Take Control Of Life, Death

By Dr. Aroop Mangalik

If you want to be comfortable, happy and be with your family and friends when you are facing a serious illness or are likely to die in the near future, you need to take control.

In recent decades, there has been what some have called “medicalization of death.” There have been many advances in medicine and a lot of people are living healthier, longer lives.

But ultimately, we all have to die.

Medicalization of death has occurred, to a significant degree, because we – society, patients and doctors – have not taken into account the fact that there are limits to life and that medical interventions can only do so much.

Understanding this reality is a major step that must be taken to get the best outcome for the patient.

How does one understand this? How do we take control of the situation?

The knowledge you need to get will necessarily come from your medical provider. The best decisions are made by having the facts – available treatment options and the likely outcomes.

Ask your provider about the nature of the illness and what is expected without any treatment.

The next steps will be to get a clear picture of what treatments are available. You should be able to get some idea of how likely it is that the treatments will improve the outcome for you.

This includes information on previous success and failures with available options. At least try to find out if the treatment is “very likely,” “likely,” or “not likely” to help.

Equally, important, you need to know what will be the side-effects of treatment. Will the treatments be harsh or mild, will they last for a short time or will they be persistent.

The cost in dollars is also something that must be considered. In this day of uncertainty we cannot ignore that factor. Many families face bankruptcy because of “long shot” medical treatments.

Once you have the information, you need to decide. It should be your decision based on the best information and input you can get.

If you feel that the treatments available to you are not going to help you achieve your goals, you can refuse those treatments. No one can force you to have a treatment you do not want.

If you choose the path of not taking the treatment, the focus changes from controlling the disease to making your life as comfortable as possible.

The medical team will work with you to control your symptoms. They will help you with pain control, nausea, vomiting, shortness of breath or difficulties in performing day-to-day activities. They will work with you to get the best out of life for whatever time you are alive.

There are many types of experts who are trained to help you. They have overlapping roles and expertise and they work together.

They are referred to as Palliative Care Specialists, Hospice Teams or Symptom Management experts. They all have the goals of making your life better and focus on you.

They also help you and your family so that you die comfortably and with dignity with your family and friends around you.

In certain circumstances, despite their efforts, living may feel like a burden. There are other options that can be utilized.

This is the option of you willfully ending your life at the time you choose. This option has been given a number of names. Physician-assisted death (and) assisted suicide being two common ones.

The option is currently available in Oregon and Washington State. In New Mexico, we are waiting for the courts to decide if such an action would be legal.

In summary, when faced with a serious illness, you should take control of your life and decide what is best for you.

Complete Article HERE!

15 Things You Should Never Say To A Bereaved Person

By Carole Brody Fleet

“I don’t know what to say.”

“I’m afraid of saying the wrong thing.”

The number of times that I’ve heard these sentiments expressed by those who surround the widowed are countless. Unfortunately, many seem to have lost sight of the fact that the words, “I’m so sorry” can be the most comforting words of all. As a result and even though it may be in an attempt to console, people can instead wind up saying some pretty ridiculous things. Having been widowed myself and at the receiving end of some of these comments (and worse), I continue to be amazed at what some say in the guise of sympathy.

Following are actual expressions of “compassion” that have been shared with widowed; including what oftentimes goes through bereaved person’s mind when hearing these expressions. We’ll call this, “What Not to Say…Ever!”:

1. When someone says: “At least you were prepared” (when death is anticipated).

What the widowed are thinking is: “Expecting death doesn’t make the reality of death any easier.”

2. When someone says: “At least s/he didn’t suffer” (when death is sudden).

What the widowed are thinking is: “That made things easier on them … not me.”

3. When someone says: “Everything happens for a reason.”

What the widowed are thinking is: “Whatever that ‘reason’ is, I’m not interested in hearing it.”

4. When someone says: “You were just meant to be alone.”

What the widowed are thinking is: “If I were meant to be alone, I wouldn’t have gotten married in the first place.”

5. When someone says: “I know how you feel.”

What the widowed are thinking is: “No you don’t, because you are not me and losses cannot be compared.”

6. When someone says: “You’ll find someone else.”

What the widowed are thinking is: “What makes you think that I’m looking for someone else right now?”

7. When someone says: “You should be ‘over it’ already.”

What the widowed are thinking is: “Well, I’m not ‘over it’ and I’m sorry if my healing timeline doesn’t fit your timeline.”

8. When someone says: “Now you’ll have closure.”

What the widowed are thinking is: “I don’t want to ‘close’ any part of my life. What does that even mean?”

9. When someone says: “S/He’s in a better place.”

What the widowed are thinking is: “Better than here with me?”

10. When someone says: “You can always get a pet to replace him/her.” (Yes, someone actually said that.)

What the widowed are thinking is: “You’re kidding, right?”

11. When someone says: “Divorce is the same.”

What the widowed are thinking is: “It’s not the same. I understand you’ve experienced the ‘death’ of a relationship. But in your case, someone somewhere made a choice. No one ‘chose’ to leave my marriage.”

12. When someone says: “You were married for so many years and he/she lived a long life.”

What the widowed are thinking is: “That doesn’t matter. It will never be long enough.”

13. When someone says: “You’re not really a widow/er because you were only married for…” (a short time).

What the widowed are thinking is: “I missed the part of the wedding ceremony that said how long we had to be married before it ‘counted’ toward widowhood.”

14. When someone says: “You weren’t technically married so you’re not really widowed.”

What the widowed are thinking is: “My heart doesn’t understand technicalities. My heart only knows that the person with whom I planned to spend the rest of my life is gone.”

15. When someone says: “S/He was my brother/sister/other relative. You weren’t technically related.”

What the widowed are thinking is: “Please make sure that I’m standing there when you tell our children that Mom and Dad weren’t technically related.”

The common thread in all of these statements (and many more like them) is that while most may be said in an attempt to comfort, absolutely none of these statements will console anyone.

So what should you say to a widowed instead?

Express genuine sympathy: “I’m so sorry; I can’t even begin to imagine the pain you’re in right now.”

You have provided immediate comfort and a sense of reassurance to someone whose world has been rocked; as well as reassurance that they don’t have to face this bleakest of seasons on their own.

Encourage dialogue: “You might not be ready to talk about it today, but when you’re ready, I’m here to listen.”

One of the most helpful things in the world is a kind ear and it is after the funeral, when everyone else has seemingly disappeared that your compassion is needed the most.

You really can be the first avenue of comfort to a widowed. No longer are the excuses, “I don’t know what to say” or “I’m afraid of saying the wrong thing” acceptable. While I’m not sure that I ever bought into the cliché that, “Ignorance is bliss,” this I know for certain:

When it comes to consoling the bereaved, ignorance is not “bliss.”

It is instead a gigantic miss.

Complete Article HERE!

Cemetery Art – 8/12/12

Idealized human depictions in cemetery art abound. I suppose they’re meant to represent a world without death. Yet it’s clear that time and the elements ravage even what is supposed to have been immutable.


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Meditation – Nothing But Death

Nothing But Death by Pablo Neruda

There are cemeteries that are lonely,
graves full of bones that do not make a sound,
the heart moving through a tunnel,
in it darkness, darkness, darkness,
like a shipwreck we die going into ourselves,
as though we were drowning inside our hearts,
as though we lived falling out of the skin into the soul.

And there are corpses,
feet made of cold and sticky clay,
death is inside the bones,
like a barking where there are no dogs,
coming out from bells somewhere, from graves somewhere,
growing in the damp air like tears of rain.

Sometimes I see alone
coffins under sail,
embarking with the pale dead, with women that have dead hair,
with bakers who are as white as angels,
and pensive young girls married to notary publics,
caskets sailing up the vertical river of the dead,
the river of dark purple,
moving upstream with sails filled out by the sound of death,
filled by the sound of death which is silence.

Death arrives among all that sound
like a shoe with no foot in it, like a suit with no man in it,
comes and knocks, using a ring with no stone in it, with no
finger in it,
comes and shouts with no mouth, with no tongue, with no
throat.
Nevertheless its steps can be heard
and its clothing makes a hushed sound, like a tree.

I’m not sure, I understand only a little, I can hardly see,
but it seems to me that its singing has the color of damp violets,
of violets that are at home in the earth,
because the face of death is green,
and the look death gives is green,
with the penetrating dampness of a violet leaf
and the somber color of embittered winter.

But death also goes through the world dressed as a broom,
lapping the floor, looking for dead bodies,
death is inside the broom,
the broom is the tongue of death looking for corpses,
it is the needle of death looking for thread.

Death is inside the folding cots:
it spends its life sleeping on the slow mattresses,
in the black blankets, and suddenly breathes out:
it blows out a mournful sound that swells the sheets,
and the beds go sailing toward a port
where death is waiting, dressed like an admiral.Nothing But Death by Pablo Neruda
There are cemeteries that are lonely,
graves full of bones that do not make a sound,
the heart moving through a tunnel,
in it darkness, darkness, darkness,
like a shipwreck we die going into ourselves,
as though we were drowning inside our hearts,
as though we lived falling out of the skin into the soul.

And there are corpses,
feet made of cold and sticky clay,
death is inside the bones,
like a barking where there are no dogs,
coming out from bells somewhere, from graves somewhere,
growing in the damp air like tears of rain.

Sometimes I see alone
coffins under sail,
embarking with the pale dead, with women that have dead hair,
with bakers who are as white as angels,
and pensive young girls married to notary publics,
caskets sailing up the vertical river of the dead,
the river of dark purple,
moving upstream with sails filled out by the sound of death,
filled by the sound of death which is silence.

Death arrives among all that sound
like a shoe with no foot in it, like a suit with no man in it,
comes and knocks, using a ring with no stone in it, with no
finger in it,
comes and shouts with no mouth, with no tongue, with no
throat.
Nevertheless its steps can be heard
and its clothing makes a hushed sound, like a tree.

I’m not sure, I understand only a little, I can hardly see,
but it seems to me that its singing has the color of damp violets,
of violets that are at home in the earth,
because the face of death is green,
and the look death gives is green,
with the penetrating dampness of a violet leaf
and the somber color of embittered winter.

But death also goes through the world dressed as a broom,
lapping the floor, looking for dead bodies,
death is inside the broom,
the broom is the tongue of death looking for corpses,
it is the needle of death looking for thread.

Death is inside the folding cots:
it spends its life sleeping on the slow mattresses,
in the black blankets, and suddenly breathes out:
it blows out a mournful sound that swells the sheets,
and the beds go sailing toward a port
where death is waiting, dressed like an admiral.

REVIEW — In Gumbo, The Grail Connection Newsletter

Marian Ronan:
The Amateur’s Guide to Death and Dying: Enhancing the End of Life, by Richard Wagner, Ph.D. Las Vegas, NV: Nazca Plains, 2012. 431 pp.

Well, it’s happening. The baby-boomers are becoming senior citizens. I joined Medicare and got my half-price MTA card in April. My husband has retired and we’re planning a trip to Paris.

But getting older isn’t all sweetness and light. Even as Keith and I are packing, my best friend from college has checked into a hospice in Toronto, her metastatic breast cancer exploding throughout her body. Ten or twenty years ago I would have characterized this as a catastrophe. Increasingly, it’s the new normal.

Apparently we Americans put a lot of energy into avoiding this “darker” side of getting older. Clinical psychologist Richard Wagner (actually I’m a psychotherapist, clinical sexologist) has extensive experience helping people to come to terms with their own deaths and the deaths of those they love, so he’s written a workbook for the rest of us: The Amateur’s Guide to Death and Dying.

The chapters of The Amateur’s Guide are structured around ten sessions of the death and dying support groups that the author leads professionally in Northern California. Ten fictional group members, composites of actual participants, interact with one another, telling their stories, and engaging the material that Wagner and other experts present. Forms are also provided for us, the readers, to respond to the materials, provide feedback, even evaluate the contents and process of the workshop.

Among the death and dying-related subjects the book/workshop addresses are fear and avoidance of the reality of death, dealing with regrets and old wounds, end-of -life documents and preparations like advance directives, wills and trusts, who to notify, distribution of your possessions, etc., spirituality in death and dying, sexuality and intimacy in the dying process, and what someone’s last weeks and days are actually like.

Reading the responses of the various group members to the presentations and assignments helps to make this material real. But doing the assignments yourself makes death and dying all the more palpable. I was surprised at how deeply moved—and disturbed—I was as I did the various exercises, for example, writing my own obituary and describing the last weeks and days of my own life. This may not be true for everyone, but for me, engaging the prospect of my death was a sobering experience. But I feel I am better for it.

No book is perfect, of course. For the first half of the book, I found it almost impossible to keep the ten members of the group straight in my head. I finally made a crib sheet with the name, age, and a brief description of each, which I printed out and kept inside the front cover. The publisher should send out a bookmark with such information on it when someone buys a copy of The Amateur’s Guide so that readers can consult it as each group member begins to “talk.” The book is also pretty large—the cover is eight by ten inches and the book is an inch thick—which made it hard for me to take on the subway, where I do a lot of my reading.

But this is quibbling. The Amateur’s Guide to Death and Dying makes a valuable contribution to helping readers come to terms with an aspect of life that too many of us tend to avoid. Grail groups around the country would do well to use it to help members begin—or continue—to deal with the reality of death

Marian Ronan blog: An American Catholic on the Margins of World Christianity.