FHC #136: Love and sexuality at the end of life with Dr. Pebble Kranz

This episode of Fixing Healthcare continues the ninth season’s focus on end-of-life issues by exploring the often overlooked topics of love and sexuality during this critical time.

Cohosts Dr. Robert Pearl and Jeremy Corr welcome Dr. Pebble Kranz, a sexual medicine specialist and medical director at the Rochester Center for Sexual Wellness.

In a recent Medscape column titled “Physicians: Don’t Ignore Sexuality in Your Dying Patients,” Dr. Kranz wrote: “I have a long history of being interested in conversations that others avoid. In medical school, I felt that we didn’t talk enough about death, so I organized a lecture series on end-of-life care for my fellow students. Now, as a sexual medicine specialist, I have other conversations from which many medical providers shy away.”

She brings a unique perspective to the podcast, highlighting the importance of addressing sexual concerns for patients nearing the end of their lives. She discusses the need for healthcare providers to have open, honest conversations about sexuality, noting that patients often want to discuss these issues, but clinicians are frequently uncomfortable or unprepared to do so.

Throughout the interview, Dr. Kranz emphasizes that sexuality is a vital part of human identity and well-being, extending from young adulthood through old age, and even in illness. She shares insights from her work, including the story of a 75-year-old patient with cancer who sought to maintain her sexual health despite her illness.

The episode addresses several key points:

  • The cultural and medical taboos surrounding discussions of sexuality, especially for patients at the end of life.
  • The importance of medical education in preparing clinicians to handle sexual health concerns.
  • Strategies for expanding the concept of sexual play and intimacy to accommodate the changing needs and capabilities of patients.
  • The role of healthcare providers in facilitating conversations about sexual health and providing appropriate treatments.

Dr. Kranz also touches on the emotional and existential dimensions of sexuality, explaining how physical intimacy can help patients feel more connected to themselves and others, even as they face terminal illness. She advocates for more privacy and support in hospital settings to allow patients to express their sexuality and maintain close relationships.

Tune in for the full interview and join the conversation on social media.

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Dr. Robert Pearl is the author of the upcoming book “ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine.” All profits from the book go to Doctors Without Borders.

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.