Monday, January 26, 2015

Stories about death from Canadian family physicians

For five years Canadian Family Physician magazine has published three articles by winners of the AMS-Mimi Divinsky awards for stories in family medicine in their January issue. There are awards for best story in English, in French, and by a medical student.  

An editorial by Dr. Nicholas Pimlott, Death and all its friends, introduced those three stories:

“This year’s best story in English, Only life, by Dr Ruoh-Yeng Chang describes her role providing palliative care to a 20-year-old woman dying of cancer. Dr Chang is repeatedly rebuffed by the patient in her efforts to medically manage the young woman’s final days with the usual proffering of hospital gowns and pain medications until she accepts that ‘only life’ with all its messiness will be allowed in that room.

The best story in French—Mission—describes Dr Jacques Pelletier’s experiences as a volunteer physician in Chad. 

Dr Amandev Aulakh’s Lessons in teaching poignantly describes the experience of gently guiding a medical student through the difficult experience of having a discussion about end-of-life care with a dying man and the sadness that moved them both to tears as they debriefed in a nearby room afterward.”

In his editorial Dr. Pimlott commented that one narrative doctors use to understand their work is restitution. The doctor heroically relieves pain and gives the terminal patient a dignified death. Dr. Chang’s story instead makes her strong-willed patient the hero:

“....Street clothes instead of gowns. Movies and music instead of tears. People streamed in and out. Normal chairs around the bed, not hospital issue. Piles of cushions and blankets in front of the TV we had to put on the ground because there was no shelf strong enough....

Only life in that room. Only love and laughter. Only videos and photos. Only living. Even when all she could do was lie in bed they surrounded her with chatter. She would sleep while her friends rocked out and wake to the same. Every waking moment of her life was on her own terms....

Death came peacefully. The only contents of that room were her loved ones and a sunbeam. She went to sleep and never woke up.”

What came to mind when I read that story, was the Blue Oyster Cult’s classic rock and roll song about love and death, (Don’t Fear) The Reaper, and a Saturday Night Live comedy skit about how it supposedly was recorded called More Cowbell. The fictitious Gene Frenkle (Will Ferrell) got next to the lead guitarist and insisted on putting the cowbell front and center. He didn’t go away quietly.

Last September I blogged about More great stories from Canadian family physicians.

The grim reaper was adapted from this 1905 image.  

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