McDoc

Just another Medical Humanities Blog

Archive for the ‘End-of-Life’ Category

Poems for December 2012

Posted by mcdoc on December 7, 2012

Ronald Wallace
(1945 – )

The Truth

for Amy

Her breast cancer, she said,
had metastasized to her liver;
she was going to die, and
soon. She said it made her
sad. I didn’t know her well.
We were co-workers and
I liked her, but
what do you say when someone
actually answers the question
how are you?
with the unvarnished truth:
Not well, she said. I haven’t
long to live. And should I
have said Oh you will! Should I
have smoothed it over
with the syrup of nervousness,
or done what I did
which was to
talk about terror and anger,
the unfairness and the lie,
to take the truth at face value?
No, she was just sad, she said.
She had her faith, she said,
and started to cry. And only then
did I see what she needed from me
was miracle, a simple belief
in miracle, and if that was varnish,
well, it would bring the grain
of the truth out, would save it
from wear and weather.
It would make the truth
almost shine.

“The Truth” by Ronald Wallace, from Long for this World. © University of Pittsburgh Press, 2003. Reprinted with permission.

David Wagoner
(1926 – )

The Escaped Gorilla

When he walked out in the park that early evening
just before closing time, he didn’t take
the nearest blonde in one arm and climb a tree
to wait for the camera crews. He didn’t savage
anyone in uniform, upend cars
or beat his chest or scream, and nobody screamed
when they found him hiding behind the holly hedge
by the zoo office where he waited for someone

to take him by the hand and walk with him
around two corners and along a pathway
through the one door that wasn’t supposed to be open
and back to the oblong place with the hard sky
where all of his unbreakable toys were waiting
to be broken, with the wall he could see through,
but not as far as the place he almost remembered,
which was too far away to be anywhere.

“The Escaped Gorilla” by David Wagoner, from A Map of the Night. © University of Illinois Press, 2008.

Advertisements

Posted in End-of-Life, medical humanities, Monthly Poetry Installment | Tagged: , , , , , , | Leave a Comment »

Poems for November 2012

Posted by mcdoc on November 3, 2012

Bruce Weigl
(1949 – )

Home

I didn’t know I was grateful
for such late-autumn
bent-up cornfields

yellow in the after-harvest
sun before the
cold plow turns it all over

into never.
I didn’t know
I would enter this music

that translates the world
back into dirt fields
that have always called to me

as if I were a thing
come from the dirt,
like a tuber,

or like a needful boy. End
Lonely days, I believe. End the exiled
and unraveling strangeness.

“Home”by Bruce Weigl, from The Unraveling Strangeness published by Grove Atlantic, Inc. Reprinted with permission. All rights reserved.

Steve Kowit
(1938 – )

Notice

This evening, the sturdy Levi’s
I wore every day for over a year
& which seemed to the end
in perfect condition,
suddenly tore.
How or why I don’t know,
but there it was: a big rip at the crotch.
A month ago my friend Nick
walked off a racquetball court,
showered,
got into his street clothes,
& halfway home collapsed & died.
Take heed, you who read this,
& drop to your knees now & again
like the poet Christopher Smart,
& kiss the earth & be joyful,
& make much of your time,
& be kindly to everyone,
even to those who do not deserve it.
For although you may not believe
it will happen,
you too will one day be gone,
I, whose Levi’s ripped at the crotch
for no reason,
assure you that such is the case.
Pass it on.

“Notice” by Steve Kowit, from The Dumbbell Nebula, Heyday Books. ©2000 by Steve Kowit. Reproduced with permission. All rights reserved.

Posted in autumnal poems, End-of-Life, Monthly Poetry Installment | Tagged: , , , | Leave a Comment »

Poems for July 2012

Posted by mcdoc on July 3, 2012

Mary Oliver

The Summer Day

Who made the world?
Who made the swan, and the black bear?
Who made the grasshopper?
This grasshopper, I mean–
the one who has flung herself out of the grass,
the one who is eating sugar out of my hand,
who is moving her jaws back and forth instead of up and down,
who is gazing around with her enormous and complicated eyes.
Now she lifts her pale forearms and thoroughly washes her face.
Now she snaps her wings open, and floats away.

I don’t know exactly what a prayer is.
I do know how to pay attention, how to fall down
into the grass, how to kneel down in the grass,
how to be idle and blessed, how to stroll through the fields,
which is what I have been doing all day.
Tell me, what else should I have done?
Doesn’t everything die at last, and too soon?
Tell me, what is it you plan to do
with your one wild and precious life?

“The Summer Day” by Mary Oliver, from The Truro Bear and Other Adventures: Poems and Essays © Beacon Press, 2008.

Mark Doty

Brilliance

Maggie’s taking care of a man
who’s dying; he’s attended to everything,
said goodbye to his parents,

paid off his credit card.
She says Why don’t you just
run it up to the limit?

but he wants everything
squared away, no balance owed,
though he misses the pets

he’s already found a home for
— he can’t be around dogs or cats,
too much risk. He says,

I can’t have anything.
She says, A bowl of goldfish?
He says he doesn’t want to start

with anything and then describes
the kind he’d maybe like,
how their tails would fan

to a gold flaring. They talk
about hot jewel tones,
gold lacquer, say maybe

they’ll go pick some out
though he can’t go much of anywhere and then
abruptly he says I can’t love

anything I can’t finish.
He says it like he’s had enough
of the whole scintillant world,

though what he means is
he’ll never be satisfied and therefore
has established this discipline,

a kind of severe rehearsal.
That’s where they leave it,
him looking out the window,

her knitting as she does because
she needs to do something.
Later he leaves a message:

Yes to the bowl of goldfish.
Meaning: let me go, if I have to,
in brilliance. In a story I read,

a Zen master who’d perfected
his detachment from the things of the world
remembered, at the moment of dying,

a deer he used to feed in the park,
and wondered who might care for it,
and at that instant was reborn

in the stunned flesh of a fawn.
So, Maggie’s friend?
Is he going out

Into the last loved object
Of his attention?
Fanning the veined translucence

Of an opulent tail,
Undulant in some uncapturable curve
Is he bronze chrysanthemums,

Copper leaf, hurried darting,
Doubloons, icon-colored fins
Troubling the water?

“Brillance” by Mark Doty, from My Alexandria © Mark Doty 1983.

Posted in End-of-Life, medical humanities, Monthly Poetry Installment, Solstitial Poem | Tagged: , , , | 1 Comment »

Engage With Grace 2011: Occupy With Grace

Posted by mcdoc on November 24, 2011

The term “Blog Rally” was coined in 2008 with the phenomenon of concerted blogging in support of the movement called, “Engage with Grace: The One Slide Project.” Engage With Grace was organized to encourage family members to discuss what is important to them with respect to end-of-life care issues. The timing coincides with the annual American Thanksgiving holiday weekend. The idea being to capitalize on the fact that many families gather together in particular over Thanksgiving.

This is a movement you can easily get behind in person if you are an advocate for good patient centered health care, which you likely are if you are reading this blog. So donate your blog, Facebook update, Twitter account (#EWG) to Engage With Grace this holiday weekend. And then put your money where your mouth is and bring it up yourself while your family is together.

Here is the this year’s post from the Alexandra Drane and the Engage With Grace Team:

Occupy With Grace
Once again, this Thanksgiving we are grateful to all the people who keep this mission alive day after day: to ensure that each and every one of us understands, communicates, and has honored their end of life wishes.

Seems almost more fitting than usual this year, the year of making change happen. 2011 gave us the Arab Spring, people on the ground using social media to organize a real political revolution. And now, love it or hate it – it’s the Occupy Wall Street movement that’s got people talking.

Smart people (like our good friend Susannah Fox) have made the point that unlike those political and economic movements, our mission isn’t an issue we need to raise our fists about – it’s an issue we have the luxury of being able to hold hands about.

It’s a mission that’s driven by all the personal stories we’ve heard of people who’ve seen their loved ones suffer unnecessarily at the end of their lives.

It’s driven by that ripping-off-the-band-aid feeling of relief you get when you’ve finally broached the subject of end of life wishes with your family, free from the burden of just not knowing what they’d want for themselves, and knowing you could advocate for these wishes if your loved one weren’t able to speak up for themselves.

And it’s driven by knowing that this is a conversation that needs to happen early, and often. One of the greatest gifts you can give the ones you love is making sure you’re all on the same page. In the words of the amazing Atul Gawande, “you only die once!” Die the way you want. Make sure your loved ones get that same gift. And there is a way to engage in this topic with grace!

Here are the five questions, read them, consider them, answer them (you can securely save your answers at the Engage with Grace site), share your answers with your loved ones. It doesn’t matter what your answers are, it just matters that you know them for yourself, and for your loved ones. And they for you.

We all know the power of a group that decides to assemble. In fact, we recently spent an amazing couple days with the members of the Coalition to Transform Advanced Care, or C-TAC, working together to channel so much of the extraordinary work that organizations are already doing to improve the quality of care for our country’s sickest and most vulnerable.

Noted journalist Eleanor Clift gave an amazing talk, finding a way to weave humor and joy into her telling of the story she shared in this Health Affairs article. She elegantly sums up (as only she can) the reason that we have this blog rally every year:

For too many physicians, that conversation is hard to have, and families, too, are reluctant to initiate a discussion about what Mom or Dad might want until they’re in a crisis, which isn’t the best time to make these kinds of decisions. Ideally, that conversation should begin at the kitchen table with family members, rather than in a doctor’s office.

It’s a conversation you need to have wherever and whenever you can, and the more people you can rope into it, the better! Make this conversation a part of your Thanksgiving weekend, there will be a right moment, you just might not realize how right it was until you begin the conversation.

This is a time to be inspired, informed – to tackle our challenges in real, substantive, and scalable ways. Participating in this blog rally is just one small, yet huge, way that we can each keep that fire burning in our bellies, long after the turkey dinner is gone.

Wishing you and yours a happy and healthy holiday season. Let’s Engage with Grace together.

To learn more please go to www.engagewithgrace.org.

This post was developed by Alexandra Drane and the Engage With Grace team.

Posted in Blog Rally, End-of-Life, Engage With Grace, medical humanities | Tagged: , , , , | 1 Comment »

Engage With Grace

Posted by mcdoc on November 25, 2010

Things we are grateful for this year

For three years running now, many of us bloggers have participated in what we’ve called a “blog rally” to promote Engage With Grace – a movement aimed at making sure all of us understand, communicate, and have honored our end-of-life wishes.

The rally is timed to coincide with a weekend when most of us are with the very people with whom we should be having these unbelievably important conversations – our closest friends and family.

At the heart of Engage With Grace are five questions designed to get the conversation about end-of-life started. We’ve included them at the end of this post. They’re not easy questions, but they are important – and believe it or not, most people find they actually enjoy discussing their answers with loved ones. The key is having the conversation before it’s too late.

Engage With Grace, theoneslide


This past year has done so much to support our mission to get more and more people talking about their end-of-life wishes. We’ve heard stories with happy endings ~ and stories with endings that could’ve (and should’ve) been better. We’ve stared down political opposition. We’ve supported each other’s efforts. And we’ve helped make this a topic of national importance.

So in the spirit of the upcoming Thanksgiving weekend, we’d like to highlight some things for which we’re grateful.
Thank you to Atul Gawande for writing such a fiercely intelligent and compelling piece, Letting Go: What Should Medicine Do When It Can’t Save Your Life – it is a work of art, and a must read.

Thank you to whomever perpetuated the myth of “death panels” for putting a fine point on all the things we don’t stand for, and in the process, shining a light on the right we all have to live our lives with intent – right through to the end.

Thank you to TEDMED for letting us share our story and our vision.

And of course, thank you to everyone who has taken this topic so seriously, and to all who have done so much to spread the word, including sharing The One Slide.

(To learn more please go to www.engagewithgrace.org. This post was written by Alexandra Drane and the Engage With Grace team. )

Posted in Blog Rally, End-of-Life, Engage With Grace, medical humanities | Tagged: , , , | Leave a Comment »