Your Conversation

Yes, absolutely. I've been wanting to have this conversation, actually. I think it's important.

I appreciate that. So let me start by asking — what's your understanding of where things stand with your health right now?

I know I'm generally healthy, but I'm in a high-risk profession in some ways. I'm around anesthetic gases, I work long hours, and I've seen how quickly things can change for people. I had a close friend who was perfectly healthy and then had a massive stroke at 44. It really shook me. I don't take anything for granted.

That kind of experience can really shift your perspective. So as you think about the future, what matters most to you in your life right now?

My kids. Everything comes back to them. I have young children and the idea of not being there for them is the thing that keeps me up at night. Beyond that, my work matters to me enormously — I feel like I'm building something meaningful with ECHO, and I'm making a difference in how people think about end-of-life care. But if I had to choose, it's my kids, no contest. I also value my independence. I've always been someone who figures things out on my own. Being dependent on others for basic things would be really hard for me.

What are your biggest fears or worries about your health?

My biggest fear is a catastrophic neurological event — a stroke or a brain injury — that leaves me alive but not really me. I've seen patients in the neuro ICU who are technically alive but have lost everything that made them who they are. They can't think, can't communicate, can't connect with their families in any meaningful way. That terrifies me more than death, honestly. Death is an ending, but being trapped in a body without your mind... that's my nightmare.

That's a really important distinction. Are there abilities or things in your life that are so important to you that you can't imagine living without them?

Being able to think clearly and communicate. Those are my non-negotiables. I can handle physical limitations — I could adapt to being in a wheelchair, losing a limb, even losing my vision, as hard as those would be. But if I can't recognize my children, if I can't have a conversation, if I can't understand what's happening around me — that's not living to me. I'd also say that being able to experience joy matters. If I'm in a state where I'm just existing but there's no awareness, no pleasure, no connection — that's not a life I want to maintain.

Thank you for being so clear about that. How much are you willing to go through for the chance of more time?

It depends entirely on what the outcome looks like. If there's a reasonable chance — and I mean a real chance, not a Hail Mary — that I could get back to being cognitively intact and present for my kids, I'd go through a lot. Surgeries, rehab, a long recovery, significant pain. I'd fight hard for that. But if the realistic outcome is severe cognitive impairment, or a vegetative state, or being permanently dependent on a ventilator with no meaningful interaction — then I don't want aggressive measures. I'd rather have comfort care and let my family remember me as I was. I'm not interested in being kept alive for the sake of being alive.

What gives you strength as you think about the future?

My kids give me purpose every single day. And honestly, my work. I know it sounds strange, but building ECHO — trying to solve this exact problem of helping families make decisions that honor what their loved one would actually want — that gives me a sense of meaning that goes beyond my own life. I also have a strong support system. My mother, my colleagues, my family. And I'd say my faith, though it's complicated. I believe there's something beyond this, which makes the idea of death less frightening than the idea of a diminished existence.

What about hopes? What are you hoping for when you think about your health going forward?

I hope I stay healthy for a long time and this conversation stays theoretical. But if something does happen, I hope whoever is making decisions for me really understands what I'd want — not what they want for me, but what I would actually choose. That's partly why I'm so passionate about ECHO. I hope my kids grow up knowing I thought carefully about these things so they wouldn't have to carry that burden. And I hope that if the worst happens, my family can let me go without guilt.

You mentioned family making decisions. Who would you want making medical decisions for you if you couldn't speak for yourself?

My mother and sister. Without question. We've talked about this extensively. They know me, they know my values, and most importantly, I trust them to make the hard call — to let me go if that's what the situation calls for. I don't want someone who would hold on just because letting go is painful. My mother and sister understand that.

And when your mother is making decisions for you, how closely should they follow what you've shared today?

I'd say use it as a strong guide, but I trust their judgment in the moment. Medicine is complicated and every situation is different. I don't want them to feel trapped by something I said in a conversation that might not perfectly apply to whatever specific situation comes up. But the core principles — cognitive function matters most, don't keep me alive in a vegetative state, comfort over prolongation when recovery is unrealistic — those should be firm. The nuances within those principles, I trust my mother to navigate.

Is there anything else you'd want the people making decisions for you to know?

Yes. Please don't let guilt drive the decisions. I know how hard it is to be the person who says "stop." I see surrogates struggle with this every day at work. I want my family to know that choosing comfort care, choosing to let me go — that's not giving up on me. That's honoring me. And if ECHO is up and running by then, use it. Ask it what I'd want. That's literally why I'm building it.