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. Now, these practices will give you that perspective shift we were talking about, but it’s up to you to generate the emotion. So keep that in mind as I go through each one because the more viscerally you feel each scenario as if it were real, the more powerful these become at creating actual change.
So, number one, prioritizing values. In today’s attention economy world, everything feels urgent and it’s hard to know what to address first. So, let’s bring death a little bit closer and ask ourselves, what will I care about most when I’m dying? Will this thing that I’m really worried about right now truly actually matter on my deathbed?
Asking ourselves these questions shifts our focus as if we were zooming all the way out in order to see the bigger picture. It can even be a decision-making tool. Recently, a young woman asked me whether she should reconnect with her estranged father. And so I asked her, what would you do if you knew he only had six months to live? And she said, “I’ve never thought about it that way before. I’d absolutely reach out to him in that case. I think I’ll do it now.”
So, why do we wait until death moves from eventuality to reality in order to take action?
Being Present
Number two, being present. Do you know what dying people really want? While you and I are out here hustling and running on fumes, they just want to wake up tomorrow to taste food again, to be with their loved ones. Nothing fancy. So maybe we don’t need to wait until death to start appreciating simpler moments in life.
To do that, we can ask ourselves, what if this is the last time I get to do or experience something? Asking myself that question turned a normal hug with my parents into a core memory because I never wanted to let go. So how about you? If you knew one day you would never hear your best friend’s voice again, how intently would you listen to them tell you a story now? How would you savor your favorite food, watch a sunset, or snuggle with your pet? Because although we can’t predict when it’ll be, one day we’ll all have a final moment with everyone and everything.
Minimizing Regret
Number three, minimizing regret. Research shows that people tend to regret what they had not done more than what they did do. And they tend to regret not living up to their aspirations more than not living up to their duties.
So let’s pretend it’s a year from now. Something happened and you realize you’re dying. And you can close your eyes if it feels accessible to you. Imagine more and more of your days are spent asleep and your breath gets shallow and slow. You realize your time is near. And as you lay there, what do you wish you had more time to do? You can open your eyes.
The good news is that the vast majority of us will live far beyond a year. And the truth is, some of us won’t. So what do you need to do today in order to minimize potential regrets tomorrow? How do you want to spend the rest of your time while you still have it?
I’m not immune from regret either. Recently, a friend of mine transitioned to hospice care. She was young, independent, and in really good spirits. So we all thought she had several months left. She loved, I mean loved, talking about death and was so excited to share some insights that I could potentially include in this talk. And then she died 10 days later. The last words I have from her are, “We can schedule a time to talk. I would love to help.”
And I kept meaning to circle back, but I got distracted. I’m human. And yet I can’t help but wonder if only I had taken a moment to disengage from my own usual patterns, that I’d be sharing her final words of wisdom with you now, instead of the story.
Living with Intention
I hope it doesn’t take personal loss or a near-death experience for us to learn these lessons. I hope that having a healthier and more intentional relationship with death can act as a catalyst for positive, incremental change in our lives, like a North Star to guide us when we found ourselves too far from where we want to be.
I hope that instead of reconnecting with someone in their final months of life, you reached out now and created decades of extra memories together. That if you were going to forgive someone anyway on their deathbed, you’d consider doing it earlier. And if you were finally going to pursue your dreams after surviving a near-fatal experience, you’d remember you already have what it takes to start now.
To this day, I still don’t know what made my patient and my friend so different for me that they died and I get to stand here. Why them and not us? What I do know is that it’s up to us to make our lives count, to choose courage over fear, connection over isolation, to arrive at the end of life and replace the words “I wish I had” with “I’m so glad I did.”
They say that we all have two lives and the second begins when we realize we only have one. So who gets to choose when that reset happens? Will it be the D word or will it be you?
