Tag Archives: death

deathnotification

“Oh God!” she groaned, looking upward with tears flooding her cheeks, which were stretched into the shape of agony. Her chest heaved uncontrollably with grief.

“I am so very sorry,” I whispered again while leaning in and stroking her hand.

This is what death notification often looks like and feels like. We doctors should be masters of delivering some of the worst news that could ever be uttered, the worst news that could ever be heard. Continue reading

One Washcloth: a Tool for Change

Wednesday, 16 Sep 2015 14:22

unnamedonewashclot

Over the past century our society has become distant from both death and the tending to our dead. According to Gary Laderman’s book Rest in Peace: a Cultural History of Death and the Funeral Industry in Twentieth-Century America, “The divide was produced by three social factors: changes in demographic patterns, the rise of hospitals as places of dying, and the growth of modern funeral homes” (p 1). Our mental, emotional, spiritual, financial and societal health has been negatively affected directly and indirectly by this disconnect. Because our relationship to death is at the core of what it is to be human, this detachment affects both individual and societal health. Continue reading

“The most significant variable of a relatively uncomplicated bereavement period or a prolonged and
tragic mourning depends to a great deal on the relationship the child and the parent had, on the old unresolved conflicts they carried within, and on the level of communication they had. Last but not least is the mourner’s early experiences with death and loss.”

~Elizabeth Kubler-Ross, MD

~~~~~~

She cried as she held the baby bird. I cried as I held her (my daughter), after all she was my baby
too.

My daughter’s attempt at rescuing and feeding the baby bird who had fallen out of it’s nest had failed. The bird had become weak and then collapsed this morning during feeding. Now it was dying. Continue reading

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“The Bereavement,” marble, 2010

Grief is a synonym for intense psychic pain. It is seldom invited and never welcomed. Death is not a gentle teacher. Everyone loses someone they love, and everyone dies someday. Everyone is afraid of it and everyone is angry at it. Some people say no no, I’m not mad and scared. Unfortunately, the truth doesn’t change because it is denied. Usually, everyone dies only once, and almost no one comes back to report the journey or the destination. For some, maybe that is one of the scarier aspects of death – the unknown. At least, it is intriguing. It is surely the essence of awe. We are left alive to wonder and imagine. We have lively imaginations. Continue reading

A “Sign” is defined as an object, quality or event whose presence indicates the probable presence of something else.

One day after having read, “Attending the Dying” by my friend Megory Anderson, I found myself at work in the ER. There was a half-naked psychotic lady screaming in the hall, the sound of a beeping ventilator alarm escaped from the curtained room of a man in respiratory failure, and a large crowd was gathering outside of Bed 2 because a matriarch was dying. Although I am accustomed to such visual and auditory chaos, it struck me that my dying patient and her family were not. Further, as I stood in this hall with the family whom I was attempting to shepherd along in creating a good death for their well-loved matriarch, I became acutely aware that I was not following the wise counsel set out by my friend, Megory.

In her brief and powerful tome, “Attending the Dying- A Handbook of Practical Guidelines”- Megory sagely advises those of us who accompany others on their journey towards last breaths. Standing in the bustle and roar of the ER, I could clearly recall her words regarding creating a sacred space for the dying and their loved ones:

“You have the calling and ability to set the stage for a good and holy death.”

“Creating sacred space is one of the first steps in setting the environment apart from day-to-day issues, which in turn helps everyone present remember the sacredness of the event unfolding.”

“Contain or mark the space.”

“Try to make this an intimate experience for the family, within the boundaries of the medical unit.”

“A sign on the door is always appropriate.”

Hmm…I thought, “What I really need is a sign. But what would it say?”

I mused that my favorite sign would go something like this:

“Shut up! Can’t you see that someone is dying in here?”

Being known for my public decorum, however, I decided against this one. But, what?

I could not imagine the family wanting a sign on the door that overtly stated that someone was dying. This would rob them of some of the privacy that I was hoping to create.

I could not come up with anything decent and reasonable on my own so I turned to the experts. In my ER, we have these fabulous humans called “Patient/Family Representatives” whose job is to socially, emotionally and spiritually help support and gain resources for people who are critically ill or dying. If ever there was a font of wisdom, these people are it! So, I presented the idea to them and of course they had the solution and here it is:

quiet please

Ah, now there we go.

This sign promotes respect and privacy without announcing the condition of the patient.

Brilliant!

So, I shared this on twitter and got this interesting response.

Love it! But this has to be “branded” or a commonly understood symbol for uninformed people to understand the message, or this funny response might be the product:

Ha!

So the point is that indeed a sign is often a necessary, simple and powerful tool in defining a sacred space for the dying, particularly in a medical facility. But remember, when creating YOUR OWN signs for this purpose: A “Sign” is defined as an object, quality or event whose presence indicates the probable presence of something else. You have to understand the sign to obey it!

Make sure your sign is recognizable, respectful, and gets the job done.

Thank you, Megory, for teaching us how to better attend the dying and to groom the environment practically and with dignity, even within the chaos of the ER.

*****

To learn more about Megory Anderson’s work visit the Sacred Dying Facebook page

Dr. Megory Anderson was called to a vigil at the bedside of a friend who was dying one night. That experience was so powerful that she began working with others who needed help attending to those who were dying. Today, Anderson is the executive director of the Sacred Dying Foundation in San Francisco, and trains others in the art of “vigiling,” a way of attending to the needs of the dying. She may be reached at: Megory@sacreddying.org

I have a very wise nurse-friend, we call her “Coop.” I have always thought that she double-dipped from the fountain of compassion. This paper, which she wrote for a Nursing 403 class, proves my suspicions true and gives us all a clue on how to become more like her. This lesson is applicable to ALL of us who care for and serve others, not just those called to nursing: Continue reading

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book

“If you don’t want to deal with death and dying, then you need to quit medicine now and become an accountant…because this is what we have signed up for and we’ve got to do a better job at it.”  Continue reading

The following image is a picture taken by Dr. Kevin Jackson. The quality of the photo has variations in clarity and color as it is a commemorative plaque hanging within the halls of the hospital in which Dr. Thoroughman practiced medicine. The engraving speaks for itself.

deathmdbrighter

 

 

(If you are not religious or are atheist, please do not be dissuaded from reading this article by the title:)

We just had a member of our congregation die relatively unexpectedly. He was in his early 50s and a father of 6. (That’s a big equation.)

My religious job is to teach our youth (teenager) Sunday School class, when I am not working in the ER or traveling to lecture. So, in this regard, today was like most other Sundays- I had gotten up early to prepare my lesson for the day. The problem was, the lesson wasn’t relevant for the day…meaning the death of this man was on everyone’s mind, and two of his children were in my class. Continue reading

end

According to Steven Covey, in his book the “7 Habits of Highly Effective People,” the second habit that one should have or develop is to “begin with the end in mind.” Now, I’m pretty sure that Covey’s intention was not to have you wake up every day and think about your death, but maybe he should consider adding this to his description of the principle. You see there is something very powerful about entertaining thoughts of your end…somehow, it clarifies and magnifies the present.  Many other “Highly Effective” and brilliant people throughout the ages have practiced this same principle.

Take Shakespeare for example, he was a pretty smart guy. By all accounts, he had a “highly effective” life, and he penned these words, “Be still prepared for death- and death or life shall thereby be the sweeter.” (Measure for Measure, Act III, Scene I)

Hmmm… sounds like he was on to something.

Centuries later, Steve Jobs, another “Highly Effective” and brilliant guy said, “Remembering that I’ll be dead soon is the most important tool I’ve ever encountered to help me make the big choices in life. Because almost everything – all external expectations, all pride, all fear of embarrassment or failure – these things just fall away in the face of death, leaving only what is truly important.”

Yep, there’s a whole lotta truth to this.

 I recently spoke at a Church who is actively seeking to look death in the face as a way of deepening the experience of daily life, a practice known as Momentum Mori, first initiated in 5th Century Benedictine spiritual practice. The congregation has devoted a whole month of sessions to this principle. Wow! Similarly, many Buddhist spend hours meditating on death. A Buddhist friend of mine spent extensive amounts of time sitting in grave yards meditating on the reality of her own death.

Anyone involved in any such bold spiritual practice is bound to find his or her daily life transformed. Living in the present with the knowledge that each moment might be your last (and preparing for it)– reorients you to what is most important in your daily living.

Personally, I came by this practice not by spiritual discipline, but by the nature of my work. I am one of the lucky ones who has the privilege of witness dying on a regular basis. Yes, I said “lucky”. You read that right.

You see, rather than choosing to add “facing death” to my spiritual practice, I am forced to look death in the face on a daily and weekly basis. I come home after most shifts recognizing that this day, this hour, this moment, could be my last. And then, I ask myself some variation of the following questions: “Is this the life I long to lead?” “Are these things the best use of my time?” “Can I sleep tonight with a clear conscience?” “Do my children know that I love them?”

And what about those questions…how do you answer them?

If your answers to any of these questions are “No,” then I challenge you to “begin with your end in mind”…it really makes everything better. Just ask Steven Covey.

Photocredits: productiveflourishing.com