Why Some Doctors Are Pushing Hollywood to Depict Death and Dying More Realistically on TV

We’ve seen it so many times: A young, handsome man rushed into the emergency room with a gunshot wound. A flurry of white coats racing the clock. CPR, the heart zapper, the order for a scalpel. Stat! Then, finally, the flatline.

This is Dr. Shoshana Ungerleider’s biggest pet peeve. Where are the TV scripts about the elderly grandmothers dying of heart failure at home? What about an episode on the daughter still grieving her father’s fatal lung cancer 10 years later?

“Acute, violent death is portrayed many, many, many times more than a natural death,” said Ungerleider, a practicing internal medicine doctor at California Pacific Medical Center in San Francisco and the founder of End Well, a nonprofit focused on shifting the American conversation around death.

Don’t even get her started on all the miraculous CPR recoveries where people’s eyes flutter open and they pop out of the hospital the next day.

All these television tropes are causing real harm and ignore the complexity and choices people face at the end of life, Ungerleider said. They create unrealistic expectations that incurable diseases can be cured and false hope that our dying loved one won’t actually die, she added. And that has people begging for aggressive, painful treatments that will never work when they could be focusing on saying goodbye.

Flipping the script on death

Ungerleider thinks Hollywood can do better. Through End Well’s annual speakers’ conference and collaboration with entertainment experts at USC Annenberg, she is on a mission to influence writers and producers to flip the script on the American way of death.

“We’re trying to embed ourselves within Hollywood,” she said. “Our goal is to encourage them to write different kinds of inspiring, nuanced and diverse storylines that are more representative of what’s actually possible.” End Well’s signature conference — a kind of TED-style symposium on death and dying — has been held in San Francisco since 2017. But this November, Ungerleider moved it to Los Angeles so a few dozen writers, producers, and social media influencers could attend alongside the hundreds of hospice nurses and grief counselors in the audience.

The speaker’s stage was also studded with stars. Talk show host and former Rockette, Amanda Kloots, talked about losing her husband to COVID-19. Comedian Tig Notaro told jokes about being diagnosed with breast cancer. Actress Yvette Nicole Brown, from network sitcoms like NBC’s Community and CBS’ The Odd Couple, was the emcee.

“When my mom passed, I called all my friends whose mom had passed before and apologized,” Brown said. “Because until this moment, I had no idea. And my ‘It’s going to be better tomorrow’ and ‘She’s in a better place’ — that helps, not at all. And I now know that.”

While other actors use their platforms to campaign against higher-profile causes like climate change and world poverty, Brown is using hers to talk about taking care of her father before he died.

‘Talk about death’

“If you are a writer or producer or a comedian, talk about grief. Talk about death,” she told the conference audience.

End Well also collaborates with researchers at USC Annenberg’s Hollywood, Health & Society program, which offers free consultations with medical experts to TV and movie writers. It was launched in 2001 with funding from the Centers for Disease Control and Prevention, recognizing that entertainment profoundly impacts viewers’ health knowledge and behavior.

The program’s linguistic analysis of TV and film scripts found writers were 82 times more likely to use the word “killing” and 30 times more likely to use the word “murder” than they were to use any one of 16 end-of-life terms, including “hospice,” “last will and testament,” or “chronic conditions.”

Ungerleider hopes writers will consult with her on how to portray end-of-life more accurately or read End Well’s white paper on diversifying and expanding their storylines.

She said some shows are getting it right, like the last season of This Is Us on NBC, which depicted Rebecca Pearson, the show’s matriarch, played by Mandy Moore, dying of Alzheimer’s and also featured several family discussions around advance planning and caretaking. Also notable, she said, is a depiction of hospice at home on the Netflix show From Scratch and a storyline from ABC’s A Million Little Things about a man with cancer choosing to end his life with aid-in-dying medication.

Researchers at USC are also working to understand what’s stopping most producers from using more realistic death narratives.

“Entertainment is still a profit-driven system and the bottom line is viewership,” said Erica Rosenthal, director of research at USC Annenberg’s Norman Lear Center, which examines entertainment’s social, cultural and political impacts.

And viewers want comfort and humor from their entertainment, she said. According to the group’s research from 2022, Hollywood executives were wary of storylines about death and dying, fearing they would alienate viewers who were already hungover from the pandemic.

Making end-of-life care funny

“There was a bit of a backlash against heavy-handed health storylines,” Rosenthal said, noting that comes with some real challenges for writers: “How do you make end-of-life care funny?”

Some industry outliers are convinced they can.

“Death stories don’t have to be sad or sappy or depressing. You can tell death stories and laugh and learn,” said J.J. Duncan, the showrunner of the Gentle Art of Swedish Death Cleaning, a new reality show on Peacock, narrated by Amy Poehler.

“What is Swedish death cleaning, you say?” Poehler asks in the show’s trailer. “Basically, cleaning out your crap so that others don’t have to do it when you’re gone.”

In the show’s first episode, three Swedes help a 75-year-old woman, Suzi Sanderson, sort through her belongings and her memories, which include working as a singing waitress in Aspen.

“I sang there for 11 years. And then I got married, and well, I have to tell the truth, it ruined my sex life,” she said, sending the Swedes into a fit of laughter.

Hollywood is slowly opening up, Duncan said, who couldn’t believe producers were willing to do a show with the word “death” in the title.

“I mean, that alone is amazing,” she said. “We had studio people say, ‘Oh, don’t say death too much,’ because it’s scary.”

Any good story has set up, conflict, and resolution, Duncan added. Maybe a hero’s journey. And there’s no reason death can’t fit into the formula.