The Death Doula Storyline in The Pitt We Should Be Talking About

The show brought death doulas into a mainstream story. Why seeing this little-known end-of-life role represented matters.

Before starting End of an Era, I didn’t know death doulas existed.

I knew about hospice. I understood the roles doctors, nurses, attorneys and funeral homes played around the end of someone’s life. But a death doula? That was completely new to me.

The funny thing is, doulas themselves weren’t new to me. My wife and I had a birth doula for both of my kids. They were there to support my wife through pregnancy and birth, but also to support us as new parents navigating something we have never experienced before.

I knew the value of having someone there to provide guidance, reassurance and support during one of life’s biggest transitions. I had just never thought about that kind of role existing at the other end of life.

Building a company focused on helping families prepare for and navigate death has introduced me to an entire ecosystem I barely knew existed.

So when The Pitt introduced Lena Handzo as Roxie Hamler’s death doula in Season 2, Episode 5, it immediately caught my attention. Not because I was discovering the role for the first time.

I realized millions of other people might be.

And instead of stopping the story to give us a lesson on death doulas, The Pitt spends several episodes showing us the role in action.

I can’t tell you whether every aspect of Lena’s portrayal perfectly represents the work of a death doula. The profession itself isn’t uniformly regulated, and the role can vary. But I appreciated seeing it portrayed in such a popular series.

So, What Is a Death Doula?

Most of us have heard of a birth doula. They don’t replace a doctor or midwife. They provide non-medical support to someone going through one of life’s biggest transitions.

Death doulas, sometimes called end-of-life doulas, provide the same type of support for people on the way out rather than the way in.

The International End-of-Life Doula Association describes the role as providing non-medical support that can be emotional, social, spiritual and practical. That might include helping someone think through their wishes, supporting caregivers, facilitating difficult conversations or simply being present.

Interestingly, the connection between birth and death doulas isn’t just a convenient comparison. Hospice social worker Henry Fersko-Weiss, one of the pioneers of the modern end-of-life-doula movement, was inspired by the birth-doula model. He wondered whether the same idea of preparation, advocacy and companionship around birth could be applied to dying.

It’s a role I wish more people knew existed, and now with Lena’s storyline on The Pitt many more will!

Season 2: Roxie, Lena and a Role We Rarely See

In Season 2, Episode 5, “11:00 A.M.,” Roxie Hamler arrives at the emergency department after suffering a seizure and injuring her leg. Roxie has terminal cancer, is receiving hospice care at home, and is being cared for by her husband, Paul. They have two sons.

Then Lena Handzo arrives. Viewers already know Lena as one of the hospital’s charge nurses, but she isn’t there for her hospital shift. She explains that she is also Roxie’s death doula.

Lena becomes a consistent presence in Roxie’s story across the next several episodes and what struck me was how undramatic much of her support is. It’s practice, emotional and human.

Roxie’s injury creates a new problem. She wants to return home, but her condition has changed what she’ll need to safely live there. Suddenly there are questions about a hospital bed, a wheelchair, a shower chair and how her family is supposed to arrange all of it.

Lena helps. She also recognizes when Roxie needs privacy and helps Paul navigate what is happening.

None of these moments is particularly cinematic. That’s what I liked about them.

When we think about preparing for death, we often jump to the big things: wills, advance directives, funeral arrangements and medical decisions. But there are countless, smaller, deeply human needs around them. Someone still needs a shower chair. Someone needs to know whom to call. Sometimes someone just needs to sit in the room.

As Roxie’s condition changes, another part of Lena’s role comes into focus: making space for what Roxie wants.

The people around her can explain her options and help make arrangements, but ultimately she is the one dying. Her wishes matter.

Serious illness can quickly turn a person into a series of questions that need answers. What’s the prognosis? What does the doctor recommend? What medications should we give? Can she go home? What happens next? But at the center of those questions is still a person with fears, preferences and a need for dignity.

Roxie isn’t the only person navigating what’s happening. Paul and their sons are losing someone they love, too.

That family dynamic is something The New Yorker explored in its recent feature, “The Doulas Who Help Us Die”, which actually discusses Roxie and Lena’s storyline in The Pitt. One of the doulas profiled, Virginia Chang, described her own philosophy simply: “the family is as important as the dying person.”

That reminded me of our birth doula. My wife was obviously at the center of the experience, but as new parents, we were both navigating something enormous and unfamiliar.

The circumstances couldn’t be more different, but the idea of supporting both the person going through the transition and the family around them feels remarkably similar.

When There Is Nothing Left to Fix

By Season 2, Episode 10, “4:00 P.M.,” Roxie’s condition has deteriorated.

Her pain is becoming harder to control. Her family gathers around her. Her children have the opportunity to say goodbye. The medical team discusses increasing her morphine to keep her comfortable, knowing it may slow her breathing.

Medicine is built around fixing things. Families want to fix things. We want someone to tell us there is one more treatment, one more procedure, one more thing we can try.

Eventually, though, there may be nothing left to fix. The goal changes.

The question shifts from how to keep someone alive to how to make whatever time remains as comfortable and dignified as possible.

Lena remains beside Roxie and her family as they navigate that transition.

What Happens After

In Season 2, Episode 11, “5:00 P.M.,” Roxie dies.

Afterward, Lena immediately starts thinking about what needs to happen next. Dana stops her and asks how she’s doing.

Lena acknowledges that this death feels different. She had spent enough time with Roxie and her family that she had become emotionally connected to them.

It’s a subtle reminder that the people who guide families through death aren’t untouched by it themselves.

There Is an Entire Ecosystem Around Death That Most of Us Never See

Starting End of an Era opened my eyes to how many people can play a role around the end of a life: doctors and nurses, hospice workers, estate planning attorneys, funeral directors, social workers, clergy, grief counselors and death doulas.

Most of us don’t really understand that ecosystem until we’re suddenly inside it. We prepare extensively for other major transitions in life. Before a baby arrives, people read books, take classes, make birth plans and assemble a team of people who can help. We work with financial advisors to prepare for retirement decades in advance.

But death is one of the few experiences every family will eventually encounter, and many of us enter it knowing almost nothing about what happens or who can help.

That may be changing.

The New Yorker reports that INELDA has trained more than 10,000 doulas globally over the past decade, while the University of Vermont’s program has trained more than 5,000 since 2017.¹

The fact that The Pitt is putting a death doula in front of a mainstream television audience at the same moment The New Yorker is devoting a major feature to the profession feels like a sign that this once-obscure role is becoming part of a much larger conversation.

Why Seeing a Death Doula on The Pitt Matters

Regardless of whether The Pitt got every detail of being a death doula right,what matters to me is that the show made the role visible. It introduced viewers to someone whose job isn’t to cure Roxie, write her will or arrange her funeral. Lena is simply another person helping Roxie and her family navigate the end of her life.

That’s what stayed with me about this storyline. Preparing for death isn’t only about documents, medical decisions or what happens afterwards. It’s also about knowing what support exists while you’re going through it. Who can help navigate the conversations? Who can support the family? Who can simply be there when there’s nothing left to fix?

The Pitt didn’t introduce me to death doulas.

But I’m glad it might introduce them to millions of other people.

¹Alexandra Schwartz, “The Doulas Who Help Us Die,” The New Yorker, August 10, 2026.