Sunday, May 2, 2010

Childhood Death . . .

Death in the world of childhood is in Chapter 10, Death, Society, and Human Experience. Kastenbaum again, bringing me to a new level of exploration. Here I was prompted to think about my experiences with death from my childhood. Death was treated in my home as something that avoided details. I remember asking more questions about my dog’s death because my father did not really give me satisfying answers. When I asked my father, “How did he die?” My father’s response was, “I do not know.” It seemed like the uncomfortable answers were always answered with “I do not know” responses. As a child, that made me want to know even more. So, I would ask my older brothers who had no trouble telling me exactly what happened. My dog had died from old age. When my brother woke up one morning, my dog was on the kitchen floor, cold and not breathing. When my brother went over to pet him, he was “stiff.” My brother got my father and they buried my dog in the backyard. A big mound of dirt with a flower on top is where my dog “left to go to heaven.” My parents were not comfortable telling me the truth about death until I was older. They would tell me some aspects of death but would be vague with the true details.
I remember when my grandmother passed away. I remember my mother crying for days. She could not eat or sleep. It was a very sad time for our entire family. My grandmother suddenly passed away at age 63. After the shock of her mother’s death, my mother slowly began to resume her own life. I remember feeling happy that my mother’s eyes were no longer swollen. I felt happy again too. I just wanted to be a child again; however, in the weeks to come, I realized that my grandmother was not coming back. The next holiday came two months after her death. Thanksgiving was terrible. My grandmother was not there and my family was sad again. I remember feeling like my life would never be the same. Death was permanent. I wish my parents would have given me that information earlier in life. It took a year of each holiday and each birthday without my grandmother there for me to figure that out.
I think death is a subject that should be treated on a case-by-case basis with children. As a parent, I will not avoid the death conversation with my children. I will try to answer the question honestly and calmly. Kastenbaum lists the stages of death comprehension in childhood in a table on page 324. Stage 1 age range is from 3 – 5 years and the interpretation of death is like a separation. Stage 2 age range is from 5 – 9 years and these children realize death is final. And Stage 3 the age range is from 9 years – adult and death is personal, universal, final, and inevitable. I agree with these stages, ages, and interpretations of death.

Euthanasia

Euthanasia, assisted death, abortion, and the right to die are discussed in Chapter 9, Death, Society, and Human Experience. Kastenbaum explores these topics like no other person! I know I have used these terms in many conversations; however, I cannot remember ever looking up the literal translation or the specific definition. It may have been my parents or older brothers that explained their own meaning of such words to me when I was a child. Let’s take euthanasia for example. The literal translation of the term euthanasia would be good or happy (eu) death (thanasia) (275). Many people do not think of “good” when speaking about euthanasia. It is more accurate to think about the original meaning of euthanasia as dying without suffering or pain. Today, the term retains something of its original meaning: a peaceful, painless exit from life. However, it also has taken on another definition: the intentional foreshortening of a person’s life to spare that person from further suffering (275).
Here are two main forms of euthanasia to think about: active euthanasia and passive euthanasia. Active euthanasia relates to actions that are intended to end the life of a patient (or animal) who is suffering and really has no chance of recovering. An example of active euthanasia is a lethal injection to a patient. Passive euthanasia, on the other hand, applies when intentional withholding of a treatment is done and that treatment may have prolonged the patients life. Not placing a person on life-support after a trauma would be one example of passive euthanasia.
The information found here is just amazing. This chapter discusses issues that we face everyday but we do not really know all that much about. For instance, the role of a nurse in euthanasia or assisted death. Most nurses are not given the attention that they deserve in such cases. Think about a family who confides their true feelings about their loved one in a hospital bed quite openly with a nurse. It is the physician, not the nurse, who takes on the medical decision-making responsibilities for patients. Remember, it was the nurse and not the physician who heard the families’ true wishes regarding this patient. It seems obvious that the nurse may spend more time with the family, but does the physician really know what the nurse was told? This scenario may have happened to someone in your family and you did not even know it. This example made me think about my experiences in the hospital setting. I, too, have spoken openly with nurses but found myself limited in conversation when the physician enters the room. The physician would come in, speak about my family member, flip through the paperwork making a few notes, and then leaving to see the patient in the next room. It is all too familiar for me. I feel like I have found a new approach for the next time.

Wednesday, March 31, 2010

This chapter in Death, Society, and Human Experience by Robert J. Kastenbaum discusses suicide. Once again, I find myself very interested in some of the facts about suicide in our world. For example, suicide is the eleventh most common cause of death in the general population. China has approximately 500,000 suicides each year (p. 199). These figures seem to be quite high when you actually look at them in print. I was surprised when I thought about how many people are associated with suicide in some way. Suicide affects young people, elders, different races, males and females. It appears to me that no one is completely exempt from suicide.
Kastenbaum talks about some basic suicide facts which I found quite interesting to know about. Most completed suicides occur in white males and increase with the age of males. Suicide is the third leading cause of death among youths from age 15 to 24 years. Bad economic times, emotional issues such as divorce, and the “emptiness” feeling are risk factors for suicide (p. 201). I have a particular friend that went through a divorce, got dismissed from her job, and just felt like everything around her was completely falling apart at that time. I never really thought that she would experience suicidal thoughts or feelings. That idea just did not occur to me when these negative situations where happening in her life. I guess I have always considered her to be powerful woman. Therefore, I assumed she would just pick herself up and move forward with her life. Looking back at this situation now, I realize how easy it would have been for her to consider suicide. Thankfully my friend made it through this and is now remarried, working, and very happy with her life. Kastenbaum was able to provide me with an image of someone who may have one or several suicidal factors. I have an awareness now that I did not have before reading this chapter.
Another topic that Kastenbaum discusses is suicide as a rational alternative. “Individuals do not destroy themselves in hope of thereby achieving a noble postmortem reputation or a place among the eternally blessed. Instead, they wish to subtract themselves from a life whose quality seems a worse evil than death” (p. 218). My initial reaction to this thought was pure sadness, especially when I thought about this happening with children or young adults. What could be so bad in a young person’s life? Then it hit me. I was overwhelmed thinking about all of the news reports on television and in the newspaper that I have seen. Most of Kastenbaum’s examples and his list of high–risk situations for suicide where all there. It seems almost obvious when you look at these news reports after reading this information about suicide.
In conclusion, I have learned many eye–opening factors about suicide. For example, a situation that can seem unimportant to one person, can be devastating to another person. The suicide statistics are high but may not even include all of the deaths that are truly associated with suicide. Suicide prevention is paramount; be aware and really listen when someone needs an ear.

Wednesday, March 3, 2010

Does everyone die in the same way? Are there any differences? Does it even make a difference to you? Robert Kastenbaum explores the Transition from Life in Chapter 4 with Dying. It starts with the actual moment of death. This makes you think about the specific act of dying. For example, older people sometimes just slip away due to Alzheimer’s disease or dementias that accompany some people in their last phase of life. Sedation can reduce awareness and responses from a patient appear impaired or not there at all. These are just a few ideas to think about when someone is dying.
Trajectories are forms of the dying process; I now know that there are many trajectories to consider. While reading this text, I found it necessary to reread some of the explanations since I started to place myself in the situation. I read it the first time to understand the material. Then, I read it again placing myself or someone in my family in that particular circumstance. Doing this gave me a real feeling for what it may be like when I die. I cried too. I never thought of myself to be sensitive enough to feel so much emotion just by reading a textbook. I know it sounds weird, but it is true.
Looking at dying from the point when a physician communicates that information to you, when someone in your family is going to die, it is quite an eye–opening experience. Within the last two years, I have had nine family members pass away. Some of them were older, distant relatives from my step–father’s side of the family. Therefore, I was not at the hospital with them when they died. However, many stories about the experience with the physicians have surfaced. The chart on page 118 in Chapter 4, “Breaking the Bad News”: Physician–Patient Communication, reminded me of some of the same scenes that played out with my relatives during their final stage of life. It is hard for me to picture the doctor just telling the patient some bad news, and then moving directly on to the next order of business. A person that is dying is not just a matter of business to their family. A much better approach to this situation would be for the doctor to establish some type of relationship with the patient and or family first. This does not have to take a very long time; however, it would make a big difference in the presentation of bad news.
Once again, I feel as though I have gained more perspective about death. It has been very interesting to read much of this information soon after nine deaths have occurred in my family.

Saturday, February 20, 2010

I am moving on to suicide. This time I have read the next section, Suicide, in The Oxford Book of Death. Once again, this is a topic that I have not really put much energy into thinking about. I am not sure if that is a good thing or not now that I am in this humanities class.
The first few entries that I read were somewhat difficult for me to interpret. Specifically, I found Shakespeare’s and Emily Dickinson’s entries to be a little difficult for me to follow. I was not able to create an image in my mind which made it hard for me to read. Virginia Woolf, on the other hand, had an interesting letter to her husband, Leonard dated March 18, 1941. After reading this entry, it was clear to me that she was writing this letter at a very bad time in her life. She wrote that she hears voices, she is spoiling his life, and he could work if she were gone. She is extremely depressed and basically says goodbye to him in this letter. She ends the entry with, “I don’t think two people could have been happier than we have been.” She seemed to realize that he was entirely patient with her and incredibly good. I think she was thanking him for that in this last statement. Woolf used powerful words in this short entry.
I read another entry by Camus, op. cit. “I have heard of a post-war writer who, after having finished his first book, committed suicide to attract attention to his work. Attention was in fact attracted, but the book was judged no good.” I followed that direction of thinking too. Suicide is not the way to attract attention to a book. He killed himself but the book still stunk! Here is another letter that caught my focus. It was written by Franz Kafka (1883 – 1924), of himself, in a letter, tr. Ronald Hayman. “You, who can’t do anything, think you can bring off something like that? How can you even dare to think about it? If you were capable of it, you certainly wouldn’t be in need of it.” He is calling himself a wimp right from the start! He admits he cannot do anything. So, how would HE be able to do THAT? I saw a little humor in this one. Last but not least, I came across the letter thanking God for not allowing him success in suicide. This was a letter to The Times dated October 24, 1980. Jean M. Haslam wrote that he attempted suicide several times ten years earlier. He states he is happily married and had an unshakeable religious faith now. It made me glad to see that he was able to turn his life around.

Wednesday, February 17, 2010

I am back with more! In The Oxford Book of Death, by D.J. Enright, I have read the section about The Hour of Death. These forty or so pages with short stories and poems offer interesting and different perspectives on the hour of death. I had not given much attention to the subject of death before taking this class. Now, I find it interesting to find so many different ways to look at death. Is it an event or a state? Is it a reflection of your life or a celebration of your death? Do you look forward to death? I mean do you look forward to that peaceful, resting that lasts forever? Does it really last forever? Is it your goal to fill your life while living so that you can actually rest when you die? Is death just time to rest? This section of the book provoked my thinking about all of this.
For example, C.G. Jung wrote, “Life is an energy-process. Like every energy-process, it is in principle irreversible and is therefore directed towards a goal. That goal is a state of rest.” This short poem continues; however, the first three lines grab your attention right away. This is the kind of reading that made me really analyze my own attitude about death. I have not decided if my ultimate goal is a state of rest. At this particular time in my life, it is all about keeping busy. Also, I have always been a multitasker; so, how could I possibly rest? I do not see that yet.
In addition, James Boswell wrote a short passage. “To my question, whether we might not fortify our minds for the approach of death, he answered, in a passion, ‘No, Sir, let it alone. It matters not how a man dies, but how he lives. The act of dying is not of importance, it lasts so short a time.’ I think Boswell reinforces the opinion that dying is actually short. It is living that is important.
The next example is from Winston Churchill. He wrote, “I am ready to meet my Maker. Whether my Maker is prepared for the ordeal of meeting me is another matter.” This made me laugh. It is right in tune with me. I have said something quite similar to this before. Specifically, the time when I met my son’s preschool teacher. I knew I was ready for him to go to preschool three mornings each week. I attended the orientation with my son, I remember the teacher following me through the classroom as I chased my two other children. She was trying to ask me a few questions about my son but could not get me to stand in one spot long enough to answer her. Looking back on that, it was funny. However, at the time it was probably frustrating for her. I still wonder if she was ready to meet me!

Thursday, February 4, 2010

Chapter 2

What is death? What does death mean? I was about to find out in Chapter 2 of Death, Society, and Human Experience by Robert Kastenbaum. I never heard the word plastination before reading this text. It is described as replacing fluids and lipids in biological tissues with polymers which then allow medical students to study such a specimen. Plastination provides a dry, durable, odorless specimen usually on one particular body part to be studied. I had not given much thought to medical students needing body parts to study until now. This is yet another area for me to consider when thinking about death and what it really means when you are “dead.”
I learned an interesting way to relate death as a concept in the section of Death as Symbolic Construction. Specifically, water is referred to as a concept just like death is. Kastenbaum states, “We look at ice, snow, mist, rain, standing pools, and flowing streams and write the formula H2O on the board and call them all water, even though their forms look so different.” I think this comparison hits the nail on the head. Death can be described in various ways also. It caught my attention and made sense to me.
I was able to identify with some of the information in Sleep and Altered States of Consciousness. A few years ago, we had a hamster named Violet. When she died, my youngest daughter told relatives that Violet was sleeping and would not wake up. It seemed so cute at that time. However, after my daughter noticed Violet’s cage was removed, she then asked me where Violet was buried. Not thinking much about this, I told her where she was buried. Later that day, I found my daughter with shovel and bucket in hand trying to “find Violet so she could wake her up and play with her.” Needless to say, we had a conversation about the difference between death and sleep. As a result, I do not think she will try to wake up animals that are “sleeping!”
Finally, in the view of death uniting or separating relationships, I felt like I could see both positions. On a personal level, I have felt that separation when someone close to me had died. It just stayed over me like a black cloud. On the other hand, in moments of strength I would feel almost happy thinking that my loved one would now be united with his family members and friends that had died. It was confusing to me at the time. I did not really talk about this with anyone since my feelings would change with the level of strength I had at that moment. It felt good to read this now and maybe even realize that I was not confused at all.