Category: Cultural Expressions

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Hospital volunteers unlock deep mysteries with dying patients

David Wynn, left, Edie Bennett, right, and Carolyn Lyon, center, are volunteers in the St. Joseph Hospital NODA program in Orange. No One Dies Alone is to provide a reassuring presence to patients who would otherwise be alone.

by DAVID WHITING

[T]here is life and death and the in-between.

It is the in-between where hospital volunteers such as Edie Bennett and David Wynn make sure that no one dies alone.

Over nearly a decade of volunteering at St. Joseph Hospital of Orange, Bennett and Wynn have comforted people going gently into the night, endured sepsis many would run away from, even witnessed people crossing death’s door and suddenly reviving.

But perhaps there is nothing Bennett and Wynn say that is more comforting than hearing when someone is unresponsive humans connect on far deeper levels than you might expect.

It has to do with love. But sometimes it also has to do with jazz.

MOVEMENT OF LOVE

Family and friends gathering with someone near death is as old as humanity. But in the modern world, there is a raft of reasons dying patients face death alone.

Some have families too far away to arrive in time, some are homeless and without support, others are estranged from loved ones, some simply outlive everyone they know.

The No One Dies Alone movement traces its roots to a rainy Oregon night in 1986.

Sandra Clarke, a nurse at Sacred Heart Medical Center in Eugene, tended to an elderly dying man who asked, “Would you stay with me?’

Clarke was especially busy with six patients, according to reports, and promised she would soon be back. But by the time she returned, the man had passed on.

For years, the incident haunted Clarke. Eventually, she discussed with staff her idea of volunteers staying with dying patients. PeaceHealth, the corporate organization of Sacred Heart Medical Center, approved her vision and in 2001 No One Dies Alone was born.

Today, an estimated 200 hospitals are involved.

Wynn first thought about dying alone when he and his family happened to be in Las Vegas and a family member died while they were there. Later, he heard about No One Dies Alone through a hospital newsletter after being treated for a condition that nearly killed him. He recalled dark, sometimes scary nights when staff held his hand and comforted his worries away. “It was like I got hit on the head with a board.

“I don’t want to sound like ‘St. Dave,’ but I wanted to do something that made a difference.”

Busy with family, camping, skiing and a demanding job as an AT&T senior project manager, Wynn offered to volunteer. Soon, he was coaxed into coordinating the program.

That was nearly a decade ago.

DEEP CONNECTIONS

St. Joe’s, as the hospital is affectionately known, averages one dying alone incident a month. That may not sound like much, but keep in mind that death is unpredictable. Some people pass within a few hours, others linger for weeks — and some walk away.

Wynn recalls a woman dying one New Year’s Eve. On his way home from a ski trip with his wife, he agreed to answer the call thinking he would be home from the hospital before midnight.

But midnight stretched to 1 a.m., then 2 a.m., then 3 a.m. Dozing in a chair, Wynn woke to daylight and the woman sat bolt upright in bed asking, “Who are you?”

Wynn stammered he was simply there to keep her company.

Soon, the woman returned to her nursing home.

When a call goes out, an army of some 45 volunteers split into four-hour, round-the-clock shifts.

Wynn recalls his first patient, a woman in isolation dying of cancer. When he opened her door, the odor nearly knocked him over. He gathered himself, sat down, took a glove off and touched the woman’s arm to assure her that she was not alone.

“It’s not always pleasant. Sitting there for hours with a gown and mask on can be difficult,” Wynn, a 61-year-old Anaheim Hills resident, allows, “but every human being deserves to die with dignity.

“I think touch is very important.”

As Wynn talks, I think of my father holding my mother’s hand and caressing her arm just before Thanksgiving as she lay in a coma. As her heartbeat slowed, I too held her hand and gently kissed her forehead.

But I wondered whether we do these things to sooth our souls or for the souls of others.

Wynn is convinced communication — both sound and kinetic — goes back and forth regardless of the patient’s responsiveness.

“When I was non-responsive,” he says of his time as a patient, “I could still think, I was still aware.”

Volunteers talk, watch TV, listen to music with patients. “Each case,” Wynn explains, “takes on a life of their own. There’s a connection.”

Wynn learned one of his patients was a musician so Wynn played classical music. But the patient grew restless so Wynn turned off the music. Later, he learned the man was a jazz musician and Wynn played something off a 1959 Miles Davis album called “Kind of Blue.”

The patient’s lips crinkled into a slight smile.

‘SACRED ENCOUNTERS’

When Bennett learned her father was in the hospital in Arizona, the retired lobbyist drove eight straight hours. But she just missed being there when dad was still alive.

The event prompted the 68-year-old Orange resident to volunteer. “You’re sharing the last stage of life’s journey,” Bennett offers. “For me there’s no more sacred an encounter.”

Both Bennett and Wynn remember every patient as if it were yesterday. One was a 26-year-old woman with a long-term disease Bennett had met at St. Joe’s the year before. Back then, the woman had a tattered stuffed animal. Bennett brought a playmate, a furry toy.

“She was sipping from a straw,” Bennett recalls, “lime Jell-O. I stroked her hair. She could have been my daughter.”

Bennett looked at the young woman and promised, “You will always be my angel.”

“Thank you,” the young woman said before slipping away.

“I still think of her,” Bennett allows, “and that was almost two years ago.”

Then there was the time when Bennett was with a dying woman gasping for air. Her breathing slowed to six breaths a minute. Soon, it was so quiet it appeared she was about to take her final breath.

Suddenly, the patient muttered something. Bennett couldn’t make it out. Another sound, “water.”

Within an hour, the patient sang, “Water, water.” Then she ate chocolate pudding. Soon, she was discharged.

“It’s rare,” Bennett says, “but it does happen.”

The mystery of the in-between.

Complete Article HERE!

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New research identifies a ‘sea of despair’ among white, working-class Americans

Princeton economists Angus Deaton and Anne Case continue to report on sickness and early death among white, middle-aged, working-class Americans.

By Joel Achenbach and Dan Keating

Sickness and early death in the white working class could be rooted in poor job prospects for less-educated young people as they first enter the labor market, a situation that compounds over time through family dysfunction, social isolation, addiction, obesity and other pathologies, according to a study published Thursday by two prominent economists.

Anne Case and Angus Deaton garnered national headlines in 2015 when they reported that the death rate of midlife non-Hispanic white Americans had risen steadily since 1999 in contrast with the death rates of blacks, Hispanics and Europeans. Their new study extends the data by two years and shows that whatever is driving the mortality spike is not easing up.

VIDEO: Here’s what you need to know about the life expectancy drop

The two Princeton professors say the trend affects whites of both sexes and is happening nearly everywhere in the country. Education level is significant: People with a college degree report better health and happiness than those with only some college, who in turn are doing much better than those who never went.

Offering what they call a tentative but “plausible” explanation, they write that less-educated white Americans who struggle in the job market in early adulthood are likely to experience a “cumulative disadvantage” over time, with health and personal problems that often lead to drug overdoses, alcohol-related liver disease and suicide.

“Ultimately, we see our story as about the collapse of the white, high-school-educated working class after its heyday in the early 1970s, and the pathologies that accompany that decline,” they conclude.

The study comes as Congress debates how to dismantle parts of the Affordable Care Act. Case and Deaton report that poor health is becoming more common for each new generation of middle-aged, less-educated white Americans. And they are going downhill faster.

In a teleconference with reporters this week, Case said the new research found a “sea of despair” across America. A striking feature is the rise in physical pain. The pattern does not follow short-term economic cycles but reflects a long-term disintegration of job prospects.

“You used to be able to get a really good job with a high school diploma. A job with on-the-job training, a job with benefits. You could expect to move up,” she said.

The nation’s obesity epidemic may be another sign of stress and physical pain, she continued: “People may want to soothe the beast. They may do that with alcohol, they may do that with drugs, they may do that with food.”

Similarly, Deaton cited suicide as an action that could be triggered not by a single event but by a cumulative series of disappointments: “Your family life has fallen apart, you don’t know your kids anymore, all the things you expected when you started out your life just haven’t happened at all.”

The economists say that there is no obvious solution but that a starting point would be limiting the overuse of opioids, which killed more than 30,000 Americans in 2015.

The two will present their study on Friday at the Brookings Institution.

“Their paper documents some facts. What is the story behind those facts is a matter of speculation,” said Adriana Lleras-Muney, a University of California at Los Angeles economics professor, who will also speak at Brookings.

She noted that less-educated white Americans tend to be strikingly pessimistic when interviewed about their prospects.

“It’s just a background of continuous decline. You’re worse off than your parents,” Lleras-Muney said. “Whereas for Hispanics, or immigrants like myself” — she is from Colombia — “or blacks, yes, circumstances are bad, but they’ve been getting better.”

David Cutler, an economics professor at Harvard who also will be discussing the paper at Brookings, said the declining health of white, working-class Americans suggests that Republican plans to replace the Affordable Care Act are akin to bleeding a sick patient. As he put it, “Treat the fever by causing an even bigger fever.”

Whites continue to have longer life expectancy than African Americans and lower death rates, but that gap has narrowed since the late 1990s. The picture may have shifted again around the Great Recession, however: Graphs accompanying the new paper suggest that death rates for blacks with only a high school education began rising around 2010 in many age groups, as if following the trend that began about a decade earlier among whites.

White men continue to die at higher rates than white women in every age group. But because women started with lower death rates, the recent mortality increase reflects a greater change in their likelihood of dying early. The numbers reported by Case and Deaton suggest that white men today are about twice as likely as they were in 1999 to die from one of the “diseases of despair,” while women are about four times as likely.

Case and Deaton play down geography as a factor in the epidemic. Yet they note that white mortality rates fell in the biggest cities, were constant in big-city suburbs and rose in all other areas. The Washington Post’s analysis published last year highlighted the same geographical signature, with a break in death rates between the two most urban classifications (big cities and big-city suburbs) and the four less urban classifications, which The Post described as an urban-rural divide.

Last week, the Centers for Disease Control and Prevention published a report on U.S. suicides by level of urbanization between 1999 and 2015, a period in which 600,000 Americans took their own lives. The report showed rising rates in each of the six urbanization classifications but found “a geographic disparity” in which rates increased as urbanization decreased. That urban-rural divide appears to have widened, particularly in recent years, the CDC reported.

Complete Article HERE!

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Mysterious ‘crouched’ burials in remote Siberia hint to the practice of ritualistic sacrifices

Fours individuals had been buried at a medieval site in a crouched position.

By

Many questions about the burials remain unanswered

During the excavation of a medieval archaeological site in a remote region of Siberia, archaeologists claim to have found the remains of four individuals buried in a crouched position. Such a strange burial had never been seen before in the region, and potentially denotes the practice of ritualistic sacrifices.

The discovery, reported by the Siberian Times, was made at the Yur-Yakha III site, which dates back to the 11th century and is located in the Yamal region in Northwestern Siberia. An analysis of the skeletal remains has indicated that three women and one man had been buried there.

Two of the women appeared to have been in their late teens or early twenties when they died. The man was thought to have been older, in his forties or fifties. All bear signs of having suffered from diseases.

“It’s hard to name all of their conditions, but for example we have found evidence for shoulder dislocation, teeth anomalies, sinusitis, post-partum trauma of the sacrum…”, lead archaeologist Andrei Plekhanov explained.

“It’s hard to say if this was normal for the period. The medical expert Evgenia Svyatova, who examined the skeletons said that the disorders were quite typical for that time, yet for four burials, it is a very large number of diseases”.

All appeared to be malnourished, an unsurprising discovery considering the harsh conditions they would have lived in.

Fire and mysterious rites

But despite having collected these important information, the team remains puzzled by the mysterious burials. They have yet to find convincing evidence to determine why the deceased had been laid to rest crouching.

The male remains suggest his body had been partially burnt after death

And the mystery deepened as the researchers conducted more investigations at the site. Their analyses have shown that the man’s body was set on fire after death – another ritual that was never documented previously in the medieval necropolises of the region.

“We can be sure that he did not die in the fire. His dead body was set on fire but not a very strong one. His bones remained almost intact, the fire damaged mostly soft tissues. At the moment, we do not know why they were buried this way, nor the significance of this,” Plekhanov, who works with the Arctic Research Centre of the Yamalo-Nenets autonomous region, said.

The team has hypothesised that the unique nature of these burials point to ritualistic sacrifices but it is also possible that these were just funerary rites specific to a particular local cultural group and that they simply had not been identified before.

Many artefacts, such as this one used to remove snow were found buried with the deceased

More excavation work is now scheduled to take place to learn more about the burials. The archaeologists will also focus on analysing the many objects that were recovered with the remains.

One of the women was buried with bronze bracelet bearing the image of a bear as well as a knife with a bronze handle, a tanning scraper, bronze and silver pendants, a ring and a ‘yangach’ – an object for removing snow from clothes. Fragments of pottery were also recovered. All these artefacts, recovered from the deceased in their afterlife, could provide new clues about the burial rituals of the region, in the Middle Ages.

Complete Article HERE!

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Going up yonder from your home

By Gerald W. Deas M.D., MPH

[D]uring my many years of medical practice, I have made many house calls on folks who were going to their eternal rest. Often, loved ones from the family have suggested that the person be hospitalized. In some cases, I had no alternative but to do so. But at other times, after surveying the home conditions and finding that they were accommodating, I have suggested to the family that I take care of the patient at home until he or she had completed the journey to the everlasting.

I am convinced that patient’s lives are extended when they are kept at home. They can hear familiar voices and songs. They can see the familiar faces of their loved ones. Often, they can taste that home-cooked food, which gives them nourishment. They are comfortable in clean beds with fluffy pillows and warm blankets. They can feel the touch of kind and gentle hands. All of their five senses are satisfied as they begin their death dream knowing that they will awaken satisfied with going home from home.

After reading the book “Ethical Ambition; Living a Life of Meaning and Worth” by the great author Derrick Bell, who recently passed, I was struck by a passage in the book that stated the following: “Life is a gift that can be revoked at any time, and that, at some point, will come to an end. And, at that end, we know our work will not be completed. Perfection will have evaded us as it has for all who came before us. If there is satisfaction, it must come from our striving toward that vision of a better world.” This statement certainly is a long quote from his book, but I think it crystallizes my thoughts on life and death.

Bell also quotes from a book by Mitch Albom entitled “Tuesdays With Morrie.” Morrie, suffering from the last stages of Lou Gehrig’s disease, tells his former student Mitch, “Everyone knows that they are going to die, but nobody believes it. If we did, we would do things differently. … There’s a better approach. To know you’re going to die, and to be prepared for it at any time. That’s better. That way, you can actively be more involved in your life while you are living.” After I read these statements from this wonderful book again, my philosophy of life and death was also strengthened.

Another book recently completed has the wonderful writing of the Rev. Paul Smith, senior minister of the First Presbyterian Church of Brooklyn Heights, entitled “The Deep Calling to the Deep: Facing Death.” This book should be read by everyone, because we all will be facing death.

Smith gives a day-to-day account of his ministry to six folks who were dying and how they and their families were comforted to know that death is not the worst thing that can happen in your life. Smith writes about the “good death” and quotes Dr. Howard Thurman as follows: “A good death is made up of the same elements as a good life.”

What is a good life and a good death? I suggest that you read this enlightened work and find out. I certainly did. I believe that all physicians, medical students and theologians should read this book as a must in their training.

Going up yonder, I feel, completes our journey on this planet, a most desirable conclusion.

Complete Article HERE!

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At the hour of death: Unlocking the mystery of dying

By Glenville Ashby

“Dying has a funny way of making you see people, the living and the dead, a little differently. Maybe that’s just part of grieving, or maybe the dead stand there and open our eyes a bit wider.” (Susan Gress Gilmore)

Glenville Ashby

Most of us have lost loved ones. It is a painful experience that sometimes takes years to heal, if ever. Many depart suddenly without notice and we are left helpless, forlorn and confounded.

Others waste away, a slow process that is painful, difficult to watch. We are called upon to be caregivers, attending to the every need of a dying relative. During that time we learn timeless lessons if we are patient, listen, and learn from this unique experience.

Like birth, death is an integral part of life that should be accorded the right, appropriate response. On a mystical level, the dying person experiences what hospice nurse Maggie Callanan calls the “Nearing Death Awareness”.

It is a process that can take days, weeks and even months; but during that time we are afforded unique information that will help us in our own spiritual travels when we are called home.

Callahan concluded in her cross-cultural research that dying persons speak of travel, maps, trains, and of queuing up to get to another place. She also found that those she studied were not heavily sedated, nor were they speaking in fantastical terms due to any neurological, physical or physiological handicap.

In her book, Final Gifts, she writes, “… we found no common cause for what we were seeing and hearing. Our patients had many different illnesses – varieties of cancer, AIDS. In some cases, their brain oxygen, body fluid and body salt levels had been documented as normal.

“Their medications varied widely, some were taking no drugs at all, others many. In short, there was no apparent physiological explanation for their communication patterns.”

Dismiss the disjointed

Unfortunately, we sometimes dismiss the disjointed, and seemingly incongruous and incomprehensible words of the dying person, attributing it to medication, dementia, or senility.

Confused, we ask the nurse or doctor to take the appropriate medical measures to quiet the patient. Somehow, we miss the mark, missing the opportunity to ease the concerns and burdens of the patient.

When we can decode what the patient is trying to say and ably respond, we have facilitated the process of transition (dying). Patients get agitated or resigned when they are not understood. The dying process becomes longer, even more tortuous as the patient struggles to convey a message or articulate a concern.

Studies have shown that dying persons will opt to leave this earth when they are satisfied that those they are leaving behind will be all right. Others protract their departure because of guilt and the need for reconciliation. They seek forgiveness for past wrongs.

Mountain of experience

A mountain of experience has taught Callanan that many dying persons want to settle personal issues before they leave. They have a thirst for closure. “(There’s) an awareness that they need to be at peace,” Callanan writes in Final Gifts.

“As death nears, people often realise some things feel unfinished or incomplete perhaps issues that once seemed insignificant or that happened long ago. Now the dying person realises their importance and wants to settle them.” We are urged to accommodate their request.

Sadly, many engulfed in the throes of dying do not and cannot speak in literal terms. They use symbolic language.

And the more we dismiss this mode of communication as insignificant, muddled thoughts, the more the patient is likely to withdraw or display bouts of anxiety. In such situations dying is painful to watch.

On the symbolism used by dying persons, we are advised to patiently learn as much as possible and be gently and constructively responsive.

Sometimes our own fears, bewilderment and anger at seeing a loved one die only exacerbate the circumstances. We withdraw, unable to openly and honestly communicate.

Friends, unable to manage their own emotions, and lost for words, do not visit not out of insensitivity, but due to their incapacity to comprehend and deal with this highly charged emotional experience.

Studies have also shown that those at the cusp of death may see and communicate with beings invisible to us.

These visitors are usually relatives and friends who have passed on, or angels, saints and religious personages that are familiar to the patient. These visions have a calming effect and it’s obvious that these exchanges serve to make the dying process peaceful and unthreatening.

Finally, hospice nurses have encountered cases indicating that patients ‘know’ the hour of their death. Others have cited cases where healthy individuals also seem to know of their demise.

In one intriguing scenario with which I am familiar, a physically robust woman, without any prodding, suddenly rushed to prepare her will and last testament. Upon completion, she hastily summoned her son, imparting every bit of religious knowledge.

“This is the most precious gift I can give you,” she told him. She succumbed a day later.

That she consciously knew that she was going to die is debatable, and I disagree with Callahan and others who argue that “dying people often seem to know when their death will occur, sometimes right down to the day or hour (and) their attempts to share information about the time of death may be clear and direct”.

However, I am of the opinion that in most cases this knowledge is a subtle, subconscious impulse unknown to the conscious mind.

Nearing Death Awareness can be taxing, taking a toll on patient and loved ones. Openness, dialogue, honesty, patience and caring by all parties will no doubt ease the burden.

Dying and death are natural, a necessary part of life. And in the same way that we learn from the living, so we must embrace the wisdom brought forth by dying people.

Complete Article HERE!

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Broken pebbles offer clues to Paleolithic funeral rituals

Pebbles were refitted during analysis.

[H]umans may have ritualistically “killed” objects to remove their symbolic power, some 5,000 years earlier than previously thought, a new international study of marine pebble tools from an Upper Paleolithic burial site in Italy suggests.

Researchers at Université de Montréal, Arizona State University and University of Genoa examined 29 pebble fragments recovered in the Caverna delle Arene Candide on the Mediterranean Sea in Liguria. In their study, published online Jan. 18 in the Cambridge Archeological Journal, they concluded that some 12,000 years ago the flat, oblong pebbles were brought up from the beach, used as spatulas to apply ochre paste to decorate the dead, then broken and discarded.

The intent could have been to “kill” the tools, thereby “discharging them of their symbolic power” as objects that had come into contact with the deceased, said the study’s co-author Julien Riel-Salvatore, an associate professor of anthropology at UdeM who directed the excavations at the site that yielded the pebbles.

The Arene Candide is a hockey-rink-sized cave containing a necropolis of some 20 adults and children. It is located about 90 metres above the sea in a steep cliff overlooking a limestone quarry. First excavated extensively in the 1940s, the cave is considered a reference site for the Neolithic and Paleolithic periods in the western Mediterranean. Until now, however, no one had looked at the broken pebbles.

Possible use of the pebbles: retoucher or hammer.

“If our interpretation is correct, we’ve pushed back the earliest evidence of intentional fragmentation of objects in a ritual context by up to 5,000 years,” said the study’s lead author Claudine Gravel-Miguel, a PhD candidate at Arizona State’s School of Human Evolution and Social Change, in Tempe. “The next oldest evidence dates to the Neolithic period in Central Europe, about 8,000 years ago. Ours date to somewhere between 11,000 and 13,000 years ago, when people in Liguria were still hunter-gatherers.”

No matching pieces to the broken pebbles were found, prompting the researchers to hypothesize that the missing halves were kept as talismans or souvenirs. “They might have signified a link to the deceased, in the same way that people today might share pieces of a friendship trinket, or place an object in the grave of a loved one,” Riel-Salvatore said. “It’s the same kind of emotional connection.”

Between 2008 and 2013, the researchers painstakingly excavated in the Arene Candide cave immediately east of the original excavation using small trowels and dental tools, then carried out microscopic analysis of the pebbles they found there. They also scoured nearby beaches in search of similar-looking pebbles, and broke them to see if they compared to the others, trying to determine whether they had been deliberately broken.

Claudine Gravel-Miguel is with anthropologist Vitale Stefano Sparacello at the Arene Candide site in 2011.

“This demonstrates the underappreciated interpretive potential of broken pieces,” the new study concludes. “Research programs on Paleolithic interments should not limit themselves to the burials themselves, but also explicitly target material recovered from nearby deposits, since, as we have shown here, artifacts as simple as broken rocks can sometimes help us uncover new practices in prehistoric funerary canons.”

 

The findings could have implications for research at other Paleolithic sites where ochre-painted pebbles have been found, such as the Azilian sites in the Pyrenee mountains of northern Spain and southern France. Broken pebbles recovered during excavations often go unexamined, so it might be worth going back and taking a second look, said Riel-Salvatore.

“Historically, archeologists haven’t really looked at these objects – if they see them at a site, they usually go ‘Oh, there’s an ordinary pebble,’ and then discard it with the rest of the sediment,” he said. “We need to start paying attention to these things that are often just labeled as rocks. Something that looks like it might be natural might actually have important artifactual meaning.”

Complete Article HERE!