Dr. Shoshana Ungerleider (right) interviews comedian Tig Notaro about drawing humor from her breast cancer diagnosis. Ungerleider is the founder of End Well, a nonprofit focused on shifting the American conversation around death. Their discussion took place in November at End Well’s 2023 conference held in Los Angeles. Britney Landreth for End Well hide caption

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Britney Landreth for End Well

Dr. Shoshana Ungerleider (right) interviews comedian Tig Notaro about drawing humor from her breast cancer diagnosis. Ungerleider is the founder of End Well, a nonprofit focused on shifting the American conversation around death. Their discussion took place in November at End Well’s 2023 conference held in Los Angeles.

Britney Landreth for End Well

We’ve seen it so many times. A young, handsome man rushed into the emergency room with a gunshot wound. A flurry of white coats racing the clock: CPR, the heart zapper, the order for a scalpel. Stat! Then finally, the flatline.

This is Dr. Shoshana Ungerleider’s biggest pet peeve. Where are the TV scripts about the elderly grandmothers dying of heart failure at home? What about an episode on the daughter still grieving her father’s fatal lung cancer, ten years later?

“Acute, violent death is portrayed many, many, many times more than a natural death,” says Ungerleider, an internal medicine doctor and founder of End Well, a nonprofit focused on shifting the American conversation around death.

Don’t even get her started on all the miraculous CPR recoveries where people’s eyes flutter open and they pop out of the hospital the next day.

All these television tropes are causing real harm, she says, and ignore the complexity and choices people face at the end of life.

They create unrealistic expectations that incurable diseases can be cured, false hope that our dying grandmothers won’t die. And that has people begging foraggressive, painful treatments that will never work, when they could be focusing on saying goodbye.

She thinks Hollywood can do better. Through End Well’s annual speakers’ conference and a collaboration with entertainment experts at USC Annenberg, Ungerleider is on a mission to influence writers and producers to flip the script on the American way of death.

“We’re trying to embed ourselves within Hollywood,” she says. “Our goal is to encourage them to write different kinds of inspiring, nuanced and diverse storylines that are more representative of what’s actually possible.”

End Well’s signature conference – a kind of TEDx on death and dying – has been held in San Francisco since 2017.

This November, Ungerleider moved it to Los Angeles, so that writers, producers, and social media influencers could attend, in addition to the hundreds of hospice nurses and grief counselors in the audience.

The speaker’s stage was also studded with stars. Talk show host and former Rockette, Amanda Kloots, talked about losing her husband to COVID. Comedian Tig Notaro told jokes about being diagnosed with breast cancer.

Sitcom star Yvette Nicole Brown (left) talks about death and grief with talk show host Amanda Kloots at the 2023 End Well conference in Los Angeles. Britney Landreth for End Well hide caption

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Britney Landreth for End Well

Sitcom star Yvette Nicole Brown (left) talks about death and grief with talk show host Amanda Kloots at the 2023 End Well conference in Los Angeles.

Britney Landreth for End Well

The emcee was actress Yvette Nicole Brown, from network sitcoms like NBC’s Community and CBS’s The Odd Couple.

“When my mom passed, I called all my friends whose mom had passed before and apologized,” Brown said. “Because until this moment I had no idea. And my ‘It’s going to be better tomorrow’ and ‘She’s in a better place’ – that helps not at all. And I now know that.”

While other actors use their platforms to campaign against climate change and world poverty, Brown is using hers to talk about taking care of her father before he died.

“If you are a writer or producer or a comedian, talk about grief. Talk about death,” she told the conference audience.

End Well is also collaborating with researchers at USC Annenberg’s Norman Lear Center and its Hollywood, Health & Society project, which offers free consultations with medical experts to TV and movie writers. It was launched in 2001 with funding from the Centers for Disease Control and Prevention, with the recognition that entertainment has a profound impact on viewers’ health knowledge and behavior.

Researchers produced a linguistic analysis of TV and film scripts which found writers were 82 times more likely to use the word “killing,” and 30 times more likely to use the word “murder,” compared to 16 end-of-life terms combined, including “hospice,” “last will and testament,” or “chronic conditions.”

Cheers once featured a storyline about designated drivers. In that same spirit, Ungerleider hopes writers will consult with her on how to portray end of life more accurately, or read End Well’s white paper on how to diversify and expand their storylines.

Ungerleider points to shows that are getting it right, like the last season of This Is Us on NBC, which featured Rebecca Pearson, the show’s matriarch (played by Mandy Moore), dying of Alzheimers and several family discussions around advance planning and caretaking.

She also mentioned Netflix’s From Scratch‘s depiction of hospice at home, and a storyline from ABC’s A Million Little Things about a man with cancer choosing to end his life with aid-in-dying medication.

Audience members participate in a talk by Katrina Spade about human composting at the Los Angeles conference held by End Well, a nonprofit focused on shifting the American conversation around death. Britney Landreth for End Well hide caption

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Britney Landreth for End Well

Audience members participate in a talk by Katrina Spade about human composting at the Los Angeles conference held by End Well, a nonprofit focused on shifting the American conversation around death.

Britney Landreth for End Well

USC Annenberg is also working to understand what’s stopping most producers from using more realistic death narratives like these.

“Entertainment is still a profit-driven system and the bottom line is viewership,” says Erica Rosenthal, director of research at USC Annenberg’s Norman Lear Center.

And viewers want comfort and humor from their entertainment, she adds. According to USC’s research from 2022, Hollywood executives are wary of storylines about death and dying, fearing they would alienate viewers who were already hungover from the pandemic.

“There was a bit of a backlash against heavy-handed health storylines,” she says, and that brings real challenges: “How do you make end-of-life care funny?”

Some industry outliers are convinced they can.

“Death stories don’t have to be sad or sappy or depressing. You can tell death stories and laugh and learn,” says J.J. Duncan, the showrunner of the Gentle Art of Swedish Death Cleaning.

That’s a new reality show on NBC’s streaming network, Peacock, narrated by Amy Poehler.

“What is Swedish Death Cleaning you say?” Poehler asks in the show’s trailer. “Basically, cleaning out your crap so that others don’t have to do it when you’re gone.”

In the first episode, three Swedes help a 75-year old woman, Suzi Sanderson, sort through her belongings and her memories, which include working as a singing waitress in Aspen.

“I sang there for 11 years. And then I got married, and well, I have to tell the truth, it ruined my sex life,” she says, sending the Swedes into laughter.

Hollywood is slowly opening up, says Duncan, the showrunner. She couldn’t believe producers were willing to do a show with the word “death” in the title.

“I mean, that alone is amazing,” she says. “We had studio people say, ‘Oh, don’t say death too much,’ because it’s scary.”

Any good story has set up, conflict, and resolution, Duncan says. Maybe a hero’s journey. And there’s no reason death can’t fit into that formula.