Public Facing Education via Social Media: A Podcast with Julie McFadden, Matt Tyler, Sammy Winemaker and Hsien Seow

Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Alex: This is Alex Smith.

Eric: And Alex, we”ve got some superstar celebrities with us today.

Alex: We got some social media celebrities with us today.

Eric: And influencers.

Alex: Public-facing influencers. I’m going to run through a list of our four guests today. We have Hsien Seow, who is the Canadian Research Chair in Palliative Care and Health Systems Innovation and Professor in the Department of Oncology at McMaster University in Canada. Hsien, welcome to the GeriPal podcast.

Hsien: Hey, great to be here.

Alex: And Sammy Winemaker, who’s a palliative care physician and Associate Clinical Professor at McMaster University in the Department of Family Medicine, Division of Palliative Care. Sammy, welcome to the GeriPal podcast.

Sammy: Thank you so much.

Alex: And Hsien and Sammy together podcast on the Waiting Room Revolution, which is available wherever you can download your podcasts, and are the authors of a book called Hope for the Best, Plan for the Rest. I was delighted to talk to Hsien about that and got a copy of his book at the recent AAHPM State of the Science Meeting a few months back.

Eric: And just a quick note, Sammy too on TikTok and on Instagram.

I think your most-watched video is around 750,000 views.

Does that sound about right?

Sammy: I don’t look. I don’t look.

Alex: And Matt Tyler is next. He’s a palliative care doctor and he is Medical Director of Palliative Care at Ascension Illinois Palliative Care. And his major social media endeavor is titled How to Train Your Doctor. Great title. My kids love How to Train Your Dragon, so it’s perfect.

Matt: Same.

Alex: And he’s on many platforms, mostly Instagram, also YouTube, TikTok, and Threads, and his videos have gotten a lot of hits. I know that some of them have had over half-a-million hits, something like that.

Matt: Wild. Yeah.

Alex: Wild, yeah. Matt, welcome to GeriPal.

Matt: Hey, I’m so excited to be here. It really feels like I made it, to be on GeriPal.

Alex: Matt is the one who kind of pitched this to us late at night on the GeriPal Pub Crawl when we were at the Annual Assembly in Phoenix. It’s like it’s lucky we still remembered the next morning this great idea this guy we met in the middle of the night had. That was a lot of fun. So thank you, Matt.

And then Hospice Nurse Julie. Julie McFadden goes by Hospice Nurse Julie. Her book is called Nothing to Fear. Her YouTube channel has over 400,000 followers and her TikTok has over 1.5 million followers. Whoa! Julie, welcome to the GeriPal podcast.

Julie: Hi, everyone. Thanks for having me.

Eric: I love that. I think our TikTok channel has like, Alex, like 50 subscribers? [laughter]

Alex: Maybe we’re up to 30 followers on Tiktok? [laughter]

Julie: Hey, all it takes is one, guys. It takes one video.

Alex: Apparently the one of me doing the flossing dance, that didn’t draw in the viewers…that didn’t do it. [laughter]

Eric: Well. Before we jump into the topic at hand, which is basically thinking about the work that we do in palliative care, hospice, geriatrics, thinking about what’s the role of this public-facing social media that each of our guests are doing, why are they doing it, some of the lessons learned, all of these things, before we even get into that topic, I think someone has a song request for Alex. Who has a song request?

Matt: That would be me.

Eric: Matt, what song?

Matt: I have chosen “Revolution” by The Beatles.

Eric: Why “Revolution”?

Matt: Well, it only felt fitting with Sammy and Hsien here with the Waiting Room Revolution to use a song with revolution in the title. Selfishly, I’m a giant Beatles nerd, so that was a major piece of the decision as well. And what we’re all doing here feels revolutionary, so why not?

Alex: That’s great. Great choice. Here’s a little bit.

MUSIC: [Alex singing]

You say you want a revolution.

Well, you know, we all want to change the world.

You tell me that it’s evolution.

Well, you know, we all want to change the world.

Then you talk about destruction.

Don’t you know that you can count me out?

Don’t you know it’s going to be all right?

All right. All right.

Eric: Excellent. Thank you, Alex.

Hsien: Fun choice.

Matt: Right on.

Julie: Good job, Alex.

Eric: So we got a lot to talk about. I’m going to smatter throughout this podcast, each one of you, kind of how you got interested or actually not even interested. How you actually physically started doing this and built up so many followers over time and why are you doing it?

I’m going to start off with Nurse Julie, Hospice Nurse Julie, I think that’s your full title on TikTok.

Julie: My official new name. I’m changing it officially. Just kidding.

Eric: Hospice Nurse Julie, how did you get on TikTok? Because I remember how we just got on TikTok not too long ago for GeriPal and it was Alex trying to convince all of us to do a dance on TikTok because he heard, I think from a student, Alex, that that’s where all the kids are.

Alex: Yeah. And from what I’ve seen on TikTok, there’s a lot of dancing. It didn’t really work for us. Can you give us some advice?

Eric: Julie, what’s your TikTok origin story?

Julie: Well, listen, you guys, I thought the same thing and I went home to see… So first off, I didn’t really plan. I truly didn’t plan this. Two years ago, I happened to have one of my really good friend’s dad was dying of cancer and he was on hospice and he was in Connecticut and he kept calling me, the son who was my friend, kept calling me and asking me questions and we would just talk and talk and talk and I would kind of rattle off my normal spiel I would say to anybody, any of my patients or their families. And his reaction was so… He was like, “I can’t believe I’ve known you for so long and I’ve never known that you knew this stuff.”

Because in my real life, at dinner parties, if I say I’m a hospice nurse, I get two reactions. One is like, “Ugh, don’t talk to me. That’s depressing.” And two, it’s like, “Oh, that must be so hard. You’re an angel.” They’re never really interested in learning about things that we know as healthcare workers.

So he was so fascinated and he was the one telling me to do a podcast because I am 41, so I’m not of the age of TikTokers, so I’m more of a podcast-era-type person. And as you guys know, podcasts are hard, and it takes a lot of work and editing and I didn’t know where to start, so I didn’t do that. But I went home to see my nieces who were 12 and 13 and they were on TikTok and I literally got on TikTok to watch their videos that we made of us dancing for my visit.

When I did that, I started seeing there were people like me, my age, talking about space and gardening and cooking, things I was interested in. So then I was like, “This is actually kind of cool.” So I’m like, “I’m going to make videos.” So I made five videos of the five things I want people to know about death and dying, the main things.

Eric: What drove you to do that? Why?

Julie: Because I had this friend who was like, “You need to tell people. You need to tell people the things you know.”

Eric: So it was that, it was that conversation?

Julie: Yeah, yeah. And because I didn’t feel like doing a podcast, this seemed so much easier, like thinking of a one-minute video I could just post of me and my bedroom talking about the things I already talk about? So that’s what I did.

Sammy: I love how honest she is. Honestly. She’s just so real.

Julie: So I just made five videos, super easy. I didn’t do my hair and makeup. I just literally talked to my phone for a minute about the things I already rattle off all the time anyway. And I think the fourth video in, it went viral because it’s a little easier I think on TikTok to go viral.

Eric: Why do you think it went viral?

Why do you think it went viral versus Alex’s dancing video, which I think his kids didn’t even probably…[laughter]

Julie: I have no idea because to be honest, that first video that went viral, to me, wasn’t that great. It was one of my videos I didn’t think was that great. It was about me talking about what happens about six months, when you have six months or less to live, the general information of what people usually look like.

To me, it wasn’t that… To me, I had much more fascinating videos that people didn’t care about, but that video, for some reason, it went viral. And then overnight I had 10,000 followers, and then I think another video went viral a couple days later. So it was just like a… I don’t know. I don’t know.

Matt: I mean, asking why a video went viral, these are one of the questions that keep us up at night, honestly.

Julie: Yeah, yeah. Sometimes it doesn’t make any sense. And the things I think will go viral, now that I’ve been doing it for three years, no one watches, but then others, other things will and it’s surprising.

So that’s how I got into it. It felt a little bit… With this friend who kind of encouraged me, and then because it was not to be, this is awful, but because it was easy, it took four days. I don’t know how long I would’ve stuck with it if it was really taking a long time, but for whatever reason, it stuck and it worked.

Eric: Yeah, that is absolutely fascinating. I’m going to turn to others just to talk about that question about how you started getting into it. And Matt, I think this comes to the question, your specific focus is How to Train Your Doctor, which is the same focus as Hsien and Sammy. Why did you start doing How to Train Your Doctor? Which, when I think about it, I think about it more Instagram. Is that how I should think about it? Is that where you grew up?

Matt: That’s where I ended up, I would say.

Eric: Oh, okay.

Matt: So my entry with this handle on social media, unlike Julie, this was more of a deliberate effort and it was an effort born from common themes I would see at the bedside. And one of the most common things that I would hear from patients, family caregivers would be I’d ask them at the end of the encounter, “What questions do you have?” And so often, they would say, “I have no idea what I should even be asking you.”

And as a palliative care clinician, that’s fine because we can go through that, assess what are their emotional needs, what data is still missing that may help them make decisions, go through those things one by one and sort that out at the bedside. But we all know there is a lot of gatekeeping when it comes to access to palliative care and hospice services, and there are a lot of folks out there trying to navigate a serious illness all by themselves. Because for as broken as the system is, there are resources out there that people don’t get access to because their doctor thinks it’s too soon for palliative care or whatever other misconceptions about us.

So I specifically started making videos on YouTube, actually. We’ll come back to that. I started making videos on YouTube to try to push back at some of the gatekeeping that happens at the bedside to try to empower folks to understand what it is that palliative care is and what they’re all about with the ultimate mission of getting people to a point where they’re demanding palliative care to be part of their care team.

Eric: And when I think about your videos, you’re sitting in a car.

Matt: Yeah.

Alex: Yeah, how did that start?

Matt: So this was an accident. So getting into all of this was deliberate. How it’s ended up, that’s where the little happy little accidents start to occur.

I started on YouTube specifically because, Julie probably knows this, but YouTube is actually the second-largest search engine after Google. And that’s where, when we all go to look up how to do things, it’s usually on YouTube, if not Google. And it’s much easier to catalog, store, sort videos on YouTube than it is on Twitter where you’re basically screaming into the void and people hear you for 30 seconds and then it’s gone.

Eric: And then they scream back at you.

Matt: So I started there. And they scream back, yes. Yeah, yes. The car thing was honestly out of necessity. I have a three and six-year-old and the car is literally the only quiet place in my entire life.

Sammy: That’s funny.

Alex: When they’re not in the car?

Eric: The acoustics are pretty good in a car, right?

Matt: When they’re not in the car. Yeah, when they’re not in the car, that’s key.

So in between trying to make these longer YouTube videos, Julie, you know it, it takes a lot of effort and coordination to make the YouTube videos. And I would always continue, I continue to drag my feet on making them because it takes some effort, whereas you can pop off a one-minute thought very easily just by talking to your phone. So in between these longer YouTube videos, I would share random car thoughts, honestly, because that’s where I was and that’s where I was thinking about things, and I would add those to YouTube as well.

One day, I was talking to a friend getting coffee and showed her some of my videos and she said, “Oh, you should really post these on Instagram.” And I said, “Why? Why would I do that?” She’s like, “I think they would just do better there.” So I trusted her and put some of these shorter videos on Instagram, and like Julie, I had 10 followers or something, but by the fourth video, one just took off and got half-a-million views and thousands of followers came with that within the span of a week. And I said, “Okay, I guess I’m on Instagram now.”

Julie: I think it shows how much people need it and want it.

Matt: Yeah.

Julie: And you’re so great at talking to people, you’re so great at speaking to the camera like it’s a person, like it’s a patient.

Sammy: So natural.

Matt: Thank you. Yeah.

Eric: Well, I guess a question for both of you. How much of it is kind of a skill you develop over time of speaking into the camera? Because I mean, this is… Your face is, for both of you, right up there in the camera on Instagram, on TikTok. Versus how much of is just natural talent, again, versus a learned skill on how to do this?

Julie: For me, it’s the most natural thing, really.

Eric: Really?

Julie: Yeah. I’m not saying, “And that’s why it’s so great.” Nothing like that. But I just mean I naturally… I think I do have a natural gift to gab.

Eric: Yeah, so you don’t really have to think about it.

Julie: That’s always been with me my whole life. I can sort of just rattle off things.

Eric: Oh, wow.

Julie: Camera or no camera, as you can tell.

Eric: Matt, what about you?

Matt: That’s not me. I’m an anxious dude. It did take practice. It took me a lot of practice. Most of those short videos that you see, I’ve done like 20 takes before you actually see the video.

Eric: Did you ever doubt yourself as you started this? Because I often doubt myself.

Matt: Yeah. I’ll say my foray into social media started before this. I had spent years on Twitter under the handle @PalliDad, which some of you may have come across that years ago, but I had plenty of practice saying things, getting them thrown in my face, getting yelled at, and all that other stuff. And part of the allure of video is that you get some of the nonverbals, you get the facial expressions, you get the tone of voice. You can convey empathy in a way that’s impossible in a text-only format.

So for me, I pretend the phone’s a person and that’s how I do it every time. I pretend I’m talking to a person rather than a camera lens and that’s how I get through it. But it has come with a lot of practice, for sure. It’s a skill.

Julie: I think it gets harder for me as the time goes. It’s been three years now. So it felt easier in the beginning because I didn’t… Now I have hundreds of videos. I kind of say the same things. It gets harder to be authentic, authentically making a video without being like, “What should I talk about this week?” I don’t like planning on what I’m going to say. I just want to feel inspired to do it, and that gets harder as time goes on for me.

Alex: Yeah.

Eric: Do you ever feel like you’re running out of topics? Because that’s the question that I always get asked for GeriPal, “Do you ever run out? Feel like you’re running out of topics?” And the answer is always no. There’s so much to talk about. But for you, Julie, do you ever feel like that?

Julie: I definitely feel like that because unfortunately, now I’m… And this is what I’m working on now is it’s really hard not to get focused on numbers and views and if someone’s going to like it, and now I have a book that I’m trying to sell, which I hate that feeling-

Eric: You’ve got a brand.

Julie: … of I’m trying to sell. I don’t like that. So I do feel like I’m running out of things that people… I don’t think I’m running out of topics. I could talk all day, but will anyone be interested in those topics? It’s getting nicher. It’s niche, niche, niche, niche. You know? But that’s okay. I need to get better at being okay with my videos not getting tons of views all the time. And that’s an ego thing that I’m working on.

Eric: Hsien and Sammy, I’d love to hear yours too. Also, I think you’re at what, 99 podcasts so far? So after I hear your origin story, kind of the same question for you. How did you both start the Waiting Room Revolution?

Sammy: Yeah. Well, I think it was from a place of serious frustration that Hsien and I both felt in our careers that we had spent decades between us trying to change the healthcare system. And so there was a moment where we said, “You know what? This needle ain’t moving fast enough. So we are going to leapfrog over the healthcare system education and we’re going to go straight to the citizens of the world and we’re going to give them the insider tips to how to improve their illness experience.” It’s almost like I love the How to Train Your Doctor thing, but we’re training people, citizens on how to be patients and caregivers and the other rules that come with having a life-limiting illness, but not at the end of life.

So we had to take all of our tricks from the end of life and pull them upstream at a place where patients and families have a different readiness, and deconstruct all of our tricks from down there and create them in a way that was palatable for people at the beginning of an illness, which is very different than at the end, and help them to navigate and remain an individual through their serious illness. And that’s not particularly sexy. So people want to hear more about gurgling and things like that. They’re not necessarily looking for how to be a patient at the beginning of our illness, but that is the biggest bang for their buck.

Anyway, so that’s our origin story. We decided to, I guess, leak our frustration into the citizen-facing social movement that we created.

Eric: So I guess the question Hsien is did you start off with the idea of creating a book or did you start off with, “Hey, we’re going to start these podcasts for people to listen to,” or how did that actually take place?

Hsien: Yeah, it’s a really great question. We just started off talking, bitching, if I can, to each other and just complaining of what could be different. And that was quite a long time of us trying to figure out what could be done different besides published papers and educate clinicians. And one day we realized we talk a lot and maybe we should record these into a podcast. And it really took us into the research of what could people actually do and deconstructing this thing called the palliative approach to care, what would that look like early?

So our first season of our podcast was us just trying to talk out our ideas of these seven keys of how to navigate a life-changing illness and-

Eric: Which mirrors your book, right?

Hsien: Go ahead.

Eric: It mirrors your book, right? Those are the…

Hsien: Yeah, exactly. That was our hope was it was us talking, and then we just said, “Would anybody listen to this podcast?” And lo and behold, people really started responding to it.

And I guess then we realized if we want to go to the people, citizens, we had to join social media, which we never had ever done before. And on Twitter/X and this and that, but Sammy’s obviously, she’s much better at it and is on TikTok and all this stuff. But really, the podcast has been a way to interact with our fans, I guess, or people who are part of the revolution in maybe a long format. We interview people from all over the world just like you guys do, and we learn something from every single guest. And I think it just allows us to really just expand this universe of who should be doing this thing we call a palliative approach to care, which is just really good care.

Eric: Yeah. I love seeing some similar guests on our show. I was listening to the Red Hoffman podcast.

Alex: I know. Yeah, me too. And I would say your podcast is much more international than ours is. We’ve had international guests, but yours, some high proportion of them are international.

And one of the things that also stood out to me is as we were talking about, “Do you ever run out of content,” part of the beauty of having guests on, like having you on, is learning about other people and there are an endless number of people doing interesting things, and for us, geriatrics or palliative care, and that is for us, this endless wellspring of content that we enjoy diving into. I wonder if you’ve had a similar sort of experience.

Hsien: I would just say that talking to all the guests has been what sort of renewed our excitement for this because I think there is a sense sometimes that you’re banging your head against the wall, that why are we keep… Always this idea of palliative care is reserved for the last weeks and days and people say, “You’re not there yet.” I mean, how are we going to change that story?

So the podcast has been, and this revolution, this social movement where we’re trying to give away this information to citizens to change their story, has been what has brought fulfillment back into our work because I think there is a sense of one person can’t make any change. And I think what we’ve learned is one person can. You can take action and take control of your story and following Julie’s videos or Matt’s videos, and these are real practical tips that people can do and use that is going to make their experience better and not only get palliative care by a specialist when they’re on hospice. They can get good, person-centered care with more good illness understanding from day one.

Alex: Yeah, just reflecting on what I’ve heard so far, I love that all of us are mission-driven. For GeriPal, it’s really to bring geriatrics and palliative care together. We’re a clinician-facing podcast, nurses, doctors, social workers, chaplains, et cetera, primarily researchers.

Hospice Nurse Julie, I can hear you talking to your patients and their caregivers when I’m listening to you. As long as they’re safe, they’re comfortable, they’re clean, I could see you saying that to them. It just flows so naturally.

And for Matt, when you’re giving people the advice, I was listening to one about how do you talk to somebody about a feeding tube that’s for pleasure? And it was just like, “Oh, they never would’ve thought of that or thought to ask about that in advance.” So it’s like these misconceptions that you’re addressing.

And then for Hsien and for Sammy, this is a real social movement that you’re trying to… The movement upstream, getting people to consider what are the serious issues at the time of diagnosis with serious illness.

So that’s kind of what unifies us, I would say. And one of the things that really differentiates us is that you’ve chosen to be public-facing, whereas we are like clinician, provider-facing, so to speak. And I think that’s a really interesting decision in and of itself. And I wonder if there’s something, if you were to give a pitch to people about why should you appeal to the public rather than appealing to your fellow clinicians, what would your argument be? Anybody?

Julie: I have one.

Sammy: Yeah?

Julie: Only because I purposely don’t… I feel like it’s speaking into a vacuum. I do think other healthcare providers need to learn about this. There’s definitely a… But I’ve never… I don’t think I appeal to an academic audience. I speak the way… How I’m talking on the video is how I talk in everyday life.

And I think when I think about… I don’t even like speaking at conferences that are with other medical professionals only because I feel like they already know what I’m saying. They already know the things that I’m saying usually. So I like speaking to the general public. That’s where I’m comfortable, but it’s all needed. There needs to be people that also speak to other clinicians. I’m just not that great at it.

Sammy: You know, I think that one of the things that is a common thread, I think between the three of us at least, is that we work in people’s homes. So I don’t know, Alex and Eric, if you work in people’s homes, but do you?

Alex: Not frequently, no.

Sammy: No?

Alex: Generally in the hospital-based hospice.

Sammy: And you do, Matt, right?

Matt: I’m more of a hospital guy.

Sammy: Oh, okay. So Julie and I work in people’s homes, and when you work in people’s homes, the power differential between the clinician and the patient and family is completely flat. And so we necessarily speak completely average. It’s just normal kind of talking to people because you are scuppered if you can’t connect with the patients and families in their home. We’re on their turf.

So I think that people like us feel more comfortable just talking to the public because that’s what we do every day of our careers, but not in the confines of a clinic or a hospital room. It’s in their homes where it is performative and there’s usually lots of people and lots of dynamics and it’s actually crazy sometimes. So I think we’re well-versed to just continue talking the way we do because that’s just normal for us.

Eric: So Sammy, does that influence you all? So you started the podcast, which for me, feels very familiar, it’s somewhat controlled. We have this time set. We can get comments when we post it on different social media sites, but when you publish something, like in your decision to go on TikTok, when you publish something there, you get a lot of comments. Do you respond to all of them? I know Nurse Julie responds to a lot of them. And is that part of that too is that there is that connection that goes beyond the video to all of the discussions that happen with the video?

Sammy: So I think one of the most incredible things is that where we were testing new content, like a new idea of being upstream and building a social movement, which neither of us know anything about, it is an immediate way to get signals from the people you’re trying to connect with. So whether it lands well or it doesn’t land well, you’re going to know about it that second. And so you can course-correct what you’re doing very quickly. So it’s like a plan-do-study-act rapid cycle quality improvement in real time.

And I remember the first TikTok video of mine that went over a million viewers was one where I had mentioned something about dying isn’t painful. And so I probably should have said, “Always painful,” but I said, “dying is not painful.” Well, every hater, mostly in the USA, piled on and I had to seek counseling from Hospice Nurse Julie, how she deals with this kind of thing because to your point, it is different than teaching healthcare providers. You are vulnerable and you open yourself up for the craziest comments for better or worse. And so you have to have a little bit of a thick skin.

And I think maybe all of us would admit at the beginning, it probably stung a bit, but then quickly you realize you just keep going and you try to answer most of the people’s comments, but you won’t get to all of them. And if you try to be a perfectionist in this, what we’re doing, it will eat you alive. So it’s important-

Eric: Hospice Nurse Julie, was that your advice? “It’s going to eat you alive. Don’t be a perfectionist.”

Julie: Yeah, you cannot… I really try not to over-edit or over-anything with my videos because I just feel like then I’ll never do it, then I’ll never… I just need to say things how I want to say things and edit-

Eric: And how do you deal with the reaction, good or bad?

Julie: Most of the time, people are great. Most of the time, people are really nice. Whenever something like Sammy said, whenever something goes mega viral, there’s millions of views, you’re always going to get… that’s when you always get people being like, “Oh, yeah? Well, blah, blah, blah, blah.” You just have to ignore them, really.

Eric: Do you spend a lot of time responding?

Julie: No, I don’t personally. I usually do the first 15 minutes just to engage, and then after that… I used to get so much. Sometimes if there’s an educational piece where I really feel like I cannot ignore this comment because this is why I’m here to educate about this opinion that someone’s throwing at me. And sometimes I get it from doctors, I get it from pharmacists, and that’s when I’m really like… Or they say they are. Whether that’s real or not, I don’t know. Sometimes it’s very surprising. I’m like, “How can you be saying this?” Then I will respond with a video to-

Sammy: Yeah, clarify.

Julie: I really pause. I always wait until I’m not angry because I don’t want to be that person on social media. I can. Believe me, I can be nasty, nasty, but I don’t really want to bring… No one’s going to listen really, unless they might because they like the sensational part of that. But I always wait until I’m not angry anymore, so I can really respond-

Sammy: Smart.

Julie: … and educate people because that’s why we’re all here.

Eric: I guess another question I’d be worried about, I’m going to turn to you first on this, Matt, is do patients ask you or family members ask you for medical advice? And how do you deal with that? Because while you’re a doctor, you’re not their doctor.

Matt: Yeah, that’s typically what I say. I mean, my profile says, “Not formal medical advice.” I think most of our bios have some version of that to say, “This doesn’t constitute formal medical advice. This is meant to be a helpful educational guide in the same way that Googling and finding the Mayo website would be. As much as that constitutes medical advice, that’s as far as this goes.”

Eric: Do you still get questions?

Matt: Oh, yeah. Yeah, I’ll get questions. And usually I will reframe those in a way that they can then take a question to their doctor to say, “Oh, based on what you’re telling me, I would probably ask your doctor this.” And I won’t… I’m not getting in the business of diagnosing or recommending particular medications or anything like that.

But yeah, people will ask me like, “Oh, what’s this medication for?” Things that get pretty granular, and I’ll say, “Typically, it’s for this, but double-check with your doctor,” and keep it as medically as Googling would be for them when it gets very specific.

Hsien: You know what’s funny is that I’m not a doctor, I’m a PhD researcher, but I work in a hospital with a lot of doctors and I always get questions from my family about, “What does this mean?” And I’m like, “I have no idea.” However, most of the questions are about how to navigate the system and what the heck is going on and not about a very clinical thing. It’s really about the mass confusion of how difficult it is to just understand what they’re supposed to do and what is the doctor really saying? I’m saying, “What they’re really saying is this. What they mean by that is this, and therefore you need to think about this.” And because I’m not a doctor, I can say whatever I want. It’s a little bit better for me maybe.

But I think that it goes back to your question of why we went public-facing because there’s such a need to demedicalize healthcare and make it… It’s about the social, it’s the whole person. And why we went public-facing is because we realized patients, there’s so many patients, families.

First of all, clinicians are already so stretched to be asked to do so many things, new guidelines, new this, new priorities, new outcome measures, new billing, new initiatives. But patients and families, it’s their life and they are so motivated, they are the most motivated. When you talk about advanced care planning, it is important and urgent. Whereas for everybody else, if you finally convince them, okay, it’s important, but it’s not urgent. But for patients and families, it is the most urgent thing in their life of this whole thing just changed our entire life forever. So they’re very motivated to take action and ask questions.

Julie: Listen, every time I hear Sammy and Hsien talk, I’m like, “I want to slow clap.” I was on their podcast a long time ago, and I remember talking to you guys and being like, “Yes.” Everything, you’re so articulate, you explain things so well. I just can’t-

Sammy: Wait. Let me give some love back to you. So I have to tell you that this social media stuff, it can be very competitive, let’s just say, and I can see how… I never knew about this stuff until a couple of years ago, but the kids and everything.

I have to tell you that one of the most beautiful things is when you meet someone, like Hospice Nurse Julie, who is out there and she has skyrocketed very quickly, but she has brought so many of us along with her. She has a low threshold to highlight other people’s work. I remember she did a video, “Oh, we have a new creator out there, Dr. Sammy,” and the generosity of other people doing this work, I don’t know if it’s because we all work in palliative care and we’re good people to begin with, or it’s something very special about someone like Julie, and Matt’s given me feedback about things. Everyone is so lovely and helpful to each other.

And so I think we feel like we’re a community of practice almost, not just individuals trying to rack up the viewers and things. And I think that’s way more important to me than how many viewers, and I can say that because I’m more of a very, very slow burn on social media. But it’s the people in the relationships that you meet. And it has been incredible. And so I feel like these people are my friends, to be honest. And you hear about, “Oh yeah, your social media friends,” but we’re friends.

Julie: Yeah, thank you.

Eric: Totally, totally.

Matt: Yeah, I have to echo what Sammy’s saying about Julie in particular. I think we’re so quick to say that people don’t want to talk about serious illness or end-of-life planning, all these things. And for me, as I was deciding, “Am I going to do this? Am I really getting on public-facing platforms to talk about this stuff?” I mean, Julie was proof of concept that people are hungry for this content.

And I think of that crusty meme that you see on the doctor’s wall saying, “Don’t confuse your Google search with my medical degree.” I think as doctors in particular, we’re so quick to begrudge patients for Googling stuff and looking online. And so from my point of view, well, why not start putting stuff out there for them to Google and find that we know is legitimate content? Because it’s either some shyster’s content or mine, so it may as well be mine. And then Julie is proof that people want the stuff, they find it meaningful.

Alex: That’s great. I know we’re running… We have 11 minutes left. And Eric, is it all right if I ask-

Eric: Go ahead.

Alex: … a round-robin about what is your most-viewed thing, and then also, if you were to recommend to our listeners who want to get into, what are you most proud of, which clip, which episode, which whatever are you most proud of? Would that be okay if we went around like that?

Eric: Yeah, a little lightning round.

Alex: Great. All right, Julie, you’re up first. What is your most viewed and what are you most proud of and want our listeners to check out? And they may be the same.

Julie: My most… Just like Dr. Sammy said, there are sensational things that I do. I mean, they’re still true, but the things that get the most views are when I talk about any kind of deathbed phenomena, so the rally or terminal lucidity, when someone gets a burst of energy at the end of life. The first time I talked about that, that probably had eight or nine million views. So that is one of my most-viewed things, any kind of deathbed phenomena.

The thing I’m most proud of though, thank you for asking, is my whole YouTube channel. So my whole YouTube channel, I don’t worry about the whole… I really focus on longer-form content that is there for people who really want and need the real education. And not that the deathbed phenomena stuff isn’t real. I mean, it does happen, but it’s just not as… I don’t think it’s educational. So I’m really proud of my YouTube channel. I spend a lot of, lot of time and effort creating videos for people who really need the information about end of life and how to navigate our medical system.

Alex: Hsien?

Hsien: Oh, man. What’s the most-viewed thing? I guess in our podcast, our season one of our podcast is our origin story and walk two roads, which is this idea of Hope for the Best, Plan for the Rest.

And you might laugh because it took us a long time to come up with our book title, but it was staring us right in the face. It was our most popular episode, and that is what I’m most proud of. I mean, of course the people we’ve met, and this, it is a social movement and we’re giving away this information because we believe it belongs to the people. So I think I’m most proud that we’re building something that will actually lead to people’s better experience. And I think the podcast and the book, these are all just tools that we’re putting out there. But other people have adapted our stuff and made it their own, and that really brings a lot of satisfaction too.

Alex: Sammy?

Sammy: Yeah, I would say other than the one I mentioned about dying is not painful, I would say that the one that seems to garner the most interest on the social media side of things is when I talk about how people can identify when they’ve entered into the last year of life, when their illness has reached a tipping point of a decline. So people seem to be quite interested in that.

And what am I most proud of? I think I am most proud of our seven keys that we have shared with the podcast and the book. I think the book for me, because maybe it’s my age, just something so tangible that you can hold in your hand. And I’m a book person, so this social media and podcasting is very foreign to me. Honestly, before three years ago, I emailed. That was as sophisticated as I was. So I think that’s what I’m most proud of, and the fact that you get used to public speaking and being on camera, I’m proud of myself for that because it’s not natural for me.

Alex: Matt?

Matt: I am really happy to share that the video I’m most proud of is also the most-viewed one, which I actually recorded at 2024’s HP Annual Assembly, walking from the coffee shop to the conference hall. And it’s a short video about me basically saying how much I love my job, how much I love working in hospice and palliative medicine.

And it was a recounting of this brief conversation I had with a man in line at the coffee shop because the person in front of that guy recognized me from Instagram and just said they love my channel. And the guy in between us turned around and said, “Okay, I have to ask you. Why does this person recognize you?” And I explained we’re here for a conference for hospice and palliative medicine, and he said, “Oh geez, that’s got to be a real bummer.”

Eric: That’s one of the two responses that we always get.

Matt: Yeah, exactly, exactly. And I got to tell him like, “No, it’s actually… It’s an awesome job and here’s why.” And I got to just gush about hospice and palliative medicine for a second. And that random video has gone to like 600,000-plus views. So just the idea that I got to pitch my job to over half-a-million people is just… I’m so proud of that. I hope my kids find that one someday. That’s the one I’m really happy that’s the most-viewed one.

Alex: Thank you all.

Eric: Well, I think we are running up out of time. I’m going to also do one last lightning round because I feel like we need more of this and I love this idea of community and we’re here to support each other. And wouldn’t it be great if we had more people in hospice and palliative care, I’m going to shout out to geriatrics, doing public-facing social media, to skip, maybe jump over this barrier that is that healthcare professionals and the healthcare systems?

Any one tip, you got one tip that you would offer to those who are on the fence about doing public-facing social media around their professional roles and to teach, to educate. Matt, for you, what would that be?

Matt: I’ll give a one-two, a hyphenated tip. We’re all about meeting people where they’re at and people are on social media. And I think if that’s not a pitch to get on there, I don’t know what is. And so the actionable tip is just do it. Just play around, experiment, treat it like a time-limited trial. Just play around and see what you find fun, what you find intellectually stimulating, and I promise you’re going to get some thank-yous.

Eric: Hsien?

Hsien: I think we have learned so much, and I literally am a PhD expert in palliative care, and we have learned so much about what does palliative care mean to the public that we have had to reframe and reshape what we do and what we say. And it makes a huge difference. If you’re not doing education in a way that is accessible to the people that you’re trying to reach, then you’re doing something wrong. So if social media is it, or just rethinking how you’re doing your education and who you’re doing it for and why, that’s what I would encourage people to think about.

Eric: Great. Sammy?

Sammy: Yeah, I think we have to remember why each and every one of us went into healthcare, which is to have some sort of relationship with patients and families. And if you don’t feel that that’s happening to the degree that you want, then I would say pivot towards the public. And I would also say it is our duty as healthcare providers to make sure that not just on an individual level, but on a population level, that we increase health literacy and illness literacy.

Eric: Great. And I love the intro of your book too, highlighting that really the big question that came up was is anything that we’re doing right now having any impact? And just everything that you’ve done.

Nurse Julie, you’re going last.

Julie: I would say, if you have something to say, say it, and also don’t take yourself too seriously because that’s what will not do it. So if you’re saying things on a daily basis to your patients anyway, or to your coworkers, when you’re real passionate about something, that’s when you record it and just put it up. And I think people really crave authenticity and realness. And so if you have something to say, just say it. Don’t take yourself too serious.

Eric: I love that.

Sammy: Me too.

Eric: Well, I want to thank all of you, but before we end, since you’re all doing this revolution, we’ll end up with a little bit more Beatles. Alex?

MUSIC: [Alex singing]

You say you got a real solution.

Well, you know, we’d all love to see the plan.

You ask me for a contribution.

Well, you know, we’re all doing what we can.

But if you want money for people with minds that hate, all I can tell you, brother, is you have to wait.

Don’t you know it’s going to all right?

All right. All right.

Eric: I love it.

Alex: Woo!

Eric: Well, I want to thank you all for being on this podcast.

Julie: Good job.

Eric: A very, very big thank you.

Sammy: Thank you.

Matt: This was awesome. Thank you so much.

Julie: Thank you, guys.

Eric: Although I worry that Alex is going to make me do more TikTok videos. [laughter]

Sammy: I think so.

Julie: I think I can see it, Eric. I can see it.

Sammy: Yeah.

Alex: I want you to dance on one of these.

Eric: Alex’s entire viewpoint of TikTok is dancing.

Hsien: Alex, I think it should be your singing, like Kelly Clarkson. Kellyoke, Alexoke. You already got it. You have 300 videos of you singing.

Alex: Right. A lot of mistakes in there too.

Eric: Thank you again for being on the podcast, and thank you to all of our listeners for your continued support.