PalliativeChronicle

Buddha's Teachings about Breathing

2011-02-13T20:10:00.003-06:00

The Buddha's Sutra on the Full Awareness of Breathing is a reminder to bring breath, body and mind into harmony, with breathing serving as an anchor as well as a place to begin to go home and reconcile with oneself.

The Body

1. Breathing in a long breath, I know I am breathing in a long breath. Breathing out a long breath, I know I am breathing out a long breath.

2. Breathing in, my breath goes deep. Breathing out, my breath goes slow.

3. Breathing in, I am aware of my whole body. Breathing out, I calm my body.

4. Breathing in, I know I am alive. Breathing out, I smile.

Feelings

5. Breathing in, I feel joyful. Breathing out, I feel joyful.

6. Breathing in, I feel happy. Breathing out, I feel happy.

7. Breathing in, I am aware of feelings present in my body and mind at this moment. Breathing out, I touch the feelings that are making me suffer.

8. Breathing in, I calm those feelings leaving my body and mind peaceful. Breathing out, I am grateful.

The Mind

9. Breathing in, I am aware of the activity present in my mind at this moment. Breathing out, I concentrate my mind and look deeply.

10. Breathing in, I untie knots created by unhelpful thinking or imaginings. Breathing out, I embrace and quiet all of my thoughts.

11. Breathing in, I gladden my mind. Breathing out, I water the seeds of loving kindness and compassion.

12. Breathing in, I cultivate forgiveness. Breathing out, I liberate my mind.

The Objects of the Mind

13. Breathing in, I observe all things transforming. Breathing out, I recognize their impermanent nature.

14. Breathing in, I detect the disappearance of desire. Breathing out, I experience non-craving.

15. Breathing in, I observe the cessation of erroneous ideas. Breathing out, I see suffering born from ignorance fading away.

16. Breathing in, I let go of the idea that I did not exist before I was born. Breathing out, I let go of the idea that I will not exist after I die.

Reminders

2011-01-28T19:57:00.000-06:00

Rituals

2011-01-26T22:10:00.006-06:00

Rituals can transform a situation. At the end–of–life, they help a person die a peaceful death, and bring reconciliation and acceptance to loved ones. Rituals come in many forms addressing the physical world (body), thoughts and ideas (mind), and the realms of myth (soul) and spirit (energy); helping to heal the pain of letting go, while at the same time connecting those bearing witness with something beyond earthly concerns.
Many religions have in common:

Creating a peaceful, soothing atmosphere,

Appealing to the senses,

Helping the dying person and all present to sense a sacred presence
Some tools:
Lighting: Soft incandescent lighting or burning candles to bring feelings of peace and tranquility.
Aromas: Burning sage, scented candles, essential oils, or incense to induce a calming effect.

Holy Objects: An altar arranged with spiritually meaningful articles, medallions, statues or pictures to offer a visual focus.

Music: To soothe and inspire. Certain instruments such as harps, drums or bells, are used in many traditions. Sounds of nature and the human voice can be very healing.
Prayer: Oral prayer in keeping with the dying person's tradition
Silence: An important sound. It is good to remember the value and necessity of simply sitting in silence with the dying person.

Self Compassion

2011-01-02T21:16:00.003-06:00

Germer, Christopher K. The Mindful Path to Self-Compassion. New York: The Guildford Press. 2009

“A moment of self-compassion can change your entire day. A string of such moments can change the course of your life” - from the Introduction

This book was written to help readers develop and strengthen their capacity for self-compassion and loving-kindness. The author believes enhancing one’s skills in these areas reduces the isolation and inevitable personal suffering that results from self-judgment, self-doubt and self-condemnation: Extending kindness to oneself as a healing strategy boosts self-esteem, increasing the likelihood of being more fully able to extend these aspirations to others.

Germer travels the path to self-compassion from the perspectives of mindfulness and loving-kindness. His basic premise is that life is tough. It is just not possible to avoid feeling bad sometimes. He argues, since feeling bad is a fact of the human condition, then recognizing the common humanity in this experience bestows permission to treat oneself with the same kindness we afford to others.

Throughout the text, the author asks questions for the reader to ponder and introduces them in a step-by-step fashion to practical techniques and exercises that support the development of mindfulness, loving-kindness meditation and self-compassion skills. Practicing these techniques is encouraged as a means to strengthen and expand one’s repertoire for dealing with negative emotions.

Absence

2011-01-01T15:00:00.036-06:00

I apologize to readers of this blog for ceasing to post without explanation. Amidst completing the requirements for the Palliative Medicine fellowship, moving from Ottawa to Winnipeg and starting two new positions, I lost one beloved relative to a COPD exacerbation and two very dear friends, one to cancer and the other unexpectedly but peacefully. Two other friends have been diagnosed with advanced cancer in the past few months. My world has become noticeably smaller and I am grieving these losses. I assumed the role of Executrix for the first time in yet another city, and experienced first hand the enormity of this task. Other responsibilities continue..... I cannot commit to regular posts, but I enjoyed blogging very much and miss this form of exploration and self expression. I will add to this site as I am able.

Natural Instincts

2010-05-12T19:55:00.001-05:00

Wild Geese

~Mary Oliver

You do not have to be good.
You do not have to walk on your knees
for a hundred miles through the desert, repenting.
You only have to let the soft animal of your body

love what it loves.
Tell me about despair, yours, and I will tell you mine.
Meanwhile the world goes on.
Meanwhile the sun and the clear pebbles of the rain
are moving across the landscapes,
over the prairies and the deep trees,

the mountains and the rivers.
Meanwhile the wild geese, high in the clean blue air,
are heading home again.
Whoever you are, no matter how lonely, the world offers itself to your imagination, calls to you like the wild geese, harsh and exciting —
over and over announcing your place
in the family of things.

May Grand Rounds

2010-05-06T06:40:00.000-05:00

Here is the link to Palliative Care May Grand Rounds hosted by Thaddeus Pope.

Measures of Inner Peace

2010-05-02T20:00:00.006-05:00

An increasing tendency to let things happen rather than make them happen.
An unmistakable ability to enjoy each moment.
A loss of interest in interpreting the actions of others.
A loss of interest in judging other people.
A loss of interest in judging self.
A loss of interest in conflict.
A loss of the ability to worry.
Frequent, overwhelming episodes of appreciation.
Contented feelings of connectedness with others and nature.
Frequent bouts of smiling.
A tendency to think and act spontaneously rather than on fears based on past experiences.
An increased susceptibility to the love extended by others as well as the uncontrollable urge to extend it.

~Saskia Davis

La Neuvaine & La Donation: Film Review

2010-05-01T18:15:00.000-05:00

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Defining Palliative Care

2010-04-27T18:00:00.003-05:00

This blog post entitled, "Palliative care needs a simple and consistent message" at KevinMD.com is worth reading.

Shell Shock

2010-04-25T08:59:00.000-05:00

"Six weeks ago I felt fine". Today, I have two different kinds of cancer, one on my vocal cord making my voice hoarse and one in my lung pressing on my blood vessels, making me feel short of breath and causing my face and arms to swell. The lung cancer has already spread to my bones. My legs are weak. Now I need a brace and a walker to walk and my back hurts. If I try to walk, I get more short of breath. My pancreas is inflamed and they say I have diabetes. I can't sleep because I am worried. What happened???
I included the words "shell shock" on the Palliative Medicine consult today, amidst the obvious issues of pain, shortness of breath.... The term was first coined in WWI to describe the confused or nervous mental condition of people who had been under fire in a war. Today, "shell-shocked" is also used to describe someone in a state of stunned confusion or shock; someone who is dazed. The signs of shell shock are disorientation and inability to focus, with reactions like shaking, nightmares, twitching, headaches, fatigue, insomnia, dizziness, anxiety, and irritability. These are also signs experienced by patients with life-limiting illnesses who develop, for example, opioid neurotoxicity or delerium. In this case though, it was simply too much, too soon, too life-altering.

der Philosoph

2010-04-23T15:05:00.001-05:00

The title of Haydn's Symphony #22, "The Philosopher", is thought to derive from the interplay in the first movement between the strings and English horns (melody and counterpoint), simulating a question followed by an answer. The composition evokes the image of a philosopher deep in thought while time passes (alluded to musically by the muted tick-tock effect). This symphony comes to mind every now and then when I find myself contemplating alternatives & having to make a decision .... trying to strike a balance between intuition (being/receiving) and reason (doing/thinking). Other balance images include the seal totem and the Third eye chakra
EMI Classics: Simon Rattle & The City of Birmingham Orchestra
I Adagio
II Presto
III Menuetto & TrioIV Finale (Presto)

Wordles & Endless Possibilities

2010-04-18T16:53:00.000-05:00

This wonderful site offers endless possibilities for creative expression using words. The developer says: "Wordle is a toy for generating “word clouds” from text that you provide. The clouds give greater prominence to words that appear more frequently in the source text. You can tweak your clouds with different fonts, layouts, and color schemes".
This wordle was created from the blog post entitled, "Is there a difference between the soul and the spirit?", March 28th.

It would be interesting to monitor ongoing symptom burden in selected patients by teaching them how to use this tool. A visual ESAS! with choice of font, color scheme and layout. On the web site, under the Wordle 'advanced' tab, words can be weighted to increase their prominence. Here is an example using ESAS symptoms with weights arbitrarily assigned, giving anxiety the highest symptom burden and appetite, breathlessness and nausea the lowest: Pain:60, Depression:20, Nausea:10, Mood:20, Sleep:80, Tiredness:80, Anxiety:100, Well-being:50, Breathlessness:10, Appetite:10. It is easy to see that anxiety is the main issue confronting this fictitious patient, followed by tiredness and sleep.

This wordle uses 'duality' font, the 'mostly horizontal' layout and the 'kindled' color scheme. It is possible to select specific colors for each word if one understands how to use HTML color names. The wordle product changes every time you make a selection.....so, if you create something beautiful, open it in window (see tab on bottom left of the wordle), then save it as a screen shot.

Specialist Palliative Care Services

2010-04-17T06:37:00.001-05:00

Teleman Suite in B flat major TWV 55:B10

At rounds this week, members of our team were lamenting the confused response they sometimes encounter from patients when they announce they are from the Palliative Care team.

"I must be dying"

"You mean there is no more hope"

"Have they given up on me?"

Similarly, we receive consults asking for "End of Life orders" when our presence earlier in the course of the patient's illness would have been helpful.

The World Health Organization calls palliative care "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness." The illness might be cancer, but increasingly the term palliative care is used in regard to conditions such as renal disease, chronic heart failure, HIV/AIDS, progressive lung disorders and neurological conditions. It is active holistic care. For this reason, the care team includes palliative medicine consultants and palliative care nurse specialists together with a range of expertise provided by social workers, physiotherapists, occupational therapists, dieticians, pharmacists and those able to give spiritual and psychological support. It is a sharing partnership between the person with the illness, their family and friends, the surrounding community and members of the health care team to re-frame hope, provide meticulous pain and symptom management and offer supportive care for the purpose of helping those involved cope with the condition and it's treatment, from diagnosis to cure or, through continuing illness to death and into bereavement.

The goal of palliative care is not dying, it is living each remaining day of life as fully as possible.

Gratitude

2010-04-16T21:12:00.008-05:00

I see trees of green, red roses too
I see them bloom, for me and you
And I think to myself, what a wonderful world.
I see skies of blue, and clouds of white
The bright blessed day, the dark sacred night
And I think to myself, what a wonderful world.
The colors of the rainbow, so pretty in the sky
Are also on the faces, of people going by
I see friends shaking hands, saying how do you do
They're really saying, I love you.
I hear babies cry, I watch them grow
They'll learn much more, than I'll never know
And I think to myself, what a wonderful world
Yes I think to myself, what a wonderful world.
Oh yeah...

Are You at Peace?

2010-04-14T20:25:00.006-05:00

"Are you at peace?" is an opening "probing" question used to gently broach the topic of existential distress. What is the comeback when the answer is a resounding NO!?

Care Search categorizes existential distress as relating to loss of control, burden on others, relationship related concerns, loss of continuity, uncompleted life task, hope / hopelessness, and acceptance / preparation. The Japanese Spiritual Care Task Force suggests psycho-existential suffering is caused by the loss of three essential components:

Loss of relationships (with others)
Loss of autonomy (independence, control over future, continuity of self)
Loss of temporality (the future)

Today I witnessed it as someone no longer able to touch/access that which used to ignite his internal spark. In this case it was math puzzles. Usual efforts to connect with what previously provided the dual power to energize and comfort failed and these had now become a source of distress, a reminder of the uninvited effects of disease and medication on the mind.

What "brings us to life", energizes & animates are the aspects of self that are precious to the individual. When you are sorrowful, look... in your heart and you shall see that... you are weeping for that which has been your delight. Kahlil Gabrin

Medicine and Society

2010-03-30T16:43:00.008-05:00

Contemporary medicine in and of itself is complex: Trying to find a professional & personal "home" amidst the tethers and freedoms becomes an even more intricate task when an academic appointment is added to the clinical practice mix. This is on my mind recently, having passed the halfway mark of this Palliative Medicine fellowship. In earlier times, physicians were accountable primarily to their patients and their colleagues. Now they are accountable to governments, institutions and commercial organizations for their competence, performance and productivity, not to mention the cost-effectiveness of their activities.

The word cloud above was created from text in the article below. Food for thought: The authors explore relationships between health care's multiple stakeholders, particularly focusing on society's expectations of a physician and a physician's obligations toward society. Selected words have been assigned greater prominence to emphasize their significance in the source text.

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Is There a Difference Between the Soul and the Spirit?

2010-03-28T22:14:00.002-05:00

Waterhouse painted "The Soul of a Rose" in 1908. I thought about this image the other day after seeing a patient with a reduced sense of smell. He breathed through a tracheostomy, bypassing the nose and the olfactory (sense of smell) apparatus because of prior total laryngectomy to remove vocal cord cancer.
The word soul brought to mind the quote "Nothing can cure the soul but the senses, just as nothing can cure the senses but the soul" Oscar Wilde
That led to "You don't have a Soul. You are a Soul. You have a body" CS Lewis From there, I spent the remainder of the evening on an interesting Internet and eLibrary journey, reading and thinking about the soul and the spirit, how these words are defined and how they tend to be used in the Palliative Medicine literature.

Here is a sample of what I read:

Our Spirit represents our true self, the spark of light. The Soul represents human/animal physical being. The Spirit is the life force that uses the soul (the body).
Is there a difference between the Soul and the Spirit? The Greeks certainly thought so as they had different words, with completely different meanings, to describe each one. The Greek word for 'spirit' is pneumatos which means air, or wind. Wind/air (breath) is associated with the quality of having life, or being alive. The word 'Soul' derives from the Greek root psukios, which means mind, the seat of human consciousness, and cognition. Today, the soul and the spirit are mostly viewed as being the same thing, but the topic allows for an interesting exercise in describing the spirit as the expression of our soul while we are alive (with abilities and senses) in our bodies. Burke McKay
The human mind comprises the brain and all its workings — memory, perception, reason, emotions. It is, in other words, the “hardware” of human existence. The human soul is what governs the human hardware — the “software” of human existence, our very own “operating system,” unique to each of us. The human spirit is the “electricity” that animates us.
Our spirits are the expression of our souls in relation to how we feel, what we sense, and how well we are able to feel and sense. Our senses are gratified by movement, tasting food, breathing fresh air, seeing, smelling, touching and hearing. If we are in pain, our spirits may be more limited than when we feel well, how much more difficult it is to interact with and enjoy the world when pain is present. Sometimes our spirit is broken. Rarely is it ever said that the soul is broken. Perhaps the combination of body and spirit serve to develop our souls until we no longer have functioning bodies. Then life continues in the form of the soul and the spirit, in pure form, with no need for sensory inputs or for physical interaction with the world. Elizabeth M. Young
The soul is the essence of humanity’s being; it is who we are. The spirit is the aspect of humanity that gives us the ability to connect with a higher power (God). The word “spirit” refers only to the immaterial facet of humanity. The word “soul” can refer to both the immaterial and material elements. Unlike human beings having a spirit, human beings are souls. In its most basic sense, the word soul means life.

It Really is This Simple

2010-03-23T21:04:00.001-05:00

"The secret of the care of the patient, is in caring for the patient."

Francis Weld Peabody 1881-1927

Peabody F: The care of the patient. JAMA 1927;88:877-882.

"The treatment of a disease may be entirely impersonal; the care of a patient must be completely personal. What is spoken of as a 'clinical picture' is not just a photograph of a man sick in bed; it is an impressionistic painting of the patient surrounded by his home, his work, his relations, his friends, his joys, sorrows, hopes and fears..."

From the Art Blog by Bob:
No other artist ever painted sickness and death quite like Edvard Munch. Munch, most famous for his iconic (and frequently stolen) 1893 painting The Scream, knew death intimately from a young age, watching siblings, family members, and friends all suffer through long illnesses against the backdrop of the cold, bleak winters of his native Norway. The Sick Child (above, 1885-1886) represents just one of his many depictions of illness.

It is Possible to Die Healed

2010-03-20T01:25:00.014-05:00

"It is possible to die healed". I read this sentence in a Palliative Medicine text recently. The author, Balfour Mount, suggested the word 'healed' embraced the concept of human wholeness. As I was pondering my definition of healing, I was transported back to Epidavros, Greece, remembering a trip to commemorate medical school graduation and the profound impact of simply sitting on the amphitheatre steps contemplating the legacy of medicine.

The ancient Greeks were treated in Asclepions. These were healing sanctuaries named for the mythological god of medicine, Asclepius. When the philosopher-physician Hippocrates, a descendant of the asclepiad began his practice he introduced observation and study of the human body. His approach provided a physical & rational explanation for illness previously attributed to superstition, disfavor of the gods and evil spirits. He believed in the natural healing process of rest, a good diet, fresh air and cleanliness and ascribed to the philosophy of physician as "healer of the sick", rather than "curer of disease". Hippocrates believed the body must be treated as a whole and not just a series of parts.

When Thomas Egnew began his PhD studies on the meaning of healing, he was surprised to learn that despite references to the word healing since ancient times, medicine had no accepted definition of holistic healing. He hypothesized that ill persons undergo transformations in which they are unable to be the persons they once were. This threat to wholeness generates suffering that involves the physical, social, psychological and spiritual dimensions of personhood. He concluded by proposing that healing is the personal experience of the transcendence of suffering and is related to themes of wholeness, narrative and spirituality. As an aside, the term medicine is derived from the Latin ars medicina meaning the art of healing.

To read Egnew's article, click on his name in this post, then select Full text (PDF) from the right column.

Hallelujah

2010-03-11T19:43:00.000-06:00

After many hours of searching the Internet and chasing false leads, this site, soundcloud.com gets the nod as the third party audio file web hosting platform for the music on this blog. It has taken a few more hours of fiddling with HTML embed codes, sound bars and colors in order to reload the musical selections in various posts. Today, it works. Tomorrow, lets hope it works. And right now, I feel like celebrating. Here is kd lang's version of the Leonard Cohen song, Hallelujah...from the Hymns of the 49th Parallel album:

Music malfunction

2010-03-07T20:46:00.003-06:00

Mailboxdrive.com, where the music files for this blog are stored, has 'crashed'. They are working to rectify the problem. In the meantime, none of the musical selections contained in PalliativeChronicle posts are working. I am looking for other music hosting sites but am hopeful (and hoping! - converting files, uploading and re-formatting the player icons takes a bit of work) all will be fixed next week.

Noble Silence ~ Meditation & Yoga Retreat

2010-03-06T19:41:00.001-06:00

Learn to be quiet enough to hear the sound of the genuine within yourself so that you can hear it in others ~ Marian Wright Edelman

In this sense, the word noble takes it's derivation from the Greek gno (as in gnosis), meaning wisdom or inner illumination. Noble Silence is the practice of intentional silence in the Buddhist tradition. No radio, phone or television, no reading, writing or talking, no communication with anyone in the group by gestures, eye contact or sign language. Yet, the silence was about presence, not absence. A day to focus on all five senses; sight, sound, taste, smell and touch, cultivating higher levels of perception and sensory awareness. Encountering silence, listening to your inner voice.
Photo obtained under creative commons license http://www.flickr.com/photos/h-k-d/

The Power of Presence

2010-03-05T20:15:00.005-06:00

In meditation class the other night, we stood facing a partner and settled into mountain pose, standing tall, feet ‘anchored’ to the floor. One member of the pair, with eyes closed, slowly raised their hands above their head and began the exercise, noticing every sound, feeling, thought, sensation, emotion and movement experienced 'in the moment', speaking each one out loud as it passed through their consciousness… “cool breeze on my feet”, “car passing by outside”, “shoulders starting to ache”, “feeling calm tonight”…. Their partner observed silently, concentrating, paying attention, and really being present. The exercise lasted 8 minutes, a chime sounded and without saying a word, we reversed roles. It was very powerful, giving the gift of presence, cultivating respect for the other person’s dignity.
The experience reminded me of a moving narrative published recently in the Journal of Palliative Medicine. It is a mother's story about caring and the power of presence. The significance of the Phil Collin's song "You'll Be in My Heart" becomes apparent toward the end of the article.

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Musical Massage

2010-02-27T10:59:00.004-06:00

Vibroacoustic harp therapy is a form of complimentary medicine in which the vibrations from harp music are used to promote positive physiological changes in the body. The healing benefits are numerous, including a reduction in pain, anxiety and stress. The harp is a distinctive instrument for therapy in that the full pitch range of the harp can vibrate the entire body. The tonal vibrations of the harp pulsate and can reach the cellular level, helping to restore physical, spiritual and emotional harmony. Experiencing the sound and vibrations of therapeutic harp music induces calm & relaxation. In the palliative world, in addition to providing adjunct symptom management, it can be a gentle way to ease end-of-life transition. In 2007, CBC Radio One producer Frank Faulk explored harp therapy, including a visit to the first hospital program in North America, offered by Ian Hepburn in Hawkesbury, Ontario. The podcast is available on the Vibroacoustic Harp Therapy website.

Web 2.0 Advice

2010-02-25T10:45:00.002-06:00

I discovered a wonderfully helpful website today called "Technology Training Wheels". The site uses a wiki format to provide information & advice for using Web 2.0 technologies. The content is prepared by librarians and accessible to all levels of Internet user. Here is the link to Blogging. The right side panel lists the links to other topics.

The Wisdom of Experience

2010-02-18T21:08:00.007-06:00

My most recent teacher trained in the early days of Palliative Medicine with Dame Cicely Saunders and Dr. Balfour Mount. His stories were fascinating, often humorous; each new gem told with his characteristic humility. He will cringe at being referred to as a 'founding father' and pivotal presence during the developmental stages of many programs, yet this is true and in more than one city. I felt empowered in his presence and relished the opportunities we had to share the care of patients. He offered his perspective on a question I have contemplated from time to time since beginning this fellowship, "What are the top three attributes of a capable Palliative Medicine physician?" Here is the essence of his answer:

Expertise in pain & symptom management because this establishes clinical competence & builds trust and confidence. Patients can not communicate effectively or deal with other issues if they are focused on their symptoms,
Ability to establish a therapeutic relationship that is personally congruent and demonstrates empathy and unconditional positive regard for the patient; then, to maintain this rapport, explore fears & concerns, re-frame hope, promote reunion, reconciliation & resolution of unfinished business,
Possess cognitive strategies and employ interventions that provide an affirming presence, educate and inform, while respecting the patient's right to choice & control.

There is soul here and the wisdom of experience speaking.

"Compassion is that mysterious capacity within each of us that makes it possible for suffering that is neither our own nor of our concern, to affect us as though it were." wisdomcommons.org

Intention Setting

2010-02-15T15:53:00.000-06:00

This vision board appears on the Abundance Tapestry blog in a posting entitled, "30 Power Words To Activate Intention Setting" I think it is beautiful. The post makes for interesting reading.

Poetry in Palliative Care

2010-02-12T16:42:00.006-06:00

dusk, dimness, dawn, rebirth

warm, glowing, light

glinting, glaring, streaming, earth

declining, shadowing, night

I am reading lately about reflection and 'narrative medicine', learning, amongst other things, that writing a poem can be a tool for self-discovery and healing. The author of this book, David Richo, draws on Buddhist thought and Jungian perspectives to coach the reader toward greater self-understanding. Mentoring & practical assistance is available online as well at "writinglife".

To enlarge the article, click the "full" button on the toolbar underneath the text.
To exit the article, hit the "esc" key on the computer keyboard.

Internet Tools to Know About

2010-02-10T09:02:00.006-06:00

There are many internet resources available under the rubric Web 2.0. Searching, filtering, trialing and ultimately selecting useful tools is an arduous process and involves a serious time commitment, but a necessary one in order to create a blog site that offers useful/interesting information for readers. Every now and then, thanks to the generosity of others and in the spirit of participation (the focus of Web 2.0), content is created and uploaded for the purpose of viewing and sharing. In this case, a presentation on Internet tools/technology that offers suggestions for helpful resources in various categories. A place to start and a potential time-saver as work begins in earnest on my scholarly project.

And, another presentation with some ideas for writing good blog posts:

Lastly, this book is very helpful:

Kundalini Yoga ~ Farewell Blessing

2010-02-06T08:57:00.007-06:00

Divinity, grace, compassion and kindness can be found in unexpected locations. This time on holiday in St. Lucia... a beautiful resort in an idyllic setting, offering opportunities to continue my exploration of the physiological and psychological benefits of meditation. On this particular morning, a kundalini yoga session (after Yogi Bhajan) taught by Niedra Gabriel with the traditional closing blessing, Long Time Sun.

May the long time sun shine upon you
All love surround you
And the pure light within you
Guide your way on

Sat Nam

The "Mozart Effect"

2010-01-24T08:35:00.005-06:00

I still love to study at night. I discovered this during my undergraduate years at the University of Toronto. It is peaceful and quiet, no extraneous noise to interfere with concentration or compete for attention. The overnight CBC radio announcer used to keep me company with gentle dialogue and lots of classical music. I didn't know much about orchestral music then and nothing about time epochs like the Renaissance, Baroque or Romantic periods. What I did know was that every now and then, I would feel calmer or more focused when a particular piece was played. I kept a small notebook on the desk and each time I became aware that the music was touching me in some way, I would write out the name of the piece or the composer. The list grew over the years and when it was time to leave Toronto for my first job, I took that list to the city's only classical music store, located in Yorkville, handed it to the salesman and said "more of this please". I walked out with a double record set entitled, The Golden Age of Baroque and went on to wear grooves in the vinyl. I have expanded my repertoire since then, embracing Mozart and Haydn & earlier works as well. All this to say, I attended an all Mozart concert at the NAC recently. Breathless & shivering with joy at times, the music filled every crevice of my being and I left the concert hall believing that music is the greatest of the healing arts.

Symphony #29 in A major K201 - Allegro con spirito (Prague Chamber Orchestra/Sir Charles Mackerras)

Violin concerto #5 in A major K219 - Allegro aperto (James Ehnes/Mozart Anniversary Orchestra)

Clarinet concerto in A major K622 - Adagio (Sabine Meyer)

Andante from Piano concerto #21 in C major K467 played by violinist Joshua Bell/ASMF

Why healing? because on the day that marked the concert, two of my patients were imminently dying: I knew when I returned from weekend call at the sister hospital, their beds would be occupied by someone else and the family units I had come to know would have been forever changed.

Celebrated Teacher ~ Ageless Voice

2010-01-23T15:50:00.001-06:00

"By three methods we may learn wisdom: first, by reflection, which is noblest; second, by imitation, which is easiest; and third, by experience, which is the most bitter."

~ Confucius

Puddle Jumping

2010-01-21T20:45:00.046-06:00

Palliative fellows & residents from across Canada "meet" via teleconference every two months to hear presentations on topics of shared interest. In yesterday's session on Grief and Bereavement, we learned that kids grieve in chunks. The speaker likened this to puddle-jumping. "For adults grief is like wading through this enormous river, whereas for children it's puddle jumping, but when they're in that puddle, it's no different to the river". There were two messages in this statement:

In between the puddles, it is play as usual. Kids experience grief differently from adults, not consistently and not all the time.
Children re-grieve the same loss as they age but not in the same way because the ability to think and process 'looks' different at age 4yr when compared to age 6 or 8 or 10yr.

Rather than ~~protecting~~ children, preparing them in an age-appropriate way to deal with loss & sad feelings empowers them. It is a legacy in the form of a "set of coping skills".

Children want to know:

Did I cause it?
Can I catch it?
Who is going to take care of me?

To enlarge this article, click on the 'full' button in the toolbar underneath the article. To close the article after it has been opened, tap the escape button on the computer keyboard:

Just Listen

2010-01-19T19:12:00.005-06:00

an excerpt
Rachel Naomi Remen

"I suspect that the most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we ever give each other is our attention. And especially if it's given from the heart. When people are talking, there's no need to do anything but receive them. Just take them in. Listen to what they're saying. Care about it. Most times caring about it is even more important than understanding it."

In the Moment ~ A Place for Living

2010-01-17T13:23:00.005-06:00

THANKSGIVING EVE
(written by Bob Franke, sung here by Issac Guillory)
It`s so easy to dream of the days gone by
So hard to think of the times to come
And the grace to accept every moment as a gift
Is a gift that is given to some
What can you do with your days
But work and hope
Let your dreams bind your work to your play
What can you do with each moment of your life
But love `till you`ve loved it away
Love `till you`ve loved it away
There are sorrows enough for the whole world`s end
There are no guarantees but the grave
But the lives we have lived and the times we have spent
Are a treasure too precious to say

Benefits of Mindfulness

2010-01-14T19:47:00.002-06:00

Ability to experience the present moment
Clear awareness of thoughts & emotions
Ability to relate to one's experience with compassion/understanding
Ability to experience/transform emotional distress
Space where creative solutions can arise

Dr. Steven Hick MBSR video presentation, "Mindfulness and being in the moment... the key to positive mental health." Presented in Winnipeg, 2008.
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Essence of Mindfulness

2010-01-10T20:56:00.002-06:00

I went into the woods because I wished to live deliberately, to confront only the essential facts of life, and see if I could learn what it had to teach, and not, when I came to die, discover that I had not lived.

Henry David Thoreau

MBSR begins on Tuesday. Eight weeks, one group session per week, daily practices, one full Saturday retreat. I am so looking forward to this experience. What is Mindfulness? According to Kabat-Zinn, it is paying attention in a particular way, on purpose.... It is a practice that uses motivation & intention to cultivate, sustain and integrate awareness into the present moment with non-judgmental acceptance.

Apparatgeist

2010-01-09T20:01:00.005-06:00

There is an interesting article about mobile phones in this week's Economist entitled "The Apparatgeist calls". It explores social & cultural factors that affect the way mobile phones are used in different countries and goes on to comment that busy lives and emerging technologies (aka "smart phones") are subjugating phone behavior and erasing some of these differences. A sardonic commentary can be found on this blog, Some Observers. The term itself & apparatgeist theory (which I had not heard of before) were coined by Katz & Aakhus in their 2002 book (Perpetual Contact: mobile technology, private talk, public performance) to draw attention to both the meanings people construct for mobile technologies and their social consequences. Reading The Economist article caused me to think about styles of communication and ultimately, to reflect on two encounters that occurred on the same day this week at the hospital. Although there was an exchange of information in both, their impact on me was noticeably different.

Picture this: Two people, each with their eyes downcast and fixated on respective iPhone screens, automatically sidestep, pass each other and traverse, one on & the other off the elevator through the open door. Without ever looking up to acknowledge each others presence, each one simultaneously seems to appreciate what has happened and chuckles to themselves.

Picture this: Our palliative team was asked to help with symptom management for a patient whose heart was weak and kidneys were failing. I began by sitting in a chair, taking my place amongst the family members encircling the bed, devotedly watching & knowing. Very quickly, it was apparent that moving to the bed and taking the patient's hand was a gesture that fit the gravity of the situation. Focused, sensitive, intimate conversation, the realization that going home was unlikely. "Breaking bad news" and the river of tears that followed.

Dying Intestate

2010-01-03T21:44:00.006-06:00

We were asked to attend a patient in the Emergency Department on New Years Day. She had become unexpectedly & suddenly very, very ill with a life-threatening complication of cancer and was not expected to survive. Her cancer had been diagnosed several months prior and was growing despite surgery, chemotherapy and radiation treatments. It became clear from reading the medical record, discussions about end-of-life issues were often postponed at the patient's request. When pressed (gently & respectfully) she gave us permission to call her good friend whom she had thought of asking to assume the role of executor. Her friend arrived discombobulated, breathless and holding back tears, rising to the task of collecting details & hastily preparing a Will with the help of a social worker. I would not want to spend my last moments on earth in this way.

Sudden, fatal illness will take some people much sooner than anyone could have predicted. If one dies without a Will in Canada, they are considered to have died ‘intestate’: This means the provincial government decides how your assets will be divided - not you. Intentions you may have had for distributing your assets (estate) are not taken into account. There could be many repercussions, for instance a common-law spouse left out of the process entirely or additional legal costs for beneficiaries, not to mention the possibility of quarrelsome litigation for “would be” heirs. Whereas when you die with a valid will, the person you appointed as your executor pays your taxes, settles debt, then distributes the remaining assets according to your expressed wishes. Everyone with assets of value (home, investments, pension, RRSPs) needs a will. There are some resources listed on the right panel of this blog and many more to be found on the Internet. Your lawyer can help and for very little money, there is a National Will Kit to guide self-preparation of a will. Some tasks that will spare family & friends unnecessary grief:

Appoint an executor (spouse, reliable family member, friend) and an alternate.
Appoint a Power of Attorney for property (this allows someone to handle your affairs should you become incapable, for example, a coma) and for personal care. If you appoint two or more persons to have your Power of Attorney for Personal Care, appoint them jointly.
Make your wishes regarding organ donation known.
Make your wishes for burial or cremation known.
Appoint a guardian for children. Specify the age of inheritance. Prepare a list of information about your child/ren, such as medical details, medication, education, daily routine, and preferences. Update as needed.
Outline how assets are to be divided amongst the chosen heirs (spouse, children, relatives, friends), including charities and/or churches. Decide on specific bequests, either of property (such as a painting) or money to certain children, relatives, or friends. Create a simple list identifying personal items, describing each item and stating to whom it is to be left.

This patient had a superstitious fear of preparing her will and appointing a power of attorney. She was an educated woman who wanted to minimize suffering and anguish for her friends and family. Making a will is a useful, practical chore, the larger issue here is that people who are dying are still living and for some, facing death while you are living is very difficult.

Words

2009-12-31T18:00:00.003-06:00

I am presently reading and really enjoying the wisdom in this book by Christopher Germer. In one chapter, he presents lists of words denoting positive and negative emotions and contrasts their effects. Not surprisingly, positive emotions have been shown to make us happy and negative ones make us suffer: cultivating positive emotions is a compassionate thing to do for ourselves. I was struck by the collective impact of these words on my mood by simply reading them aloud. I have gone back to these pages a few times and the effect is always the same.
I love words! I still have the Thesaurus (scuffed, dog-eared, missing a few pages, torn cover) given to me by my grade 7 home room teacher, Mr. Hiscoke. He was big on words and deserves some of the credit for the enthusiasm I still feel when I find just the "right" word to express myself. All this to say, that in reading Germer's lists of emotions, I was reminded of the 10 most beautiful words in the English language prepared by lexicographer, Wilfred J. Funk (son of the founder of Funk & Wagnails, publisher of dictionaries). These words get around. I was first introduced to them in Elizabeth Hay's novel, Late Nights on Air. Here they are, see what you think: hush, dawn, lullaby, murmuring, tranquil, mist, luminous, chimes, golden, melody.
As a bit of an experiment, on occasion I have sat at the bedside of a restless patient and spoken these words aloud, slowly & quietly to see if they soothed. I believe they did have some effect.

Prairie Soulmate

2009-12-30T18:29:00.007-06:00

Song for a Winter's Night

Composed by Gordon Lightfoot, Sung by Sarah McLachlan

The lamp is burnin' low upon my table top

The snow is softly falling

The air is still within the silence of my room

I hear your voice softly calling

If I could only have you near

To breathe a sigh or two

I would be happy just to hold the hands I love

Upon this winter night with you

The smoke is rising in the shadows overhead

My glass is almost empty

I read again between the lines upon each page

The words of love you sent me

If I could know within my heart

That you were lonely too

I would be happy just to hold the hands I love

Upon this winter night with you

The fire is dying now, my lamp is growing dim

The shades of night are liftin'

The morning light steals across my windowpane

Where webs of snow are driftin'

If I could only have you near

To breathe a sigh or two

I would be happy just to hold the hands I love

Upon this winter night with you

And to be once again with you

Dying & Choosing to Stay at Home?

2009-12-29T17:43:00.005-06:00

Distribute a list of essential numbers to those who can get the word out if you need help.
Get to know your neighbors.
Ask for help & schedule your friends (and neighbors) in a rotation of support duties.
Make children a part of your life. Feeling young is a jolt in the arm.
Get your paperwork in order - Keep your will, advance directive, power of attorney documentation and financial details close at hand.

Taken from Chatelaine, April 2007. The article was entitled "Lessons from Adele" and authored by Cynthia Brouse. It outlines how one woman who was unmarried, childless and living alone managed to rally a social support network that enabled her to stay at home until her death from lung cancer. Very useful advice and a heartwarming, true story. To enlarge, tap the "full" button underneath the article.

Metta

2009-12-23T09:45:00.002-06:00

May you be safe

May you be happy

May you be healthy

May you live with ease

Follower's Widget

2009-12-12T09:38:00.000-06:00

eBlogger recommends adding a Followers button to encourage all readers to become followers. I added this button today, in the sidebar. I approached blogging with some hesitancy at first, incrementally permitting greater exposure to the WWW as I became more comfortable with the concept. I am enjoying reading other's blogs and learning from them as well, perhaps those of you who read this blog feel the same way. I extend a warm invitation to you to become a follower.

Taking a Spiritual Inventory

2009-12-11T20:56:00.008-06:00

The full text by Kathleen Dowling Singh can be viewed by clicking the link above. In her words, " It is not too late to take stock of our lives, even in the last weeks and days of terminal illness. And for those of us in the midst of life, in the apparent safety and security of our health, it is not too early. No matter how much time we have left to live, the answers to the following questions, voiced in the quiet honesty of our own hearts, provide direction to the rest of our living."
Who have I been all this time?

How have I used my gift of a human life?
What do I need to "clear up" or "let go of" in order to be more peaceful?
What gives my life meaning?
For what am I grateful?
What have I learned of truth and how truthfully have I learned to live?
What have I learned of love and how well have I learned to love?
What have I learned about tenderness, vulnerability, intimacy, and communion?
What have I learned about courage, strength, power, and faith?
What have I learned of the human condition and how great is my compassion?
How am I handling my suffering?
How can I best share what I've learned?
What helps me open my heart and empty my mind and experience the presence of Spirit?
What will give me strength as I die? If I remembered that my breaths were numbered, what would be my relationship to this breath right now?
These questions are contained in the "End-of-Life" tools found on the PBS website devoted to journalist Bill Moyer's 4-part series "on our own terms" that aired in 2000.

Compassion Fatigue

2009-12-11T19:47:00.001-06:00

I attended a one-day conference on this topic in late November. The speakers delivered excellent presentations, thoughtful and insightful commentary taken from their real-world experience in helping professionals who are involved in palliative care. Both David Kuhl and Françoise Mathieu quoted Remen (1996):

"The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet."

The comedian Susan Stewart offered wisdom in a hilarious monologue, impressive for both it's content and duration (no notes). Amongst her questions to us, "Have you ever stood in the shower looking at the cream rinse bottle, wondering if you had already put the conditioner in your hair?? Why do we lose track??" The answer... Because in our minds we are already at work, "showering" with our patients. In moments like this, the self-care experts say it would be more beneficial to simply feel the water on your body, be mindful of the warmth and take the opportunity to stay in the moment with self awareness. It is hard though. This morning in the shower, I was reminded of the Remen quote. I was thinking about the sweet face of the 30-something patient, wife, sister and mother, contorted with suffering, imminently dying from a metastatic cancer that she has battled for 6 years. It will be possible to help a bit more with the pain but the real anguish is not physical.

Online Learning

2009-12-05T18:12:00.002-06:00

I have come across two websites recently, each with a catalog of learning modules that have been prepared with multidisciplinary input. The first is the Online Cancer Education Forum, designed to provide continuing education for cancer professionals practicing in different countries. Readers of the European Journal of Cancer Care are first informed of a new topic by way of an abstract in the print version of the journal. The abstract provides an overview of the topic and a link to the body of the module. The module downloads easily and contains:
An introduction to the topic
Learning objectives
Background information
Learning activities& thinking points
Links to resources required to complete the activities

View current topics
The second is the Current Learning in Palliative Care site. Tutorials are designed to be completed within 15 minutes.

Scholarly Project

2009-11-29T23:14:00.002-06:00

Another evening spent developing queries and searching databases, pondering, considering and ultimately discounting all but one of the ideas I had penciled in my moleskin as possible topics for a scholarly project. The "novelty" factor is an important influence here. I am less interested in writing a review article or conducting a clinical trial and more interested in developing a learning tool that incorporates Web 2.0... something new, something I have not done before.... A significant time investment is expected, culminating in a formal report & presentation. The mind map adjacent is a placeholder. I want to sit with my idea for a few days gauging my interest and enthusiasm "indicators". Meanwhile, this article was a source of inspiration:

The Power of Music

2009-11-27T22:03:00.024-06:00

The glorious voice of Carolyn Sampson with The King's Consort performing Sancta Maria, mater dei K273 from Mozart's Exsultate Jubilate (written 1777).

Please note: In re-engineering this post with the new embed code for music from soundcloud.com (following the crash of mailboxdrive.com where the mp3 file was stored), the remaining content of the post was lost. It included commentary about the power of music and a link to Lightbridge Music.

One Slide & The Momentum of Networking

2009-11-24T21:07:00.000-06:00

Engage with Grace Project

The Chaplain

2009-11-24T20:04:00.002-06:00

We had journal club today. The article was an interesting one, dealing with spiritual care as a dimension of palliative care, and it summarized the findings of a national consensus conference. Spirituality was defined as the aspect of humanity that refers to the way individuals seek & express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred. The importance of including a chaplain on the interprofessional team caring for the patient was emphasized. I have seen chaplains working in health care but never really understood how their role differs from that of theologians, ministers or faith-based healers etc. In Anesthesia practice, our paths usually crossed at times of tragedy, and then it was for the family, rarely the patient. I recall Father Mulcahy, the fictional chaplain from M*A*S*H and other fictional characters featured in the Doonesbury comic and a couple of novels, Camus' "L'Etranger" (a favorite of my french teacher) and Heller's Catch-22. So, when I came home from work tonight, I searched reliable old Wikipedia and Google as an introductory means to help me understand the distinction. Chaplaincy is a recognized profession - one where the practitioners possess the educational requirements to screen, assess and counsel those needing spiritual or emotional support. As well, they can perform religious services such as last rites, marriages and baptisms. The role is not necessarily faith-based, making some knowledge of other belief systems necessary. A chaplain could be a priest, pastor, ordained deacon, rabbi, imam or other member of the clergy serving a group of people who are not organised as a mission or church, or who are unable to attend church for various reasons; such as health, confinement, or military or civil duties. In recent years many non-ordained persons (lay chaplains) have received professional training in chaplaincy and are now appointed in settings such as schools, hospitals, universities, prisons and elsewhere to work alongside or instead of ordained chaplains. In Canada, Health Care Chaplains may be certified by the Canadian Association for Pastoral Practice and Education.

eHealth for Consumers & eMedicine for Physicians

2009-11-16T10:30:00.005-06:00

I am located somewhere between early & late adopters when it comes to embracing a new product, technology, or idea. Not on the cutting edge but not a straggler either. Here are two Microsoft powerpoint presentations available from slideshare that I enjoyed watching... I am still contemplating 'how', 'how much' and 'what' of the Web 2.0 technology to incorporate into my own learning, continuing education & practice, not to mention into interactions with patients, colleagues and those who call me their teacher & see me as a role model.

Jungle Dreams

2009-11-14T22:41:00.001-06:00

I tossed and turned last night dreaming of the jungle in vivid color. The foliage was typically dense and the sights & sounds similar to what I have seen in documentaries and movies. I didn't recognize any of the characters. So far nothing unusual. There were several scenes, different plots, rather disorganized and disjointed but in retrospect, all the pieces were bound by a common thread, 'contrast'. As each section unfolded there was order mixed with confusion, harmony jumbled together with discord, calm intertwined with struggle, living beside dying... A metaphor for my personal experience of the first two months of Palliative fellowship. Returning "home" to Winnipeg this past month has been restorative in many ways. The landscape was soothing, the weather surprisingly warm, friends, colleagues and co-workers were welcoming and so interested in my stories. It felt good to be "known" again. There was time for all that fills my senses. The purpose of this month was an elective in Web 2.0 technologies. I worked hard, learned a stunning amount of useful, practical information, and thoroughly enjoyed the brilliant librarians (& their library humour) at the NJM Health Sciences Library. My emotions are mixed as I prepare to return to Ottawa and continue the clinical fellowship.

Mindfulness Meditation

2009-11-11T13:21:00.006-06:00

Today I finished an on-line course entitled "Mindfulness and the Brain". The idea of exploring both meditation and keeping a personal journal emerged from reading the article below and preparing the contents for presentation at Palliative Journal Club in September. The authors conclude only these two practices, out of many possibilities examined, have sufficient scientific evidence to support their use for mitigating burnout & compassion fatigue in physicians caring for dying patients.
Six weeks and several hours of training in the science & practice of meditative awareness later (I listened again and again to the lessons) and I am convinced this is worth further study.

Trying new (to me) technology

2009-11-04T11:31:00.021-06:00

Buddha Blessing by Alicepopkorn, digital artist. I have spent the better part of 24 hours over several days trying to figure out how to change the format of audio files and upload music. None of this new technology comes without some sort of struggle. There are so many options out there, finding the "best" resources requires some persistence and a lot of trust. In the process, I stumbled across a website where the photographs are shared through a creative commons process. I tried to upload the picture to this blog directly using Flickr but success came only after emailing it and uploading from my own computer. Tomorrows project - authorize posting from Flickr to Blogger. This elective month is flying by. I am just skimming the surface of all there is to learn and meanwhile trying to figure out what tools will be useful to me in my academic career. Perhaps you would like to listen to Sanctus (Locus Iste) performed by Libera & found on their Visions album.

Infant son

2009-11-02T17:33:00.009-06:00

I was on overnight Anesthesia labor floor call on Saturday... a bustling, happy place usually. The words "code blue newborn" echoed overhead about 2am. I was already running. My pager was bleeping and vibrating in that tone reserved for the worst of emergencies. He was perfectly perfect at the moment of birth, a little extra encouragement needed to cry. Something wasn't quite right though, the team working diligently, ultimately a heart not perfectly formed. The curious thing was, in between epidurals & C-sections that day, I had been searching, cataloging & practicing the empathic phrases palliative care physicians tend to use when speaking with dying patients and their families. There are words that resonate & "carefully-crafted" sentences that tend to reach more deeply than others. I never imagined I would be using them with distraught and grief-stricken parents.

~~Lullaby~~

What I wouldn't give
To have you in my arms again,
Breathe your scent
And snuggle close to you.
I want to watch you sleep,
See your chest rise and fall
In peaceful slumber.
Let me lay my hand
Over your heart,
So I can
Feel it beating
Beneath my touch.
I want to be
Lulled to sleep
By its rhythm.
~~ by Tara Simms

We do not remember days; We remember moments.
~~ Cesare Pavese

The Household Guide to Dying

2009-10-31T23:23:00.011-05:00

Sound macabre? This novel offers a poignant and irreverent look at the process of dying, from the vantage point of a 30 - something fictional woman who moves between the roles of daughter, wife, mother, advice columnist and novelist. Written by Debra Adelaide, the pages contain humor, wisdom, practical advice and enough tenderness to to cause the reader to shed a few tears. I enjoyed this book. It was my selection to facilitate for book club and I am looking forward to discussing the book and the topic with my book club buddies this Wednesday evening. Here are a couple of reviews/interviews:

Conversations live with Vicki St. Clair - Seattle radio KKNW am 1150, review by Cynthia Baxter
Sydney Morning Herald - May 17, 2008 - Interview with Susan Wyndham
The Ember - Nick Terrell
ABC National Radio, Australia (Richard Aedy interviewer) Podcast - Debra Adelaide is the second interview

Music

2009-10-28T17:06:00.005-05:00

The term music thanatology is new to me. It refers to a musical modality that combines harp and voice at a dying patient's bedside to create an atmosphere of serenity & comfort. In the larger context, structured (improvisation, analysis, writing lyrics) & unstructured (simply listening to music) music therapy is but one component of a holistic approach to palliative care with many reported benefits. Selections from the Baroque or Renaissance eras would be my choices, but it happens that the "best" music depends on the treatment goals and not necessarily on personal music tastes.

Care for the Spirit - the NFB documentary "Griefwalker"

2009-10-27T13:25:00.011-05:00

National Film Board of Canada

The film's website

Exerpted from the film's website: Stephen Jenkinson has been called the Angel of Death. Whether sitting at the bedside of a dying woman, or speaking to clinicians dedicated to delaying death, Jenkinson bears a message that most do not want to hear: that death is not something to be denied or avoided but "befriended." A Harvard-trained theologian who has traveled far from Western religion, Jenkinson says there is a "hole inside most of us and it's in the approximate shape of a soul." Griefwalker is filmmaker Tim Wilson's extraordinary portrait of his friend Jenkinson and his work with the dying. The film weaves an illuminating picture of a remarkable man, and leaves us with a deeper understanding of how our deaths should be held as "a prized possession."

Anonymous patient

2009-10-23T19:56:00.025-05:00

I found this picture on the Internet. There was no attribution. A colleague kindly supplied the artist's name, Robert Pope, and this led eventually to yet another website to explore The End of Life Project.
Canadian artist Robert Pope (d. 1992) devoted the last few years of his short life to documenting his experience as a patient with lymphoma. Physician Jock Murray has immortalized Pope's work in a book entitled, Reflections - Illness and Healing: The Art of Robert Pope

Contemplating the future in beautiful locations

2009-10-23T13:18:00.008-05:00

Two years to ponder options, professional & personal - punctuated with
the good fortune to step away from the ordinary & predictable first to
Martinique, then to France looking for inspiration. A taste of my favorite photographs from these places, a reminder that j' ai eu de la chance, and later, a few from the new nest - chaos to order at home thankfully - have not yet hit my stride in the training program though. Establishing a rhythm, achieving the balance between learning, studying & practicing in this new field and guarding those activities that are soul-restoring - meditation, music, art ..... Perhaps this blog, entitled Literature, Arts and Medicine will interest you too. What is known is that mindfulness meditation and journal writing are the only activities with evidence to show that regular practice mitigates burnout and compassion fatigue in those caring for patients at the end of life.

Blogpost using email

2009-10-22T14:00:00.006-05:00

Navigating the Web & Web 2.0 technologies - This information literacy elective is amazing. Kudos to Tania, MLS extraordinaire. Only four days into the month and words like wiki, blog, html code & personalized home page have meaning and relevance. Contrast with key punch card, card reader, MS-DOS, floppy disc....

Longevity in medicine...

2009-10-21T09:59:00.000-05:00

The motivator for a mid-life career change. Or more to the point, a mid-life everything change. Back to school & student status, from renovated century home & well-trodden pathways to small (but lovely) apartment in an unfamiliar city & new province, whole segments of my former life "in storage"... The words, "What have I done?" resonating with every step during my early morning walk to work those first few weeks.

Euthanasia - Interview with Dr. Mount

2009-10-20T10:15:00.005-05:00

Interview with Dr. Balfour Mount
CBC - The Current - July 22, 2009

Insightful interview with a compassionate practitioner who champions palliative care.