Host: Liz Poret-Christ

Guests:

Tracey Piparo

Jennifer O’Brien

In this special episode of Difficult Conversations, Liz Poret-Christ hosts in memory of her husband Ken, whose voice you hear in the show’s intro/outro and who passed away about a year ago from glioblastoma. Liz shares how that loss and the painful reality that palliative care and hospice are often introduced far too late sparked the conversation. She welcomes two guests, Tracey Piparo, a longtime physician associate who transitioned from emergency medicine to palliative care because she realized patients and families weren’t being truly heard, and Jennifer O’Brien, a healthcare leader and author of The Hospice Doctor’s Widow, who became an advocate for “death literacy” after caregiving for her late husband through a 22 month cancer illness. Together, they lay the groundwork for why these services matter: palliative care can support quality of life alongside curative treatment, while hospice focuses on comfort and support at end of life.

The heart of the episode tackles why clinicians “dance around” these conversations: fear of failure, discomfort with mortality, a high-achiever culture that equates death with losing, and confusion about palliative versus hospice. Liz shares her personal story of repeatedly asking when to involve palliative care, only to be told “not yet,” until a hospice physician finally stated plainly that Ken was actively dying, leaving little time to prepare family and say goodbye. Tracey explains how avoiding clarity can rob patients of informed choices and argues communication should be treated like a clinical procedure, trained, practiced, and supported by specialists when needed. Jennifer adds a compassionate framework her late husband used “precious time” to help families understand when it’s time for the most important conversations (“I love you,” “I’m sorry,” “I forgive you,” “thank you”), and emphasizes that preparing for end of life doesn’t destroy hope, it reshapes it. The episode closes with a strong call for both clinicians and families be clear, ask early, bring in palliative support sooner, and replace “but and or” with “and” so care can hold “hope” and preparation at the same time.

For More Information:

Difficult Conversations Podcast

The Orsini Way

The Orsini Way-LinkedIn

It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

Tracey Piparo LinkedIn

Jennifer O’Brien Website

Precious Time Implementation Guide (free download) by Jennifer O’Brien

A Guide to Palliative Care & Hospice (free download) by Jennifer O’Brien

Free Resources (free downloads) by Jennifer O’Brien

The Hospice Doctor’s Widow: A Journal by Jennifer O’Brien

This episode of Difficult Conversations features Dr. Jessica Daigle, a board-certified pediatrician, NICU and pediatric hospitalist, and founder and CEO of Mom & Me, MD, joining Dr. Anthony Orsini and Liz Poret-Christ for a conversation about what families remember most in healthcare, not perfect outcomes, but how clinicians show up in the hardest moments. Jess opens with a core theme, medicine’s discomfort with silence, uncertainty, and pain, and how the pressure to “fix” everything can unintentionally deepen trauma. The discussion repeatedly returns to the idea that there are multiple patients in the NICU experience (baby, mother, father/partner), and that compassionate presence, transparency, and patient-centered communication can change how families carry grief, fear, and uncertainty.

Jess shares her personal path into NICU work, first through early fascination with neonatology, then through a personal experience, a traumatic miscarriage where she delivered her baby herself, and later a prolonged hospitalization and preterm birth of her son Liam. Those experiences reshaped her focus from “the baby only” to the whole family system, and helped inspire her work through Mom & Me, MD. She also highlights her devotional book Anchored in Hope for NICU parents, designed to support the emotional and spiritual toll alongside the medical journey. The episode closes with Jess reflecting on her first time delivering serious news as an attending, how hard it is to balance urgency, honesty, and empathy, and the lasting truth that even when outcomes are heartbreaking, families often remember and value the clinician who stayed present and helped them navigate with humanity. Please hit the subscribe button now! For More Information:

Difficult Conversations Podcast

The Orsini Way

The Orsini Way-LinkedIn

The Orsini Way-Instagram

drorsini@theorsiniway.com

It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

Jess Daigle, MD FAAP LinkedIn

Dr. Jess Daigle Instagram

Mom & Me MD

Anchored In Hope: A NICU Parent’s Devotional: 30 Days of Strength, Peace, and Hope by Jessica Daigle, MD

The Long Dying of Baby Andrew by Robert & Peggy Stinson

Difficult Conversations with Dr. Anthony Orsini Podcast- Episode 91: Not What I Had In Mind with guest Laura Diaz-Freeland

Difficult Conversations with Dr. Anthony Orsini- Episode 93

Difficult Conversations is back with one of its most personal, emotional episodes yet. Dr. Anthony Orsini and Liz Poret-Christ return to talk with guest Dr. Stephanie Tan, a physician and clinical trial specialist whose career has spanned surgery, dermatology, pharma, academia, and regulation across Asia and Australia. Stephanie shares how her own health redirected her from surgery into research, giving her a rare 360-degree view of medicine and clinical trials. That perspective and her personal journey ultimately led her to co-found AbbeMed, a doctor-led concierge service that helps patients and families cut through red tape and connect with the right specialists, clinical trials, and cutting-edge therapies around the world.

The heart of the episode is Stephanie’s deeply moving story as both doctor and mother. She recounts the long, frustrating process of noticing her young daughter’s developmental delays, fighting through months-long waitlists, and finally receiving an ultra-rare genetic diagnosis, only to be met with silence from the pediatric neurologist who didn’t know what to say. Dr. Orsini and Liz unpack what compassionate communication could have looked like in that moment and why “I don’t know, but we’ll figure it out together” can be so powerful. From there, they explore how AbbeMed aims to be that “friend in the business” for families facing complex or rare conditions, and Dr. Tan offers advice to new doctors: stay curious, think beyond rigid training, be honest when you don’t know, and always validate your patients’ emotions. She closes with a message of hope for patients and caregivers: Keep an open mind, don’t give up, if there’s a will, there’s a way, and services like AbbeMed exist to walk that path with you acting like you have a friend in the business. Download this episode now to hear more!

Top of Form

Hosts:

Liz Poret-Christ

Dr. Anthony Orsini

Guest:

Dr. Stephanie Tan

For More Information:

Difficult Conversations Podcast

The Orsini Way

The Orsini Way-LinkedIn

The Orsini Way-Instagram

The Orsini Way-X/Twitter

drorsini@theorsiniway.com

It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

AbbeMed