I have some marvelous news!
My good friend and colleague, Dr Cheryl Cohen Greene, is a sex therapist and surrogate partner therapist. On October 26, 2012, Fox Searchlight Pictures will release a movie, The Sessions. It’s the poignant story of her work with one of her famous clients, journalist and poet Mark O’Brien. The movie is finally being released to the general public after a round of critically acclaimed premieres at film festivals all over the world.
Helen Hunt plays Cheryl in the movie. The cast also includes John Hawkes and William H. Macy.
Cheryl and I have another connection too. If you’ve spent any time with my new book, The Amateur’s Guide To Death and Dying; Enhancing the End of Life, you will probably remember Cheryl from Chapter 6. She did the presentation on sex and intimacy concerns.
I am so proud of Cheryl, the work she does, and the recognition she is finally receiving for her groundbreaking work with sick, disabled, elder, and dying people.
These are all so sad.
Another wonderful review of The Amateur’s Guide To Death and Dying; Enhancing the End of Life has appeared. This time the review comes from my colleague, the very talented author, Mikaya Heart. Her review appears on the Blogging Authors website.
In our society, death is a taboo subject, and many people won’t talk about it at all. I’ve always been fascinated with the process of dying, and how someone’s energy remains after they die, often affecting us on a deep level. I recently read a great book on the subject by Richard Wagner. A gay man, an ex-Catholic priest, and a psychotherapist, Richard was first exposed to the process of dying during the AIDS epidemic in the early eighties when his friends were dying in droves. I won’t say any more about his own journey since it’s all in the book, but rest assured—he knows what he’s talking about. As he says, none of us will get out of here alive—so let’s talk about how to make that process of transition easier.
Richard started a group called Paradigm specifically designed to help sick, elder and dying people and their friends and families avoid the kind of nightmares that he had seen repeated again and again, based on society’s phobia about death. Perceiving that basic information is being withheld from dying people, he ran countless groups on death and dying in the San Francisco Bay Area, and has helped thousands of individuals over the years. He took groups of ten people for ten weeks, inviting various experts to come and give presentations on different aspects of what is involved in dying: legalities such as wills and executors; talking to one’s family and friends; assisted dying; what to expect of your body as it gives up; spiritual aspects of dying, and other topics.
The Amateur’s Guide To Death and Dying is an in-depth account of one of these courses, profiling the ten people who attended it, each chapter covering a different week. Those ten fictional characters are, Richard says, “composites” of some of the real people who took his course over the years that he ran it. The reader gets to know the individuals very well (sometimes painfully well) throughout the course of the book, as they reveal their deepest inner fears in the safety of the group. They all become more familiar with the concept of death and how to deal with it. Some of them, interestingly, move further away from it, while some go the other way. They all become more empowered. This book is written from a personal perspective, which is essential for any good writing on such a personal subject. Richard deserves congratulations for being brave enough to deal with such a difficult topic in a very open, accepting and compassionate manner.
My only complaint is that I wanted more. Since this book is quite long enough as is, I hope that Richard and others will consider writing more books. Because, as a society, we have failed miserably in talking about the realities of death and dying, there is a great deal still to be discussed. How can relatives and friends help a person who is dying? Do dying people benefit from getting permission to die from those they are close to? How can we change our desperate need to hold on to what we call the state of living even when it is clearly time to let go? How can we learn to relate to the positive aspects of death? How does the energy of an individual affect us when they are no longer present in a body? Richard’s book touches on some of these very profound questions, but they (and many others) need to be addressed in greater depth.
Mikaya Heart is an award-winning author who writes on subjects as varied as orgasm, shamanism, sports, lesbianism, politics and travel. Her memoir, My Sweet Wild Dance, which won a Golden Crown Literary Award, was described as “soul-refreshment of the highest order.” Mikaya uses shamanic methods to teach people how to operate from a place of trust instead of fear.
By Joe Timmerman
Death is a very difficult topic to discuss. It’s not a subject that most people enjoy pondering. It is especially difficult to discuss with someone whose death may be imminent. Like many issues, it might be easier to just avoid the topic altogether. However, as is often the case, pretending the issue doesn’t exist won’t make it go away, and can often make the end result more difficult to deal with. Thus, the news the Madison medical community will start providing end-of-life planning as a standard patient service is welcome, indeed.
End-of-life planning involves sitting down and coming up with an “advanced directive.” An advanced directive is essentially a set of written instructions regarding a patient’s preferred medical care that are carried out in the event the patient is no longer able to make those decisions. For example, a patient might specify that, if they should enter into a vegetative state, they should be taken off the ventilator and allowed to die.
Preparations for death, such as end-of-life planning, are becoming increasingly accepted in the medical community. According to guidelines published by the American Society of Clinical Oncology, all terminally ill patients should sit down and discuss their end-of-life wishes with their family and health care team.
Advanced directives are beneficial for a variety of reasons. To begin with, people should have their health care administered according to their own preferences. If someone wishes to be kept alive on a ventilator, then he or she should be able to. If someone wishes instead not to be put on a ventilator, then they shouldn’t have to be put on one against their will. Just because someone can’t communicate his or her preference doesn’t mean it shouldn’t be honored. Either way, this is utility enhancing for the patient.
As for the health care provider and the patient’s family, they aren’t forced to make life-or-death for someone else. Making these decisions are, as one might expect, extremely taxing, and everyone is better off if the patient makes his or her own decision ahead of time rather than leaving it to a third party. In a powerful Time Magazine article, Joe Klein recounts his difficult experience making these decisions for his own parents. As he writes, “I spent the next five months as a death panel for both my mother and my father.” He later writes he was “extremely fortunate” to transfer his ailing parents to a health care provider that was much more willing to candidly discuss death.
Coming up with an advanced directive also helps to keep health care costs down. CBS News reports Medicare spent $50 billion in 2009 on doctors and hospitals over the last two months of patients’ lives. The kicker? “20 to 30 percent of these medical expenditures may have had no meaningful impact.”
Over the course of one year, Medicare alone spent as much as $15 billion of treatment had no positive effect on patients’ quality of life. This is a prime example of wasteful spending that, in today’s age of fashionable austerity, needs to be eliminated. A significant portion of this spending could be eliminated if people were only kept alive as long as they wished to be.
It might seem that doing anything less than everything to extend a person’s life would be unethical. However, if the person doesn’t want to be kept alive though extraordinary measures only to suffer for longer, their wish should be honored. This can only be accomplished through people having candid discussions with their families and doctors. The fact that local health care providers are starting to encourage these discussions is good news for all Madisonians.