Living Life With the End in Mind
A public radio host is bringing Minnesotans together to talk about death
(Editor’s note: This story is part of a special report for The John A. Hartford Foundation.)
Cathy Wurzer made a dying man a promise.
Through interviews with Bruce Kramer (a former dean at the University of St. Thomas in St. Paul, Minn.) beginning in 2011 on Minnesota Public Radio, where Wurzer hosts the regional portion of Morning Edition, she confronted death in a way she never had before. Kramer had a terminal diagnosis of ALS, commonly known as Lou Gehrig’s disease, and he and Wurzer broadcasted — and podcasted — a series of candid conversations about coping with the end of life. The promise: carrying on the work after Kramer's death in March 2015.
Wurzer made good — no great — on her promise. In 2016, she began traveling to counties throughout Minnesota to host community conversations about death and living exuberantly through the end of your life. The project is called End in Mind (formerly The Convenings). End in Mind begins in a county, or group of connected counties, with a major Wurzer-hosted kickoff event followed by months of related community-led programming and events.
"Most of us are going to face disability and disease, right? We're all going to die," Wurzer says. "So the question that I always keep in mind, and what I'm really interested in is: How do you want to live with those inevitable challenges and into your certain death like [Kramer] did?"
The Spark You Need
End in Mind is broader than encouraging and teaching people to make advance care plans regarding their preferences for end-of-life medical treatments, though that's part of it.
"It's not just about checking off something on a box on a form," Wurzer says. "It's more about these heart-to-heart conversations about living and really dying. How do you want the end to go? What are the choices you want to make?"
The End in Mind events gather people of all ages and levels of wellness to talk about something so taboo, yet so universal. Wurzer and other End in Mind guests help attendees think about accepting the end of life and reframing fear as an opportunity to decide for yourself how you want to live while you still can, openly and honestly — taking agency over end-of-life choices, involving those you love and cherish most.
The project has made its way through most regions of the state: southwestern Luverne near the border of Iowa, Lake Superior's main Minnesota port city, Duluth and more metropolitan areas like Coon Rapids and Anoka. Most recently, End in Mind has been working just south and west of the Twin Cities in Scott and Carver counties, which together have a combined population of around 250,000.
Tamara Severtson is the south metro community engagement lead for Allina Health, a health care system in Minnesota, and also the mission integration manager at St. Francis Regional Medical Center in Shakopee, Minn., a city in Scott County. She is part of End in Mind's steering committee for the work in Scott and Carver counties.
"Advance care planning gets to be very clinical, and obviously that's very important, but End in Mind comes in with this whole top layer of the importance of conversation — knowing that a lot of times people need a spark, something to help us have these conversations," Severtson says.
A Recent Kickoff
The spark in Scott and Carver counties was a kickoff event in late October at Mystic Lake Casino in Prior Lake. More than 300 people gathered in an event room knowing full well they'd be spending the next several hours thinking about, and discussing, death and dying with family, friends, strangers or all three.
Wurzer led the room through a night of meaningful and emotional conversations with guests, interspersed with performances by poets and musicians. She interviewed Michael Bischoff of Health Story Collaborative, an organization that collects and shares stories of people navigating serious illnesses. Bischoff has brain cancer and a predicted 15 to 18 months to live. He talked about what healing and staying in the moment means to him.
Palliative care specialist Dr. James Risser of HealthPartners (a health care provider and insurance company in Minnesota) spoke with Wurzer about how doctors can help patients feel better even if a cure isn't possible. "What we've lost in medicine is the heart," Risser said somberly. At round tables, the people of Scott and Carver counties were asked to discuss with one another: What matters to you? What gives your life meaning? And do your daily decisions reflect that?
And with that, the community members got sent off to continue the work on their own, with the help of community programming through February. "Let's Talk Cremation" at a local funeral home. "The 'H' Word — Who Needs Hospice?" at a rehabilitation center. A "Life and Death Comedy Show" at Prior Lake High School. Ted Talk viewings, legacy letter writing parties, death cafes and more. In late February or March, Wurzer will return for a closing event.
"It's a community celebration of: What did you do? What did you learn?" Wurzer says. "It's far beyond politics and what I do in my day-to-day job. There's a real sense of impact and connection and community where we go, and it's really amazing to see these moments of grace and sacredness — not in a religious connotation, but where what is essential is revealed."
Impact and Extension
One community that sticks in Wurzer's mind is Ely — a town of 3,000 or so on Minnesota's northeastern Iron Range. At End in Mind's final Ely event, 30 percent of attendees said they had not thought about their end-of-life wishes prior to the first event but 90 percent said they'd thought about end-of-life wishes since the kickoff event. Wurzer shared that some attendees get dragged to End in Mind via a parent or partner, thinking this stuff doesn't pertain to them and then leave realizing, "Oh, these are conversations that we all need to have."
After two years of success around rural, urban and suburban Minnesota, End in Mind is looking to cross state borders. Wurzer has already been in conversation with folks in Michigan and hopes to take the project even farther.
"I'm sure people think, 'Why is Wurzer doing this?'" she said. "But I have to say: The work is really inspirational. I find this expansiveness in myself when I'm doing this stuff, and it goes beyond my political reporting. I hope it helps people to some degree. I want people to die fully alive."