Death Doula Wisdom

In the fall of 2021, just months after starting ketogenic therapy for bipolar 1 disorder, I began working as the Marketing and Development Director for Serenity Hospice and Home. This was my first experience of hospice, and paradoxically, while surrounded by death, I was simultaneously being reborn as I implemented metabolic therapies, put my bipolar 1 disorder into complete remission, and reclaimed my life. 

Nestled in a small Illinois town, Serenity offers both in-home care and an inpatient facility for symptom management and respite, surrounded by forests and cornfields. Many patients who spend their final days at the Serenity Home lovingly refer to it as “God’s waiting room to heaven.” Time slows there, and life and death intertwine in an otherworldly atmosphere. A serene heaviness fills the air–like a warm weighted blanket– imbued with love, grief, and profound human vulnerability. 

When a patient passes at Serenity, they are honored with a 'walk out,' where staff and family reverently escort the body to the hearse. Even if I hadn’t known the patient personally, I was always moved by the experience. Witnessing the intimacy of loved ones saying their final goodbyes deeply impacted me, changing how I think about death—and what truly matters in life.

Between Worlds: Lessons in Mortality and Mental Health

I live with a persistent awareness of human fragility and a faint but lingering fear that I could once again slip between the cracks of reality. Whether or not one struggles with mental illness, we are all simultaneously vulnerable and powerful; death is inevitable, and life remains a boundless miracle. To be human is to embody these seemingly irreconcilable juxtapositions. Recovering while working in hospice deepened my ability to embrace mortality and reinforced what my illness had taught me: life is transient and unpredictable, every moment of good health should be venerated, and nothing is more important than valuing love, connection, and service.

The hospice nurses I worked with embodied this spirit. One of them described herself as a “midwife to the other side,” ushering people into death with as much compassion as one might welcome a newborn into life. They consistently went above and beyond, providing far more than basic healthcare. After finishing her rounds, one nurse spent time walking with a patient with Alzheimer’s and discovered that, though he could barely hold a conversation, he could play hymns from memory at the piano. He had once been a church pianist, and his ability to serenade other residents with Amazing Grace, despite his deteriorating condition, was both mesmerizing and tragic—a brief escape from a mind ravaged by dementia.

In these patients, I saw struggles I recognized from my own experiences with bipolar mania: disconnection from reality, confusion, anxiety, and panic. Interacting with them reminded me of my own hospitalizations, where I was physically present yet trapped in a dark, parallel reality.

My path out of bipolar symptoms came through metabolic therapies. I now view the psychosis that once overwhelmed my life not as a purely psychological disorder but as a neurological one rooted in mitochondrial dysfunction. While dementia is widely acknowledged as a neurological condition, psychosis in bipolar disorder and schizophrenia is often seen as mysterious and elusive. Yet both may stem from the same root cause: impaired mitochondrial biology.

Beneath the Surface: The Metabolic Iceberg of Mental and Neurological Illness

In a recent article, Neurodegeneration and Metabolism: Seeing Beyond Symptoms to Root Causes, metabolic psychiatry pioneer and author of Brain Energy, Dr. Christopher Palmer, elaborates on the work of Drs. Matthew Phillips and Martin Picard, who propose that neurodegenerative diseases like Alzheimer’s (as well as Parkinson’s, amyotrophic lateral sclerosis (ALS), and Huntington’s disease) are akin to “metabolic icebergs.” In their framework, the visible symptoms—like memory loss and confusion in dementia—represent only the tip of the iceberg, while the hidden bulk consists of underlying mitochondrial impairment. Environmental influences—ranging from toxins and poor nutrition to chronic stress and inactivity—disrupt mitochondrial health and eventually give rise to the outward symptoms of neurodegenerative conditions. Phillips and Picard promote inducing mitohormesis, providing small doses of beneficial stress to mitochondria (through tools like fasting, a ketogenic diet, exercise, and cognitive challenges) that: “may be optimally activated by strategies that facilitate a balanced oscillation between challenging (but not excessive) stressor phases, which temporarily disrupt mitochondrial biology, and complete (but not excessive) recovery phases, which provide adequate time for mitochondria to repair and recalibrate prior to the next stressor.” Dr. Palmer emphasizes the impact of their work, aligned with his brain energy theory, “Ultimately, the goal is to address the root causes—restoring energy balance at the cellular level and, in doing so, transforming the lives of those affected by these devastating diseases.”

Having experienced firsthand the liberation from psychosis and other debilitating symptoms of bipolar disorder through metabolic therapies, I am passionate about raising awareness of the connection between mental and metabolic health. Metabolic therapies that induce mitohormesis have the potential to protect and restore brain function—offering hope for both psychiatric and neurological healing.

The Transformative Power of Mortality: Finding Meaning after Metabolic Healing

Viktor Frankl, a renowned psychiatrist, neurologist, and Holocaust survivor wrote the influential book Man’s Search for Meaning, which reflects on his experiences in Nazi concentration camps and explores how finding purpose in suffering can help individuals endure unimaginable hardships. Frankl’s philosophy, known as logotherapy, emphasizes that life’s meaning is derived from how we respond to challenges, no matter how difficult they may be. His words resonate deeply with me: “Live as if you were living a second time, and as though you had acted wrongly the first time.” In many ways, my recovery through metabolic therapies feels like a resurrection, not to be taken lightly. Now that my health has been restored, each moment feels like a second chance—a chance to live with love and intention. 

I aspire to be as kind and compassionate as the hospice nurses I worked with, but I discovered my calling was not as a doula to death, but as an advocate for metabolic therapies to help those seeking rebirth. Recently, as I approach my one-year anniversary as the Mental Health Communications and Advocacy Manager at Metabolic Mind, I’ve found myself reflecting on my time in hospice. That experience taught me invaluable lessons, yet I couldn’t be more grateful to now devote my career to raising awareness of the connection between metabolism and brain health. In my experience, metabolic therapies are a hidden gem, desperately needed by countless people burdened by psychiatric, neurological, and other chronic conditions,  with the potential to improve, and sometimes fully restore, quality of life. Sharing this path to healing has given me a purpose that will last a lifetime.