Finding Your Meaning and Purpose by Looking at the End of Life with Dr. Kathy Zhang

Christine Li  0:01  
Welcome back to the Make Time For Success podcast for our final episode of 2021. This is episode number 55. These past couple of years inside the COVID 19 pandemic have caused us to reflect on the topics of death and dying. But they've also forced us to review how we're spending our time and leading our lives. We are very fortunate today to have the reflections of Dr. Kathy Zhang, Palliative Medicine Physician, Author, and Podcast Host to help us think and feel our way through these difficult topics together. Dr. Luyi Kathy Zhang, is an Assistant Clinical Professor of Medicine at NYU, and the host of the Purpose Filter Podcast, where she shares stories insights in inspiring interviews to help people transform their lives. From the Inside Out. Her mission is to bring the clarity purpose and meaning that comes with confronting our mortality to those fortunate enough not to have to, because everyone deserves to live the life they want, with the time they have left. From the moment I press record on this interview, our conversation was a really deep, I think you're gonna learn a lot from this particular episode. And it's a beautiful one. Let's go listen to it now.

Hi, I'm Dr. Christine Li, and I'm a psychologist and a procrastination coach. I've helped 1000s of people move past procrastination and overwhelm so they could begin working to their potential. In this podcast, you're going to learn a powerful strategies for getting your mind, body and energy to work together so that you can focus on what's really important, and accomplish the goals you want to achieve. When you start living within your full power, you're going to see how being productive can be easy, and how you can create success on demand. 

Welcome to the Make Time for Success Podcast. Hi, everyone. This is Dr. Christine Li and today I have the pleasure of introducing you to Dr. Kathy Zhang. And she is a palliative medicine doctor, and a podcaster and an author. And she and I just met a few minutes ago by video, but she put out a post in a podcasting group looking for podcast guests and offering to come on other people's podcast. So thank you, Kathy, for sending out that message to the universe. And we've connected since so thank you for being on this show.

Kathy Zhang  2:49  
Thank you for having me. I'm excited to connect and talk and see what comes out of our conversation.

Christine Li  2:55  
I am really excited everything that Kathy wrote on the pre show guest form, fit everything that I'm interested in to talk about. So I think we're in for a treat today. So Kathy, could you tell us a little bit about yourself, just your background, maybe how you became a doctor, anything you want to fill us in?

Kathy Zhang  3:16  
Okay, so I'm an only child of Chinese first generation immigrants. We came when I was very young, like three, and my parents were new to the country working class. And I essentially grew up in a public school environment, was able to make it to medical school. And then I trained in internal medicine, and worked for a few years as a hospitalist meaning a physician who takes care of patients who are sick enough to be hospitalized for whatever it is infections, heart failure, strokes, etc. And I loved it. However, I felt like something was missing. I just felt like I wanted to spend more time with my patients. I felt that I was I didn't I wasn't equipped to have kind of difficult conversations, but the most meaningful ones that I wanted to have with them. So after about four years of working, I decided to go back to training and do a fellowship in hospice and palliative care, which is a discipline that focuses on quality of life relieving pain and symptoms in patients who have serious and or terminal illnesses. And so that's what I've been doing for the past couple years. And I just love I love the field. And it's just the most raw kind of expression of being a human that you can have. You know, when patients are sick and they're dying and their families are involved with that just everything gets heightened. So it's just really Beautiful, and, you know, challenging in many ways. But what brought me to where I am now is I during COVID, it was just really a wild kind of difficult journey for a lot for a lot of us. And I just found myself feeling so hopeless. Because normally I work with dying patients, which I had gotten used to, in a sense, but then you just explode with people who were, you know, essentially, we're fine one day and dying the next. And it was, I found myself in a very dark place, I had to get therapy coaching. And now I'm to the point where I can talk about it, I started a podcast. And yeah, that's kind of where we are now.

Christine Li  5:57  
Yes, that's a beautiful story. I think a story that incorporates your self discovery and trying to satisfy the nudges inside of yourself, but then also having to push that even further because of COVID. And because it sounds like the COVID situation forced you to have to examine parts that you didn't even know you had to examine. Mm hmm.

Kathy Zhang  6:24  
Yeah, totally. It's, um, I don't know that on a certain point, you find yourself being like, Yeah, I'm well adjusted, I'm on autopilot. And you kind of think like, I'm fine. I'm, I don't, everything's okay. And then something happens. And you find yourself being like, Okay, what's going on. And sometimes it takes a traumatic event or a challenge for us to re examine where we are, what our values are, what's important to us, and then be able to change ourselves to meet that challenge, in a sense. And I think that's what happens for our patients, too, right? They, they find themselves sick, they find themselves potentially dying, and something happens inside where they get a lot of clarity, they find purpose, they find meaning, but it's not always a easy journey to get to that point. There's a lot of emotions, there's a lot of things that come up during that.

Christine Li  7:29  
Yes. And I admire you being in the palliative medicine field. As a psychologist myself, I always say that bereavement and issues around dying are not my strength. As a therapist. I am learning. My eyes and ears are open. But I would say I didn't have a natural connection with that area. I'm wondering, How did you know that you would be great at this, that that nudge inside of you? What did it feel like? And what were you telling yourself?

Kathy Zhang  8:10  
Hmm, that's a great question. You know, that was the biggest thing I was afraid of was because I'm a I'm a feeler, right. I'm an empath. I just want I love people. And I was like, am I going to be able to be around these people, and not just completely meltdown all the time, because of how much emotional stress there is, and what ultimately called me to it. And it's funny, I never really thought of anything in medicine as a calling. Like, I knew I wanted to be a healer, I knew I wanted to help people. But palliative care specifically feels very much aligned with who I am as a person and what I want to contribute to the world. I think, ultimately, it was like, I want to have deep and meaningful connections with patients and families in a way that I wasn't feeling like I was able to have when I was working before. And I think what it came down to was, this is probably one of the most important things that anyone will have to go through in their life. And if I have the training from fellowship, if I have the innate kind of desire to want to be around this, then you know that's what I'm going to bring to the table then that's what I'm going to do and you know, the emotions, the challenges of it. It just makes you appreciate what it is to be alive and how lucky we are. So it's been you know, it's been a blessing in many in so many ways in my life.

Christine Li  9:56  
Okay, I'm glad you and palliative care have found each other I would imagine they are the most beautiful people in that field so that you're actually connected with also very talented and empathic providers and human beings. Alright, so I find myself thinking about the concept of personal boundaries, and how does the specter of death change boundaries between people and how you've been able to work through your own relationship with your patients and their families? From a boundary standpoint? I hope that makes sense.

Kathy Zhang  10:38  
Yes. So I always previously prided myself on my ability to compartmentalize, I would, I would be like, you know, what, I'm, I'm the type of person that my work, emails never come to my phone. It was very, like, strict separation of what I called, like, work and state. And, and so then that's why I thought that I'd be really good at palliative care, because I was like, you know, I'll be able to leave them at the hospital. And then when I go home, I'll be home. And then you, you get to and you realize there's no, there's no way that that's possible. Right? We're humans, of course, we're going to feel of course, we're going to emote, of course, we're going to feel so many things when we're working so closely with these patients and families. And so when it comes to boundaries, what I've found, I think that helps the most is focusing intentionally on the present. And saying, like, you know, if I'm here with you, right now, it's me and you, it's 100%, I'm in the moment, we're here together. Or if I'm with a patient, like they're telling us a story, or they're telling us about their illness, where they are with them, and then to do as much as we can and to kind of hone those skills of being in the present. So that when we do leave that encounter, we're not sitting in the shower, crying, just being like, oh, my god, that was such a terrible, sad case, which, you know, you do that happens, and that happens a lot for me and COVID. But I think it was also the, the tension between feeling like, I shouldn't feel like this. I'm, you know, I'm good at this. I'm, I'm I compartmentalize, well, why am I feeling this? And it was allowing those emotions to kind of flow through me. And once it did, you just feel so much lighter, and more grounded and more centered and more connected, in a sense as well.

Christine Li  12:44  
It's kind of sounds like the need for boundaries kind of dissolved in a way if you're present with yourself and present with your patient, that if you're with them, there's no need to defend, which is very interesting, because again, I feel like probably I'm feeling right now still a resistance to kind of confronting some of these issues around the painfulness the scariness of death. I think that's natural, too. But I think I'm also fascinated by anyone who works in palliative care. I think you all are angels, angels and very talented angels at that.

Kathy Zhang  13:27  
We're not angels. Thank you for thank you for thinking of us like that.

Christine Li  13:32  
You're very welcome. You do very difficult work, I would say very meaningful, difficult work. So what would you like our listeners to understand about palliative medicine and hospice care?

Kathy Zhang  13:47  
So I think one of the most common myths and I think it's being debunked a little bit more and more with more media coverage, and the more we talk about it, but one of the common misconceptions is that they're, they're lumped together they're the same thing. A hospice is specifically for patients who are have less than a six month life expectancy. Palliative care is a an approach to care and approach to treating the whole person, physical, mental, emotional, spiritual, existential psychosocial. And that can start at any point, a person gets diagnosed with a serious illness, let's say kidney failure, heart failure, severe, you know, lung disease or neurologic injury, anything like that. And we can help support patients and families through that. Not necessarily for them to say like, oh, I don't want treatment. That's not the case in palliative care. It's to find ways that we can support their goals. If their goals are like, I want every single treatment in the world. We can help them make that a reality. And at the same time, we also talk with them about advanced planning. Because, you know, let's face it, when you have a serious illness, a lot of things start going on inside your head, start to think a lot of things, even if you don't want to. And your family starts to think about the same things as well. And so we help with those conversations about like, Okay, well, in case, you're not able to make your own decisions, who do you want to make decisions for you choosing, you know, a health care proxy, in that sense. And then also just talking really about what their values are? I think a lot of people think that it's about life or death. And in the end is, you know, I mean, life is in general, but I think it's more important that we talk about what gives us meaning, what gives our life purpose, what makes us feel like, you know, I had a great day today. And I, what, why I started the podcast was that I wanted to shift that focus that clarity from the end of life two decades earlier, to where we are now. Because if we can ask ourselves these questions, I think it would really just transform everything that we do, which is make everything be looked at in a different way.

Christine Li  16:18  
Yes. And please, at this time, can you tell us a name of your podcast?

Kathy Zhang  16:23  
Oh, it's called the purpose filter?

Christine Li  16:26  
Yes. And I would encourage everyone here to listen to Kathy you can hear already how wonderful she is her episodes are delightful to she's really reflective really tells wonderful stories, and I think has such meaning to teach us all. So thank you for launching that. Because that takes courage to, to put out a podcast.

Kathy Zhang  16:50  
Thank you. Yeah, it's been. It's been good, challenging in its own ways, as you know. But it's been something that I really enjoy.

Christine Li  17:00  
So the reason that I reached out to you is not only the palliative care, but also the fact that you were writing in that Facebook post about how you've learned so many different principles of living intentionally, because you've worked with the sick and dying, could you please share that process of how you were able to extract those pieces of learning and some of the best things that you have learned?

Kathy Zhang  17:29  
Hmm. So what I've learned most I mean, it's patient encounter, after patient encounter and story after story, because that's really what it is, it's being able to connect with people, and learning what makes them feel alive. And then being able to bring that back to our life. I'll tell you a story. I once had a patient who was probably in his 60s. Him and his wife lived together, they didn't have any children. They were in a long marriage for decades. And he would walk every day in his apartment building just up and down flights of stairs, like 17 flights or something. And one day, he slipped and fell, had a huge brain injury that was very devastating to the point where the wife, and he was not going to be able to regain any kind of significant neurologic function where he could like talk or interact or do much outside of being on a ventilator for the rest of his foreseeable future. And his wife made the incredibly difficult decision to take them off life support, because she was like, he wasn't, this is not him, he would never want to live like this. And, you know, I got called in because they're like, Okay, we need some help taking this patient off the ventilator, making sure he's comfortable talking with the family, etc. So I go in, and I'm talking with his wife, and she's saying how they met at a bus stop, because he used to share like the same bus route. And he would like, take extra stops that just so that they could spend a little bit more time together. And as we were about to start the process, she looked at me and she had this almost like shameful look on her face. And she was like, Is it okay, if I climb into bed with them? You know, she's like, I just want to hold him in a sense, and I was like, who am I to judge you to want to climb into your husband's hospital bed? So, you know, she did and it was beautiful. I, you know, I cried. I teared up. I'm just naturally a teary person, a cheerful person, I guess. And I just remember going home that night, and I remember I was in bed, and my husband was fast asleep. And I had this overwhelming feeling of like, oh my god, oh my god, the same things gonna happen to him, in a sense, right? Bringing all of that with me at home, which again, I try not to, but I can't help it I'm human, I ended up just kind of like Bear hugging him and clutching his, his, and I was just crying was kind of tears flowing the entire time, thinking that the same thing was going to happen to him. And he was fast asleep, he was just like, you know, and meanwhile, I'm like, and, you know, we woke up the next day, and I was, you know, knock on wood. But everything that I've experienced in palliative care just makes me so grateful, and I think makes us all in the field who work with these types of patients. So grateful for the things that we do have for the things that we take for granted. For you know, just being able to wake up just and talk and stand, there's some patients who are like, I would give anything, to be able to just eat a bite of food without immediately throwing up. And, you know, that happens in a lot of patients who have, let's say, stomach cancers, etc. And it just makes me think, like, Wow, I feel like I have a lot of problems, like I get worried about things I stress out about my family, my kids, my work, etc. But then if you take a step back and think about life, in that manner, it just all your stresses, all the kind of BS melts away a little bit. And to be able to indulge in that is just a really wonderful feeling. Even if it does come from pain, even if it does come from sadness.

Christine Li  21:49  
beautifully put, I think it's also born out of desire, desire, to make beauty and to contribute, and to connect with purpose that lays inside of you. And I see all of it, as I'm watching you talk today that you've managed to put all of this in a beautiful life of your own. So congratulations on doing that. I think you've married your empathic, bent with a really important part of the medical and life field that showcases your talents, and is really remarkable. So thank you for being able to articulate this with us, too. I think it's incredible. Thank you, you're very welcome. I'm going to ask about self care. Because you did put that as one of your desired prompts. And I'm a big fan of learning self care, especially if you have been ignoring your self care. Could you talk a little bit about self care and self love?

Kathy Zhang  23:01  
Yes, I recently was talking with someone on the podcast. And we kind of realized that a lot of times we think self love and self cares, a destination. Or we think like, I'm going to get there, if I do X, Y and Z. And that it's more helpful in many ways to think of it as a journey of just constantly discovering and rediscovering how we can better care for and how we can better love ourselves in our field. What I also love is that, more so than any other discipline in medicine, we focus on self care the most because of how heavy and challenging our work can be. And we we really try to emphasize that self care is the best way for us, and the best vehicle for us to provide the most compassionate care that we can for our patients and their families. Because if we don't have the energy, the mental capability to be able to sit there to be able to talk with these people, then how are we supposed to guide them through their own journeys? And I remember there was an article somewhere, and I forget if she's a psychologist, or something, but she wrote like self care is more than just kale and yoga, or something. You know,

Christine Li  24:32  
I would agree. Yeah.

Kathy Zhang  24:35  
Where I think it's wonderful that self cares just made this huge kind of explosion, especially during the COVID era. However, I think in many ways, at least, let's say in like, some companies will say like, Okay, well, here's a spa package or go to yoga, which is great and mindful. At the same time, I think self care is more than that it's about, in many ways, setting boundaries for what we can and can't do. Or finding ways to say that like, Okay, this is the capability, the mental energy that I have for this. And let me intentionally find ways to rebuild that. Maybe my energy is depleted from something, let me see if I can find ways to rest, to recuperate, and then be able to bring back more of myself in order to contribute in order to grow. And to build that resilience. In a sense, it's a muscle for us to say, Okay, here's the challenge, I can meet it head on, or I need to rest a little bit and then be able to come back and continue to serve and to help.

Christine Li  25:55  
Beautiful, so important, so important. We need to feel ourselves and we need to love ourselves. And love is a terrific type of fuel for sure. I have a question. I'm not sure. It's, it's just in my mind. So I'm going to ask it at the end of life. What do you notice, with people about their reflections about themselves? How much they love themselves? How much they feel? They've filled their purpose, things like that?

Kathy Zhang  26:27  
Mm hmm. That's a great question. I think, and I'm a victim of this to where, clearly I am an overachiever in many ways. And sometimes, when you go through life, you think, what's my purpose? Like? Why am I still here? What am I doing with my life. And I've realized that no one really discovers what their purpose in life is, until you get to the end, until you're at that point where you're like, Oh, I'm coming to my time. And you start to look back on your life, in all different ways, and things start to stick out. And sometimes patients will say things that they never thought would make them feel like they they lived. That like made their life meaningful, right? They have like beautiful family and friends and all of this stuff. And they're like, Yeah, you know, one time, I had this one patient who was like, I saved a woman from being sexually assaulted, because I overheard some men in a bush, not in a bush, but like, in an alleyway talking. And I kind of just, like, told them to just buzz off. And I made sure that she got home safely. And he was probably in his 50s. And he's like, that made me feel like, my life was well lived, just kind of like that one interaction. And he didn't even speak to her. He never knew her. But when he came to that point, he was like, Yeah, that's what I remember. That's what I feel, like made my life worthwhile. And so I find myself thinking, and really knowing that the purpose of our life is to really just soak up as much as we can while we're here. Because in so many ways, it's so unfair, isn't it? There are people who live to 120. And babies die. And sometimes you get caught up in like, what's the meaning of why? Why do some people not make it? Why do some people do, and that can be jarring in many ways. But I think if we can just focus on making our lives, like the best life that we can possibly have, in whatever way that means to each of us, then I think when we get to the end, then we can look back and reflect and say, Oh, I thought the purpose of my life was to do this. But really, it was to whatever to give back to serve, to love my family to, you know, have a child to, you know, do the work that I do, etc, etc. So, yeah, it's it's just people really find a lot of clarity at the end of life and when they're faced with their mortality, like you said, not because they they want to, but because they have to.

Christine Li  29:41  
Wow, I didn't realize when I asked the question that I was going to get the best answer ever. So thank you so much for coming on this show for being such a lovely human being, and for teaching us so much about your process. Your philosophies and your work. I really appreciate your being here.

Kathy Zhang  30:04  
Thank you. It's so such a pleasure. Thank you for having me. You're very welcome.

Christine Li  30:08  
Please let us know how we can really stay in touch with you and continue to learn from you.

Kathy Zhang  30:14  
So my website is purposefilter.com And I'm on Instagram @purposefilter. Love it.

Christine Li  30:23  
Thank you, Kathy. I want to wish you all the best.

Kathy Zhang  30:28  
Thank you so much. 

Christine Li  30:30  
Alright, everyone, we just had a lovely, lovely interview. I want you to go live your life. Be grateful when you can take care of yourself, and I will see you next week. Bye. Thank you for listening to this episode of the Make Time for Success Podcast. If you enjoyed what you heard, you can subscribe to make sure you get notified of upcoming episodes. You can also visit our website maketimeforsuccesspodcast.com for past episodes, show notes and all the resources we mentioned on the show. Feel free to connect with me over on Instagram too. You can find me there under the name procrastinationcoach. Send me a DM and let me know what your thoughts are about the episodes you've been listening to. And let me know any topics that you might like me to talk about on the show. I'd love to hear all about how you're making time for success. Talk to you soon.

Transcribed by https://otter.ai