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Silence Causes More Suffering at the End of Life Than Death Itself

2025 ⸱ 

Anao Zhang, Phd, LCSW

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What happens when a patient’s wishes go unspoken at the end of life?

In this powerful talk, Anao Zhang shares the story of a 19-year-old with advanced cancer, caught between his family’s cultural beliefs and his own quiet wish to die at home. It’s a story about silence—what it protects, and what it costs.

Dr. Zhang is a palliative care social worker and researcher focused on adolescents and young adults with cancer. His work sits at the intersection of clinical care, mental health, and human connection, helping patients and families navigate some of the most difficult conversations we face.

His message is clear: silence causes more suffering at the end of life than death itself.

This talk is an invitation—not to have perfect words, but to begin. To listen. To make space for what matters most.

Watch more from End Well and join the conversation about how we care for one another at the end of life.

About the speaker(s)

Dr. Anao Zhang, PhD, LCSW, OSW-C, ACBT is a leading voice in adolescent and young adult (AYA) palliative and psychosocial oncology. As an Associate Professor at the University of Michigan and Research Director for Clinical Services in its AYA Oncology Program, Dr. Zhang sits at the powerful intersection of science, care, and humanity. He is known for developing innovative, evidence-based mental health solutions that honor the complexity of living—and dying—young with cancer.

Trained in both clinical social work and advanced statistical modeling, Dr. Zhang leads nationally recognized research that translates cutting-edge mental health science into real-world tools: from AI-powered distress screening apps to hope-based therapies like solution-focused brief therapy and digital cognitive behavioral treatments. His work is grounded in equity, dignity, and the belief that healing isn’t only about curing—it’s about caring, deeply and creatively.

Dr. Zhang has secured nearly $3 million in research funding and published over 90 peer-reviewed studies. But what matters most to him is this: making space for the emotional truths of young people navigating serious illness. He believes that palliative care is not just an endpoint, but a radical act of presence and partnership.

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