Monday, July 27, 2009

SYTYCD Trubute to Breast Cancer

To reality TV fans out there, this post is probably old news. However, I recently was alerted to this clip from the TV show "So You Think You Can Dance". This show is a competition where dancers compete, are judged, then eliminated. On Wednesday July 22nd, there was a piece done as a tribute to those battling breast cancer.

The piece was choreographed by Tyce Diorio and preformed by Ade Obayomi and Melissa Sandvig with music by Maxwell's cover of Kate Bush's "This Woman's Work". The choreographer said he was inspired by his friend Michelle's battle this year with breast cancer.

The music is a beautiful accompaniment. Starting with what sounds like crying, the dancers mimic the emotion of sorrow at the diagnosis. The lyrics to the portion of the song played:

Pray to God you can cope
I stand outside
This woman's work
This woman's world
Oooh, it's hard on the man
Now his part is over
Now starts the craft of the father

I know you have a little life in you yet
I know you have a lot of strength left
I know you have a little life in you yet
I know you have a lot of strength left

I should be crying but I just can't let it show
I should be hoping but I can't stop thinking
All the things I should've said that I never said
All the things we should of done that we never did
All the things I should've given but I didn't

Oh darling make it go
Make it go away

There are beautiful moments symbolizing the friendship and strength of those who come along side someone with cancer. The dancer with cancer falls in exhaustion, her partner catches her; she dives out in trust and he catches her; she pounds on his chest in anger, and you watch him struggle privately. Ultimately she rises as he lifts her in resolution onto his shoulders.

Dance is yet another creative way to express emotions and narrative. The clip below is from the episode with some introduction, then the 1:20 min dance, followed by the tearful responses of the judges. Hope you enjoy! Subscribers, if you have trouble viewing the video please go to the original Pallimed post to view.

Monday, July 27, 2009 by Amy Clarkson · 2

Monday, July 20, 2009

Warren Zevon's The Wind

Warren Zevon was an American singer-songwriter known for his "sardonic wit and blazing intelligence" which he incorporated into his music. Some of his well known songs include "Werewolves of London", "Roland the Headless Thompson Gunner", and "Lawyers, Guns and Money". In 2002, Zevon was diagnosed with mesothelioma. He refused any treatment and started on his final album The Wind.

The Wind features guest appearances from several of Zevon's close friends (Tom Petty, Bruce Springsteen, Don Henley to name a few). The making of the album was made into a documentary for VH1 entitled, Warren Zevon: Keep Me In Your Heart.

When I first heard The Wind, I knew it was Zevon's final album, made while he was dying, and so I listened to it differently than I would other albums. It seems to frequently refer to Zevon's illness (but maybe that's just me). Some songs seemed to contain a lot of regret.

Included on the album is a cover of the Bob Dylan song "Knockin' on Heaven's Door". (Not hard to see how this one relates to dyint.) Another song, "Disorder in the House" (recorded with Bruce Springsteen and winner of a Grammy for Best Rock Performance by a Duo or Group With Vocal), is about a house coming apart and falling down. It starts with the lines:
Disorder in the house
The tub runneth over
Plaster's falling down in pieces by the couch of pain

It ends:
Disorder in the house
All bets are off
I'm sprawled across the davenport of despair
Disorder in the house
I'll live with the losses
And watch the sundown through the portiere

Below is "Keep Me in Your Heart" also from The Wind.

Shortly after his diagnosis, in 2002, Zevon appeared on The Late Show with David Letterman as the only guest for an entire hour (most of the appearance can be seen on You Tube). Zevon was a frequent guest on The Late Show. When discussing his cancer, Zevon says,"I might have made a tactical error in not going to a physician for 20 years. It was one of those phobias that really didn't pay off." Later on, Letterman asks Zevon if he knows something about life and death that Letterman doesn't know. Zevon responds, "Not unless I know how much you're supposed to enjoy every sandwich." (The line "enjoy every sandwich" then became one of Zevon's more famous lines.)

Warren Zevon died September 7, 2003, less than two weeks after the release of The Wind on August 26th.

Special thanks to one of my colleagues, Leighton Sweet, for tipping me off about this artist.

Monday, July 20, 2009 by Amber Wollesen, MD · 7

Monday, July 13, 2009

"Death" W.B. Yeats

William Butler Yeats was both a poet and a dramatist. Born in Dublin in 1865, he was awarded the Nobel Prize in Literature in 1923. Unlike many award winners, his greatest works were actually completed after winning the Nobel with collections of The Tower(1928) and The Winding Stair and Other Poems (1933).

The poem "Death" was published in The Winding Stair and Other Poems. It was actually written in reaction to the assassination of his political friend Kevin O'Higgins, which is referenced in the later part of the poem.

What I really like about W.B. Yeats is that I have to reread his poems a few times to really grasp what he's trying to say.


NOR dread nor hope attend
A dying animal;
A man awaits his end
Dreading and hoping all;
Many times he died,
Many times rose again.
A great man in his pride
Confronting murderous men
Casts derision upon
Supersession of breath;
He knows death to the bone --
Man has created death.

The sentiment in the first part of the poem is that simple profound truth; that we as humans, unlike other animals, are cognizant of our own mortality. As far as we know, birds are not flitting around the sky worrying about death, or even experiencing hope for the future.

It is this fact that allows us the material we write about in this blog. People contemplating death and grief give us music, art, poetry, books, etc.

Although the next line "Many times he died,/ Many times he rose again" may sound like reincarnation, I think more accurately Yeats has something like this in mind, from his poem "Under Ben Bulben":

Many times man lives and dies/
Between his two eternities

There are many symbolic deaths we go through in life, only to rise again and continue.

Although the last portion is in direct relation to his friend, it relates to the inescapable nature of dying. Mr O'Higgins had played a role in the executions of some IRA members, his assassination being in retaliation to this. He said to his wife, "Nobody can expect to live who has done what I've done."

The image of a man looking head on towards certain death, in fact casting scorn at the idea of avoiding or replacing death (casts derision upon/ supersession of breath), may be a maturing from the initial feeling of dread at dying or hope to avoid it seen in the beginning of the poem.

As for the last line that "Man has created death", it's often quoted out of context from the poem.
There are two thoughts I have for this. The first, when thought of with the beginning idea of the poem, that animals are unaware of their own mortality, well then it is we, "man" by our own awareness of dying that indeed we have created the concept of "death". Second, he simply could be referring to his friend Mr. O'Higgins, who by his own admittance, undertook actions that led to his death, thus perhaps he actually "created" his own death?

Any other thoughts?

Jeffares, AJ "W.B Yeats, man and poet" 1996

Monday, July 13, 2009 by Amy Clarkson · 4

Monday, July 6, 2009

HawthoRNe and Palliative Care

Ok, I had no intention of watching a new television series (I already have way too many stored on the DVR). But after catching the first two minutes of the HawthoRNe episode "Yielding" in which they speak of discontinuing a patient's life support, I had to keep watching. I guess my curiosity got the better of me. Below is the first two minutes I was speaking of.

For those of you not familiar with this new TNT series, it centers around the Chief Nursing Officer, Christina Hawthorne (and the cleverly capitalized RN in the title is all TNT, not me), played by Jada Pinkett Smith. Hawthorne just lost her husband about a year ago and this series deals with her personal life as a new widow and now single mother along with her work as the CNO.

This episode focuses mostly on an elderly woman who has been on the ventilator now for 10 weeks and the hospital is feeling the pressure to get her extubated because they need the ICU bed. My first issue with this episode comes when they are speaking with the patient's son. They tell him that when there are no brain waves there is no chance for recovery. A correct statement but hmm... Is she brain dead?

The son asks for just 24 hours more to come to grips with things then he will take her off the life support himself(they offer to help him with it but he wants to do it himself). But the hospital needs the bed. So Hawthorne sets a storage room up to house the ventilated patient and thus give the son 24 hours more. A storage room complete with a shorting out power strip to plug the vent into. Again, hmm...

Meanwhile, a seemingly uncaring daughter enters the picture and demands the patient be taken off the life support right now as the patient had stated she did not want this. She goes to the cold hospital administrator type who demands the plug be pulled. (Is there an advanced directive? Or was it just a verbal thing? That was unclear to me.)

The biggest issue though was the very strange way of they had of removing "life support". They turn a dial and the patient's pulse and blood pressure drop (but you could still hear the vent going). Then they turn it again and the pulse and blood pressure drop further (vent sounds still present) and you hear the flatline. Hmm...

But even though Hawthorne wasn't able to grant the sons wish, it all ends ok. We find out later, the son had gotten a chance to come to the patient's room and say goodbye and the evil daughter cries when they told her her mother had died.

The title I started with for this post was "HawthoRNe and Palliative Extubation" but as I was writing I realized that they never say the word extubation and that is indeed not what they do. They say "remove life support" and "pull the plug" and it is all done with one dial. I do applaud the writers of Hawthorne trying to address end of life issues and the sentiment is there, but the attempt left me a bit confused. It seemed to be focused more on the stereotype of what people think "life support" is than any medical facts. I realize that the sentiment was really the whole point, but I couldn't get past the poorly done technical parts.

The episode had some other issues (nurse in hot pants doing drug inventory). The characters seemed stereotypical and the other plot lines were predictable. Some of the acting wasn't great. I think this may be the one and only time I watch HawthoRNe but I would be interested to hear what others, in and out of the medical field, think.

Monday, July 6, 2009 by Amber Wollesen, MD · 6