in Vermont's Northeast Kingdom, serving globally. New episodes are recorded live on the third Wednesday of each month, 4p –5p ET, with a live Q&A for Graceful Lifers.

Join the Graceful Lifers community at Substack for exclusive invitations to join live audience and Q&A sessions with guests and deeper conversations about navigating life's thresholds.

You can find the hub of Graceful Transitions' work at Linktr.ee/pmsears