Category: Death Curiosities

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Books bound in human skin?

A UCLA librarian on why you’ll want to read about them

Books bound in skin, which feature in “Dark Archives: A Librarian’s Investigation Into the Science and History of Books Bound in Human Skin.”

By Leslie Pariseau

That a librarian has written a book about rare leather-bound books and a major literary imprint has published it is a triumph for bibliophiles everywhere — especially when you consider the source of the hide. “Dark Archives,” a deep dive into the history and mechanisms of sourcing, tanning and binding human skin into books, won’t be everybody’s cup of tea. But if you take comfort in reading Stephen King and Shirley Jackson on a stormy night or watching medical procedures on YouTube or you were the kind of kid who stole off to the occult section of the library (130 in the Dewey Decimal System, if I remember correctly), then Megan Rosenbloom’s strange history might be for you.

With sincere curiosity and clear-eyed analysis, Rosenbloom, a librarian at UCLA with a specialty in the history of medicine, unfurls the stories of the binders of the skins and their previous inhabitants: Mary Lynch, a young Irish widow who in 1868 died of trichinosis in a dreary Philadelphia hospital, her thigh skin saved in a chamber pot for decades; a Civil War soldier whose skin was stolen by Dr. Joseph Leidy and eventually became the binding for his “Elementary Treatise”; the highway robber George Walton, who planned for his own transformation into two books after his execution in 1837.

Over Zoom Rosenbloom jokes that she didn’t set out to be the “human skin book lady.” But her interest in rare books, combined with an early job in a medical library, led her down a winding path. “The things that I learned were just so shocking,” she says. “You mean medical students used to literally dig up graves and steal bodies, and their teachers were pretty fine about that?” Indeed, a good deal of “Dark Archives” engages with questions of consent around human bodies, especially during and after death — down to the most banal-seeming of our organs.

Growing up in a working-class Irish Catholic family in Philadelphia, Rosenbloom was attracted and repelled by “darker things” from an early age. This specific curiosity was first piqued in 2008 as she wandered around the Mütter Museum at the College of Physicians of Philadelphia, which houses (among other bodily obscura) Einstein’s brain and a chunk of John Wilkes Booth’s vertebra. Rosenbloom came upon a case of leather-bound books whose display text claimed they were made of human skin — via a process called anthropodermic bibliopegy, practiced by 19th century doctors who wanted to give their own collections a special touch.

“A dead person’s skin had become a by-product of the dissection process,” Rosenbloom writes, “like a piece of animal leather after a butcher’s slaughter, harvested solely to make a doctor’s personal books more collectible and valuable.” Imagine a veterinarian keeping her feline patients’ hides and then covering her most prized medical books with them — except, in this case, the veterinarian would also be a cat.

In earnest pursuit of answers, Rosenbloom formed the Anthropodermic Book Project, which sets out to test as many books purported to be bound in human skin as possible. So begins her jaunt across through the U.S. and Europe to harvest samples. Rosenbloom’s project takes her to the library at the Los Angeles County Medical Assn., the site of a book supposedly bound in the skin of a white man captured by Native Americans; to Harvard, whose library holds not one but two prospects; to Cincinnati, home to a copy of Phillis Wheatley’s poems bound in 1934; and elsewhere, with often surprising test results.

Her travels extended to other relevant sites, from an old-fashioned tannery in upstate New York to understand the leather-making process to a Cleveland nonprofit dedicated to preserving tattooed skin once its (consenting) owner’s soul has departed their earthly vessel.

Rosenbloom is well aware that morbid curiosity can read as glibness. “The book walks a line,” she says, acknowledging the timing of the book’s release, in a year of multifarious horrors, with characteristic good nature. “I thought it was effective to have a guide because you should have someone you can trust.”

The author earns that trust. The result of Rosenbloom’s probing travelogues, lively histories and deep study of book stewardship is an incongruously bright-eyed view of a subject that, in the hands of another scholar, might be either plodding or gruesomely sensationalistic. The true story of how people became books is surprisingly intersectional, touching on gender, race, socioeconomics and the Western medical establishment’s colonialist mindset.

“Every time I tried to research a book, I would almost always find a doctor involved,” Rosenbloom says. “And the sort of disconnect between the way our society views doctors and then how this got done … is fascinating to me.” She says she spent time with texts like Ruth Richardson’s “Death, Dissection and the Destitute” to understand the rift between famous male doctors and the patients they treated: “People who didn’t have access to assert themselves or have agency around their bodies. What of them? It’s a harder story to tell.”

“Dark Archives” confronts the myth of Nazis turning human skin into gruesome objects, concluding the infamous lampshade (whose existence remains unproven) had become “an outsize emblem of the brutality of the Nazi regime.” She turns this conflation of history into an ironic twist on the banality of evil: “It’s easier to believe that objects of human skin are made by monsters like Nazis and serial killers, not the well-respected doctors the likes of whom patients want their children to become someday.” More than a tromp through a bizarre subset of bibliophilia, “Dark Archives” is a truth-telling expedition.

Rosenbloom’s nuanced approach is intertwined with her work as the cofounder of the Death Salon, an organization whose mission is to “[encourage] conversations on mortality and mourning and their resonating effects on our culture and history.” Styled after an 18th century salon, the event series is part of the Order of the Good Death, a group that works to promote the death positive movement — which aims to destigmatize dying.

“Basically everything that you take for granted and think is normal around death is totally culturally relative,” says Rosenbloom. She remembers having “a seed of fear” planted after attending an uncle’s funeral around 11, observing family members as they approached and retreated from the open casket. Eventually, she understood the necessity of confronting her own anxieties around mortality from an intellectual perspective. “I’m a bit of a control freak, anxious person, and if there’s something I can do or if I can learn about things and try to understand them, that helps with the anxiety thing.”

In many ways, “Dark Archives” feels like an extension of Rosenbloom’s death positive work, urging us to confront not just what happens to physical bodies after they die but the memory of people who occupied them — and a society that has systematically brushed them aside. “We can’t go back in time and stop anthropodermic books from being created,” writes Rosenbloom, “but since they exist, they have important lessons to teach us — if we’re willing to reckon with their dark past and all that it tells us about the culture in which they were created.”

Complete Article ↪HERE↩!

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How Death Doula Alua Arthur Gets It Done

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In 2012, Alua Arthur quit her legal career to become a death doula. The problem was that she had no idea such a job existed. “All I knew was that there had to be a better way to give support during one of the most lonely and isolating experiences a person can go through,” she says. Now 42, she is a leader in the field of death work and has guided thousands of people and their loved ones through the end-of-life process. She has also trained hundreds of other death doulas through her company, Going With Grace, and is on the board of directors at the National End-of-Life Doula Alliance (NEDA)

This year, as COVID has forced so many Americans to cope with sudden loss and their own mortality, Arthur has been inundated with new clients and students as well as larger questions about how to handle constant grief. She lives in Los Angeles. Here’s how she gets it done.

On her morning routine:
I usually get up around 8:30 or 9:00 a.m. I’m a night owl, and it helps me in my work because people tend to die between 2:00 and 5:00 a.m. I’m not sure why; there are a lot of different theories about it. But I’m most awake and alert at that time. The witching hours. I love to burn my incense at 4:00 a.m. and greet the crows.

Most mornings I meditate right after I get up. After I meditate, I fill up my gallon jug of water and exercise. I need to sweat and move. I love anything where the instructor is like, “Faster! Go! Only ten more seconds!” Since we can’t do group fitness in person right now, I have to re-create it in my house. It doesn’t work quite the same, because I will stop and eat snacks in the middle of a video. But I’m trying. Exercise and meditation are the things that keep me sane and grounded. They’re the baseline.

On being drawn to end-of-life care:
Being around death has made me more honest. I see that what we don’t say chokes us as we die. People always think they have more time, and when they realize that they don’t, they have regrets about things they haven’t done. I try to do what I feel like doing right now. And if that means eating white-cheddar Cheetos for breakfast, I will. Which is what I did this morning. I won’t always be able to taste delicious things, so let me do it now.

On managing her clients:
I don’t take on more than one client at a time who is imminently dying, because I want to be on call for them. Whatever they need, I will do. When a client with just a couple of weeks or months left first comes to me, we’ll go through the long list of items to consider in death and dying, and then we’ll create a plan. That usually happens over the phone. Then I go to visit, put my hands on them, really see what their physical condition is, and see what kind of support they have.

I continue to visit every week or so until their condition starts deteriorating fast, and then I’m there more often. I might be there when they die, and if I’m not, I’ll come sit with their family or caregivers afterward until the funeral home comes. I may also help wrap up practical affairs — possessions, accounts, life insurance, documents. It’s exhausting for a family to have to think about that when they’re also grieving, and I’m equipped to help. I’ll sit on hold with insurance companies, make funeral arrangements, all that stuff.

Beyond those who are imminently dying, I often have several clients who need end-of-life planning consultations. I can take on a couple of those at a time. That could be someone who has just gone on hospice and it doesn’t look that bad yet, or someone who just received a diagnosis and wants to prepare.

On winding down after an intense day:
I’ll drink wine and hang out with a lover. I’ll go out dancing until 5:00 a.m. Sometimes I just want to shut the brain off after a long day, and the best way to do that is by spending time with friends and people who tickle me. But it’s also good to spend a lot of time alone, which is the default these days. I like silence.

On becoming a death doula:
I spent the bulk of my career in legal services in L.A., working with victims of domestic violence. Then there were some big budget cuts, and I wound up getting stuck doing paperwork in the courthouse basement. I was already depressed and burnt out, but it blossomed into an actual clinical depression. So I took a leave of absence and traveled to Cuba. While I was there, I met a German woman who had uterine cancer and was doing a bucket list trip. We talked a lot about her illness, and her death. She hadn’t been able to discuss a lot of those things before, because nobody in her life was making space for her to talk about her death. Instead, they’d say, “Oh, don’t worry. You’re going to get better.” I came back from that trip thinking I wanted to be a therapist who worked with people who were dying.

I applied to schools to become a therapist, but in the meantime, my brother-in-law got very sick. So I packed up and spent two months in New York with him. That experience gave me a lot of clarity on all the things we could be doing better in the end-of-life processes. It was so isolating and I couldn’t understand why. Everybody dies — so why does it feel so lonely? After that, I did a death doula program in Los Angeles, called Sacred Crossings, and then I founded my company, Going With Grace.

On leaving her law career (and a steady paycheck):
It wasn’t a hard decision to leave my job as an attorney. The challenging part had more to do with identity and what achievement means. I was born in Ghana, and we’re all raised to be doctors and lawyers and engineers. So I was going against societal expectation and parental expectation. It was also tough to be broke for a long time. My student loans were in forbearance. I spent a lot of nights lying on my mom’s couch wondering how I was going to make things work. If my friends were going out, they’d have to pay for me or else I couldn’t join them. To support myself while I was starting my business, I worked part-time jobs at a hospice and a funeral home.

Eventually, I started hosting small workshops about end-of-life planning. I charged $44 dollars for people to come together and learn how to fill out the necessary documents. Now I have my own doula training programs. I have about 100 students at the moment, all online.

On charging for her services:
I have to navigate the financial conversations with a lot of directness. Part of the challenge is that our society doesn’t see the financial value of having somebody be kind and supportive. Being able to hold so much compassionate space when somebody’s dying — that is a skill. It needs to be compensated highly.

On living with grief:
I’m constantly grieving with and for my clients and their family members, all the time. There’s no fixing it. I have to be present with my feelings and let them wash over me, in whatever expression they take. If I try to shut off that part of myself, it becomes much harder to function in everyday life. Grief doesn’t always look like crying. Sometimes it looks like anger, promiscuity, or eating everything under the sun. Like all things, it’s temporary.

On how COVID has changed her work:
We have to rely much more heavily on technology and remote communication. There’s also a lot more interest in the death doula training program. Death is on a lot of people’s minds, and I’ve seen a lot more people starting to do their end-of-life planning — mostly healthy people in their 40s with young kids. A lot of people have seen younger people die suddenly, and it’s changed their perspective.

On her own end-of-life plan:
I would love to be outside or by windows. I want to watch the sunset for the last time, and I want to have the people I love around, quietly talking, so that I know they’ve got each other after I leave. I want to have a soft blanket and a pair of socks because I hate it when my feet are cold. I want to smell nag champa incense and amber. And I want to hear the sound of running water, like a creek. I’d love to enjoy all those senses for the last time. And when I die, I want everybody to clap. Like, “Good job. You did it.”

I want my funeral to be outside, and I want all my jewelry to be laid out. As guests come in, they grab a piece and put it on. I want my body to be wrapped in an orange and pink raw silk shroud. They’ll play Stevie Wonder — “I’ll be loving you always” — and everyone will eat a lot of food and drink whiskey and mezcal and red wine. There will be colorful Gerber daisies everywhere, and they’ll take me away as the sun goes down. And when they put my body in the car, the bass will drop on the music, and there will be pyrotechnics of some sort. I hope my guests have a grand old time and dance and cry and hug each other. And then I want them to leave wearing my jewelry.

Complete Article ↪HERE↩!

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How ‘I Am Dead’ Uses Death to Illuminate Life

Developer Ricky Haggett and designer Richard Hogg talk about how the puzzle adventure game is “not spooky or sinister,” but is instead a story about people and relationships.

by Trilby Beresford

Welcome to October, a time that, depending on which social circles you frequent, may be dominated by conversations about the next-gen Xbox Series X/S and PlayStation 5 consoles set to release in just a few weeks; and their respective launch titles.

While for many players this month may also contain video games that indulge in creepy vibes or costumed assailants (Resident Evil, anyone?), this week’s column features an interview with two of the creatives behind Annapurna Interactive’s puzzle adventure I Am Dead, a game that one might assume involves terror and tragedy, but actually, that couldn’t be further from reality.

Hollow Ponds developer Ricky Haggett and designer Richard Hogg, both who are U.K.-based, describe the truth and meaning behind their latest offering, which just dropped on consoles.

I Am Dead is a Colorful Game About Living

As the title suggests, I Am Dead does involve a dead person, but it’s not explicitly about death or dying. As developer Ricky Haggett recalls on the phone with The Hollywood Reporter, “It’s not really a spooky or sinister game. It really is a game about people’s lives.”

Artist and designer Richard Hogg chimes in with the irony that the game, which features bright colors and an inviting sense of warmth, is releasing in October, the month of Halloween. “It suddenly occurred to me, wow, we’re launching a game called I Am Dead, about ghosts, kind of during Halloween season, and that’s so duplicitous because our game isn’t at all scary,” he says.

The story of the puzzle adventure game follows a deceased museum curator named Morris who sets about to explore the afterlife, a world filled with learning and discovery. The idea came to the developers years ago when they were working on another, entirely different game, where the central idea was “somebody dead in a grave — somebody from like the Bronze age, who was thousands of years old, with all of their tools, clothing and equipment that they would have had with them,” explains Haggett. “Occasionally people turn up in a bog or in the ice where it’s like, oh this person is this many years old and we can learn about their lives from these objects that they had with them.” He goes on to say, “We never ended up making that game, [but] then when we came to make I Am Dead, the first thing that we had was the idea of this mechanic.”

“I remember being really into the idea of it being a game about a dead person, but not about them dying — one benchmark idea was that you wouldn’t know how they died,” says Hogg, “instead the game is about how they lived.” He adds that death is a common theme of video games, but the stories are often about that moment when someone dies and how it happened. “We liked the idea of using death as a way of illuminating life.”

I Am Dead is set in present day in a location similar to the seaside town of Hastings, where Hogg resides. “It’s full of anecdotes and mini-stories about people’s lives and people’s relationships with each other that I think work a lot better [than the game that was set in the Bronze Age] because they’re things we can understand and that we can relate to.”

Morris is loosely based on Haggett’s geography teacher from back at school, a man who used to walk with his fingers tucked into the waistband of his trousers. “He was quite an elderly, fairly eccentric guy,” Haggett recalls. “He’s the sort of person that you see, if you go to the supermarket in the U.K. quite early in the morning,” adds Hogg. “The only people who do their shopping early in the morning are maybe people who’ve retired. Sort of non-descript, middle class guy in his 60s, probably quite cheerful, probably quite a fun granddad, quite an interesting guy, but at the same time doesn’t choose his own clothes, his wife chooses his clothes for him.”

While developing I Am Dead, Haggett and Hogg drew upon their shared enthusiasm for the literary works of Patrick O’Brian, scribe of the Master and Commander books about historical naval warfare. “They’re the sort of books that someone like Morris would read,” says Hogg. And then there’s libraries and museums, which Hogg and Haggett frequently meet at. “This game is kind of like a love letter to small, provincial British museums that we’re massive fans of,” Hogg concludes.

I Am Dead is currently available on Nintendo Switch, PC via Steam and the Epic Games Store.

Complete Article ↪HERE↩!

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Dramas discuss what makes a good death in the age of Covid

By Alex Spencer

The coronavirus pandemic has forced millions of us to come face to face with death in ways that we never imagined. Whether we’ve experienced personal losses, attended virtual funerals, or watched death tolls creeping up on the news, we are all confronting the pain of illness, death and grief and we’re having different kinds of conversation than we did before.

Researchers from the A Good Death? project at Cambridge University’s English faculty have teamed up with Menagerie Theatre Company to create three original audio plays, released online for free today (Wednesday) to help us to think and talk about this new reality. Written and recorded during lockdown by Menagerie actors, Seven Arguments with Grief, End of Life Care – A Ghost Story and A Look, A Wave are short 15-minute plays that provide glimpses into the thoughts and feelings of a bereaved mother and a hospital doctor, and reflect on the final farewell of the deathbed goodbye.

Written by Patrick Morris, co-artistic director of Menagerie, and inspired by the research of Dr Laura Davies into the history of writing about death, these plays don’t try to provide answers about how to handle what we’re all experiencing, in different ways, right now. What they do is capture personal stories and aim to be authentic to how hard life, death and loss can be.

Laura told the Cambridge Independent: “We have been running them since 2018 to improve conversations about death and dying using literature and the arts that means we run public events such as workshops for bereavement counsellors, people who work in palliative care, hospice workers and we use literature, museum objects and artworks to help people talk about death and dying.

“During the pandemic we built on an existing connection with Menagerie Theatre at the Cambridge Junction to think about how we could make some audio drama that people could listen to at home or on headphones that hopes, in a non-direct way, to help people to think about death and dying in a different way to the headlines of the death toll creeping up.

“We wanted people to think about what they believe and how they are feeling and what their experiences are. Right now we are all being forced to confront a reality that is universal but in a new way. Our ancestors would have been closer to death with it being more common for people to die in the home – child mortality rates were higher and plague and disease that couldn’t be controlled were more usual. We have been protected in the west from that sense that things are beyond our control and that we are quite vulnerable as human beings. You can’t avoid death and dying at the moment and many people are reporting feeling anxious about it, but of course you can’t hide.

“It’s important there’s a way to think about these ideas and listen to a story that can prompt reflections without increasing fear and anxiety. The work of literature and drama is to stimulate emotions,but with a bit of distance because you know it isn’t real. Our message is that death is part of life and that the way in which individuals experience life, death and loss is complicated and unique, andthat there is not a right or wrong way to grieve or a right or wrong way to live your own life knowing it will end.

“The more you talk about it doesn’t make it more likely to happen, but it can enhance the way you live.

“Even if there are elements of death and dying we can’t control, such as where and when and how we might die, it helps to have shared your wishes with your family and to have thought about what you might wish your legacy to be. They can help you to come to terms with it.”

A Good Death? includes workshops designed for practitioners, such as bereavement counsellors and hospice workers, along with public events, creative collaborations and online resources. The project also uses literature and the arts to open up new conversations about death, dying and bereavement.

Laura added: “One of the things emerging in terms of cultural impact is the experience of complicated grief that comes from a traumatic death. Early research points to the fact we are looking at long-term consequences for people’s mental health because they may have experienced not being able to be with a loved one at the end, or only being able to attend a funeral by Zoom. And missing out on those kinds of rituals makes it harder for people to grieve. Psychologists are looking at this cohort of bereaved people and the impact it will have on them.”

Menagerie is a new writing theatre company, resident at Cambridge Junction. It aims to develop and produce new plays which engage powerfully, imaginatively and critically with the contemporary world. Its co-artistic director Patrick explained: “There are so many books about the grieving process as if it’s some kind of logical process rather than something that’s actually faltering, that stalls, that destroys some people, but makes other people. I wanted to create a space for the real difficulties of grief.”

On the value of this collaboration, Laura added: “Working with Menagerie has given me a new perspective on my research into 18th century literature. These plays turn abstract and complex ideas into personal stories, showing new angles that I’ve not noticed before. And they capture brilliantly both how similar our struggles today are to those of the past, and how every person’s response to death or loss is unique.”

The plays can be listened to on the A Good Death? project website, good-death.english.cam.ac.uk/collab , where you can also watch interviews with the researchers, writer and actors.

Complete Article ↪HERE↩!

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Race, education, gender may influence some divergent views about death

Danvers resident John Barbieri looks over a collage of photos of his late wife, Ann “Peachie” Barbieri. They were married for more than 60 years.

By Mark Arsenault and Liz Kowalczyk

A Boston Globe-Suffolk University poll late last year shows that, for the most part, Massachusetts residents share widespread agreement on issues related to the difficult subject of death.

They say society would be better off if end-of-life issues were discussed more openly and believe terminally ill patients should have more options to choose when and how to die. A sizable majority say they would prefer to die at home, and many men and women have first-hand experience with hospice, according to the poll of some 500 residents across the state.

But some major — and subtle — differences emerged along racial, education, and gender lines, a sign that physicians must address cultural attitudes and life experiences, not just medical options, to reduce inequities in end-stage medical care. The poll showed differences in the types of diseases people most dread, how religion affects views on death, and when to stop aggressive treatment at the end of life.

For example, the survey found that Black and Hispanic people are more likely than white and Asian people to say religion and spiritual beliefs guide their medical end-of-life wishes. And it found that Black people more often want to continue treatment for an incurable, debilitating disease than other groups, likely reflecting longstanding fears of under-treatment due to a history of discrimination.

The poll also found women were more likely than men to believe greater public discussion about death is a good thing and have more religious and spiritual beliefs guiding their medical decisions at the end of life. Women were also somewhat more likely to believe in the afterlife.

Differences among groups also emerged on what life-threatening disease they most feared. Black and Hispanic people identified cancer above all, while white and Asian respondents identified Alzheimer’s and dementia as the condition they most dreaded. Similar differences were found along educational lines.

Complete Article ↪HERE↩!

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The Final Chapter

By Melissa Red Hoffman, MD

The first time I saw a death certificate, I was 19 years old. The cause of death was listed as “laceration of the trachea and esophagus, also laceration of heart and lungs with fractures and bleeding caused by two gun shots in the neck and chest.” The death certificate belonged to my father, killed by a terrorist while on a business trip in Cairo. By the time I laid eyes on it, the certificate only served to confirm a very painful truth: My father’s story had come to a very tragic and bloody end.

It’s 26 years later and I’ve managed to use this tragedy to inspire a career focused on both trauma and hospice and palliative medicine. In the simplest terms, I spend half my time trying to save lives and the other half trying to ensure a good death. For me, it works. But there’s no denying that my father’s legacy is always lingering in the background, whether I am in the trauma bay or at a patient’s bedside. The cause of death imprinted on that death certificate, along with the fear, pain and suffering that I assume it caused my dad, and the grief, sadness and never-ending longing that it evoked within me and many members of my family, is never far from my mind. And for reasons that I don’t fully understand, I have reread that death certificate more times than I can count.

That being said, the first time I was actually handed a death certificate to complete, I was well into my yearlong hospice and palliative medicine fellowship, and my only response was, “What am I supposed to do with this?” Despite 10 years of training including medical school, general surgery residency and critical care fellowship, I had never seen this form in the hospital, much less received any guidance on how to complete it. My hospice attending provided some cursory instruction and assured me she was available if I had questions, and that was that.

Since then, I’ve filled out more than 100 of these forms; when I work as a hospice attending, it’s not unusual for me to fill out a half-dozen death certificates during an eight-hour shift. The CDC publishes a free guide ( www.cdc.gov/ nchs/ data/ misc/ hb_me.pdf) that has proven to be helpful to me as I’ve attempted to correctly determine and report the cause of death. State medical boards stress that physicians should exercise their best clinical judgment when filling out the form and that lawsuits involving death certificates are exceedingly rare, but I still sometimes find it nerve-wracking to determine the exact steps that led to a patient’s ultimate demise. While completing a death certificate presents an intellectual challenge and demands a short, but not insignificant, time commitment, I have recently come to view the process as something more profound than another item on my to-do list. Because this form is required for both burial and cremation, I now regard it as both the final chapter of a patient’s life story and the first chapter of a family’s bereavement narrative.

I often think of my father when filling out these forms and it always gives me pause. When I open the medical record, I’m usually touched by the thought that I’m very likely the last physician who will ever study this information. Reading through the chart, I like to linger for a moment or two and think: Who was this patient? What did he do for work? Who did she love, and, just as importantly, who loved her? I also find myself wondering what happened. What, if anything, could we have done differently or better? Could we have caused less suffering? Provided more comfort? Consulted palliative care earlier or at all?

Last week, while I was working at the local inpatient hospice facility, a female patient, five years younger than me and recently diagnosed with metastatic cancer, died before I had the opportunity to round on her. When I went to view her body, I was struck by the stark difference between the glowing, robust woman pictured in a photo hanging above her bed and the bald, gaunt corpse lying curled up on her side. “She truly had nothing left to give,” I commented to the nurse and the chaplain as they gathered her few belongings to return to her family. As I was getting ready to leave for the day, the funeral director arrived to collect her body and asked if I had a few minutes to complete her death certificate. I knew almost nothing about this woman—she had been under my care for only a few short hours—and yet I was tasked, and blessed, with signing off on the final chapter of her life. With this last act of patient care, I was able to support her family in the first steps along their grief journey.

As a surgeon trained in hospice and palliative medicine, my personal narrative has changed from “There’s nothing more I can do” to “Let me walk with you.” Taking the time to complete a death certificate is another way for me, and all surgeons, to follow a patient’s story to the very end.

Complete Article ↪HERE↩!