Death doulas are trained in medical terminology and disease progression but focus on emotional support, education, and presence — acting as the eyes and ears for hospice teams that can only visit for one hour a week. O'Brien's Doula Givers Institute has trained over 400,000 people in 39 countries.
Where this was said
At 41:43 · chapter starts 39:35
The mood briefly lightens as Dubner checks in on Roth himself — 74, cycling to the Stanford campus, in good health. Roth reflects that his extensive thinking about organ donation has made him a committed deceased donor, and that moving to California in 2012 prompted him and his partner to consider what aging in place might look like: they made sure the bathrooms were big enough and the house could easily be made wheelchair accessible. It's a small, practical insight into how an economist thinks about future-proofing a life. Dubner then makes a rare personal disclosure: his sister died the previous year, a 'pretty rotten death' in which she wanted to hasten the end but they couldn't physically orchestrate it. The experience, he says, made him think that almost anyone who encounters a bad death firsthand might immediately become a supporter of MAID. Roth agrees: an aging population means more people have now witnessed a peer's agonizing death, and he expects support to grow.
Predictions that AI would eliminate radiologists were spectacularly wrong. Since those predictions, Mayo Clinic's radiology staff grew 55% and the specialty became the second-highest paid in medicine. The reason: AI automated scan-reading, but only 36% of a radiologist's time was ever spent doing that.
Self-help fails because people are sold one universal cure by the hyper-responders who had a transformative result from it. The real problem is context: every method works for the right person at the right time, which is almost never you just because the author says so.
Spencer Greenberg was once so socially anxious his heart pounded just approaching a stranger. His therapist gave him homework: go to a bar alone, talk to 5 strangers. Starting with asking for the time, he worked up to asking men for hugs — and his anxiety fell dramatically in 6 months.
A person who flies regularly but obsessively checks weather forecasts before every flight is not doing exposure therapy — they're teaching their brain that flying is only safe with the ritual. Safety behaviors prevent the brain from ever learning that the feared thing is actually fine.
The worry-time technique assigns all worries to one scheduled slot (e.g. 5 PM). Every time a worry surfaces, you write it down and ban yourself from engaging with it until that time. When 5 PM arrives, most worries feel trivial and the act of batch-worrying exposes how little it actually accomplishes.
In a randomized study of 20 habit techniques, 'habit reflection' stood out: recall a past habit you successfully built, write down what helped you succeed, then apply those same strategies to your new habit. It works because it's self-adapting — it uses whatever worked for YOU.
The tiny habits technique — always having a minimal version of your habit you can do when life gets in the way — keeps the mental machinery of habit formation from breaking. Paradoxically, people given a tiny-habit fallback option were MORE successful at the full habit, not less.
Fears and worries act like playground bullies — they want to ambush you. But when you deliberately seek them out and choose the time of engagement, they lose their power. The volitional act of starting the fight on your own terms is one of CBT's most underappreciated insights.
Most downtime defaults are things you regret immediately after — phone scrolling, binge TV. 'Glad you did it' activities meet the same need for rest but leave you feeling like you spent your time well. The switch from a bad screen to a documentary, a book, or a walk costs almost no extra effort but compounds into identity over time.
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