Cancer, Religion and a ‘Good’ Death

It is hard to know how much my patient, caught in an eternal childhood, understood about his cancer.

By Mikkael A. Sekeres, M.D.

When I first met my patient, three years ago, he was about my age chronologically, but caught in an eternal childhood intellectually.

It may have been something he was born with, or an injury at birth that deprived his brain of oxygen for too long — I could never find out. But the man staring at me from the hospital bed would have been an apt playmate for my young son back home.

“How are you doing today, sir?” he asked as soon as I walked into his room. He was in his hospital gown, had thick glasses, and wore a necklace with a silver pendant around his neck. So polite. His mother, who sat by his bedside in a chair and had cared for him for almost half a century, had raised him alone, and raised him right.

We had just confirmed he had cancer and needed to start treatment urgently. I tried to assess what he understood about his diagnosis.

“Do you know why you’re here?” I asked him.

He smiled broadly, looking around the room. “Because I’m sick,” he answered. Of course. People go to hospitals when they’re ill.

I smiled back at him. “That’s absolutely right. Do you have any idea what sickness you have?”

Uncertainty descended over his face and he glanced quickly over to his mother.

“We were told he has leukemia,” she said. She held a pen that was poised over a lined notebook on which she had already written the word leukemia at the top of the page; I would see that notebook fill with questions and answers over the subsequent times they would visit the clinic. “What exactly is that?” she asked.

I described how leukemia arose and commandeered the factory of the bone marrow that makes the blood’s components for its own sinister purposes, devastating the blood counts, and how we would try to rein it in with chemotherapy.

“The chemotherapy kills the bad cells, but also unfortunately the good cells in the bone marrow, too, so we’ll need to support you through the treatment with red blood cell and platelet transfusions,” I told them both. I wasn’t sure how much of our conversation my patient grasped, but he recognized that his mother and I were having a serious conversation about his health and stayed respectfully quiet, even when I asked him if he had questions.

His mother shook her head. “That won’t work. We’re Jehovah’s Witnesses and can’t accept blood.”

As I’ve written about previously, members of this religious group believe it is wrong to receive the blood of another human being, and that doing so violates God’s law, even if it is potentially lifesaving. We compromised on a lower-dose treatment that was less likely to necessitate supportive transfusions, but also less likely than standard chemotherapy to be effective.

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“Is that OK with you?” my patient’s mother asked him. I liked how she included him in the decision-making, regardless of what he could comprehend.

“Sounds good to me!” He gave us both a wide smile.

We started the weeklong lower-dose treatment. And as luck would have it, or science, or perhaps it was divine intervention, the therapy worked, his blood counts normalized, and the leukemia evaporated.

I saw him monthly in my outpatient clinic as we continued his therapy, one week out of every month. He delighted in recounting a bus trip he took with his church, or his latest art trouvé from a flea market — necklaces with glass or metal pendants; copper bracelets; the occasional bolo tie.

“I bought three of these for five dollars,” my patient confided to me, proud of the shrewdness of his wheeling and dealing.

And each time I walked into the exam room to see him, he started our conversation by politely asking, “How’s your family doing? They doing OK?”

Over two years passed before the leukemia returned. We tried the only other therapy that might work without leveling his blood counts, this one targeting a genetic abnormality in his leukemia cells. But the leukemia raged back, shrugging off the fancy new drug as his platelets, which we couldn’t replace, continued to drop precipitously:

Half normal.

One-quarter normal.

One-10th normal.

One-20th normal.

He was going to die. I met with my patient and his mother and, to prepare, asked them about what kind of aggressive measures they might want at the end of life. With the backdrop of Covid-19 forcing us all to wear masks, it was hard to interpret their reactions to my questions. It also added to our general sense of helplessness to stop a merciless disease.

Would he want to be placed on a breathing machine?

“What do you think?” his mother asked him. He looked hesitantly at me and at her.

“That would be OK,” he answered.

What about chest compressions for a cardiac arrest?

Again his mother deferred to him. He shrugged his shoulders, unsure.

I turned to my patient’s mother, trying to engage her to help with these decisions. “I worry that he may not realize what stage the cancer has reached, and want to avoid his being treated aggressively as he gets sicker,” I began. “Maybe we could even keep him out of the hospital entirely and allow him to stay home, when there’s little chance …” My voice trailed off.

Her eyes above her mask locked with mine and turned serious. “We’re aware. But we’re not going to deprive him of hope at the end …” This time her voice trailed off, and she swallowed hard.

I nodded and turned back to my patient. “How do you think things are going with your leukemia?”

His mask crinkled as he smiled underneath it. “I think they’re going good!”

A few days later, my patient developed a headache, along with nausea and dizziness. His mother called 911 and he was rushed to the hospital, where he was found to have an intracranial hemorrhage, a result of the low platelets. He slipped into a coma and was placed on a ventilator, and died soon afterward, alone because of the limitations on visitors to the hospital during the pandemic.

At the end, he didn’t suffer much. And as a parent, I can’t say for certain that I would have the strength to care for a dying child at home.

Complete Article HERE!

French archaeologists find ancient grave of child, pet dog

French archeologists dig at an ancient child burial site recent at the Clermont-Ferrand Airport. France’s National Institute of Preventive Archaeological Research said Thursday the site dates back 2,000 years.

French archaeologists said Thursday they discovered the grave of a small child with what appears to be a pet dog dating to the Roman rule of the region about 2,000 years ago.

The researchers said they found the burial site during a dig at the Clermont-Ferrand Airport in central France. They believe the child was about a year old and buried with animal offerings along with the remains of the pet dog inside a coffin.

The coffin was found in a 6-by-3-foot grave. It was surrounded by 20 objects, including terra cotta vases, glass pots, half a pig, three hams and other pork cuts along with two headless chickens.

“The graves of young Gallo-Roman children are often located outside the community funeral home and sometimes even buried near the family home,” a statement from France’s National Institute of Preventive Archaeological Research said. “These toddlers rarely benefit from the same funeral practices as their elders, who at that time were generally cremated.

“The furniture that accompanies the deceased of Aulnat is quite exceptional, both in terms of its quantity and quality. Such a profusion of dishes and butchery items, as well as the personal belongings that followed the child to his grave, underline the privileged rank to which his family belonged,” the institute said.

The discovery is part of a dig that covers 7.4 acres where numerous objects from the Iron Age to the Middle Ages have been found. Researchers are conducting tests of glassware and containers to learn what they might have held.

Complete Article ↪HERE↩!

7 Films to Help Children Dealing With Grief

We are at a time when large numbers of children are experiencing loss. Here are seven movies to help them develop coping skills.

Lewis MacDougall plays a young boy with a sick mother in the fantasy drama “A Monster Calls.”

By Stacy Brick

There’s no way to sugarcoat it: The pandemic has plunged the world into a crisis of grief. It has caused the deaths of more than 290,000 people in the United States, many of them grandparents and parents. In New York State alone, 4,200 children lost a parent or caregiver to Covid-19 between March and July, according to a study from the United Hospital Fund. (These were the most recent figures available on parental death from Covid.)

For any family who lost a loved one this year, regardless of the cause of death, the pandemic has kept them from being able to properly mourn their loss. And now the holiday season is here, which can be a grief trigger, especially for kids.

Children who lose a parent are at higher risk for lasting mental health issues, including anxiety and depression. Supporting a grieving child involves normalizing their feelings while giving them tools to cope — talking about death, however, can sometimes feel overwhelming. Parents and children may both be reluctant to have conversations that bring up difficult emotions, but it’s important for parents to provide opportunities to acknowledge their child’s feelings.

Film can be a gift in these times. Often, a movie about death can provide just enough distance for a productive discussion. Giving children examples of others’ loss can help them feel less isolated in their own bereavement; watching a character in a film can get the child thinking about their own grief journey and the tools they might use to cope.

The following films, suitable for children ages 6 and older, offer helpful ways to explore death and the accompanying emotions, while providing parents an opening to talk about loss. Content that might be disturbing to young children is noted.

Actor Anthony Gonzalez is the voice of 12-year-old Miguel in the Pixar film “Coco.”

Coco (2017)

109 minutes; Rated PG; available on Disney+

This colorful, Academy Award-winning Pixar film based around the Mexican holiday of Dia de los Muertos (Day of the Dead), follows 12-year-old Miguel’s journey to the Land of the Dead. While there, he unlocks family secrets and learns that the dead continue to exist in the memory of the living.

The Black Stallion (1979)

118 minutes; Rated G; available on Amazon.

After a young boy named Alec and a horse are washed up on a deserted island from a shipwreck that killed Alec’s father, the orphaned boy and the animal soon form an inseparable bond. The pair are rescued and Alec becomes determined to turn “The Black” into a racehorse with the help of a grizzled old trainer. Alec’s connection with the horse brings him solace, helping him deal with his grief for his father.

Fly Away Home (1996)

107 minutes; Rated PG; available on Amazon.

After her mother dies in a car crash, 13-year-old Amy (played by a young Anna Paquin) is sent from New Zealand to Canada to live with her father. She adopts a nest of abandoned goose eggs, and when they hatch she finds herself in charge of teaching the goslings survival skills — including how to fly south for the winter. In the process of taking on the mother role for the goslings, Amy is able to grieve for her own mother. Please note: The car crash is shown in the film’s opening sequence.

Ages 12+

Laia Artigas plays Frida, a girl recently orphaned who moves to the country to live with family.

Summer 1993 (2017)

100 minutes (subtitled); available on Amazon.

After her mother’s death, 6-year-old Frida must move from Barcelona to the country to live with her aunt, uncle and younger cousin. The young girl soon struggles with grief and her place in this new family. Often presented from Frida’s viewpoint, with overheard conversations and waist-high camera angles, the film is based on the director’s personal experiences with loss.

A Monster Calls (2016)

128 minutes; Rated PG-13; available on Amazon.

Conor’s mother is gravely ill, and the 13-year-old struggles with anger, sadness, guilt and anticipatory grief. To cope with all the overwhelming emotions, Conor (Lewis MacDougall) conjures a monster who offers up three fables and then demands one from him — it must be his ultimate truth. MacDougall gives an authentic performance as a boy learning to face the truth, even though it is contradictory and complex. Please note: There is some destruction of property, physical bullying and verbal abuse.

When Marnie Was There (2014)

103 minutes; Rated PG; available on HBO Max.

In this feature from Japanese animation powerhouse Studio Ghibli, Anna is sent by her foster mother to visit relatives at the seaside for fresh air after having an asthma attack. Once there, she ventures into an abandoned mansion and discovers a new friend, Marnie, who may or may not be the ghost of her grandmother. Anna is then forced to confront feelings she has been avoiding about the loss of her family.

The Farewell (2019)

98 minutes (subtitled); Rated PG; available on Amazon.

The matriarch of a family in China is diagnosed with terminal cancer, but no one has told her. The family comes together one last time under the guise of a large wedding, but it’s really to say goodbye. The film, based on the writer and director Lula Wang’s personal story, shows profound cultural differences in attitudes about death and grieving.

Complete Article HERE!

What was a funeral like 8,000 years ago?

Newly discovered child burial site reveals ancient secrets

Entrance to Makpan cave, Alor Island, where the burial was discovered.

By

Humanity has done a pretty good job of recording its collective history over the past two or three thousand years. Earlier time periods, though, are still very much shrouded in mystery. Now, a groundbreaking new archeological discovery in Indonesia is revealing secrets from 8,000 years ago.

Archeologists from The Australian National University have discovered an ancient child burial site located on Alor Island, Indonesia. While a funeral for a child is no doubt a morose and depressing event in any century, this unearthing is providing some invaluable insight on early mid-Holocene era cultural and burial practices.

Stunning burial practices unearthed

Articulated left foot (bottom left) and right foot (center) excavated in the ANU laboratory.

According to lead researcher Dr. Sofia Samper Carro, it’s clear that the child was laid to rest with a formal ceremony of some kind. The research team estimates the child was between four and eight years-old at the time of death.

“Ochre pigment was applied to the cheeks and forehead and an ochre-colored cobble stone was placed under the child’s head when they were buried,” she says in a university release. “Child burials are very rare and this complete burial is the only one from this time period,”

“From 3,000 years ago to modern times, we start seeing more child burials and these are very well studied. But, with nothing from the early Holocene period, we just don’t know how people of this era treated their dead children. This find will change that.”

Of particular note is the fact that the child’s arms and legs appear to have been removed and stored elsewhere before the rest of the body was buried. This sounds rather odd from a modern perspective, but researchers say it isn’t wholly unprecedented.

“The lack of long bones is a practice that has been documented in several other burials from a similar time period in Java, Borneo and Flores, but this is the first time we have seen it in a child’s burial,” Dr. Carro adds.

Why did ancient cultures remove arms and legs before burials?

The answer is probably lost to the sands of time, but researchers theorize some form of religion or spiritual belief is a likely explanation.

“We don’t know why long bone removal was practiced, but it’s likely some aspect of the belief system of the people who lived at this time,” Carro adds.

While teeth examinations project the child as being around six to eight years-old, the full skeleton appears to be closer to four or five years-old.

“We want to do some further paleo-health research to find out if this smaller skeleton is related to diet or the environment or possibly to being genetically isolated on an island,” the lead researcher comments. “My earlier work from Alor showed adult skulls were also small. These hunter-gatherers had a mainly marine diet and there is evidence to suggest protein saturation from a single food source can cause symptoms of mal-nourishment, which affects growth. However, they could have been eating other terrestrial resources such as tubers.”

“By comparing other adult burials we have found from the same time period with this child burial in a future project, we hope to build a chronology and general view of burial practices in this region from between 12,000 to 7,000 years ago which at the moment is still scant.”

Complete Article HERE!

Indigenous death doula mentorship program aims to teach youth to help others through grief

‘I just want to be able to support my family and my community [when] people die’

Kayleigh Lagimodiere and her mother Dana Connolly. Lagimodiere is one of 12 Indigenous youth who have been accepted into the Indigenous death doula mentorship program.

By Lenard Monkman

A new death doula mentorship program is being offered to Indigenous youth to equip them with skills to help others deal with grief and loss in their communities.

“It’s important for me to learn about this work because prior to colonization, I think we shared a different relationship with death. One that wasn’t so scary and fear-driven,” said Kayleigh Lagimodiere.

Lagimodiere, who is Cree, is 17 and one of 12 young people chosen to take part in the Indigenous Death Doula Program being offered by Blackbird Medicines in partnership with Canadian Roots Exchange.

A death doula is someone who supports people who are experiencing grief and or going through the process of death.

In January, Lagimodiere’s aunt Tracey Stevenson died and she got some experience doing death doula work.

“An elder from Swan Lake [First Nation] came and taught me how to prepare the body,” said Lagimodiere.

“That was like the first time that I had actually seen a dead body. Prior to that, at funerals, I wouldn’t go up.”

Lagimodiere said there have been a few recent losses in the family and they were having a hard time navigating through the grief.

“I just want to be able to support my family and my community [when] people die,” said Lagimodiere.

“I want to be able to help restore our practices that were there and to help people.”

The experience inspired her to apply for the Indigenous Death Doula Program, which was accepting applications from youth aged 12-29.

Lagimodiere said there were a number of different interest options that were available to applicants. She chose palliative care, harm reduction, cultural death practices, legacy planning and culturally grounded death and dying resources.

Indigenous grief

The program was started by Blackbird Medicines and its Indigenous death doula collective, which includes Connor Sarazin, Tasheena Sarazin, Colleen Cardinal and Elaine Kicknosway.

Founder Chrystal Toop, Omàmiwininì (Algonquin) from Pikwakanagan First Nation, started doing death doula work in 2018.

Chrystal Toop is the founder of Blackbird Medicines. The organization is offering an online death doula mentorship program for Indigenous youth ages 12-29.

“I come from the background of a full spectrum or a life spectrum doula worker,” said Toop.

“So I started out working with babies, pregnancy, things like that. But there’s just a huge demand on the other end, on that death spectrum.”

According to the website, Blackbird Medicines offer a range of services including virtual consultations, slideshows and videos for funerals, virtual funerals and aftercare to support people who have lost loved ones.

“For a lot of us, we came to this work because we were doing social services, front line work,” said Toop.

“Some of us have stories around missing and murdered men, women, girls, two spirit. And we have these personal experiences, so we recognize that Indigenous death doula work includes harm reduction from death.”

For the doula program, they are hoping to get more young people involved.

“The program itself is a gentle introduction to people, to support them,” said Toop.

It features two individual one on one sessions, as well as two group sessions with the whole collective, all of which will be done online.

Kicknosway said doing death doula work comes naturally to her. She has helped friends and family who have lost loved ones to cancer, but has also helped families go through things like suicide or other tragedies.

“What does Indigenous grief look like?” said Kicknosway.

“We need to make it a natural place to talk safely and to have spaces for this work.”

Complete Article HERE!

Couples Care for Stillborn Babies for Weeks While Grieving, & We Need to Be OK With That

By Sabrina Rojas Weiss

When Chrissy Teigen lost her baby Jack last week, some disapproved of the fact that both she and her mother shared images of themselves holding him. Those people may be surprised to learn that some parents go even further when grieving a stillborn baby, choosing to visit and hold them for days or weeks. As October is Pregnancy and Infant Loss Awareness month, we want to help spread the word that this is one of many ways to grieve and memorialize a miscarriage or stillborn child.

“She was a fully grown baby and I kept thinking that she would wake up at any minute,” British mother Jess Mayall told the Sun of her stillborn daughter Ava. Her hospital in the U.K. allowed her to keep Ava in a refrigerated device call a CuddleCot for two weeks. That meant that she and her partner could hold her, take pictures with her, and even take her on walks in a stroller to say goodbye.

“The hospice was a life saver for us,” Mayall said. “The support they offered us really changed our experience and we are so glad that we were able to make two weeks’ worth of memories with her before laying her to rest.”

This is a practice some hospitals and pregnancy-loss organizations have recommended for bereaved parents, even sometimes suggesting they bring the baby home for a short time. While in the U.K., most hospitals have CuddleCots, there are parents and others hoping to bring more of them to the U.S., where often parents don’t even get to see or hold their infants after losing them.

The prospect of holding and caring for a deceased infant is not for everyone, though. We hope to help normalize many ways to cope with this tragedy. Here are some other ways to grieve and memorialize pregnancy and infant loss:

Seek the help of a doula. BirthWaves.org has doulas in five states who provide free help for parents during delivery of a stillborn child as well as with all the difficult things that come after they return home, from lactation support to funeral arrangement.

Hire a photographer who is comfortable with bereavement photos, or take pictures yourself.

Frame an ultrasound picture or create art with their footprint.

Buy a customized Molly Bear that is the weight of your baby.

Fill out a special memorial baby book.

Create a customized book for you and your other children to read together.

Make a memory box.

Reach out to a local or online support group.

Share your feelings with friends and family. No one needs to go through this alone. You may also be surprised to learn that someone close to you suffered from miscarriage or stillbirth without telling anyone until you did.

Read about other beautiful ideas from Still Standing magazine.

Complete Article HERE!

Talking to your child about death

You need not worry excessively about what to say. According to one study, children just want to “hear the truth expressed in kind words.”

By

Death is often a sore subject and one that adults like to avoid talking about. But because it is inevitable, at some point we are going to have to talk to our children about it.

Sometimes their own curiosity may force us to broach the subject, like when your six-year-old child innocently asks if you’re going to die someday. What would your response be? Would you try to invent something in order to spare them any worry or would you tell them the truth in a way that they would understand? While most parents find it difficult to talk about death and dying with their children, the best way to go is by telling them the truth in a way they best comprehend.

In fact, children do think about death. Some even play games in which someone pretends to die. Therefore, death should not be considered a taboo subject, and you should welcome any questions your child may have about it. By occasionally talking openly about death, you help your child learn how to cope with the loss of a loved one.

Talking about death will not cause your child to have morbid thoughts. Rather, it will help him or her alleviate their fears. However, you may need to correct some misunderstandings. For example, some experts say that many children under the age of six do not view death as final. In their games, a child will be “dead” one moment and “alive” the next.

When they get a little older, however, children begin to grasp the seriousness of death—a fact that may cause them to have questions, concerns, or even fears, especially if a loved one has died. Therefore, it is vital that you discuss the subject. Several mental-health experts believe that a child will develop anxieties related to death if he or she feels that they are not allowed to talk about this subject at home.

Here are some tips to guide you when the subject pops up:

Take advantage of opportunities to talk about death: If your child sees a dead bird on the side of the road or if a beloved pet dies, use simple questions to encourage him to talk. For example, you could ask: “Does a dead animal suffer? Is it cold or hungry? How do you know that an animal or a person is dead?”

Do not hide the truth: When an acquaintance or a relative has died, avoid using confusing euphemisms such as “He has gone away.” Your child might wrongly conclude that the deceased will soon return home. Instead, use simple and direct words. For example, you might say: “When Grandma died, her body stopped working. We can’t talk to her, but we will never forget her.”

Reassure your child: He or she might think that their actions or thoughts caused someone’s death. Instead of just saying that they are not responsible for what happened, you could ask, “What makes you think that it is your fault?” Listen carefully, without belittling their feelings. Also, since a young child might think that death is contagious, assure them that it is not so.

Draw out your child: Talk freely about loved ones who have died, including relatives whom your child has never met. You might evoke fond memories of an aunt, an uncle, or a grandparent and relate amusing anecdotes. When you openly discuss such people, you help your child understand that they need not avoid talking or thinking about them. At the same time, do not force your child to talk. You can always broach the subject later, when you feel the time is right.

You need not worry excessively about what to say. According to one study, children just want to “hear the truth expressed in kind words.” Be assured that a child will usually not ask a question unless he or she is ready to hear the answer.

Complete Article HERE!