Jerome Groopman's The Measure of Our Days is a compelling look at what we can learn about living when life itself can no longer be taken for granted because of severe illness. Jerome Groopman, M.D., one of the world's leading researchers in cancer and AIDS, is Professor of Medicine at Harvard Medical School, Chief of Experimental Medicine at Beth Israel Deaconess Medical Center. His laboratory helped to develop the new protease inhibitors for the treatment of AIDS, and in January of 1998 his laboratory identified another gene that appears to play a role in breast cancer.
Groopman has written extensively for many publications such as The New York Times, The Boston Globe, The New Yorker, and The New Republic and Time magazine as well as medical and scientific journals. The Measure of Our Days tells the reader about Groopman's technique with patients, not directly, but through stories. Groopman takes his title from a Psalm of David, Psalm 39, "Lord, make me to know mine end, and the measure of my days, what it is; that I may know how frail I am.
Dr. Groopman, as well as being a prolific writer, has an exceptional insight of the importance of confronting one's death, both for the patient and for their family and friends. The eight patients he synopsis’s vary extensively in their personalities and in their ailments, yet each of them in the end display a kind of heroism, strength, and the power to change their lives no matter what their diagnosis. Groopman's book is more than a collection of moving stories about sick people; it is about the strength hope gives us in times of need.
Groopman accounts the illnesses and deaths of four AIDS patients; there is the young boy who survived acute myeloblastic leukemia, but died of AIDS, from a blood transfusion, later in his teens; the physician with hemophilia, a fellow in Groopman's own research laboratory, who had been infected with HIV; an aged European businessman, and a young woman who contracted AIDS on vacation in Martinique. The book shows how she disengaged herself from the other AIDS patients in the waiting room because she did not want to face her future with this illness. She did not even tell her mom until she decided to adopt a child. Dan also hid his illness until he felt he had to tell Groopman incase it could effect his work.
As a nursing student, I have had some exposure to death during patient care. My first encounter with direct death was witnessing a patient after attempted resuscitation efforts die in the emergency department. As I observed others reactions, I noticed I was the only one who seemed fazed by the preceding events and the end result, although I didn’t show it outwardly. During my Aging and End of life clinical rotation, I have been exposed to a near death experience with a family and I had the rewarding experience of forming a relationship with the patient’s wife during the short hour I was in their home. From reading the accounts in this book, it confirmed to me the importance of catering to the needs of the family and the dying as an important issue to address as they are critical to overall care.
Sadly, life is a terminal illness, and dying is a natural part of life. Deits pulls no punches as he introduces the topic of grief with the reminder that life’s not fair. This is a concept that most of us come to understand early in life, but when we’re confronted by great loss directly, this lesson is easily forgotten. Deits compassionately acknowledges that grief hurts and that to deny the pain is to postpone the inevitable. He continues that loss and grief can be big or small and that the period of mourning afterward can be an unknowable factor early on. This early assessment of grief reminded me of Prochaska and DiClemente’s stages of change, and how the process of change generally follows a specific path.
Although illness narratives are not novel or new, their prevalence in modern popular literature could be attributed to how these stories can be relatable, empowering, and thought-provoking. Susan Grubar is the writer for the blog “Living with Cancer”, in The New York Times, that communicates her experience with ovarian cancer (2012). In our LIBS 7001 class, Shirley Chuck, Navdeep Dha, Brynn Tomie, and I (2016) discussed various narrative elements of her more recent blog post, “Living with Cancer: A Farewell to Legs” (2016). Although the elements of narration and description (Gracias, 2016) were easily identified by all group members, the most interesting topics revolved around symbolism as well as the overall impression or mood of the post.
This internal conflict is a result of the mistakes a physician makes, and the ability to move on from it is regarded as almost unreachable. For example, in the essay, “When Doctors Make Mistakes”, Gawande is standing over his patient Louise Williams, viewing her “lips blue, her throat swollen, bloody, and suddenly closed passage” (73). The imagery of the patient’s lifeless body gives a larger meaning to the doctor’s daily preoccupations. Gawande’s use of morbid language helps the reader identify that death is, unfortunately, a facet of a physician’s career. However, Gawande does not leave the reader to ponder of what emotions went through him after witnessing the loss of his patient. He writes, “Perhaps a backup suction device should always be at hand, and better light more easily available. Perhaps the institutions could have trained me better for such crises” (“When Doctors Make Mistakes” 73). The repetition of “perhaps” only epitomizes the inability to move on from making a mistake. However, this repetitive language also demonstrates the ends a doctor will meet to save a patient’s life (73). Therefore, it is not the doctor, but medicine itself that can be seen as the gateway from life to death or vice versa. Although the limitations of medicine can allow for the death of a patient to occur, a doctor will still experience emotional turmoil after losing someone he was trying to
The sub-title of Elisabeth Kübler-Ross’ book describes her audience as doctors, nurses, clergy and the family of dying patients. Because of her target audience the book is written on a more emotional level, citing examples of both positive and negative death experiences. There are no detailed descriptions of what happens to the body as it dies, just discussions of how the dying person might feel and how they might want to experience their last moments of life. Sherwin Nuland takes a much more scientific approach with his book “How We Die”. In chapter seven, Accidents, Suicide and Euthanasia, Nuland describes in great detail the pathophysiology of why a person dies from sepsis and pulmonary infection. His book is targeted more towards the health care professional who is familiar with long drawn out discussions of the pathophysiology of a certain disease process. The choice of target audience by each author correlates to their discussions regarding who controls the death experience. Kübler-Ross argues for patient input and control and so...
Kübler-Ross, Elisabeth. On Death and Dying: What the Dying Have to Teach Doctors, Nurses, Clergy and Their Own Families. London: Routledge, 2009. Print.
Just as we witness life, we must witness death. It is neither defeat nor failure, but a normal process in life. It is always devastating for the patients and their family members to be given a diagnosis of terminal illness, with the feeling of hopelessness as there is nothing more that can be done. It’s not totally true! No matter how big or small the intervention is, there is always something that can be done. And oftenly, it is the little things that make a huge difference to the patients and their family
Death alone is a scary thought to most individuals. People who live their life in fear of death don’t really get the most out of life. Someone who is terminally ill would be in a similar situation. There are two ways to live life after being diagnosed terminally ill. One way would be to get the most out of what remains of the person’s life. This would be considered the positive outcome. In the story “Letter from a Sick Person” the narrator recently has been informed he is terminal. Instead of panicking or being upset he embraces it. He accepts that his death is unavoidable and it gives him a brand new meaning in his life. He states, “In journeys, the greatest grief is hidden”. This life explains while he is not exactly happy he has discovered a way to cope with his illness. He feels as if it was his time stating, “I tell you I wanted death to come like a captain and carry me off”. Even in his death he knew that it wasn’t him who would be forced to overcome his death but the people left
Gonzales, Laurence. Deep Survival: Who Lives, Who Dies, and Why: True Stories of Miraculous Endurance and Sudden Death. New York: W.W. Norton &, 2003. Print.
‘Being Mortal’ was a fascinating read about a young man who grows in the understanding of death and dying and what matters most in the end. We all have constraints and no matter how well we take care of ourselves and live our life, death comes to us all; and how we meet that end can be very different depending on how we want to spend the last moments of our journey. Medical science has its power and pushes the boundaries of life and death, but it can’t always save you, it won’t always work out the way that you hope it does. Doctors like Atul Gawande struggle to fix everyone’s problem and cure the patients who come into the hospital; but as the book progresses Atul finds that there are ways to handle patients’ lives and it doesn’t always involve
Hutchinson, Tom “Illness and the hero’s journey: still ourselves and more”, CMAJ. 162.11 (2000):p.1597 web (date accessed).
When it comes to a bad diagnosis it is often difficult for doctors to tell their patients this devastating news. The doctor will likely hold back from telling the patient the whole truth about their health because they believe the patient will become depressed. However, Schwartz argues that telling the patient the whole truth about their illness will cause depression and anxiety, but rather telling the patient the whole truth will empower and motivate the patient to make the most of their days. Many doctors will often also prescribe or offer treatment that will likely not help their health, but the doctors do so to make patients feel as though their may be a solution to the problem as they are unaware to the limited number of days they may have left. In comparison, people who are aware there is no cure to their diagnosis and many choose to live their last days not in the hospital or pain free from medications without a treatment holding them back. They can choose to live their last days with their family and will have more time and awareness to handle a will. Schwartz argues the importance of telling patients the truth about their diagnosis and communicating the person’s likely amount of time left as it will affect how the patient chooses to live their limited
Alan Seymour’s The One Day Of The Year, set in the early 1960’s is one of the most evocative Australian plays of the 20th century. The “1960s” also refers to an era more often called the Sixties, standing for the complications of inter-related cultural and political trends around the globe. This play follows the story of a young university student, Hughie Cook who assists his girlfriend, Jan, in writing an article criticising Anzac Day. This article causes great distress in his ex-serviceman father, Alf, who courageously fought in World War Two. Seymour’s play gives readers an insight into the lives of those whom ANZAC day effects and brings to the light issues such as multiculturalism, education and the class system. The three main characters are all representations of the dry
Nurses are both blessed and cursed to be with patients from the very first moments of life until their final breath. With those last breaths, each patient leaves someone behind. How do nurses handle the loss and grief that comes along with patients dying? How do they help the families and loved ones of deceased patients? Each person, no matter their background, must grieve the death of a loved one, but there is no right way to grieve and no two people will have the same reaction to death. It is the duty of nurses to respect the wishes and grieving process of each and every culture; of each and every individual (Verosky, 2006). This paper will address J. William Worden’s four tasks of mourning as well as the nursing implications involved – both when taking care of patients’ families and when coping with the loss of patients themselves.
“The Hospital Window” by James Dickey is an emotional poem about a son’s struggle to cope with his father’s imminent demise. This poem incorporates figurative language as well as metaphors that create a story of emotion. It evokes such true emotion by drawing the reader into the fidelity of the relationship between a son and his father faced with the reality of death. Not only death in a physical sense, but also the journey one takes to reach that point and the transcendence of faith. Each element of the poem is a cliffhanger for the next line, resulting in a read that sparks the true creative power of the readers’ mind.