About Dr. Monica Williams-Murphy (120 Posts)

Dr. Monica Williams-Murphy is a Board Certified Emergency Medicine Physician, who practices in one of the largest emergency departments in the United States at Huntsville Hospital. Through her writing and speaking, she is devoted to transforming the end of life into a time of peace, closure and healing. Media Page


“If you don’t want to deal with death and dying, then you need to quit medicine now and become an accountant…because this is what we have signed up for and we’ve got to do a better job at it.” 

These were some of my opening words at the Grand Rounds I recently gave at my medical school alma mater. More than a few doctors looked taken aback, others nodded their heads in agreement.

We are in a weird place in medical history. We have rapidly advanced, technologically, in the span of one human life time from simple penicillin to laser guided gamma knives. We are so consumed by all of this sexy medical technology that we are giving the general public the idea that we have the “eternity pill” or something. Not the case. This is certainly not helped by the fact that the medical profession has lost its ability to speak of death and to teach of its certainty. So, in honor of my earlier reference to accounting, here is my mathematical expression of our problem:

High Tech + Absent Death Awareness= Irrational Expectations @ the End of Life



Hmm…now I’m no rocket scientist (nor am I an accountant), but I’m pretty clear that the solution to the problem is changing the “death awareness” variable since we are not going to waste our technological advances:

High Tech + Death Awareness= Reasonable Expectations @ the End of life

So, to all of you medical students and residents (and seasoned attendings) out there: One of the most important facts of life is that it ends. It is moral medical malpractice not to tell your patients where they are in the “map of life.” With as much effort as we put forth to give patients a good life, we should also give them a good death. Patients and families need to hear the “facts of life,” delivered compassionately, from you…otherwise, you might need to look into accounting.

 Monica Williams-Murphy, MD

Our Book: It's OK to Die

"It's OK to Die" is a ground-breaking book filled with graphic stories straight out of the Emergency Room illustrating how most Americans are completely unprepared for death and dying. In response, the authors have created a unique and comprehensive guide urging EVERYONE to prepare in advance, to assure their own peace and to prevent the suffering of their loved ones.
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8 thoughts on “Counsel: Quit Medicine and Become an Accountant, By Monica Williams-Murphy, MD

  1. Rea

    “Life is fleeting and fragile. Live and love as though every day is your last….Leave no words unsaid, leave no plans unmade.” [IT’S OK TO DIE, p. 19] To do this is to remain gently aware that death will take every one of us some day. “Them” is “us.” We are all human, first and last. To deny (“forget”) this is the avoidable moral error. It may hurt to remember. It is worse to forget.

    In this case, forgetting is unethical because it causes harm to the patient and his family. It is the opposite of good/appropriate/necessary medical practice. Ethical mistakes are unacceptable especially whenever there is a clear and open path to avoiding them.

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  4. Virginia Seno

    While it’s unlikely that anyone who is not (yet) comfortable talking about death and dying will leave their profession for that reason; it is likely that they have noticed who among their colleagues *is* comfortable in facilitating patients and families through serious illness decisions and impending loss.

    So rather than ask them to leave the profession, maybe they’d take more to the idea of finding a colleague who knows how to be-with dying and either ask them to facilitate in a situation and/or request an in-service and lessons with them. It’s tacit wisdom and experience usually that has created someone’s knowledge, skill and ability to attend to dying well; but these folks are around and they will be happy to guide anyone to the simple awareness (of being) that is already there but not yet recognized.

    If anyone reading this is interested in a question set for having these conversations with ease (Monica and I worked on this together), I”ll send a copy at your request.

    1. Dr. Monica Williams-Murphy Post author

      Yes! Actually, scratch my advice. Rather than quitting to become an accountant, take a day off and take Dr. Seno’s course on becoming comfortable with end-of-life communications :-)

      1. Guillermo Godoy, MD

        As a medical professional with interest in BioEthics, a Regional Ethics Committee member and a neonatologist, I encourage all health care providers to discuss, learn and be involved with end of life decisions, living wills and health care directives. It is one area in which a single answer doesn’t fit all situations. It is uncomfortable for us and all community members, and our patients need direction, concealing and support.

  5. Lorree Ratto

    Dr. Seno, I would like to see your question set. I am responsible for teaching our medical students about death and dying. I am passionate about end-of-life communication. I have made reading Dr. Williams-Murphy’s blog a requirement. As a fellow in thanatology, I always think I have everything related to death and dying covered but then some new information or sometimes old information presented in a new way comes along and I think, “wow, what a great thing to share with our students.” However, I have to agree with Dr. Williams-Murphy in that some physicians, regardless of all the training, seminars, books, and classes — need to become accountants.


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