The big thing that's happened is, in the time since the Affordable Care Act has been going on, our medical science has been advancing. We have now genomic data. We have the power of big data about what your living patterns are, what's happening in your body. Even your smartphone can collect data about your walking or your pulse or other things that could be incredibly meaningful in being able to predict whether you have disease coming in the future and help avert those problems.

Arriving at an acceptance of one's mortality is a process, not an epiphany.

You may not control life's circumstances, but getting to be the author of your life means getting to control what you do with them.

No one teaches you how to think about money in medical school or residency. Yet, from the moment you start practicing, you must think about it. You must consider what is covered for a patient and what is not.

We yearn for frictionless, technological solutions. But people talking to people is still the way norms and standards change.

Making systems work is the great task of my generation of physicians and scientists. But I would go further and say that making systems work - whether in healthcare, education, climate change, making a pathway out of poverty - is the great task of our generation as a whole.

I talked to over two hundred patients and family members about their experiences with aging, serious illnesses, and the big unfixables. But I also spoke with scores of physicians, and especially geriatricians, palliative care doctors, hospice nurses, and nursing home workers. The biggest thing I found was that when these clinicians were at their best, they were recognizing that people had priorities besides merely living longer. The most important and reliable way that we can understand what people's priorities are, besides just living longer, is to simply ask. And we don't ask.