Read the full transcript of hospice and palliative care doctor Luyi Kathy Zhang’s talk titled “3 Questions To Ask Yourself Before You Die”, at TEDxJacksonville, November 15, 2025.
Listen to the audio version here:
The D Word: Why We Avoid Talking About Death
LUYI KATHY ZHANG: No one wants to talk about the D word. Instead, you’ll hear, pop your clogs, if you’re in the UK. Raise ni iku, which means to go to the next world in Japanese. And, my newest favorite, German, or at least my attempt at it, for looking at the radishes from below. And just in case some of you are thinking of another D word, relax. It’s only death.
And it makes sense. Death is fascinating and also frightening, and yet has the power to transform us, to shape and alter the trajectory of our lives unlike anything else we know. In fact, I’d love to see a show of hands. How many of you have either had a near-death experience or lost a loved one, and it made you rethink your life and how you want to live it? Okay, that’s a fair amount of you.
Death as a Catalyst for Change
Well, you’re not alone. After surviving an otherwise fatal gunshot wound, activist and Nobel Peace Prize recipient Malala Yousafzai said, “I realized I could either lead a quiet life or I could make the most of this new life I’d been given.” Candy Lightner founded Mothers Against Drunk Driving after her daughter was killed by a repeat offender. And before Steve Jobs died of cancer, he referred to death as “the single best invention of life,” calling it life’s change agent.
You see, it’s often not until something like dying or near-death experience happens that we finally wake up and see things clearly. I’ve seen it time and again as a hospice and palliative care doctor who tends to seriously and terminally ill patients. Sometimes it feels as though tragedy, grief, and regret are prerequisites of clarity. But what if it didn’t have to be that way? What if we could learn and apply the lessons of death without the associated pain and suffering?
By embracing and leveraging our mortality, we can begin to replicate death’s transformative effects on life by intentionally inviting death in instead of pushing it away.
My Own Brushes with Death
Like some of you, I’ve also had brushes with death that fundamentally changed me. I was 13 when I nearly drowned in a wave pool of all places. And it was a surreal experience to go back to daily life with the knowledge of how close I came to not having one.
Then, early in my training, I took care of a young woman in her 20s. She was only a couple months older than me at the time. She was a Chinese immigrant and an only child, just like me. She had dark chocolate eyes and even darker hair. We even had the same name. It was like looking in a mirror except one of us had widespread terminal cancer. Her parents had flown in from China to care for her, thinking that they still had several months together. And then she died a week later.
Death changes us. I mean, how could it not? And yet, those changes can actually be in a positive direction. My patients often tell me that they’re more grateful, compassionate, even inspired to take action. I know I am. And believe it or not, we can reverse engineer those changes in our own lives without having to watch anyone die.
The Autopilot Problem
You see, after watching countless people take their last breaths, I started noticing some patterns. After a brush with the D word, many people will say an A word instead. Like, “I feel like I’ve been asleep in my own life.” Or “I’ve just been on autopilot mode.”
And that makes sense because our supercomputer brains love automation. Our brains are about 2% of our body mass, yet require 20% of our oxygen consumption, the most out of any organ. And our brains love to simplify, streamline, and adapt over time in order to conserve energy. It’s the reason why something like driving seemed nearly impossible when you first started. And now, you probably can’t even remember how you drove to your destination, much less where you parked your car.
The issue is, our autopilot modes are often so strong and so efficient that it can take a significant external life event to jolt us awake. Relocation, retirement, a milestone birthday, divorce, bankruptcy, parenthood, job loss, a new relationship, illness, and of course, death. These events act like short circuits for our brains, making us go, “Whoa, what am I doing here?” And it’s precisely those interruptions in our usual habituated patterns that make us ripe for the opportunity to embrace change.
But it’s not necessarily the event itself that does this. If you finally quit smoking after surviving in your fatal car crash, it’s not because you downloaded any new information during the event that helped you to do so.
Likewise, if you switched careers after watching grandma die and you realized life was short, it’s not because you magically developed the career change skill during that time either. Which means, right now, you already have everything it takes to change. Because transformation starts with two things. Something to shift our perspective and something to generate enough emotion, positive or negative, to get us to take action. The goal, though, is to change our lives because we want to, not because we’re forced to.
And I know what some of you might be thinking. You’re like, weird death lady up there wants me to pick out my own casket and I’m not ready for that. Don’t worry. Oh, fun fact. Apparently, Irish slang for coffin is a wooden onesie. Regardless, it’s nothing that serious or drastic.
Instead, here are three exercises you can do in your daily life to help you prioritize values, to be more present, and to minimize regret.