BJ Miller Sees The World Differently

Cold Open

Shoshana: So tell me about the accident. What do you remember?

BJ: Mmm. So I don't remember anything. Almost no memory of the evening, which is very common with a traumatic injury.

This is my good friend, Dr. BJ Miller. And for now, I just want you to hear the story of what happened to him in 1990, when he was a 19-year-old student at Princeton.

BJ: So sophomore year, early sophomore year, it was just after Thanksgiving break, we'd just gotten back to campus. It was, I guess I got back a Sunday. I remember we watched the movie Goodfellas in the theater. It was in the theaters, and that was the night we got back. And then Monday night. I remember, I was, heading to a, the computer lab to print out a paper. But I ran into, two buddies of mine, and we decided to go have a beer it wasn't a crazy night. We went out onto the, into the town a little bit. And then we decided to go get a sandwich. Pretty innocuous stuff. And at Princeton campus there's a commuter train called the dinky of all things. And, it's on the way to the Wawa market to get a sandwich, and we, decided to climb it like you would, you know, it's just parked. We just, we didn't even think we were doing something that crazy.

BJ: I grew up in the Midwest, we had diesel trains. This is an electric train where the wires run overhead.So I just, I happened to be the first one up and when I stood up , I got close enough to what's called the pantograph, which is the metal thing that connects the train itself to the electric wires, I had a metal watch on my left wrist and the electricity arc to the watch. And, that was that big explosion. And na na na.

Shoshana: Yeah. And have you ever had conversations with your friends that were there with you about what, what they saw and experienced?

BJ: Yeah. Oh yeah. There was a foursome of us and a guy named Tommy too. But Tommy was, I think he was studying that night more dutifully. So it was just Pete and Jonathan and I, , we've talked about it a lot. I mean, they've kind of helped me remember.

BJ: Very quickly they went into action. Pete, who's this enormous superhero, a guy, he looks like a, he looks like a comic book superhero. He's this square jaw, huge shoulders. He's a beautiful soul. And he heroically gets up on top of the train, and Pete got up there and found me unresponsive. And it's often happens with that much electricity. You'll stun the heart but then you auto, you sort of auto defibrillate, um, which is what happened to me. So I was sort of probably. You know, in some fibrillation and then came to and was just flailing wildly and which is apparently common with electrical burns. And I was just punching Pete. I was, you know, just flinging around and Pete was trying to hold me down so I didn't roll off the train and make everything worse, which was apparently not easy. Um, and so he's holding me down the Jonathan, while Jonathan runs and calls 9 1 1, cops come.

BJ: We went to the local hospital, to do the immediate emergency care, which is basically, they just cut holes in your skin to let the heat out. And then they were putting me in a helicopter to go to, uh, the burn unit at St. Barnabas, and I have a vague memory of them loading me into the helicopter. And I was almost six five, I was in my native height and I was, I just remember them awkwardly, couldn't fit me in the helicopter. They're sort of funky conversation about how to get me in there. I vaguely remember that.

BJ would stay in that burn unit for about 2 1/2 months. To save his life, surgeons amputated both of BJ's legs below the knees and his left arm below the elbow.

Shoshana: The story of what happened that night is very traumatic. Um, and yet I've heard you talk about it so many times

BJ: Yeah.

Shoshana: And it doesn't seem to visibly upset you. How do you feel when you're asked to tell that story?

BJ: You know, it's sometimes – it's a funny feeling, Shosh. I, you know, I have told this story so many times, you know, so part of me is just sort of inured to it. But, that doesn't do justice to what's happening here internally. What, what's happening for me, it's been 35 years, you know, early on it would be emotional and hard for me to talk about, but that shifted pretty quickly. And then, then it became sort of like it feels like talking about a movie I saw that I happened to be in. Because I, I don't really remember so much of that evening. I guess I'm almost kind of fascinated, like, I can't believe that happened. I wonder what that felt like, you know? And so I guess my feeling, an overwhelming feeling, is kind of curiosity it also comes with all sorts of wonderful feelings by now, because that experience really was a gateway, a portal to me, learning so many things that became invaluable to me in my own arc of life. So many things happened because of that night. So it's no longer a story purely of trauma. It's many other things. So, I was gonna say, it's a pleasure for me to talk about it. It's certainly not hard for me to talk about at all anymore.

Shoshana: So you told me once, disability is an interesting minority group because any of us can join at any time. How do you think that reality, that anyone could become disabled, affects the way society treats people with disabilities?

BJ: Well, I think it just ramps up the fear. A lot of folks deal with hidden disabilities, which is its own trick. But mine are very obvious. And so you walk around as this big projection screen, people just look at you and, and it's, you know, there's like a primal fear sets in oftentimes. The way the world handles disability, it's, it's shifted in my 35 years, I don't feel so ghoulish in the world anymore. But early days, you'd either get this, sort of weird, kind of Christ-like thing, like, oh, like you've got special powers in some weird way. It was like Jesus or Frankenstein, or they treated you as like this monster that they were terrified of and visceral and like literally would cross to be on the other side of the street. Parents would, I would see them pull their kids away from me and you know, just, you'd clear the sidewalk just walking down it sometimes. I, it's rarely I, I haven't had that experience in a long time, but that was much more normal back then.

BJ: So to answer your question, you look at my body and, and on some level, a person at some brainstem level knows that that could happen to them, you know. It's not like you're going to become a different race or the other ways we divvy up people in minorities and majorities. But on some level I think people understand that this could be them, and that's terrifying. So then you become this symbol of their fear.

There are so many things that I could talk to BJ about. He's one of the smartest and most thoughtful people I know. But today, I want to focus on how he came to live in a body that is visibly different—and how those differences inform the way he sees the world.

I’m Dr. Shoshana Ungerleider and this is Before We Go. This season, we’re in conversation with people from all walks of life, exploring how we live alongside mortality.

Today’s episode: BJ Miller Sees The World Differently.

Act I

I like to ask the people I interview to introduce themselves, because sometimes their answers

go into directions I did not expect. BJ is a good example of that.

Shoshana: So I clearly know the answer to this question, but I'm gonna ask it anyway. Uh, tell me who you are and what you do.

BJ: I am a physician. Um, but I say physician in that way because I don't, I don't really practice medicine per se anymore. I do sort of related things, but anyway, I'm BJ Miller. I'm a palliative care and hospice physician, and an educator and writer of some kind, sort of wrote a book, but mostly I'm a palliative care doc.

BJ’s work in palliative care is how we became friends. We met in 2015 when I invited him to give a lecture at my hospital in San Francisco. And in 2018, my father and I executive produced a Netflix documentary called End Game. It followed terminally ill patients who were nearing the end of their lives and the people who cared for them. BJ was one of the palliative care doctors featured in the film.

End Game: Patient: I think the scary part is the unknown. BJ: Mm-hmm. Patient: And the lack of control. It could be terrible, but it could be wonderful. BJ: I will tell you Tekla, and from doing this work and being near people who are at the very, very end, everything I've ever seen would suggest that wherever we're going, whatever abyss we're meeting, it I don't know that it's so bad.

The film was nominated for an Academy Award. BJ and I both traveled to Los Angeles for the ceremony.

Shoshana: I just wanna tell you, I was in LA recently and drove past the Mel's diner that we went to at like 2:00 AM after that Netflix Oscar party in 2019. Do you remember

BJ: I do. Remember who we saw there?

Shoshana: Uh… yeah.

BJ: (laughs) What is his name? Ron Jeremy, right?,

Shoshana: The porn star?

BJ: Yeah. The porn star. Yeah. That, that, that guy.

Shoshana: We w 're like, what, where are we right now? And then we saw like the Dragon Mother Amelia Clark from Game of Thrones at the next table. It's, it's so LA.

BJ: Yeah, man, that was God, that was great. And so fun. But boy, still think we should have won that one. But anyway, you know, lovely.

When BJ was featured in End Game, he was running the Zen Hospice Project in San Francisco. Because of lack of funding, it closed its doors in the summer of 2018. BJ continued to be a practicing physician until the pandemic, when he and his business partner founded an online palliative care company, called Mettle Health. It focuses on the social – not the medical – side of care.

BJ: I love medicine. It saved my life. There's, there's much I love about medicine and there's much I really do not like about healthcare. And you know, I only ever went into medicine to kind of learn a bag of tricks that would put me in front of people to have something to offer. Folks who were strugg ling as I had, had struggled myself, and I was only really genuinely interested in the existential and spiritual and social issues. The physiological sort of symptom management stuff was a piece of the puzzle that I, I enjoyed, I cared about. But for me, the existential stuff is the big juicy stuff. And that's not a medical thing, you know. Dying, suffering. These are not purely medical pursuits by any stretch.

And that brings us back around to BJ's disability and how it shapes how he looks at the world. And that story didn't actually begin that night on top of that train. It began long before...in BJ's childhood.

Shoshana: Tell me about your mom and what she taught you about living with a disability.

BJ: So my mom, she's, uh, 82 now, Susan, but we'll call her mom. She and I have always been super close. I am, I've always been a little bit of a mama's boy. Happily and proudly. So, um, so mom, she had polio when she was, 18 months old, you know, in the pandemic, back in the forties. And so for much of my childhood, she just wore a brace on her right leg and walked with crutches and was incredibly strong and functional. You could do just about anything. , So she had a disability, but it wasn't very disabling. It didn't really hold her back, as she got into her forties, the early eighties, I was maybe 10, 9, 10, 11 years old, post-polio syndrome, revealed itself as this knock on effect from the virus. So from. The early 1980s. It's just been a long, slow, steady decline from a physical point of view. She's just lost function after function. And now at this point, she's barely outta bed. So I've just watched, her illness, her disability, sort of run rampant with her and just take, take, take from her. So growing up with a disabled mom sensitized me in all sorts of ways. We could talk about that for days, but yeah,

Shoshana: You went off to college, I know, with no plans of, of becoming a doctor or a palliative care physician. What were your hopes and dreams when you entered Princeton?

BJ: Certainly, medicine had not been on my radar, but I'm not sure what was frankly, I didn't know. Um, and, and I was fortunate at that, at, at that age and that stage to land in a place where you didn't really have to know. I just got to explore learning in this cool way. And it was beautiful. I loved it, I don't know where I would've headed. I probably would've defaulted to sort of following in my dad's footsteps and sort of into the business world of management or some something.

Shoshana: Oh my God. You would've hated that.

BJ: Uh, you're, uh, yes, you are absolutely correct. I would, uh, I would not have enjoyed that. And another way of saying that is things happened in my life that made it clear that there's a lot of other stuff I would enjoy so much more,

In case it’s not clear, the things that happened in BJ's life started with climbing on top of that train at Princeton and getting hit with 11,000 volts of electricity. For a while, doctors

weren’t sure BJ would survive his injuries.

Shoshana: You've said that you don't remember being aware that you were close to death until after that the danger of dying had largely passed. What do you remember about being told that you'd become a triple amputee as a result of the accident?

BJ: That was a really interesting moment. With burns, it's not always clear how much tissue is viable and, and for that reason, and also you're hemodynamically all over the place. Your blood pressure, your heart rate, you're not stable. So you're not a great candidate for surgery if you don't have to have it.

BJ: So my first surgery wasn't until I think day five or six. . Of course you wanna leave as much tissue as possible, but that ends up being a nidus for infection. And that's the thing that often kills people who have been burned. So there's a, is a real, obviously, highly technical thing happening at the medical level. I mean, obviously I was terrified. I was in pain, I was confused. I was many things, but there was also a piece of me that sort of knew what was happening. I wasn't surprised to hear him say I was about to lose the legs, and the real wild moment was when I came out of that first surgery. And the burning again, super, antiseptic. You know, my parents could only visit one person at a time. No friends could come in. You know, it's really, you're, you are wholly cordoned off, but there's the journey to the OR and I remember coming out of the OR and heading back to the room and my friends had shown up just to be in the lobby.

BJ: It was so beautiful, Shosh, like, the people who showed up was. I couldn't believe it. I was so surprised to see all these people. And I remember I saw, my mom first, and, I just remember saying to her, oh, you know, wow, mom, now we have, so much more in common. And I meant it.

<longer music pause here…to let that moment sink in!>

By the time BJ realized how close he’d been to death, it was four to five weeks into his recovery and the danger had largely passed.

BJ: Part of me thinks I was just out to lunch and didn't know all sorts of things that were happening. But I think actually a part of me, and not, I, I don't say this as a, as a comment about me, but as about humans in general, when they're cast into situations that are so intense, dangerous, where there is no choice in the matter. You are just in it. I remember them talking about, when they were operating on the arm and they were gonna have to maybe take it at the shoulder. And I remember this sort of life and death conversation kind of hushed in the corners, but I just remember having this knowing that I wasn't going to die, that they weren't gonna take arm at the shoulder. There was this subterranean deep thread that was calm, that knew something about how this was gonna go for me. And it was, it's mysterious. I don't know what that voice was. I've never talked to other people about, who've been in similar situations, whether they had such a voice. But it was, uh, a really, kind of a cool piece of this, something in my body knew, uh, what was happening.

Shoshana: Has that voice ever come back to you since?

BJ: Yeah, if I let it, you know. It's a deep, quiet, subtle voice. It doesn't yell anything, but I have to real, I mean, yes-ish, but I have to be, you know, with our educated minds and our conscious minds kind of pushing us in various directions and us trying to will ourselves to do things and all that stuff is so loud that, it's hard for me to hear that, that other knowing voice, that mild quiet, knowing voice, I can, he's in there too. But he's not as accessible to me. I have to really work to hear him.

Shoshana: Yeah. Does that, does that scare you?

BJ: No, no. Quite the opposite. It's comforting, if that knowing voice was telling, I think if that knowing voice was telling me, I, you know, maybe this was really the end. The content of what that voice was telling me was not the thing, it was just this calm knowing inside of me, whatever, wherever this was headed. I, I don't think it mattered much what the voice was telling me. It just, it was a, it was a calm relationship to the truth.

Shoshana: Hmm. Calm relationship to the truth. Oof.

BJ: Yeah.

Shoshana: Um, okay. Uh, big question for you here. How did your accident change how you saw yourself and, and then how others saw you?

BJ: In so many ways? You know, we could talk for days on this stuff, and so much of this is thanks to growing up with the mother I did, and the family that I did. A dad who loved my mom, who happened to be disabled, et cetera. I mean, the, the whole picture was very helpful for me in so many ways. So I knew from a very young age that the, the identity and that we put so much stock into our appearance and the way we look and our sort of relationship to the norm or the standard thing. I, the comparing and contrasting, I was certainly subject to all those forces, but a piece of me just from watching my mother in the world knew there was something else going on too, and knew that my mom, I'd watch people treat her as though she was a tragedy or less than or not worthy or all sorts of junky stuff. And so from a very young age, I, I, I knew better. I as a 5-year-old, I was in this way wiser than a lot of middle aged people who were throwing a bunch of junk at my mom.

BJ: And so I knew that we weren't our bodies in this way. So I, I, I couldn't pretend to think that my life was over now that I didn't have four limbs or whatever now that I couldn't play football, or I don't, you know, I, I, I knew enough that that was just bullshit. It wasn't factual. That was huge. A lot of my compadres, in the disability world or in the rehab hospital setting, you know, they had to go learn that lesson and that could take years if you ever get it. But I just, I had such a head start. I already knew that was the case. Now I had to sort of backfill in the gaps in my own feelings about it all. And then another piece of the answer to your question, Shosh, is you know, I'm a suburban white guy who went to an Ivy League school and, you know, externally, I'm one of those guys to whom much was given, silver spoony kind of stuff. And I knew that I was lucky in those ways, but I also knew that that didn't do justice to how I actually felt. I often felt I was sort of melancholy kid. I often felt like I was, you know, on the wrong planet or born at the wrong time or into the wrong body. That I was not experiencing life as a super lucky guy to whom much was given. I was aware of all sorts of sorrows, my own and others, and how hard it was, even if he had four limbs and how I just was, I had a, a, a discomfort in my body and in my person.

BJ: And, and so when this happened pretty quickly, the feeling was like, oh, oh, like was relief. And again, this is, these are all, there's so many layers to all this. So, there was all sorts of, a lot of torment. But there was a piece of me that was a little bit relieved because essentially I now looked more like I felt, you know. I looked different and I'd always felt a little different. I now finally had some obvious struggle. I, I could feel my own pathos. Now, at least outwardly, not everyone was looking at me like, we're gonna give you any credit. 'Cause you're just a lucky kid. And, and I also, and it also gave me this, um, experience that I, I always wondered if I was sort of a weakling, you know, could I handle so much the, the hard stuff that befalls other people? And so now I have my answer. Yeah, I could. So there's so much to this. I mean, I'm, and I'm just highlighting some of the really positive things. And again, the, the course to get to these lessons was tricky, but those are all undeniably true statements. And, and the sort of the lasting ones for me.

You're listening to Before We Go. We'll be right back.

Act II

After about two and a half months in the burn unit, and more time in rehab, BJ Miller returned to school at Princeton.

Shoshana: You've said in those early days that you would've hidden your disability if that was possible to hide it. Um, what made you change your mind about that

BJ: Well, I remember my parents when I was heading back to school and I was trying to get a driver's license again, and I can't remember the order of things, but mom, I think it was applied for a disabled license plate. And I remember being really upset about that

BJ: In contrast to what everything I just said, like it took me a while so I just remember being really upset that I was gonna be, signaling to the world, even through my car that I was, uh, quote unquote a disabled person. I didn't wanna lead with that. I know I just had a lot of mixed feelings about it. And, So the upshots of what I just described to you. So much that came because I did not have a choice at the level of identity of how I saw myself in the world. I, I was inherently, at least on this frame, out of the closet I couldn't pass. And, you know, the staring from strangers and parents pulling their kids away from me and all that stuff was very painful. And I knew from my mom that that was their problem, not my problem. But it still sucked. I still did not enjoy it, so that's why I say I would've sure if I could have passed, I would've, but so much of the power came because I didn't have a choice. I, I had to kind of own this eventually, one way or another. And that in so many ways that's something I'm extremely grateful for.

Shoshana: BJ, how did you decide to become a physician and specifically a palliative care doc?

Shoshana: So got through college. I majored in art history. Graduation rolled around. I did not have any clear sense of what I was gonna do for work. All I really knew is that I had developed this broad interest in being alive and this broad interest in what makes a human being a human being. A broad interest in a sense giving back. I don't love that language, but essentially giving back, I mean, people went to so much trouble to help me survive. And so I, I, I did feel something of a debt. And I knew from my mom and from the disability rights movement that my own experience in this body was something as we've already discussed, that would teach me things and made me in some ways more creative and more resilient. And this, in some ways was something to celebrate and love. And so I wanted to find a way to work with it, not, you know, put it behind you, this sort of overcome kind of language. How do you, it's not, I'll never overcome it. It's not in the past ever.

BJ: So I knew these things and so that it's a matter of taking that suite of impulses and trying to find how to apply that. There was a moment like, well, gosh, if, if my physician had walked in in this body, like, wow, how powerful that would have been for me. So it felt like a way to exercise the things I was learning where these experiences would give me insight. It would be in some ways something of an advantage if you think of medicine, the practice and of caregiving, having something to do with empathy. My empathy machinery was really ramped up. So medicine lit up as a interesting way to exercise all this stuff. And I also remember, I really do, I do much better with low expectations. And I remember like, I don't like high. And I remember thinking like, that's kind of a moonshot there. I didn't know any disabled people in medical system and you know, you know, the medical training thing is, you know, not easy physically. And so it was fun to pick something that no one would've expected me to do or would wonder even if I could do. 'cause that was more motivating for me. To dramatically just stomp all over these low expectations that I was receiving from others and tempted to take from myself, you know?

BJ: So something in that mix pointed me towards medicine and frankly, Shosh, I didn't, I didn't have anything else I knew I really wanted to do to make a living. So, it wasn't like this huge passion. My deal with myself was, Hey, like, don't die on this hill. Like, you almost just died. Now don't die trying to prove that you can do medicine, whatever. So like, if it gets too much, you'll drop it you know, at this point by now, I was starting to embody the lessons of, I knew how to fall, I knew how to fail, quote unquote, and that was a real g too, so I could try things. It doesn't work, doesn't work. What's the worst that could happen?

It never did get to be too much. BJ graduated medical school, but then he hit another snag.

BJ: I thought I was gonna go into rehab medicine. I felt like the closest fit, and deep into medical school I fell outta love with rehab medicine for all sorts of reasons. And I actually dropped out of the match. I didn't know what I was gonna do. My buddy and I were working a little tea business, , but it was my dean at UCSF two deans there, and they said something like, I hear you, but why don't you do your internship? Once you've done that, then you can have a license. As a gp, it's easier to jump back into medicine if you, if you want to. So they convinced me to do my internship. I did my internship at the Medical College of Wisconsin, which is where my parents were living in Milwaukee at the time. I went back to be with them, and over the course of that internship, I stumbled into a palliative care elective and fell. Immediately head over heels in love and reoriented to palliative care. And that was it. Off I went. Yeah.

Shoshana: And my goodness, thank, thank goodness you did, um, because you've certainly made the field so much better, um, by, by being a part of it. Um, I think I know the answer to this, but are you a better physician because of what you experienced?

BJ: Infinitely. Of course, I have no idea how it would've been without it, but I, yes, uh, undeniably yes. Especially in our field of palliative care. You know, if, if I were a surgeon or something who was doing my more manual work, uh, probably not. But in palliative care, undeniably, yeah.

And this is one of the really interesting things about the way BJ views his disability. On the one hand, he sees his brush with death as something that opened him up and made him able to connect with people who are facing the end of life.

And on the other hand, he believes that disability is a construct – like race.

Shoshana: Tell me more about that.

BJ: Well, so, when you think about it, like disability. So, what's the dis, it's dysfunctional. Something's aberrant, something's gone wrong. Compared to, to what? So who gets to be the standard? What is the standard against which we're comparing everybody. I'm disabled. Only insofar as I'm not, you know, the normal body, what the hell is the normal body anyway? What gets the prize of normalcy and standard you just look around, we're making that shit up all the time.

BJ: I'm disabled by some measure, but I'm more functional. A lot of people I know with four limbs, you know, you get clear on the made upness of so many of the ways that we, divvy the world up or the, the, the nature of identity is, is, is, is such a, a made up phenomenon. It's a powerful one, reified by culture and society and. I would be lying if I, if I didn't say it wasn't sometimes painful to not be included in the world of the norm, but by now , it's also fed me so much and made me question so much that I found valuable.

BJ: So, so when someone, when I see someone, one of our patients, you know, struggle, feeling abnormal, feeling dysfunctional, feeling left out, well, I have obviously a lot of feelings for what they're going through. And I also get to know that on some level, if we have enough time, we can talk ourselves into realizing like, again, that's the world's problem. You get to be normal 'cause you are, the comparing contrasting crap is powerful and unavoidable and also so problematic. This is needless suffering. I sometimes when I used to talk to school kids more often so eventually some kid, you know, don't you miss having two hands or. All your feet or something like that. I would always love those questions because then I could say to them. Well, yeah. You know? Sure. I, yeah, two hands was, yeah, it was a lot easier. It was great. Yeah. But yeah, don't you miss having three hands, you know, and they would look at me like, what the, what are you talking about? And sometimes the kids would get it. I'd be like, oh, right. Like, you know, that's just because that's what most people have. That's what we just assume is the way. But wouldn't it be great to have three hands and I, as a one handed person, wouldn't it be great to have two hands? Sure. But I don't, I'm pretty sure you don't sit around show thinking, God dammit, I wish I had three hands, you just, you gotta get, find your way. And this happens with illness in our line of work all the time. You gotta find your way to not the way you wish the world to be, or you like the way the world is and the way my world is, is in this particular body and, and I get to do all sorts of things with this body. It's great.

Shoshana: You've had to navigate a lot of assumptions from people, about what your life must be like. How do you handle it when people make those assumptions about your capabilities or your

BJ: Hmm, hmm. It used to be more upsetting. Now it's just playful. Like now it's sort of just fun because like, it's always the thing to learn for all of us is when you kind of on the receiving end of, other people's projections, and we all are, you know, we're projecting all the time, but you get, I'm just, I'm a little more savvy at spotting it now, you know, because I do care what other people think. I would be lying if I to you, if I done, I still, I, I do, I care what people think. I care, so if, if my presence is causing anguish for someone or. It's flummoxing for someone or whatever. I don't, I don't like that. I don't enjoy that.

BJ: And eventually, as we all must, you know, gotta learn that the projections from others are not our responsibility. I have to remind myself of that daily. By the way, I mean, as physicians, I mean, even if I'm not practicing medicine per se, we have taken oaths, we are committed to the wellbeing of others in a, in a powerful, serious way. So I still have to remind myself because we can affect each other's experience. And even though I might be able to affect someone's experience who's projecting a bunch of junk at me, that's not mine. Their stuff is not mine. It's not my responsibility. That lesson continues to be a tough one, but I'm a little closer to remembering it because of all these things.

Shoshana: And a, and a really helpful thing for everybody to think about and, and remember, right?

BJ: Yes. The, and one thing that's super, I wanna make sure to get across these stories are dramatic or different in some ways compared to some, but they're just variations on the theme. Themes that we all go through. Mortality, suffering. Some more obvious than others differences. Are we good enough? Are we whatever enough? Are we normal? Are we abnormal? Are we, you know, these are, I would think are universal

Shoshana: Yes.

BJ: This has been a sort of an obvious situation that's pushed these issues to me earlier in life, per se. And therefore forced me to deal with those very important questions in a serious way. But back to your point, this is stuff for all of us. You know, you don't have to lose limbs to kind of wonder if you're right in this world.

Next time on the show, while her best friend, Molly, was losing her life to cancer, podcaster Nikki Boyer was trying to have a baby. After multiple miscarriages, Nikki turned to IVF. Only to face even more heartbreaking losses.

Nikki: I was so, um, driven, mildly obsessed, with like getting through it. No, rephrase that. I wanted to get over it. And I knew over it just meant let's have another pregnancy. So I couldn't even grieve. I see how women get obsessed with this and how it becomes like just who you are and you lose sight of everything else that's going on in your life.

But experts say we need to re-think the way we view – and talk about – miscarriage.

Jessica: The numbers, the statistics are so clear. One in four pregnancies results in miscarriage, approximately, and why are we being basically groomed, I think, to blame ourselves when we become one of those numbers?

That’s next time on Before We Go.