When a Cough Becomes a Killer: What Everyone Needs to Know About Pneumonia

Pneumonia kills millions every year, often because people wait too long to get help. Learn why denial can be deadly, how to spot the warning signs early, and what you can do to protect yourself and the people you love. https://bit.ly/43S5ROB

In this Episode:

• 01:40 - Avoiding Falls - Kiss Guitarist Ace Frehley Had a Fatal Fall in His Home
• 03:49 - Road Trip to Wyoming and Cowboy Cookies
• 04:43 - Diane Keaton, Died From Pneumonia, Produced a Documentary Called "Heaven"
• 13:36 - Pneumonia-the Silent Global Killer
• 17:01 - What Exactly is Pneumonia?
• 21:05 - How to Avoid a Premature Death from Pneumonia
• 26:00 - When Is It Time to Seek Help for Possible Pneumonia?
• 27:02 - Pneumonia Summary
• 29:03 -  Ticus Poetry from his book WHAT'S LEFT OF ME: Poems of a dead soul
• 30:03 - Outro

Transcript

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Hello and welcome to Everyone Dies. This week's podcast is about pneumonia, which was Diane Keaton's cause of death. Pneumonia kills millions of people around the world every year, often because people wait too long to get help.

In this week's episode of Everyone Dies, we talk about why denial can be deadly, how to spot the warning signs of pneumonia early, and what you can do to protect yourself and the people you love. So relax and settle in for our podcast about serious illness, dying, death, and bereavement. Because everyone dies, but no one has to face it unprepared.

I'm Marianne Matzo, a nurse practitioner, and I use my experience from working as a nurse for 47 years to help answer your questions about what happens at the end of life. And I'm Charlie Navarrette, an actor in New York City, and here to offer an every-person viewpoint to our podcast. We're both here because we believe that the more you know, the better prepared you are to make difficult decisions in a crisis.

Be advised, this podcast does not provide medical nor legal advice. Please listen to the complete disclosure at the end of the recording. In the first half, Charlie has a report about Diane Keaton's documentary, Heaven, and our recipe of the week.

In the second half, I'll be talking about bacterial pneumonia. And in the third half, Charlie has a poem from Tychus Poetry. So, Charles, how are you? Well, you know what? I'm okay.

Thank you for asking. Listen, I've discovered something, ace freely, you know, the original lead guitarist for Kiss. Yeah.

Did he kiss somebody? I'm going to guess so. In his lifetime, he was a rock musician. Yeah, yeah.

So, anyways, yeah. So, you know, I mean, he died several weeks ago, and I come to find out he died from a fall. Really? From falling.

So, I bring this up because, you know, we've, you know, you know, on the air, we have one episode in particular about falling. I think we have probably more than that. Well, you're right.

I'm just thinking of, excuse me, of a long episode that we have. But yes, we bring this up. So, ladies and gentlemen, if, you know, ace freely can fall and die, well, you know, please keep that in mind for yourselves, too.

Please be careful, you know. So, do you know the details? Like, where did he fall? Did he fall in his bathroom? That's the typical place. I know he was at home.

I'm not sure it was in his bathroom, but it's very, very possible. Yes. Or maybe it's that at some point he had to go to the bathroom.

To take his makeup off? Um, that was makeup? I did not know that. So, yes, all joking aside, please take care when you walk, when you put your shoes on, when you get up. Look at your feet.

Look at your feet. What else am I missing, Marianne? Put your shoes on immediately when you get up. Look at your feet.

And don't be rushing. You got no place that's that important to go. That's, that's true.

Except heaven. You don't want to rush there. Yes.

You can wait 15 seconds to get your bearings before you stand up. That's right. Okay.

Okay. That being said, for our first half, our travels this week took us to Wyoming, the first state to grant women the right to vote in 1869, long before the 19th Amendment was passed in 1920. This progressive move earned it the name Equality State.

And while women were enjoying the right to vote, not to be confused with equal rights, which still has not been ratified into law, they were also baking a delectable takeaway, cowboy cookies. These oversized oatmeal confections are generously studded with chocolate chips and pecans. They're absolutely perfect for long trail rides or for your next funeral lunch.

Bon Appetit, partner. Ladies and gentlemen, actor Diane Keaton died on October 11, 2025 of bacterial pneumonia. In addition to acting, producing, writing, and a passionate renovator of unique homes, she also directed, including a documentary in 1987 called Heaven, described as a surreal mix of interviews and archival footage exploring popular ideas of the afterlife.

She described the movie as having clarified her own personal beliefs. Why would there be such a place as hell for any of us? The interview subjects, ministers, atheists, children, courting couples, and several of Keaton's family members, variously describe heaven as an open space, as gleaming with diamonds and gold. And as a young boy says, all white like marshmallows.

Several people assert that you can't get fat in heaven. Between the interviews, Keaton lays a collage of archival film clips from a variety of movies stating, maybe what I'd like to do in heaven is look at images forever and select them. Much of heaven takes place in a white room striped in odd shadows.

Seated at a table, interviewees answer questions such as, is there sex in heaven? And what are the rewards of heaven? Let's sample a few. The opening question is, are you afraid to die? Answers included, death is an illusion. There is no death.

I don't believe in heaven. I ain't making many future plans because I don't want to live that long. Also asked, do you believe in heaven? Answers, yes, I believe there is such a place as heaven.

I believe in hell. Well, yeah, maybe. I don't know where I'll be tomorrow, but I know where I'll be in 10,000 years.

Next, are you afraid to die? Responses, we just work our butts off our whole lifetime to die at the end of it, just to go on to something better. Another person observes, no, as a matter of fact, it's interesting that in the salvation army, when a person dies, we don't call it passing away or going to the other side or passing on. We call it promoted to glory.

Question three, how does an expert view heaven? Answers, I'd like to tell you about the place called heaven. Heaven, the place where the Lord God Almighty dwells. Let us compare it to New York City.

If the New Jerusalem were only 1,500 feet tall, like the tallest buildings in New York City, it would still be 1,400 times greater in size than New York City. This means that Jerusalem is over 5,000 times higher than New York City. Welcome to a place where death cannot come.

Number four, can death be here on earth? Answers, heaven is here, but it hasn't fully manifested itself yet. A couple were asked, is there love in heaven? The gentleman turned to his wife and said, I think you are heaven. I think your eyes are heaven.

Isn't that sweet? It's so sweet. Yes. This question, is there sex in heaven? Received the greatest number of responses.

Heaven is sex. Heaven is an orgasm. It's the best.

Then this guy turns to his partner. You love it. She laughs and agrees.

Sex in heaven has to be, well, you can do it with yourself. We wouldn't have to go out and look for it Friday night at a bar or anywhere else. You won't get any venereal disease because you know how clean you are.

We are going to have an orgasm that you can't even comprehend. Is there sex in heaven by heterosexual or homosexuals or animals copulating? There's no need for the physical attachment. There is sex, but it is automatic.

And so you will not need to get on top of somebody and ramming away. That is not necessary. Next up.

What are the rewards of heaven? Responses include, I know they will be waiting for me on the other side. There's even a possibility we can all become gods and goddesses ourselves and rulers of our own world. You could spend a year communicating with a tree and you will never be bored.

Everything's just going to be no pain. Barks root beer, happiness, torpedo sandwiches. Additional questions asked.

Are you afraid to die? Can you prove there's a heaven? How do you get to heaven? And the last word, not really a question, goodbye. Responses included. First, my mother died about 12 years ago.

My brother died seven years ago. My husband died nine years ago. Sadness, sad life.

A lot of friends too died. I couldn't believe it. I lost my family, but the dearest one in my family was Sadie.

And when I lost her, I thought I lost everything, which I did. But I figured I had to go on. Diane Keaton approached religious questions in other forms as well.

In the introduction to her 1983 photography book, Still Life, she wrote, Heaven seemed the notion where everything was perfect. And by being perfect, heaven was motionless. In a Vanity Fair interview, Keaton offered her own personal definition of heaven.

Staying alive as long as I can in good health and with a good attitude. Diane Keaton had long been preoccupied with the afterlife. In the same interview, she described herself as having grown up as a morbid child with a fear of death.

The oldest child of an Irish Catholic father and a Methodist mother, both of whom abandoned religion in the 1960s, she had an early interest in Christianity out of a desire to get to heaven. As an adult, she identified as an agnostic. She told the interviewer, But I understand the longing and the need for more.

For something better, fuller, for love. You can find Diane Keaton's documentary, Heaven, online and watch it for free. Please go to our webpage for this week's recipe for cowboy cookies and additional resources for this program.

This is the part where we ask for your financial support. Your tax-deductible gift will go directly to supporting our non-profit journalism so that we can remain accessible to everyone. You can donate at www.everyonedies.org. That's every, the number one dies, dot org.

Or at our site on Patreon under Everyone Dies. Marianne. Thanks, Charlie.

Pneumonia is a very common disease in both children under the age of five and adults over the age of 75. And is responsible for three million deaths each year around the world. Many older adults at the beginning of the pneumonia symptoms tell themselves that, Oh, it's just a cold or it's allergies or a cough that just won't go away.

I remember when my mom got very sick and refused to go to the doctor because what was he going to do about it anyway? And that it would just go away. I was living a thousand miles away from her and my siblings reported to me how sick she was and how she was refusing to go to the doctor. I called to talk to her and heard the same things that she had told them.

My mom was a depression baby and wouldn't spend money on things unless she absolutely had to, including seeing a doctor. So I took a different approach than my siblings. I knew she was a proud woman.

So I said that if she died of pneumonia, people would say, Why didn't she go to the doctor? Her pneumonia could have been treated and that people would think that she was not very wise in her decisions. After we hung up, she called my brother to drive her to the doctor and she recovered. But waiting too long as an older adult to get treated can result in dying sooner than you would have otherwise.

So let's talk about pneumonia, what to look for, how you can make good choices if you get sick. Pneumonia is named depending on when and where you get the infection. So pneumonia can be divided into community acquired and healthcare associated.

Community acquired pneumonia is acquired outside of the hospital where there is no contact with the healthcare setting for at least 30 days before the symptoms start. Healthcare associated pneumonia happens as a result of being in the hospital or other healthcare setting. Today, I'm going to focus on community acquired pneumonia because if you are at home, you are making the decisions about whether or not you're going to get care.

In the United States, although pneumonia is associated with fewer deaths in children than in developing countries, it remains the most common cause of hospitalization in children, the second most common cause in adults, and one of the leading causes of death. Despite advancements in prevention, diagnosis, and treatment of pneumonia, including vaccines, newer antimicrobials, and other rapid diagnostics, the death rate is still high in older adults, especially those who wait to get treated until they are already in respiratory failure or septic shock. Risk factors for developing community acquired pneumonia include being male, age younger than five in older adults, especially those over age 65, passive and active smoking, malnutrition, diabetes, heart disease, asthma, chronic bronchitis, neurological disease that has impaired swallowing, immunosuppression, alcohol dependence, having the flu, poor dental hygiene, contact with children, and the use of proton pump inhibitors.

Those are the drugs that decrease stomach acid production. So, what exactly is pneumonia? Pneumonia is an infection that affects the lungs, causing the air sacs, those are called the alveoli, to fill up with fluid or pus. The alveoli are like bunches of little grapes in our lungs that give more surface area for the blood to absorb the oxygen.

If the alveoli are full of fluid or pus, it makes it harder for the oxygen you breathe in to get into your bloodstream. Pneumonia can be caused by bacteria, viruses, or fungus, and it can make it hard to breathe. The most common symptoms of bacterial pneumonia include fever, cough, shortness of breath, and increased sputum, that's mucous production.

Other symptoms include feeling tired, headache, muscle aches, spitting up blood, shivering, and joint pain. Pleuritic chest pain due to localized inflammation of the pleura may also be present. In several cases, low blood pressure is a sign, and other signs of pneumonia can include fast breathing, fast heart rate, needing to use your chest muscles to help you breathe, and confusion.

And the confusion comes from not having enough oxygen in your blood so that your brain is not getting enough oxygen. So there's this scoring system called the CURB-65, C-U-R-B-65. And this is a pneumonia severity score that's used to decide if someone needs to be hospitalized or if they need to be admitted to intensive care.

So a person gets one point for each of the following. So confusion is one point. Uremia, which is the buildup of waste products in the blood from kidney failure.

And the way they do that, they do a blood test, and they order what's called a blood urea nitrogen test, or a BUN. And if that's greater than 20 milligrams per DL, then you would get a point for that. Respiratory rate, and that would be if you were breathing faster than 30 breaths a minute.

Hypotension, which is low blood pressure where the upper number is less than 90, and the diastolic number, the lower one, is less than 60. And if you're older than age 65, you get a point. So if the CURB-65 score is greater or equal to 2, it's a signal that you would need hospitalization.

A score of greater than 4 or equal to 4 indicates intensive care admission. So as you can see, what would get you into the hospital if you're over age 65, all you need is one of those other vitals. Pneumonia is treated with antibiotics, but they need to be started early enough to be effective.

You can't wait and wait and wait and then say, okay, I'll go to the hospital and I'll get antibiotics, because at that point, it may be too late. Typical pneumonia can vary in prognosis, meaning what's going to happen. And it depends on many factors as age, cognitive status, what other diseases a person has, such as cancer or chronic respiratory disease, if they're immunosuppressed, chronic alcohol misuse, and the need to be on a respirator.

Older people are more likely to have poorer clinical outcomes than younger individuals. If the pneumonia is left untreated, up to 30% of the people will die. So what can you do to avoid a premature death from pneumonia? Number one on the list, get the pneumonia vaccine.

Vaccines can help prevent infection by some of the bacteria that can cause pneumonia. According to the CDC, all adults 50 and older should get the pneumonia vaccine. It is two injections, one year apart, and then one dose every five years.

Charles, do you get your pneumonia vaccine? It's funny, I was just thinking, I know I've had every vaccine. I sound like an idiot. I mean, more than usual.

That's how I abuse myself. I know, you don't need any help from me. Thank you.

So listen, answer me this, riddle me this, Batman. Yeah. Do you keep your immunization records all in one place? Yes.

So then after we're done, you should go and look and see, because you need to have that booster every five years. Also, another thing that's really easy for people is if you go to one place for your vaccines. So, I mean, I shop at CVS, they don't support us, they should.

But going to CVS, they keep my record of my immunization. So I can just go online or call the pharmacist and say, when's the last time I had my pneumonia? And they can easily tell me. Or if you get them at your doctor's office, the problem with that sometimes is they don't always have everything there in stock, then there's a record there.

But CVS works for me, so it's something to consider. So, number one, get your pneumonia vaccine. Number two, wash your hands.

Although pneumonia itself isn't contagious, it can be caused for a variety of infectious organisms like viruses, bacteria, and fungi. Washing your hands is the best way to avoid transferring those organisms into your respiratory system. Like, you know, if you rub your hands across your nose because your nose is dripping because you have a cold.

You're just asking for it all to go climbing up there and making you sick. Three is avoid exposure to people who are ill. Most respiratory infections can spread through these tiny particles in the air or in the surfaces that we touch.

Avoid contact with people that you know are sick is an important step in preventing respiratory infections and possible pneumonia. Adopt healthy habits. How you care for your body and the environment around you can play a big role in your body's ability to resist infections that can lead to pneumonia.

The following actions can help you strengthen your lungs and your immune system. And these are all the things I tell you all the time. And you just never listen to me, but I'm going to tell you again.

Getting enough rest. Eating a balanced diet. Exercising regularly.

Avoiding smoking. Reducing your exposure to harmful chemicals or pollution. And staying up to date on your vaccinations.

Five, keep a cold from turning into pneumonia. If you already have a cold, talk to your doctor about proactive steps that you can take to prevent it from turning into pneumonia. Some of the recommendations can include making sure you get enough rest while recovering from a cold or other illnesses.

Drinking lots of fluids to help eliminate congestion. And how that works is that the more fluids you have in your body, the looser the secretions are and the easier they are to cough up and cough out. And if you do, you know, bring, pull up a, what do we call it? A loogie.

A loogie? Oh my god. Or whatever that gunk is in your lungs, don't swallow it. Spit it out.

Spit it out. I see people doing that and then they swallow it and my stomach just turns. You don't need that in your body.

Your body is expectorating it. The big word for it. So just better out than in, spit it out.

And also taking supplements like vitamin C and zinc to help boost your immune system. So when should you see a healthcare practitioner? It can be difficult to tell when a cough from a cold has turned into something more serious. When you have a viral infection, your cough can last for several weeks.

If you have a cough that doesn't go away or you have any of the following symptoms, you should schedule an appointment with your healthcare professional as soon as possible. Or if you can't get in, then go to a walk-in center or go to the emergency room. And these symptoms are fever, sweating, shaking, chills, rapid shallow breathing, difficulty breathing, shortness of breath, loss of appetite, nausea or vomiting, confusion, or a bluish color to your lips or your nail beds.

So what did we learn today? Pneumonia is a potentially serious complication of upper respiratory infections that can spread to the lungs. It can be caused by a variety of germs including viruses and bacteria. Babies under age 5 and adults over 65 are recommended to get the pneumonia vaccine.

Individuals of any age who are at an increased risk should also get the vaccine. And healthy habits and good hygiene may also reduce your risk of getting pneumonia. So questions, can I answer for you, Charles? Well, Marianne, let's get back to me.

Why should this week be any different? Yeah, exactly. Thank you. I don't know why I just have to keep coming up.

All right. So, oh, what is this thing I had? I took. I'm almost afraid to ask.

Yeah, and it's either, Marianne, RVS or RSV? RSV. Okay. Is that have something to do like a pneumonia shot thing? No, there is an RSV vaccine and RSV is a lung infection that's different than pneumonia.

Oh, yeah. Yes, yes. So you can get an RSV vaccine, but that is not going to protect you from pneumonia.

Got it. I'm sure I've had the pneumonia shot, but I will look into that today. Thank you.

Thank you. I want a full report. You have to be your own best advocate.

Yeah, absolutely. And don't wait if you have these symptoms. Yes.

Get thee to the hospital or to your healthcare practitioner. Yep. Yes.

For our third half, we have a poem written by Tychus Poetry from his book, What's Left of Me? Poems of a Dead Soul. Come dressed in all shades of color at my funeral. Don't you dare show up in black like the color of your hearts.

Wear red like the anger I swallowed until my throat burned raw. Wear orange like the warning signs you all ignored when I stopped smiling. Wear yellow like the light I tried to be for everyone but myself.

Wear blue like the ocean I drowned in without ever leaving the shore. Wear purple like the bruises you couldn't see on my spirit. Wear white like the lies you told me when you said, I'm here for you.

Make my mourning look like living for once. And that's it for this week's episode. Please stay tuned for the continuing saga of Everyone Dies and thank you for listening.

This is Charlie Navarrete and from actor Elliot Gould about Diane Keaton. It's a beautiful thing in a way that all of us come and all of us must go. But I didn't expect Diane to go even though I knew she wasn't well.

I'm so happy to have known her. And I'm Marianne Matzo and we'll see you next week. Remember, every day is a gift.

This podcast does not provide medical advice. All discussion on this podcast, such as treatments, dosages, outcomes, charts, patient profiles, advice, messages, and any other discussion are for informational purposes only and are not a substitute for professional medical advice or treatment. Always seek the advice of your primary care practitioner or other qualified health providers with any questions that you may have regarding your health.

Never disregard professional medical advice or delay in seeking it because of something you have heard from this podcast. If you think you may have a medical emergency, call your doctor or 911 immediately. Everyone Dies does not recommend or endorse any specific tests, practitioners, products, procedures, opinions, or other information that may be mentioned in this podcast.

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