So my work is to bring people together,
to break bread, and spark social change.
We’ve dedicated the dinner table
to ending the horrors of genocide,
the Israel-Palestine conflict.
We’ve talked about God, future of agriculture.
We’ve even talked about the history of hip-pop.
These dinners have resulted in action, to be sure.
But the most powerful thing that create
is deep engagement, and profound relationships.
And I strongly believe
the relationships create velocity.
If you want our ideas,
these ideas worth spreading,
to move with power and swiftness through the world.
The depth of our personal relationships
equals the speed of our superhighway.
I imagine the table as a great magnet,
that draws us together, holds us in embrace,
and then releases us back into the world.
The table and fire are also where we first concentrated calories by cooking.
也是在这里 作为一个物种 我们做出了革命性的巨大改变
That’s where we as a species made a massive evolutionary exchange,
trading these big bellies and small brains
for very large brains and small bellies
It’s a missing link between human and ape.
It also started this amazing tradition of the table-shaping culture.
Voltaire and Diderot had the most illuminating moments at dinners in salons.
Benjamin Franklin and J.B. Presley
helped spark industrial revolution with the table ruminations.
The birth of modern art,
we can thank a lot to
格泰鲁德 斯泰因 和 爱丽丝 托克拉斯
Gertrude Stein and Alice B. Toklas,
在沙龙中除了常见的宴会食物之外 他们会供应一些其他东西 比如大麻
while in their salons they were serving, among other things, cannabis fudge.
And even though alcohol and cigars were often the main course.
James Watson and his Los Angeles gatherings of the Tie Club
brought us the double helix.
But what does the table have to do with medicine
and the state of our health-care system and being on the stage?
So that begins on a spectacular summer morning. I was on a train,
going between Portland and Seattle.
The tracks were following the beautiful, beautiful lower Pudget Sound.
Um… I was immersed in a conversation with two strangers.
Both of them were doctors.
One of them involved in concierge medicine.
And the other had just left the practice, the family practice.
She was on a one-year walkabout,
in search of what it really means to be a healer,
feeling pretty beat-up by the current medical system.
So this impromptu conversation in the dinning car, over a table,
prompted to, revealed to me, two devastating statistics.
The first one was that
the vast majority of American bankruptcies are related to end-of-life expense.
That hit me like a total blow to the gut.
What came next? Slap to the face.
75% of Americans want to die at home, yet only 25% of them do.
For a lay person, I was just outrageous and shocking.
As the train rolled along,
this outrage sparked a memory.
I was thrown back to being ten years old.
My father lived in a nursing home,
having recently been diagnosed with Alzheimer’s.
I didn’t like visiting in there.
We didn’t know how to talk about death and illness of my family,
so denial was often the route we chose.
Two years later, when I was 12,
I woke up in the middle of the night.
I had a strong sense that I was awake for a reason.
But I didn’t know what it was, and I looked at my alarm clock,
and the time was 3:43 a.m.
A few hours later, I was to find out that
my father’s heart had stopped at 3:43 a.m,
while I laid awake in bed about 20 miles away.
To this day, not spending more time with my father during his final years
is one of the only major regrets I have in life.
So as the train was rolling into Seattle.
Outrage, memory, I would got inspired.
I’m still sitting with the physicians.
And I asked them two questions.
I said first:” Do you agree
that how we end our lives is the most important
and costly conversation Americans aren’t having?”
They said:” Absolutely.”
So I said secondly:
” So if I was crazy enough,
to launch a national campaign called
Let’s Have Dinner And Talk About Death?
Do you think I would find wide support?
医生 医院 病人 乃至每一个人 他们会支持我吗
Would doctors be interested, hospitals, patients, essentially every one?”
They said absolutely.
Both of them grabbed my hands
These complete strangers looked at me in the eyes and said: “This must happen.”
So a couple weeks later,
found myself among my colleagues at the University of Washington, masters of communication
in digital media, and I pitched them the idea.
I said:” I wanna start a large scale intervention.”
They laughed a little bit.
”Who do you want to have this intervention with, Michael?
It’s not a family, but the country.
So then they asked:” What is the topic
of this intervention gonna be?”
“How we die.”
They didn’t laugh at that time.
There was a stillness in the room.
But within a few days, they had agreed.
And me and Scott Macklin,
the associate director of the department,
had signed up 12 master students.
And we started designing together, eating together, building this new platform,
and really facing our own mortality.
At that point, deathoverdinner.org was born.
So before, we were talking about romantic train rides,
and historic feasts and death.
And that Harvard statistic that found 62% of bankruptcies in the U.S.
are caused by medical expense,
and the leading factor in that is end-of-life expense.
Another harrowing statistic emerged this fall.
And that was from the Mount Sinai School of Medicine.
And it found that 43% of all medicare patients
spend more than their total assets, out of pocket,
on end-of-life expense.
对我来说 这些信息带来的冲击 确实如遭掌掴
So for me, this was pretty much in my face.
And the question was how do we act on this information.
Politicians, who urge action,
have been cast as advocating death panels.
As you know, hospitals and insurance companies
have been stymied by issues of fiduciary responsibility,
threat of lawsuit, and current limitations of hospice system.
So these metrics were gonna change.
It became clear to my University of Washington students
that what was required
was actually a grassroots movement,
something that was decentralized and citizen-led.
So we started to imagine a patient-led
revolution held at dinner table.
And we chose All Hallows’ Eve
as an evening to have a very particular kind of death dinner
with perhaps the best drinking game of all time.
We filled a goblet full of Grappa.
Grappa is a drink of a fair amount of gravity.
and we [laugh]…
and we passed it around the table. Everyone raised the glass.
As they did, they paid tribute to recent ancestor, recently passed ancestor, etc.
Someone that they admired made major impact on their life.
有人大哭 有人大笑 有人愤怒 有人受到震动
And there were tears, there was laughter, there was anger, there was shock.
Everything at the table.
But the most important thing that we experienced, the most prevalent emotion, is gratitude
for those people that did come before,
And there are amazing stories emerged and filled the space.
One student, Cynthia Andrews gave a spirited shout out,
这杯酒我想敬我的祖母Willa Bell Sutton
said:” I wanna raise my glass to Willa Bell Sutton,
my grandmother, the strongest bitch that ever lived.”
And there’s the laughter subsided.
She told us a story about how her grandfather wooed difficult Willa Bell.
Night after night, he cooked her dinner.
At the end of dinner, he would take a single pearl
and roll it across the table to her.
And after 40 nights, she had a full necklace,
and that’s when he proposed marriage.
So, after Halloween,
how do we turn evenings like this into something wider,
like, where’s the social action here.
And so we started to imagine a digital framework
that would allow people to gather those that are closest to them.
And, and have this important conversation
to consider what we want our final days to be like,
who we want near us,
and how we can support the wishes of those that are closest to us.
So we are modest at first. We thought we could maybe reach a couple thousand people.
当我们开始接触一些领导人 医保 健康工作人员
And as we started to reach out to leaders, and health care, wellness,
even in spirituality, doctors, writers.
You name it, entrepreneurs.
What we found is this provocation,
Let’s Have Dinner And Talk About Death,
had had a resonant chord, a deeply resonant chord.
By Christmas break, only a couple months after we started,
we had already amassed a superstar group of leaders in health care and medicine
as advisers, recent partners in the project,
many of whom are seated among us today.
And that point became abundantly clear.
This is a conversation that the entire country needs to be having.
And it’s starting to look like we have a team in place
to not just reach just a couple thousand people,
but to reach hundreds of thousands of people.
Cause if the first sensation, the first response is
”How morbid! Why do I want to stop and talk about death,
especially over dinner?”
What happens is people immediately lean in and they begin sharing and they begin talking.
They talk about how beautiful their father’s death was,
or how awful, you know, some other passing for another loved one.
We assume that America’s afraid of this conversation,
但我相信 并且希望你也相信 这是一个文化迷思
but I believe, and I hope you believe, that that’s a cultural myth.
And I think that the only thing that’s necessary is the proper invitation, permission and guidance.
So medical professionals are constantly thinking about how to engage patients in these difficult conversations.
But I don’t think it can always start with doctors and nurses talking to patients.
I think sometimes it needs to happen with ordinary people talking to each other.
Hospitals, funeral parlors and insurance offices are really not the only place that we should confront death.
The proper depth of that conversation doesn’t happen
when we are intimidated and overwhelmed and sad.
只有当我们不那么警惕 十分放松的时候 谈话才可以顺利进行
It happens when we’re most comfortable, when our guard is down.
And the ritual of breaking bread, perhaps with a little addition of wine,
会营造出一个温暖 可靠 充满信任的空间
can create a space that has warmth and trust and authenticity.
The dinner table is absolutely the most forgiving place to have this kind of conversation.
Within this context, what seems like a scary or difficult conversation?
当然不会 晚餐谈话是自由的 开放的
Certainly isn’t. It’s liberating. It’s transformative.
It brings us closer together, reminds us of our humanity.
它让我们比以前 甚至是坐下来之前 更加坚强 豁达 睿智
And it leaves us stronger, broader and wiser than we were, than we sat down.
And hopefully leaves us more prepared for a conversation
with our doctor, a difficult one in future,
or a conversation with our father’s nursing home that we weren’t prepared to have.
所以在仲夏之前 我们将会上线一款测试版 让我们边吃晚餐边聊聊死亡
So by mid-summer, we’re gonna launch a beta version of Let’s Have Dinner And Talk About Death.
And what this is is an invitation for anyone who’s interested to create their own dinner.
and lead people through, choose your own adventure, adventure
to gather people that you want, people that are closest to you
to select pre-dinner reading materials,
to hold conversational prompts and structure.
And at the end of it, to provide action items for each person who took part in it.
它可以是生前遗嘱 预立的指示 向国会的请愿书或者器官捐献
And that will be living wills and advanced directives, and petitions to Congress or organ donorship.
And at the end, what it’s gonna give you
is the ability to share about the experience but also a social media badge.
And I think it’s a little funny.
I survived a death dinner.
Will it move the needle?
I’m not sure.
But what our hope is is to spark the gentlest revolution imaginable.
And I say that with total authenticity
I would love everybody in this room to be a partner in this project.
So, how effective will we be
obviously is gonna be told the test of time. Will people actually
take the time to have these dinners and bring people to their homes,
或者无论在哪里 即使是一家快餐店也好 花时间来进行这样的晚餐呢
wherever they have it, even if it’s at a fast food restaurant.
After our first dinner, our prototype dinner,
three of my students, independent of the class, and my web developer after hearing about it
immediately went out, and brought their families together,
looking at their parents directly in the eye and saying:
” How do you want your final days to be
and how can I be a powerful agent in supporting that? “
So that gave me some real hope.
And then on at All Hallows’ Eve I mentioned.
I was asked to imagine my own final days.
And as I began giving a rehearse response,
something that I felt passionate about since I was 17,
这件事是这样的 我想要孤独的死去 我希望滑落山间
that went something like, “I’m gonna die alone. I’m gonna slip off into the mountains.”
Um… I don’t wanna be a burden to my family or society.
Just about… I was really revving up. I was gonna deliver it in a beautiful fashion.
It wasn’t true any more.
And I answered, much to my surprise:
在人生的最后时光里 我希望被我最爱的女儿们August 和Valer
”All I want for my final days is to be surrounded by my two loving daughters.
August and Valer.”
这个简单但至关重要的问题 对我来说 有了全新的结果
So this simple but crucial question yielded completely new results for me.
Looking at death has taught me how to live.