If you learn how to die, you’ll learn how to live

April 29, 2015 by the sibyls Leave a Comment

BEING MORTAL: Medicine and What Matters in the End

By Atul Gawande

Metropolitan Books/Henry Holt & Company, 2014.

Review by Kerry Cue

Atul Gawande

The reason this book is so meaningful, so compelling and why it ranks as a rare must-read is because, in telling the story of how to die a good death, it slowly addresses an equally important question namely ‘how are we to live a good and meaningful life?’

Atul Gawande, surgeon and writer for The New Yorker, dreams of new ways of caring for the frail and old. He questions the bureaucratic nature of aged care institutions where the elderly are kept ‘safe’, but hardly ‘alive’. And he rails against the invasive, painful and ultimately futile medical procedures inflicted on the dying. Yet this book is no dry academic tome. Gawande tells the storxy of dying and death of his father, also a surgeon, from first discovering the tumor in the spinal column, through the family’s struggling with medical options – operate? His father might become a quadriplegic. Don’t operate, he may become a quadriplegic! – to his father’s final days.

There is one strong and clear message from this thoughtful exploration of the end stage. Patients could have good days even when dying. But to achieve this goal they must be asked, or think about, at least, ‘what are your greatest fears?’ and ‘what are your current goals?’ Simple questions but from the answers patients discover how they are to live in their final days and, eventually, die.

Gawande has managed to take the fear away from our modern, Western view of dying, which, in many aspects involves, an impersonal, sterile, ICU bed intubated with a tube down the throat and a total loss of control. Dying need not be like this. Gawande shows how the human spirit can flourish and life can be fully lived to the very end.

Photo source: Unsourced book review blog, Tapestry held in the Victoria and Albert Museum, London.

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Chemo Journal I

April 9, 2015 by the sibyls 1 Comment

by Sibyl Jules

How do you describe the old chemo trip which, incidentally, I finished 2 weeks ago after 6 months of 2 weekly cycles? This is only my experience- everyone has different sorts of chemo and some are much worse than others. My side effects were horrible on one drug, which I was spared after 4 cycles because of weird stuff happening. I never wanted to know what the side effects might be beforehand- then I’d only get them! A useful tip shared by an oncology nurse friend was to keep the literature they gave me as a reference if something did feel unusual or bad, and just read it as you need to. This helped me avoid worrying about things that might happen and to respond appropriately to them if they did.

I can’t say chemo was easy, but when I meet with any of my ‘cancer club’ as my partner calls them, he always comments how happy we all are. We are, after all, alive, and eating, drinking (albeit a modified beverage of choice) and laughing with friends. I think that the last 6 months of chemo has taught me to enjoy and savour every tiny joy- cooking and sharing food and wine with good friends and family has always been an important part of our lives- so when chemo flattens me for a week, being able to eat and drink and meet friends again- or go to WOMAD, the happiest 4 days of the year as I know it- gives me much to be happy about. Every tiny joy helps…Look for them- they make you feel safe and help to stave off the anxiety and fear.

Oddly, chemo has also reminded me how much I love my work. I’ve been able to work two or three days a week, throughout chemo. I found that focusing on thinking and working, surrounded by busy people doing interesting things has helped me to avoid the pitfalls of the ‘poor-me-illness-behaviour mode’, which I might be prone to without the focus! I’m lucky I can choose when I go to work and if I feel too bad I crash and burn, but usually I get some days in each week. I’m also fortunate I love my work. And having a supportive and loving family and partner has helped too of course. I’ve loved having old friends call up out of the blue, and have been overwhelmed by the incredible generosity and thoughtfulness of people around me. Totally unexpected and humbling.

On grumbling about chemo prior to treatment starting, a surgeon reminded me that I am very lucky to be offered chemo- a treatment that may help keep me alive. For some things there is no such treatment and for that reason I knew I’d just have to go with it, knowing that every 2 weeks, just as I’m beginning to feel a bit ‘normal’ again, another bus will run me over.

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Jules is a perceptive observer and an irrepressible, positive force as well as director and publisher for the Neuro Orthopaedic Institute, Adelaide, SA. And here is the Chemo Fashionista post of the fabulous Jules at WOMAD, Adelaide.

Train your brain to ease PAIN

February 2, 2015 by the sibyls 1 Comment

by Kerry Cue

Norman Doidge, the author of The Brain that Changes Itself has a new book The Brain’s Way of Healing out this week (Scribe). An extract titled Brain Heal My Pain was published in The Australian, 31 Jan 2015, (paywall link) here.

You can find another extract at The Daily Mail (UK)

The extract tells the story of Michael Moskowitz, a psychiatrist turned pain specialist, who suffered from chronic pain for 13 years following a serious accident when he fell off a blow-up ring being towed by a speedboat. His pain was 8 out of 10 on the pain scale (10 is being dropped into boiling oil).

Moskowowitz began to realise that the areas that process memories, thoughts, movements, emotions and images had been pirated to process pain. He drew 2 maps of the brain one for chronic pain and one with no pain and he visualised the area dedicated to pain in the brain shrinking. He believed that he could reclaim the ‘visual areas’ of the brain where images are processed by forcing it to visualise images of the brain.

He was applying the theory of brain plasticity first brought to public attention by Norma Doidge. After one year of persistent visualisation, he was pain free.

There, at the bottom of Pandora’s Box is one word. HOPE. Something we should all visualise, perhaps.