At the age of thirty-six, on the verge of completing a decade’s training as a neurosurgeon, Paul Kalanithi was diagnosed with inoperable lung cancer. One day he was a doctor treating the dying, the next he was a patient struggling to live. When Breath Becomes Air chronicles Kalanithi’s transformation from a medical student asking what makes a virtuous and meaningful life into a neurosurgeon working in the core of human identity – the brain – and finally into a patient and a new father. What makes life worth living in the face of death? What do you do when when life is catastrophically interrupted? What does it mean to have a child as your own life fades away? Paul Kalanithi died while working on this profoundly moving book, yet his words live on as a guide to us all. When Breath Becomes Air is a life-affirming reflection on facing our mortality and on the relationship between doctor and patient, from a gifted writer who became both.
No one appreciates the detail of being alive more than the dead. In Lisbon, a man encounters his mother sitting on a park bench who laughs with the impudence of a schoolgirl. She has been dead for fifteen years. In Krakow market he recognises Ken, his passeur, the most important person in his life between the ages of eleven and seventeen. They last met when Ken was sixty-five – forty years ago. The number of lives that enter any one life is incalculable. In this nomadic and playful book which travels through fictions across Europe, seemingly disparate stories reveal themselves to be linked, mislaid objects find their place and sensual memories penetrate the present.
Francesca Stubbs holds our hand as we take a walk through old age and death. Fran brings us to drinks with her dear friends, dropping off mouth-watering suppers for Claude, her ex-husband, warm and cosy in his infirmity. She visits her daughter, Poppet, holed up as the waters rise in a sodden West Country, and texts her son Christopher in Lanzarote, as he deals with the estate of his shockingly deceased girlfriend. The questions of what constitutes a good death and how we understand it preoccupy this glittering novel.
“We have to take a good hard look at our own attitude toward death and dying before we can sit quietly and without anxiety next to a terminally ill patient.“ Elisabeth Kubler-Ross
This quote refaces the attached article: Looking at the Dying Patient: The Ferdinand Hodler Paintings of Valentine Godé-Darel Pestalozzi BC. Journal of Clinical Oncology, Vol 20, No 7 (April 1), 2002: pp 1948-1950
The Swiss artist Ferdinand Hodler created a sequence of paintings documenting the death of his young lover Valentine. In the words of the article author ‘He created a series of paintings that force the viewer to face the process of dying. It may be helpful to an oncologist to sense his or her reaction to these visual stages of suffering.’
Click on the article for more of the sequence of paintings…
The Sick Child touches on the fragility of life. It draws upon Munch’s personal memories, including the trauma of his sister’s death, and visits to dying patients with his doctor father. He described the 1885 painting as ‘a breakthrough in my art’ and made several subsequent versions, of which this is the fourth.
Acquired by the city of Dresden in 1928, it was displayed in the Gemäldegalerie. A decade later, the Nazis declared that Munch’s art was ‘degenerate’ and, in November 1938, all his works in German public collections were collected in Berlin for auction. The Norwegian dealer Harald Holst Halvorsen secured as many as possible, including The Sick Child, and returned them safely to Oslo. Thomas Olsen bought the painting in 1939 and gave it to the Tate. Norway fell to the Germans in 1940. Looking back, Olsen explained that his gift was stimulated by ‘my knowledge, from talks with Munch, that he felt the need of recognition in Western Europe, especially so after the advent of Hitler.’
After seventy-six-year-old Caro Spencer suffers a heart attack, her family sends her to a private retirement home to wait out the rest of her days. Her memory growing fuzzy, Caro decides to keep a journal to document the daily goings-on—her feelings of confinement and boredom; her distrust of the home’s owner, Harriet Hatfield, and her daughter, Rose; her pity for the more incapacitated residents; her resentment of her brother, John, for leaving her alone. The journal entries describe not only her frustrations, but also small moments of beauty—found in a welcome visit from her minister, or in watching a bird in the garden. But as she writes, Caro grows increasingly sensitive to the casual atrocities of retirement-home life. Even as she acknowledges her mind is beginning to fail, she is determined to fight back against the injustices foisted upon the home’s occupants.
Publisher: The Women’s Press Ltd
“My name was Salmon, like the fish; first name, Susie. I was fourteen when I was murdered on December 6, 1973. My murderer was a man from our neighborhood. My mother liked his border flowers, and my father talked to him once about fertilizer.”
This is Susie Salmon. Watching from heaven, Susie sees her happy, suburban family devastated by her death, isolated even from one another as they each try to cope with their terrible loss alone. Over the years, her friends and siblings grow up, fall in love, do all the things she never had the chance to do herself. But life is not quite finished with Susie yet . . . The Lovely Bones is a luminous and astonishing novel about life and death, forgiveness and vengeance, memory and forgetting – but, above all, about finding light in the darkest of places.
“Several days before Christmas 2003, John Gregory Dunne and Joan Didion saw their only daughter, Quintana, fall ill. At first they thought it was flu, then pneumonia, then complete sceptic shock. She was put into an induced coma and placed on life support. Days later – the night before New Year’s Eve –the Dunnes were just sitting down to dinner after visiting the hospital when John suffered a massive and fatal coronary. In a second, this close, symbiotic partnership of 40 years was over. Four weeks later, their daughter pulled through. Two months after that, arriving at LA airport, she collapsed and underwent six hours of brain surgery at UCLA Medical Centre to relieve a massive hematoma.
This powerful book is Didion’s ‘attempt to make sense of the weeks and then months that cut loose any fixed idea I ever had about death, about illness … about marriage and children and memory … about the shallowness of sanity, about life itself’. The result is an exploration of an intensely personal yet universal experience: a portrait of a marriage, and a life, in good times and bad.”
“Mary Anne Schwalbe is waiting for her chemotherapy treatments when Will casually asks her what she’s reading. The conversation they have grows into tradition: soon they are reading the same books so they can have something to talk about in the hospital waiting room. Their choices range from classic (Howards End) to popular (The Girl with the Dragon Tattoo), from fantastic (The Hobbit) to spiritual (Jon Kabat-Zinn), with many in between. We hear their passion for reading and their love for each other in their intimate and searching discussions. A profoundly moving testament to the power of love between a child and parent, and the power of reading in our lives.”
Publisher: Two Roads
“Ethel and Ernest were solid members of the English working class, part of the generation that lived through the most tumultuous years of the twentieth century. They met during the Depression–she working as a maid, he as a milkman–and we follow them as they court and marry, make a home, raise their son, and cope with the dark days of World War II. Briggs’s portrayal of how his parents succeeded, or failed, in coming to terms with the events of their rapidly shifting world–the advent of radio, television, and telephones; the development of the atomic bomb; the moon landing; the social and political turmoil of the sixties–is irresistibly engaging, full of sympathy and affection, yet clear-eyed and unsentimental.”
Publisher: Alfred A. Knopf
“A lot of professors give talks titled ‘The Last Lecture’. Professors are asked to consider their demise and to ruminate on what matters most to them: What wisdom would we impart to the world if we knew it was our last chance? If we had to vanish tomorrow, what would we want as our legacy? When Randy Pausch, a computer science professor at Carnegie Mellon, was asked to give such a lecture, he didn’t have to imagine it as his last, since he had recently been diagnosed with terminal cancer. But the lecture he gave, ‘Really Achieving Your Childhood Dreams’, wasnt about dying. It was about the importance of overcoming obstacles, of enabling the dreams of others, of seizing every moment (because time is all you have and you may find one day that you have less than you think). It was a summation of everything Randy had come to believe. It was about living. In this book, Randy Pausch has combined the humour, inspiration, and intelligence that made his lecture such a phenomenon and given it an indelible form. It is a book that will be shared for generations to come.”
Watch a recording of the lecture at YouTube– > Here <
Publisher: Two Roads
For most of human history, death was a common, ever-present possibility. It didn’t matter whether you were five or fifty – every day was a roll of the dice. But now, as medical advances push the boundaries of survival further each year, we have become increasingly detached from the reality of being mortal. So here is a book about the modern experience of mortality – about what it’s like to get old and die, how medicine has changed this and how it hasn’t, where our ideas about death have gone wrong. With his trademark mix of perceptiveness and sensitivity, Atul Gawande outlines a story that crosses the globe, as he examines his experiences as a surgeon and those of his patients and family, and learns to accept the limits of what he can do.
Never before has aging been such an important topic. The systems that we have put in place to manage our mortality are manifestly failing; but, as Gawande reveals, it doesn’t have to be this way. The ultimate goal, after all, is not a good death, but a good life – all the way to the very end.
Aurora and Emma are mother and daughter who march to different drummers. Beginning with Emma’s marriage, Aurora shows how difficult and loving she can be. The movie covers several years of their lives as each finds different reasons to go on living and find joy. Aurora’s interludes with Garrett Breedlove, retired astronaut and next door neighbor are quite striking. In the end, different people show their love in very different ways.
Producers: James L. Brooks
Director: James L. Brooks
Writer: James L. Brooks
A dreamer who aspires to human flight is assigned public service after one of his attempts off a public building. This leads him to meeting a young woman, who is dying of motor neurone disease. The strong-willed woman admits her wish to be de-flowered before her death. The man, struggling to maintain his relationship with his girl friend, declines but offers to help pay for a gigolo to do the deed. The following events play off the inherent comedy and drama of the circumstances.
Producers: Ruth Caleb, Anant Singh, Helena Spring
Director: Paul Greengrass
Writer: Richard Hawkins
Having recently witnessed the death of her husband from a neurological disease, Anne Turner is diagnosed with a near-identical illness and determines to end her life once her condition has reached a critical point.
As her health deteriorates, Anne’s son and two daughters struggle to reach a consensus over their mother’s intentions and while they search for alternative options, silent recriminations and stubborn practicality threaten to tear the family apart. With her family at logger heads, Anne must also face the fury of her best friend, whose opposing views bring them into direct conflict.
Perhaps the antidote to John Diamond and Ruth Picardie? This is another dying journalist – but this time the emphasis is definitely on humour, except of course …. he is dying. The book is a sequence of letters by the humourist Miles Kington to his literary agent suggesting book titles that he could write, to make ‘…cancer work for its living‘. Written after his diagnosis with pancreatic cancer, this is a very funny book and although it doesn’t set out to pass on deep messages about life and death, I sort of feel it does.
The novel tells the story of the rise and fall of the mythical town of Macondo through the history of the Buendi family. It is a rich and brilliant chronicle of life and death, and the tragicomedy of humankind.
Title: One Hundred Years of Solitude
Publisher: New York : HarperCollins
Nye’s father has been certified for hospice care, but Nye would rather move into his father’s trailer and take care of him himself. In this masterful, graphic portrayal of a father and son dealing with home care, Wright’s mastery allows the reader to witness the deepest emotions on many levels, where what is said is only half the story.The graphic vocabulary, in a palette of blue, red and black, is carefully planned. Flights of visual fancy express genuine emotion rooted in reality.
I really enjoyed this graphic novel. It is funny and inventive and deals (I think very movingly and honestly) in the relationships within families and the tensions and challenges that caring for someone at the end of life brings. This is a book I have already started to lend (which I never do), and I would recommend it as a thought provoking read for students at any part of the course. You can find out more about the backstory to the book and the writer at the dedicated website.
‘How the Poor Die’ is a short essay published in 1946 describing Orwell’s experience in 1929 within a Parisian hospital. The essay can be found in a number of collections – or if you are willing to tolerate some typos there is an online version of the text here.
I thought this quote was a nice one about the experience of being ‘teaching material’:
“Later in the day the tall, solemn, black-bearded doctor made his rounds, with an intern and a troop of students following at his heels, but there were about sixty of us in the ward and it was evident that he had other wards to attend to as well. There were many beds past which he walked day after day, sometimes followed by imploring cries. On the other hand if you had some disease with which the students wanted to familiarize themselves you got plenty of attention of a kind. I myself, with an exceptionally fine specimen of a bronchial rattle, sometimes had as many as a dozen students queuing up to listen to my chest. It was a very queer feeling — queer, I mean, because of their intense interest in learning their job, together with a seeming lack of any perception that the patients were human beings. It is strange to relate, but sometimes as some young student stepped forward to take his turn at manipulating you he would be actually tremulous with excitement, like a boy who has at last got his hands on some expensive piece of machinery. And then ear after ear — ears of young men, of girls, of negroes — pressed against your back, relays of fingers solemnly but clumsily tapping, and not from any one of them did you get a word of conversation or a look direct in your face. As a non-paying patient, in the uniform nightshirt, you were primarily a specimen, a thing I did not resent but could never quite get used to.”
This Radio Play is made available via the Education Recording Agency (ERA) licence, as such the following link will only work via a computer on the HYMS network. >click here<
When Megan first tells Anton that she’s afraid something’s wrong, he brushes her fears away. Later, when they’re sitting in the waiting room at the Oncology Department, he still refuses to believe that Megan is ill. Even when the diagnosis of cervical cancer is given, he struggles to accept it. He hopes
against hope for a miracle. But in this story there is no miracle, and Meic Povey’s play traces the journey of a man faced with losing the woman he loves. It’s a searingly honest account, based on his own experience, of facing up to the reality of a partner’s terminal illness
One of the aspects of this drama that I felt was particularly convincing was the tension that often surfaced between the partners. As you just hear the two voices of Anton and Megan, without anything from a ‘professional’ voice – it made me think ‘I wonder what they were saying?’. Where does Megan get her version of the staging of cervical cancer? I think you could stop the play at any number of points and ask, ‘What might a health professional say/do/not do/not say at this point?’
Lucinda Gane, Christopher Reid’s wife, died in October 2005. A Scattering is his tribute to her and consists of four poetic sequences, the first written during her illness, and the other three at intervals after her death.
Philip Roth’s twenty-seventh book takes its title from an anonymous fifteenth-century English allegorical play whose drama centres on the summoning of the living to death and whose hero, Everyman, is intended to be the personification of mankind. The fate of Roth’s Everyman is traced from his first shocking confrontation with death on the idyllic beaches of his childhood summers and during is hospitalisation as a nine-year-old surgical patient through the crises of health that come close to killing him as a vigorous adult, and into his old age, when he is undone by the death and deterioration of his contemporaries and relentlessly stalked by his own menacing physical woes.
Stephen Bradley HYMS:A very painful depiction of a man with terminal disease contemplating his life and impending death. Often difficult and even unpleasant to read, but excellent. Quite similar in tone and themes to Tolstoy’s Ivan Illyich
In 1956, toward the end of Reverend John Ames’s life, he begins a letter to his young son, a kind of last testament to his remarkable forebears. ‘It is a book of such meditative calm, such spiritual intensity that is seems miraculous that her silence was only for 23 years; such measure of wisdom is the fruit of a lifetime. Robinson’s prose, aligned with the sublime simplicity of the language of the bible, is nothing short of a benediction. You might not share its faith, but it is difficult not to be awed moved and ultimately humbled by the spiritual effulgence that lights up the novel from within’ Neel Mukherjee, The Times
The more startling for the economy of its prose and plot, this novel’s story, set among the manicured lawns and euphemisms of Whispering Glades Memorial Park in Hollywood, satirizes the American way of death and offers Waugh’s memento mori.
Sue Hubbard HYMS:A different view of death? Quite black humour but does make you think about priorities.
Keynes weaves an intricate tapestry as he unfolds the home life of Charles Darwin, meticulously retelling the tale of Darwin’s struggles with his thoughts on evolution, the anguish resulting from the loss of his daughter, and how her death affected his thoughts on human evolution.
Author: Keynes, Randal
Title: Annie’s Box: Charles Darwin, his daughter and human evolution
Publisher: Fourth Estate; New Ed edition