Dr. Tim Ihrig, Founder and CEO of Ihrig MD & Associates
An important part of living well is embracing all chapters of life. How do we normalize death in order to think of it as a natural part of human existence? Dr. Tim Ihrig, founder and CEO of Ihrig MD & Associates, unlocks the wisdom of being present to celebrate a life well-lived as he explores the opportunities in palliative and hospice care. He offers a sustainable foundation that empowers caregivers to engage with patients at a depth that allows for a deep appreciation of living.
Timothy Ihrig, M.D., M.A., is the founder and Chief Executive Officer of Ihrig MD & Associates. Dr. Ihrig is an internationally recognized expert in palliative care and hospice medicine. He cares for the most vulnerable and sick individuals. He creates and leads health systems and teams through change that care for the most seriously ill people. He is recognized for combining clinical and administrative experience in creating health and social care systems that reliably deliver high-value outcomes in a financially sustainable manner for seriously ill populations. His expertise is understanding risk as applied to healthcare systems, payers and providers, its effect on micro- and macro-economics, population health, regulatory compliance and their interactions. The fundamental principle of combining his visionary approach to care delivery through a unique philosophical perspective and implementing them via defined pathways enhance whole-person, relationship-based care. This has led to unparalleled success in across-the-continuum population health and community-based care program development and innovation.
Dr. Ihrig previously served as the Vice President and Chief Medical Officer of Hospice and Community Care, and prior to that, the Chief Medical Officer for Crossroads Hospice and Palliative Care from 2017-2021 and as Medical Director of Palliative Care at the Trinity Regional Medical Center (TRMC) of the Unity Point Heath Health System - the third largest non-denominational health system in the United States from 2010-2016. TRMC was one of thirty-two Pioneer Accountable Care Organizations established through the Centers for Medicare and Medicaid Innovation. His care model was the catalyst for Trinity Regional Health System success within the Medicare Shared Savings Program - attaining average shared savings of one million USD annually from its inception during his tenure. He was also a member of the Board of Managers of the Unity Point Health Accountable Care Organization and the Unity Point Health Regional Organized System of Care Committee.
In addition, his efforts were seminal in UnityPoint Heath being granted the 2013 Circle of Life Award by the American Hospital Association. One of nine institutions that year across the country to receive this prestigious award, it recognizes innovative programs in palliative and end-of-life care. Dr. Ihrig’s program is recognized as a national leader in integrating palliative care across the healthcare continuum.
Dr. Ihrig’s featured TED talk has been viewed more than 1.4 million times globally, and National Public Radio’s “All Things Considered” featured him in a story on the development and transformative nature of his philosophy of care. He is the co-author of Palliative Care and Symptom Management, and is contributing author of The Art of Healthcare Innovation: Interviews and Industry Insights from 35 Game-Changing Pioneers.
He is endorsed by the Center for the Advancement of Palliative Care as a national level clinician-educator, as well as the Australian Minister of Health as an International Fellow for his innovative approach to caring for the most seriously ill. In addition, he is palliative care content expert to the Accountable Care Learning Collaborative through Western Governors University in collaboration with the Duke-Margolis Health Policy Institute and Dartmouth Institute of Heath.
Dr. Ihrig attained a degree in medicine from the University of Nebraska College of Medicine and a Masters degree in Molecular Biology from the University of Nebraska at Omaha. He completed his residency in internal medicine at the University of Iowa, Des Moines and a fellowship in Hospice and Palliative Medicine at Stanford University in Palo Alto, California.
His other interests include sexuality at the end of life and Global Health. He is the former Medical Chair of the Health Services Committee for Empower Tanzania Incorporated whose mission is the development of sustainable healthcare solutions in sub-Saharan Africa for individuals suffering with HIV/AIDS, cancer and other life-limited illnesses.
Show Notes
Dr. Tim Ihrig shares his background in palliative care and hospice medicine. [03:20]
A journey outside of Western medicine and culture. [04:21]
A gateway to understanding the human experience, [06:33]
How can we reform health care? [09:43]
Living is a physiologic process, not chronologic. [14:31]
Why do some with a particular cancer live longer than others? [15:44]
How can we help physicians understand that death isn’t failure? [18:03]
What are four questions a caregiver can ask a terminally ill patient? [20:13]
What’s the gateway to higher truth? [30:28]
How can we live more deliberately? [34:35]
Transcript
Bisi Williams 0:00
Hi. I'm Bisi Williams, you're listening to Health2049
Dr. Tim Ihrig 0:07
Accepting that we're going to die is not giving up. It just allows us to define more clearly what it is we're going to fight for. When we say talking about death steals hope, I found just the opposite. It's empowering because that fear, it's not a fear of death itself. It's a fear of a lot of patients who are getting dead, the dying process between now and that moment of inevitability where we exhale our last breath. And coupled with that is this misperception that death or Mother Nature can be beaten, particularly in Western medical societies, and that leads to a paralysis of living in the setting of a dying body, we're missing the opportunity to rethink what it means to be a caregiver.
Bisi Williams 1:43
There are only two things we know for sure in this life, we are born and we will die. As a culture, we invest in nutrition and exercise as a means to live well. But a critical part of living well is dying well. The most common fear in Western society is that the process of death will be painful, prolonged, and will reduce the quality of life.
In this episode, we'll discuss how we can learn to accept death as a normal part of our human existence and life. We're very happy to have Dr. Timothy Ihrig on the show today. He's the CEO and Chief Medical Officer of Ihrig MD & Associates, and is an internationally recognized authority on hospice and palliative care. His TED talk, What We Can Do to Die Well, with over 1 million views, urges doctors to emphasize overall quality of life while helping seriously ill patients approach end of life with dignity and compassion. Hi, my name is Bisi Williams, and welcome to Health2049. I'm delighted to welcome to our show today Dr. Tim Ihrig.
Dr. Tim Ihrig 3:14
Thank you so much.
Bisi Williams 3:15
Tim, tell us a little bit about your work and your life.
Dr. Tim Ihrig 3:20
I am a physician, palliative care and hospice. I came to medicine rather late, in my mid 30s. And the space I work in is understanding and caring for those who are facing the last chapters of their life. I've worked in big hospital systems. I've worked for home-based and community organizations and cared for 1000s and 1000s of people who have walked this journey. I've walked it as a provider, as a friend, as a human. And the space I'm in now is as a kind of consultant, trying to identify what the next opportunity is to engage in a broader human level beyond the human condition, if you will, to affect change in health systems and medicine as well as people in general. So that's where I sit today.
Bisi Williams 4:14
Fantastic. Thank you. So Dr. Tim, tell me a little bit about your work in Africa and Tanzania in particular.
Dr. Tim Ihrig 4:21
Yeah, it's probably some of the most transformative work I've ever done. I was witness to a different journey, a journey of life that's outside of Western medicine and culture. I was with an organization called Empower Tanzania Incorporated and we were creating sustainable end of life programs for people in northeast very, very rural off the grid Tanzania. And it was early in my training during internal medicine residency and then at the end of my fellowship at Stanford University that I went back and learned that there is a different way to live these chapters, and one of the most powerful lessons was just to be present.
I can't get Tylenol in the rural, Sami District Usambara Mountains of Tanzania. But the power of presence and acknowledging inevitability, transcends pain in fear. And my Swahili is minimal at best, so, just the human connectivity is the lesson that has empowered me to care at a level that I need to care at, and to be vulnerable at a depth that I need to be vulnerable at to walk this journey with people and not feel as though I'm overwhelmed and not feel as though emotionally I'm being rundown. And I'm having people take things from me. No, it's a reciprocation. People often say, how do you work in hospice? That's got to be so depressing and so sad. And yeah, there's times it's very sad, but I have never lived more throughout my medical career and training and throughout my life than when walking the journey with other human beings.
Bisi Williams 6:25
That's wonderful. Can you tell us why you are passionate about palliative care?
Dr. Tim Ihrig 6:33
That's a big question. For me, palliative care extends beyond the science of medicine, and the clinical practice of medicine, it's been a gateway to understanding the human experience. And you're so right, in your lead in the introduction, that there's two things that are absolutely certain in this life that we’re born and we will die. And walking the journey with 1000s of people, their families and caregivers, I realized that there is a disconnect between inevitability and how we can continue to live and love and learn and grow through every breath. I think you're spot on and saying there is this tremendous fear of death and coupled with that is this misperception that death or Mother Nature can be beaten, particularly in Western medical societies. And that leads to really a paralysis of living in the setting of a dying body, we're missing the opportunity to rethink what it means to be a caregiver, and when we talk about what the future holds, and how we can make the world and life better for ourselves and our children and grandchildren.
First of all, death is not even really acknowledged. And if we don't acknowledge its existence, and its inevitability, it precludes us from accepting it. And by acceptance, I don't mean just kind of rolling over and letting it happen, we fight but we have to fight for that which is sacred to us. On the architecture of this reality, of a physiologic reality, of an identification of what is possible, and what is not possible, and accepting that we're gonna die is not giving up. It just allows us to define more clearly what it is we're going to fight for.
When we say talking about death steals hope I found just the opposite. It's empowering because that fear that you referred to earlier is interesting, it's not a fear of death itself. It's a fear of a lot of patients who are getting dead, the dying process between now and that moment of inevitability where we exhale our last breath. And so I'd love to explore and share why I think that exists and some underlying tenets that are uniquely human that lead us to that place of paralysis and dying before we actually draw our last breath and how we can overcome that. Does that make sense?
Bisi Williams 9:21
It makes 100% sense. And I'm ready to go on this magic carpet ride based on reality with you. So, Tim, tell me, what is your vision for the future of care in 2049? Paint that picture for me please, and our audience.
Dr. Tim Ihrig 9:43
I think it starts with a fundamental understanding that it's not presently about health care reform, to get to 2049. We have to reform how we care, what is as yet to be defined is why we die. Once we understand that, and we can map out this trajectory of inevitability, and identify points in our human journey, when our capacity to be healthy, our capacity to heal or recover starts to diminish. In layman's terms, it's Mother Nature, the circle of life, if you just draw an arc, half a circle on a chalkboard, and the left side is where we're born. And on the far right side, there's a moment we die.
There's a time period that we will all enter into, or most of us and unless we're killed in a car accident or something tragic, all of a sudden, most of us will enter into this period that our body starts to slow down. We need to identify that period. We need to understand that it is a natural process, it is inevitable. It's not because any individual has failed to do something correctly, or that it can be overcome with bells and whistles and escalation and clinical intervention. And we need to parallel care choices pursuant to where individuals are at.
When we align ourselves with Mother Nature and we align ourselves with what a body's capacity is, my experience is people live longer, all diseases, all ages, and they live better. And they live really more according to what's important to them. It goes beyond medicine. So to understand why people die, people don't die from cancer, people don't die from dementia, people don't die from X, Y and Z people died because their bodies were worn out, from a physiologic perspective. All of these things are accelerants and influence the rate at which our body's capacity to maintain the status quo, or heal or recover. All of these things dramatically influence the rate at which we're able to do that or not. We don't have a mechanism to identify that period, which I simply termed the inflection period. It's a time at which our capacity changes.
When we identify that and we apply that to relevant conversations and we translate that through a series of questions that I've asked, every patient I've ever had, the pathway forward to living a life, overcoming fear of death, not being paralyzed because we're afraid of dying. What I've termed in many interviews is the closet monster, this thing that creeps out. When I was seven, my dad used to come in and open the closet door and turn on the light and say, look, there's no monster in here. Here's the truth. And that's what we need to bring forward through an understanding of this process of inevitability and living and applying the relevant clinical options, as well as what an individual holds sacred.
Once we have a new foundation to think about living, which is how we think about dying and identifying opportunities to care, it's an absolute game changer. All this manifests from an entire career of practicing and saying, okay, this is how it all makes sense. This is how the success of empowering people to live and listening to their little voices is translated into a model and into science that can be applied to a broader population.
Bisi Williams 13:43
So tell me more, your future of our end sounds really quite lovely, humane, warm, and calm. Tell us a little bit more about the inflection point, which is a very elegant way to talk about the transition into the next stage of our lives. And do you imagine, some people want to identify that telomere and freeze it and then others like you, it's like, how do we bring grace and dignity into the arc of our life? And I love that you talk about our living, not are dying. Can you tell us a bit more about that?
Dr. Tim Ihrig 14:31
Absolutely. And not to be picky, but I think a very important point is that it's not an inflection point. It's not just one line in the sand that we crossed and everything changes. It's a period of time. And that period, I think, is dependent on many things. Everybody's individual, everybody's unique, and then sure there's going to be genetic factors that we find planned for this. I studied molecular biology before medicine. And so there's an understanding that there's a component in each of us that makes each of us unique and different. And so this inflection period is a physiologic process, not chronologic. I've cared for 105 year olds who have just worn out, have cared for five week olds, who have just worn out. And so it's not dependent on the number of candles in the birthday cake.
Bisi Williams 15:34
Tell me more about that. I mean, that's quite the range, tell me what the inflection period is like for a five month old, and 105 year old.
Dr. Tim Ihrig 15:44
This is at some level theoretical, because, again, it's a concept that has been applied to every individual I've ever cared for, for me it made sense. And it's put the pieces of their unique puzzle together very nicely without fail. I can't say that the five week old versus the 105 year old that there are different amino acids or chemical markers that fluctuate, I'm sure there are, that's the next stage and elucidating the science behind this. I think the fundamental truth is, the physiologic capacity of any individual is finite. And this is where it goes back to, perhaps genetics as a component as well as the surroundings, nature and nurture.
Some people have a larger capacity physiologically than others, some people are likely to have a larger, more robust, physiologic capacity to withstand insults. Why does someone with a particular cancer live a lot longer than someone else? We have these median life expectancies, but there are variances and I think it's going to come down to both the physiologic as well as the emotional, the spiritual, the whole human being, the whole humaneness of the journey. So the five month old, compared to the 105 year old, I would offer it at a very fundamental level. They're really similar, their physiologic capacity has come to its endpoint. And no matter what we have in clinical medicine, which really is grounded on escalation of clinical intervention, it's a linear algorithm.
I'm trained to recognize disease and debility. And if I see it, I do something about it. And if disease or debility increases, I do more to it. But there's this point at which that more is actually costing quality and potentially length of life, we're doing things to a disease rather than for and with a human being.
Bisi Williams 17:59
Tell me more about that. I love how you phrase that.
Dr. Tim Ihrig 18:03
I think it's predicated, and we A, are not trained as clinicians to acknowledge death, to accept it, to translate it, as I had said before. And so for me, there is this subconscious cultural, from the culture of medicine, belief that's instilled that if someone dies, I as a physician, have failed. And I learned early on every patient I ever see, I mean, yes, I'm in palliative care and hospice, so it makes it closer. But when I teach med students and residents and fellows, I say every patient you ever see is gonna die. And most of them have this ghastly look on their face. Hopefully, it's not because there's something you do or don't do. But this is the inevitability, every one of us is going to die. So we have to accept that.
We have to realize that when people die, pursuant to this natural progression through the inflection period, it's not a failure on our part, because there's no way we're ever going to be able to beat or overcome Mother Nature. A lot of conversations I've had and this goes to 2049, how do we empower physicians to live and love and learn and grow as well, and recognize this inevitability and engage in a much more intimate level and be more vulnerable in their practice with their patients is to understand this and realize that when somebody dies, if we've done a couple of things on this journey, and I'll get to that in a second, but when somebody dies is not a failure of medicine is not a failure of us as a clinician.
If we have recognized inevitability and translated it to the best of our ability to the patient and family and ask four salient questions, questions I've asked every patient I've ever had. And we use that as the architecture for caring when somebody dies, it's not a failure, and we don't have to own it. We don't have to feel as though we have failed.
Bisi Williams 20:07
I think that's important. And I would like it. What are the four questions that you ask?
Dr. Tim Ihrig 20:13
So the four questions are these, Bisi, how are you? Then we pause, then the response, I'm good, Tim. Yeah, I'm good. Then we pause and I hold your hand and I lean in and say, how are you? And I listen, that opens the door of vulnerability bidirectionally. We take the time to come to that space, that intimate space of not just a mere platitude, how are you? But how are you? It's very disarming for a lot of patients, because they've never been asked that at that level. And if we're quiet as providers, people tell us everything we need to know.
This will probably go into a couple hours, but I'm willing to listen, absolutely. And concrete examples of this, I'd say a dozen or so times, in my clinical practice, I've been the first physician called to see someone in the emergency department. Someone comes in and they're fraught with symptoms, shortness of breath, pain, a myriad of issues, and they haven't seen a provider in many, many years. And the relationship I had with emergency departments was, well something's going on, let's get Tim down here. And all the lab tests are waiting for results. They've gone to radiology, we don't have any imaging left, and I sit down and I ask that question, how are you? How are you?
These dozen or so times the individual various ages says, Doc, I'm dying. Tell me about that. Not, I hit my knee and it hurts so much and I'm dying because it hurts, but they're like, I'm dying. And what they relay is not, I've got a widely metastatic, pancreatic cancer, they just say, about two months ago, I woke up and something was different. And since then, things have been different. There's a dozen or so times the lab results come, imaging comes back and yeah, there's absolute proof this is a disease state that is accelerating this physiologic decline, progressing you through this inflection period. Yeah, you are dying. And so that first question is so relevant and so important.
The second question I asked is, are you scared? And most people say, Doc, I'm not scared of dying. Which is interesting, because that's not the question I've asked. Now Bisi, if you asked me, Tim, are you scared? Yeah, I'm scared of those millipede things. But when somebody leads with, I'm not scared of dying. That right there is like somebody is in the mindset that something in their body has changed. And maybe they can't say it's widely metastatic parathyroid cancer, or, X, Y and Z, but people know.
And what are they scared of? We touched on it earlier, they're scared of getting dead, they're scared of this time between right now. Or they know something's changed, or we've just articulated that there's a new diagnosis or whatever. And that time when they're going to die, they're scared of the unknown. We can overcome that fear when we embrace the unknown. We embrace it because it's like whatever this diagnosis is, just generally, how the path follows and I don't say these things to be mean, or curt, but to empower you, because it's your life. You're the owner of it, and you get to decide what path we choose. But to choose a path means you have to be totally informed.
So if we say it's lung cancer, or we say it’s dementia, or we say it's interstitial pulmonary fibrosis, or whatever it is, we can generally map that out once we understand where you've come from the last two weeks, two months, two years. We just map it out on this arc. And the puzzle starts to fit together. And so there's nothing to be afraid of as far as fear. You can be angry. You can be sad. But we needn't be afraid of the unknown, because it is known. And it's empowering when we say here's the truth.
The third question, what is sacred to you? And this is really the fulcrum upon which everything we do exists. How do we want to live and love and learn and grow? Whether you have two weeks or two years, we still can explore our humaneness and challenge ourselves and engage at a very deep meaningful level with ourselves, our Creator and those that are around us during this period, but it's really defined.
Bisi Williams 25:09
What do people say that's sacred to that?
Dr. Tim Ihrig 25:13
I don't know why I just flashed to this Bisi, but there was one gentleman who said, what is sacred to me, teaching my wife to use the riding lawn mower. And you explore that further, really, there’s this fundamental tenet: what is sacred to people is being in the moment, telling those in their lives that they love them, and what they mean to them, and being present. There's things worse than dying. And it's if you miss the opportunity to tell your loved one who's dying that you love them, or vice versa to tell those surrounding you when you're dying, that you love them. Because once you're gone, you never get that opportunity.
So what's sacred to most people is understanding the truth. And living pursuant to their rules. Giving them the pen to write this chapter as best we can, as best they can. To have some skills to manage symptoms and to be present and to be truthful and be honest, and to be side by side an advocate for that truth, they're writing the chapter. So that's what's sacred to people is ownership.
Then the fourth question, and this really has been consternating to a lot of fellow clinicians, because it flies in the face of science, but I ask what is your little voice telling you? And that little voice, again, without exception, is the greatest prognostic indicator I have ever found. It's better than a CAT scan. It's better than lab work. It's better than all of the bells and whistles because people say, we're at the first of February and somebody says, I really hope, I want to make it through Valentine's Day, because that's when we got engaged, that's our anniversary. When somebody says that's what my little voice is saying, as I hope I make it another two weeks, they really have just a couple of weeks left to live. No matter what we do or don't. No matter if it's another line of chemotherapy, or a surgery or this or that. That is born out to be an ultimate truth. If someone says, I hope I make it to my son's graduation. Well, then we're looking at a couple of months. I've had people diagnosed with particular diseases, and I asked that question, they say, Yeah, I don't know, I don't really hear anything. Well, that tells me we're outside this window of months, maybe it's six months, maybe it's a year and things can change because life is very fluid. But that's telling that we're not perhaps well into the last chapter of someone's life.
But how are you? Are you scared? What is sacred to you? What is your little voice saying? Those are the questions that lift us above this fixed false belief that Mother Nature can be beaten, this paralytic fear that prevents us from living our entire lives and transcends medicine. That's where I see the future is if we can reset how we think about care and apply a new mental construct. A colleague said Sir Isaac Newton was sitting in his garden and an apple fell and hit him on the head, as the story goes, and he didn't just say ouch. He said, Why did that apple fall? So fast forward we have Newtonian physics. A unifying theory that holds the universe together. And it's pretty simple, gravity, gravitational forces. In no way am I saying that I'm Sir Isaac Newton, it's just an analogy a friend made. He said what you're hedging towards is a new truth and inevitability, a universal glue that holds us all together, that you're asking why do people die? And trying to identify markers that say, I think we're within this period. You've done that through your four questions. Now let's find the science behind it. And that's something that can be applied universally, and help us live better lives.
Bisi Williams 30:01
I love that. So Dr. Tim, what does a loved one do when they hear the inner voice? You've given me a clue to the universe, when someone you love says, I'm looking forward to a wedding, and now that I have this information from you, what does one do with that information?
Dr. Tim Ihrig 30:28
That's one of the most insightful and beautiful questions that's ever been asked. So I appreciate that. I think before respectfully, we can say what someone does with that, we have to be open within ourselves to listening and hearing our little voices. And then that allows us to be open to listening and hearing someone else's little voice. So I think our culture as, I don't like the word progress, so I'll say digressed to the point where we drowned out that little voice.
Aging is equated with, you've done something wrong. If you're not on the cover of GQ or Vogue, then the value or worth of your life is diminished at some level in Western society. So if we understand that we have to listen to that voice and then we can be mindful of these things that people bring forward. And you ask that question at such an appropriate time, because I just had a dear friend walk this journey with her mom. Her mom was, retrospectively, saying these things. Talking about this piece of jewelry or reminiscing about her childhood makes perfect sense now, but at the moment, we're not tuned into it because culturally we're subconsciously taught to really drown out that little voice at some level.
So what do we do when we're open to it and we hear it, we explore it. You can just simply say, all of us, it's not for the goofy, long white coat physicians, you can just say, Mom, how are you? How are you? You go back to those four questions. And it's not you just read them verbatim, it just comes out, it's a natural conversation. And through those four questions, again, is going to be an exploration of what's going on, and you're going to be able to define everything we've talked about. And that's a gateway to a higher truth.
That's a gateway to a more meaningful relationship with ourselves, and with those that we love, and we care for. When we miss the opportunity to engage at this level, whether you're a physician, nurse, mother, father, son, daughter, too often I've seen we come to the very last page of the last chapter of our life and we feel bitter. We feel as though the opportunity to live, the choice for us to live pursuant to what's sacred to us has been stolen from us, because nobody has been listening or hearing what we're saying or asking these questions. And when we exhale, our last breath, how tragic that it is, perhaps with regret, or disappointment. Again, we can be sad, and we can be angry that we're in our last chapter, but we needn't be afraid or bitter or resentful. When we live and love and learn and grow and laugh and cry collectively through this time, that’s living a life. Death is not the opposite of life, death, it's the culmination of having lived a life.
Bisi Williams 34:09
That is probably one of the most optimistic and beautiful things that I've ever heard about dying. What I'm hearing from you is to approach death unprepared can cause fear and to accept death, one must be prepared. Does that make sense to you?
Dr. Tim Ihrig 34:35
I'm going to use that, absolutely and to accept it and being prepared for it doesn't mean we persevere about it. It doesn't mean that this looming foreboding entity exists, ironically it is very powerful and it's not we're all gonna die, so hurry up and do everything and force yourself to be happy. It's, how do we be present in the moment and if you'll allow me to, perhaps use an analogy of something that helped me and it's helped me translate this for so many people.
On my trips to Africa, the transition point is Amsterdam. There’s the Schiphol Airport in Amsterdam and in the airport is an actual museum. And my first time through, there was a collection of Rembrandt's and staring at a self portrait of Rembrandt through the years and having gone from there into very rural Tanzania just under the Kenyan border, Rembrandt’s life is very structured, it's very linear. Every time I see a self portrait of Rembrandt, whether it's the first day of February, the first day of October, sunny, cloudy, rainy morning night, it never changes. And there's power in that.
As human beings we like structure, we like comfort, this is what's going to happen. But if you think about it, it really is antithetical to what living in life really is. Because life is fraught with ambiguity. I don't know what's going to happen two minutes from now. Medicine, the practice of and the way we've dealt with clinical interaction, escalation of care, and not acknowledging death is really Rembrandt, it's fixed. It's static.
When we come back across the pond, and I go to the Museum of Modern Art in New York City, and I stand in front of a Jackson Pollock, abstract expressionism and at home, a lot of people are like, just keep walking, that makes no sense. That's just silly. That's just nonsense. But to me, February 1, October 1, morning, night, sunny, rainy, Jackson Pollock is anything but static. And the power in that even if I walked by it, and I stand in front of it three times in the same visit, it reflects back to me who I am at that specific moment in time, it is manifest from all of my hopes and dreams and fears, successes, perceived failures, right where I am when I breathe at that moment. It embodies the true nature of walking the journey of life.
That's what the four questions allow us to do. That's realizing that it's not a fear of death, but a fear of this ambiguity. It's a fear of the unknown. It's a fear of Jackson Pollock. And if we can help each other, we can help ourselves, just breathe into that. All that fear goes away. And we live more deliberately, for ourselves and for our loved ones than we ever dreamed possible. And as physicians, get back to the future, that's what this inflection period is. It's all integrated into this. It's empowering us to think differently, to feel differently, to be vulnerable, differently, to care differently. That is what's transformative. That is what is going to make the difference over the next several decades for you and I and our kids and our grandkids.
Bisi Williams 38:30
Well, that is a world and an ethos and a methodology and a mindset that I can embrace wholeheartedly. Thank you for your wisdom, for your joy, your optimism, and a very beautiful picture as we design the time of our life. Thank you for sharing, and for joining us on Health2049.
Dr. Tim Ihrig 38:57
Thank you, it has been quite delightful.
Bisi Williams 39:02
And that brings us to the end of another edition of Health2049. I'd like to thank my guest Dr. Timothy Ihrig for sharing his vision for the future of health and wellness in the year 2049. If you liked what you heard, please subscribe, rate, review and tell one friend about us. Thank you for listening. I'm your host Bisi Williams, take care and be well.
