Visionaries: Alexandra Drane engages with grace

Following is Part Three of our email interview with Alexandra Drane, TEDMED 2010 speaker and founder of Eliza Corporation. Here are Part One and Part TwoIn this final installment, Drane discusses work she considers critically important both personally and nationally, and what she does to maintain her own good health and considerable vitality.

Engage with Grace, the movement you co-founded to help families be better informed about and to cope with end-of-life decisions, is a force behind National Healthcare Decisions Day on April 16th. Can you talk about which current challenges in health and medicine have made these decisions more critical than ever?

We just don’t do end-of-life well in this country – and that stinks for a lot of reasons.

First, you only die once. Thank you, Atul Gawande, for making that incredibly straightforward point – among others – in this remarkable New Yorker piece about making our last days as pleasant as possible.

Second, since you only die once, die the way you want, and make sure your loved ones get that same honor. It’s a gruesome concept – except it’s not.  Stay here for a minute. We live with such intent, why wouldn’t we want the end of our lives to have that same grace? Why wouldn’t we want to make sure our loved ones are treated with that same dignity?

Third, doing end-of-life well is a gift that keeps on giving, for the person who has a far better experience at the end of a life well lived, but as importantly for those who are left behind. There is no worse hell than second-guessing how you supported a beloved in his or her last days, particularly when what the system often provides – not by willful mal-intent, just by not knowing how to do anything else – is unnecessary and I would even say inhumane.

Fourth, with the demographics shifting the way they are, the magnitude of this problem is quickly going to become unmanageable. It’s bad for us as humans. It’s bad for us as a country.

And this is one of the only places in healthcare where we are all naturally aligned! Most people want less care at the end of life (70% of people want to die at home, yet only 30% do), and less traditional/intensive care usually produces better outcomes and a higher quality of life. Check out stats from the Coalition to Transform Advanced Care. The potential savings are enormous.

In other words, just by designing a system/process where people are informed and get what they want, we get better outcomes, and massive savings.  Here’s the most beautiful thing about it, though. We don’t even have to bring up the cost savings!  While they are relevant to those concerned with the disaster-pointing cost trajectories of our shifting demographics under current care models, just by getting people what they want, the savings will take care of themselves. So don’t focus on the cost; it takes away from the beauty of the story! Instead, focus on this: Just by giving informed people what they want at the end of their lives, we get better outcomes and a better quality of life. Why would we not want that?

When the ‘Death Panel’ fiasco came along, a lot of people, understandably confused by the baloney that was trumpeted about, stood up and articulated that they did not want Death Panels. Based on their understanding, they were right. But they missed the opportunity to stand up for what they did want. And every day that we let the current reality of how end-of-life usually happens continue, we all miss that opportunity.

Let’s agree together to do this better – for ourselves, for our loved ones, for everyone.  Let’s articulate clearly, and loudly, a better reality.  Doctors, we want to know what’s going on with us and with our loved ones in an advanced illness situation. We don’t want false hope, we just want you to be direct, and gentle in how you share with us.  We want to hear our options, all of them, not just the ones that include more and more traditional care delivered in a hospital.  We want you to involve our friends and family in these discussions. Let’s think together based on what options exist in these hard situations.  We want our doctors to be okay with our choices – even if they include intentionally requesting less invasive care in return for a better quality of life.  And most importantly?  Most of us just want to go home.

This discussion matters. We need to have it on a national level, and we need to have it as individuals, as mothers and fathers and children and siblings and cousins and co-workers and friends, and as a population that cares a whole heck of a lot about living a good life, because the end of each of our stories should be just as glorious.

Engage with Grace.

What’s one thing you do every day (or as often as possible) to maintain your own health?

I laugh – all the time – at myself, at the inanity of how many mistakes I make, at how hard this all is, at how beautiful we all are with our extraordinary complexity and yet insane simplicity.

I say inappropriate things, because I can’t help myself, and because they are usually true, and because having real conversations is just fun.  And people are generally more productive when you’re starting from a baseline of authenticity and joy and soul and humor.

I revel in the humility of the great joy that we, at this very moment, are alive. And that in and of itself is a gift. One to be cherished, one to be leveraged, one to be celebrated.  I’m realizing in my old age that being successful is not about being perfect, or sometimes even particularly good at what you do. It’s about being slightly less screwed up than everyone else – at least for this moment – and caring a whole lot in the process.  When you remind yourself that you’re lucky to be alive, that it’s never going to be perfect (for anyone), and then focus on the importance of what you’re trying to achieve, you just feel better.

And finally, I try to sleep more, love my family a lot, and remember to seduce my man on a regular basis.

I guess that’s more than one.

For more from Alexandra Drane, watch her TEDMED 2010 talk.  

Visionaries: Alexandra Drane on crafting seductive health messages

Alexandra Drane

In Part Two of our email interview with Alexandra Drane of Eliza Corporation, she talks about how most health messaging fails miserably at inspiring change in behavior.

Here’s Part One of the interview.

Your latest new venture, Seduce Health, talks about why so many health messages, both in the private and public sectors, fail miserably to change behavior. What are they missing?  What’s your favorite example of a bad message, in form or content? A good one? 

One of the most gorgeous things about the healthcare space is almost everyone in it is here because they care. They are mission driven to make this world a better place for people – particularly as it relates to health. And that’s a good thing!!  But it’s also our Achilles’ heel. We often project that fanatical level of interest in health and healthy behaviors on the people we are trying to influence, as if they too are spending most of their waking hours thinking about and obsessing over what creates better health-related outcomes. Sadly for all of us, they’re not. In fact, the average person would rather eat worms than read my thoughts on healthcare! They’re out reading about who slept with whom or which team won what or feeling secretly delighted that Facebook’s stock is down because they don’t own any and they don’t work there (at least, that’s what I’m doing).

By virtue of the fact that we sometimes think we’re ‘all that,’ we seek to influence people in ways that don’t resonate because we presume a level of baseline interest or engagement that is just not there. One of my favorite examples is to look at the advertising and marketing efforts of the food, tobacco and beverage companies, and then compare them to most of ours. We send pictures of diseased kidneys; they feature smokin’ hot models with grease from a bacon double cheese burger running down their arms.  Hmmmm – who’s going to win there?  That’s not always true, but you get the point.

My pleasures are fleeting.

The problem (opportunity?) is also compounded when you consider that we as an industry spend 30 cents for every $30 our ‘competition’ (those same food tobacco and beverage companies) have at their disposal. They’re simply spending more money. And with a greater self-awareness about what sells, what resonates, what inspires and seduces and beguiles. And not to pile on, but to be fair – their job is easier! I can sell the pants off how good a donut would taste right now (or Fritos, or a sausage, or …), but convincing you that carrots will hit that same spot?  Slightly more challenging.

So, is the answer to just use beautiful models in all that we do? Of course not. It’s far more complicated than that. But it does require that we inhale more humility about what the average person finds intriguing, what real people are interested in spending time thinking about, and that we design our outreach efforts in a way that fully and unabashedly incorporates that very different perspective.

Bite me! I

How can we do that? By adding joy, soul, humor to our approach…by paying attention to the universal conversations that are happening at the water cooler, at the dinner table, at the bar…. by meeting people in the messy realities of their lives, speaking with them in a way they can understand, one that doesn’t feel condescending or academic, and working to help them solve the problems they care about, which may or may not be the ones on which we are focused.

We work hard to infuse our health messages with a true consumer approach, and we do all we can to avoid tactics like medical terrorism – a favorite go-to of many health organizations – even though the literature (and common sense) shows that terrifying someone into action may work once but has a very short half-life. Many of our favorite examples of what we love, and what we don’t, live at Roll around in them for a bit and share what you think!

It’s not hard to do on paper – the tough part is being brave enough to roll out this kind of approach in the real world.  Luckily, we’ve been able to convince (coerce?) some of our customers into trying fresh approaches, and they work! For example, we reached out to women due for a mammogram with a flirty approach and found that women were 26% more likely to schedule a mammogram after hearing this message versus a straightforward reminder:  “Believe it or not, there’s a mammography machine out there that really misses you. You don’t call, you don’t write. Do you think you’ll visit soon?”

The one thing we know for sure is no one has figured out how to really nail this yet. But we think with time, with more experience, with more data, with more humility, and really with more bravery to try genuinely unorthodox and thrilling approaches to engagement – approaches that DON’T presume people are sitting around waiting to get lectured – we’re going to get there.

–Interviewed by Stacy Lu