BJ Miller, M.D.

Co-Founder, Mettle Health | Author, "A Beginner's Guide to the End"
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Dr. BJ Miller is a renowned advocate for holistic well-being, resilience, and building a life full of meaning. A survivor of a life-threatening accident during his sophomore year at Princeton that made him a triple amputee, BJ’s personal journey has shaped his dedication to improving the human experience. With a background as a palliative care physician and as the co-founder of Mettle Health, he brings a unique perspective to conversations on mental health, longevity, and the necessity of building a life that is more wonderful, not just less horrible. Incredibly warm, personable, and engaging, BJ’s universally inspiring and powerful message is to reconsider, embrace, and prioritize what truly matters in life.
As a palliative care physician, BJ has an intimate relationship with suffering and what it takes to minimize it outside of medical intervention. His support of those who are chronically and terminally ill, combined with his own experience as a patient, have informed his philosophy on living meaningfully. By discovering what matters most to us as we near the end, we can reverse-engineer a life that is rich and fulfilling for all our days, rather than just the last few. He emphasizes the value of a perspective shift, the untapped potential of the aesthetic domain, and the importance of radical acceptance of the self and all life throws at you.
Dr. Miller’s commitment to patient-centered care and to sparking productive conversations about living life fully until the end has propelled his career. Between 2007 and 2020, he worked as a palliative care physician and Assistant Clinical Professor of Medicine at University of California, San Francisco. During this time, he also served as the Executive Director of Zen Hospice Project from 2011 to 2016, playing a pivotal role in developing and sharing a pioneering model of human-centered end-of-life care. In 2020, he co-founded Mettle Health, an innovative online palliative care counseling platform offering psychosocial support to patients and families facing health challenges, and to the caregivers and physicians that support them. Mettle Health aims to give patients the agency to address their holistic needs beyond managing their illness, and to give the physicians and caregivers who must remain strong for everyone else a safe place to fall apart. Dr. Miller is also the Honorary Medical Chair of Dream Foundation, the only national dream-granting organization for terminally ill adults.
“What Really Matters at the End of Life,” BJ’s TED Talk on living well until the end and humanizing end-of-life care has garnered over 15 million views and is ranked among the most viewed talks. He is prominently featured in the Oscar-nominated Netflix documentary End Game about terminally ill patients and physicians seeking to change perceptions around life and death. He can also be seen in the Disney+ docuseries Limitless with Chris Hemsworth, helping the star navigate the complexities of aging and come to terms with his inevitable mortality.
Recognizing the lack of resources for the living amidst an abundance of self-help books for mourners, BJ authored The Beginner's Guide to the End: Practical Advice for Living Life and Facing Death. A comprehensive and compassionate guide to dying — and living fully until you do — this manual demystifies many of the logistical and personal questions often asked both by those facing the end of their life and by the loved ones who survive them.
Raised in Chicago, BJ graduated from Princeton University with a bachelor’s degree in art history — a major he switched to post-accident to learn to shift his perspective and appreciate the beauty the world has to offer as he navigated life in his new body. After several years working in both the art and disability-rights non-profit communities, he enrolled at UCSF where he completed his MD as a Regents' Scholar in 2001. He completed his internal medicine residency at Cottage Hospital in Santa Barbara,California, where he served as chief resident. He completed his fellowship in Hospice & Palliative Medicine at Harvard MedicalSchool, with his clinical duties split between Massachusetts General Hospital and Dana-Farber Cancer Institute.
Throughout his journey, BJ has been recognized with various awards including the William Osler Distinguished Teaching Award and the AAHPM/Project on Death inAmerica Palliative Medicine Community Leadership Award.


The Therapeutics of Beauty

There is immense healing to be had in experiencing the beauty this world has to offer. Our spirits are lifted when we listen to our favorite song, immerse ourselves in a world of fiction, or get a whiff of freshly baked cookies. When we tap into these sensorial delights, we connect to what makes us human and we feel the poignancy of being alive and in the present moment. BJ speaks of beauty in the philosophical sense, as truth incarnate. More than a pleasant distraction, beauty leads to a sense of awe and helps us to be with reality rather than fight it; to be of this world, of nature, rather than separate from it. As the arbiters of beauty, we can create these instances of aesthetic gratification anywhere and everywhere, on scales as small as person-to-person interactions or as large as entire system redesigns. Isolation and alienation have become the modern norm, and aesthetics offers a path to a sense of reconnection and belonging. In this wide-ranging discussion customizable to your audience, BJ Miller explores the therapeutic potential of the aesthetic domain in healthcare, architecture, and beyond

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Rethinking Happiness

What is happiness, really? We all strive to be happy, but would we actually recognize and appreciate it if we were to achieve it? To BJ Miller, happiness is not merely the absence of sadness in the same way that health is not the absence of illness. His concept of happiness is rooted in acceptance—in accepting all parts of ourselves: the good, the bad, and the ugly. When we honor our sorrows as we do our joys, our failures as much as our successes, we create a worldview in which every part of us belongs. And as this perspective begins to shift, we discover what it feels like to no longer be at odds with ourselves. This internal peace, this acceptance of life’s highs and lows, is the key to true and resilient happiness. In a world that sells happiness as a luxury that few can afford, BJ offers a grounded and accessible alternative.

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The pandemic has stretched many industries beyond their capacity. Three years in, Americans are resigning in droves or resorting to substance abuse or other maladaptive responses. Mounting stressors are pulling the covers on our incomplete or inadequate coping habits; it’s as though we aren’t allowed to have complex emotions. Reductive American notions of toughness mean people are discouraged from being honest with themselves and each other and are made to feel ashamed when what everyone really needs is compassion. Markers of mental health and social isolation are proving this point. Prior notions of self care, e.g. spa days, are proving grossly inadequate and possibly besides the point. Resiliency on the other hand, is a more deeply-seated state of being, no matter who you are or what sector you work in. Importantly, resiliency is dynamic in nature, not divisive, and it is incumbent on employers and employees alike to chart a course to well-being together.

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Moving with Empathy: Serving Financial Clients Through End-of-Life Preparations

The end of life is an ecosystem: personal, familial, clinical, and financial. In fact, many surveys find that not wanting to be a financial burden at the end of life is one of the most important issues for patients. Understanding the world of the patient puts you in a better position to anticipate the needs of clients and how best to serve them. For anyone doing the work of helping people prepare and plan for the final stages of life, no matter what stage the client is at, empathy should be at the core of that effort. And yet, it is very difficult to put yourself in the shoes of someone who is facing the end of their life. How can we help people in the prime of their life, plan for something they can’t imagine? In this talk for financial and insurance audiences, BJ addresses how to best support clients in this time of need.

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Limitless: Mastering Resilience and Acceptance

When BJ Miller was a sophomore at Princeton, a nearly fatal accident led to the loss of three of his limbs. For many, this would have been the start of a life full of misery and self-pity. But BJ, recognizing there was nothing he could do to change his situation, let go of his former life, mourned the loss of his former body, and moved to a place of acceptance. This deep and all-encompassing acceptance gave him a new lease on life and allowed him to truly live. Many of us will never experience what BJ went through, but his inspiring story serves as a roadmap for navigating all instances of loss, unexpected change, and things out of your control. BJ’s identity is not in what was loss, but rather in the parts of him that remain and in the new components born in the face of adversity. Based on lessons BJ offered in the Disney+ docuseries Limitless with Chris Hemsworth, BJ makes the case that when we accept all parts of ourselves, all of life’s highs and lows, we develop a resilience that serves us to overcome any obstacle.

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End of Life Care

How do we frame the subject of mortality so that it becomes something we dare to see? As something that binds us together? As a normal part of a healthy life? The hope is to be less paralyzed by the fact that we all die, and more inspired to appreciate what we have while we still have it. That is, to live until we actually die. It starts with all of us - including those charged with operating the healthcare system - leading with our humanity instead of our station or profession. And it pays to realize that the things that matter most at the end of life tend to be non-medical. This fact should empower people - patients and families - to take charge of their situation; it should also help to offload clinicians and the healthcare system as a whole. People have been dying for a very long time, but only recently have we outsourced death and dying to an industrialized healthcare complex, where death has become more complicated and daunting than it needs to be. The new way forward is for patients and providers to enter into a partnership with each-other, where each takes responsibility for their part in the process. With a little bit of effort, we can reclaim the humanity of the subject and uptick the importance of joy and meaning and connection. We should all share in the burden and privilege of caring for one another through life's most vulnerable and poignant moments.

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Diversity, Equity, and Inclusion: Expanding the Conversation

The recent amplification of diversity, equity, and inclusion initiatives is long overdue. But despite the best intentions, certain populations are still left out of these conversations. We’ve begun to see progress in terms of race, gender, and sexuality, but very little movement in the way of disability. The continued exclusion of disability from DEI conversations reinforces societal biases, hampers the advancement of disabled communities, and perpetuates systemic barriers. Presenting from the vantage point of both a physician and a triple amputee, BJ Miller illustrates how to ensure your diversity initiatives encompass disability and explores the attitudes and practices that must change to establish equitable access and opportunity for disabled individuals. By recognizing and addressing disability as a crucial dimension of diversity, we can strive towards a more inclusive and equitable society for all.

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What really matters at the end of life | TED
BJ Miller, M.D.
In facing death, this doctor sees a way to live well | PBS Newshour
BJ Miller, M.D.
End Game | Official Trailer | Netflix
BJ Miller, M.D.
Death as Part of Life | Arts & Ideas at the JCCSF
BJ Miller, M.D.
2015 Spotlight Health Opening and Welcome | Aspen Ideas Festival
BJ Miller, M.D.


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Three Practices to Combat Climate Grief
Tricycle Magazine
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Sadness Isn't An Emeny
All There Is with Anderson Cooper
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Electrocuted by 11,000 Volts, Now a Triple Amputee…and an MD
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COVID Exposed Gaps Palliative Care Can Fill
Hospice News
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The Myth of Closure
YG2D Podcast
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What Is Death?
New York Times
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Don’t Tell Me When I’m Going to Die
New York Times
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One Man’s Quest to Change the Way We Die
New York Times


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Patient-Centered Care
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Physicians & Other Providers
Wellness & Mental Health
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