What have you learned from dying people that has surprised you the most?

The way that health-care providers and doctors talk to patients causes them more pain than the disease itself. As I've spoken about this study to varying audiences, nonmedical audiences are often surprised that I'm surprised because it seems to be so common.

How often did you see people use their final months time to deepen and improve relationships?

The will to do that was certainly present in the participants. Many said, "I'm saying things to you that I've never said to anybody, and I wished I could." And some said, "We'd like you to write a book, and we know you have to disguise us. Don't disguise us so much that our families won't recognize us, because perhaps they'll come to an understanding of who we are."

What are the most important things that the public needs to know about pain management and palliative care?

Physical pain becomes the focus of existence. It obscures the psychological and spiritual concerns of the individual. But 85 to 95 percent of pain can be controlled, and people can be clear-thinking and participate in relationships.

It's important that physicians, nurses, and other health-care professionals understand pain management, as well as management of other symptoms—whether it's shortness of breath, nausea and vomiting, constipation, or diarrhea. Whatever the symptom, there is now a whole body of knowledge to make sure people are as comfortable as they could be.

What kinds of pain are you not able to medicate?

In the book I talk about the a ha moment I had when I realized that one woman's pain had to do with estrangement between her and her daughter. You can't medicate that. It's psychological/spiritual suffering and pain that people experience ...