Palliative Care Book of the Month
LIFE IN A HOSPICE
Reflections on Caring for the Dying
Radcliffe Press, 2007
ISBN 978 18461 92 432
RRP £19.95 $US39.95
This is a narrative text based on interviews with 31 people who work in hospices, covering the whole range from directors to volunteers.
Ann Richardson clearly describes the content of her book: it starts with a chapter describing what hospices do and why the care they provide is different from hospitals (Chapter 1). The first main section then describes the work undertaken in hospices (Chapters 2-5), including all aspects of patient care but with particular attention to the processes of helping dying people and supporting their relatives after a death. The next section (Chapters 6-8) explores the difficulties entailed in hospice work and the various means employed by staff to cope with them. The third section (Chapters 9-10) addresses the underlying question of why people undertake this work. Finally, the last section (Chapters 11-12) offers some reflections on working in a hospice both in terms of practicalities and, more fundamentally, what has been learned from the experience.
I liked this book because it brought hospice and palliative care to life. I did not necessarily agree with all the ideas and opinions given, but they provide material with which to reflect on your own hospice and practice. And I enjoyed it because of the way the material was set out and stitched together, which suggested a labour of love.
DVD and Book Reviews
DVD: The Wit
Actress: Emma Thompson
Director: Mike Nichols
Screenplay by Emma Thompson and Mike Nichols
Based on a 1998 Pulitzer Prize-winning play by Margaret Edson
HBO Home Video, released September 11th, 2001
RRP: Amazon.com $US5.99, Amazon.co.uk £3.54
I stumbled across this film whilst shopping for a Christmas present for my wife. If you have not seen it, you must. I have to admit that I had never heard of it—perhaps my mind was brooding on other things the day it was released.
The story is of Professor Vivienne Bearing (Emma Thompson), an expert on the poetry and Sacred Sonnets of John Donne, who is diagnosed with advanced ovarian cancer and finds herself in a most unfeeling medical environment. Emma Thompson’s portrayal of the patient, shaved head and all, is brilliant. The story is moved along by her frequent asides to the camera in which she describes her ordeal, a technique I am told is called ‘breaking the fourth wall’. The film is enhanced by Donne’s poetry and by flashbacks to earlier in Vivienne’s life.
The cancer treatment she receives may be OK, if experimental. But the manner in which it is delivered is appalling. The Consultant has the personality and the compassionate caring of an unimaginative, unfeeling pachyderm. The Fellow in training is an insensitive twit. If this film is used as a training exercise for health care professionals (see below), to stimulate thought and discussion in a supervised setting, I can accept the film’s portrayal of everything you should never do. However, I would have preferred them to rotate several different Consultants and Fellows through Vivienne’s care (the treatment takes eight months), to demonstrate how absolutely abysmal the personal care depicted in this film is. A middle-of-the-night talk with a caring nurse brings a glimmer of hope, but that conversation is turned into a discussion of Vivienne’s ‘code status’. I shudder to think that viewers in a lay audience would think that all doctors in oncology units were like this!
The film is also designed to be a training film for health care professionals. At www.growthhouse.org/witfilmproject/index.html, it says that a copy of the film is available free to medical colleges and training courses, providing you are willing to provide feedback on its use. Whether this is international or applies only to the USA is not stated. Anyway, Amazon is just about giving it away.
Although the insensitivity of the doctors portrayed in this film left me in professional tears, it is an excellent film made by serious professionals. Emma Thompson has five Academy Awards, for Best Actress (Howard’s End, The Remains of the Day, Sense and Sensibility), Best Supporting Actress (In the Name of the Father) and Best Adapted Screenplay (Sense and Sensibility). Mike Nicholls won an Academy Award for Best Director for The Graduate, amongst many other awards and nominations.
I thought Emma Thompson was brilliant as the patient and was pleased to read several reviewers who said she would have at least received an Academy Award nomination had this film be made for the big screen. But no studio is going to bankroll a film about a woman’s struggle with a fatal disease.
If you teach end-of-life care or ethics to undergraduates, you need this film. If you teach trainees in oncology or palliative care, you must show them this film.
SOFT SIFT IN AN HOURGLASS
Stories of Hope and Resilience at the End of Life
Armour Publishing, 2009
RRP $US16.00, not listed on Amazon.co.uk
Also available at www.armourpublishing.com
Rosalie Shaw is an Australian who was a teacher and then a nurse, before training in medicine and becoming a pioneer in the specialty of palliative care. Since 1992, she has worked in Singapore and this book is a collection of 48 short tales relating to her work there. She is an astute observer and the patients and their families are colourfully portrayed. Each story is about a difficult or challenging point in the course of a terminal illness and many end with a gently stated moral to guide us toward better clinical practice. The wisdom of Rosalie’s considerable clinical experience shines through, but I also found it enjoyable to read.
The title is taken from The Wreck of the Deutschland by English poet Gerard Manley Hopkins. But, tucked inside the back cover, is one of Shaw’s own:
I have potions
But no witches' brew
For the tsunami of grief
When the ship
From the shore
DISCOURSES ON AGING AND DYING
Suhita Chopra Chatterjee, Priyadarshi Patniak and Vijayaraghavan M. Chariar (Eds)
Sage Publication, 2008
RRP £14.99, $US32.95, $AU49.95
Review copy supplied by Footprint Books www.footprint.com.au
In Europe, the old-age dependency ratio (the number of persons aged 65 and over, compared to the number aged 15-64) will more than double to 48% by 2050. In India, the elderly population will exceed 100 million by 2013. Mind-boggling figures.
The first section of this book deals with spiritual perspectives on aging and dying with chapters on the Hindu, Muslim and Buddhist approaches. I found these particularly interesting, although they revealed how superficial was my knowledge of other belief systems. The second section deals with the socio-ethical dilemmas of aging and dying in the Indian context. The last section deals with end-of-life care.
This is a most thought-provoking collection of essays. Although written primarily from the point of view of the cultural milieu and belief systems in India, there is much to reflect on that applies to the rest of the world, both developed and developing. I cannot help but think that our death-denying societies have something to learn here.
Note for authors: If you wish to have your book reviewed, please send to:
Dr Roger Woodruff
IAHPC Bookshop Editor
210 Burgundy St, Suite 9
Heidelberg, Victoria 3084
Note: Review copies become property of IAHPC and are not returned to the author. Only palliative care related books which are previously approved will be reviewed. Due to the large number of requests, we can't provide exact dates of when books will be reviewed.
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