Dr. Rachel Carson is a nephrologist in Nanaimo. After initial training as a family physician, she trained in Internal Medicine at UBC and did her Nephrology fellowship at the University of Western Ontario, followed by research in conservative management of endstage renal disease at the Royal Free Hospital in London, UK. She led the establishment a new full service renal program for Centre and North Vancouver Island between 2008-2012. She has a two-decade interest in end-of-life care and advance care planning. She is the physician lead for advance care planning for Island Health Authority, has a provincial leadership role with BC Renal around palliative and end of life care for nephrology patients. She works provincially with the BC Centre for Palliative Care implementing Serious Illness Conversation training and on system-level changes to the Electronic Health Record to improve documentation so that patient wishes are Expressed, Heard and Respected. She is also training her pandemic puppy “Atlas” to help shoulder people’s worries as a healthcare therapy dog.