Monday, September 28, 2009

"That's Not My Name" by The Ting Tings

The nice thing about art is the ability to interpret a piece from your own perspective based on your life experiences and knowledge. Tonight I will attempt a great feat by turning a song about being left alone and ignored on the dance floor into a reminder of the importance of respect in caring for patients.

The Ting Tings released "That's Not My Name" in 2008 and it quickly spread through MySpace and eventually the UK Charts to become a dance club anthem.  The catchy yet slightly bratty lyrics feature a frustrated woman who despises being forgotten and never having anyone identify her as someone of worth.  The big bass drum beat and hand claps in the opening verse give the song a cheerleading type quality matched by lead singer Katie White's chanting style of singing.



The dramatic pause of music allows the full weight of the lyrics sink in: "With nothing to consider, they forget my name (ame, ame, ame)" the final words like a pitiful echo chamber resonating the isolation the singer feels.


After listening to this song about 20 or 30 times, the whole dance club vibe started to wear off and I began to think about this song from the point of view of a patient who may feel isolated in a hospital. With the simple reframing from dance club to a hospital many of the lines take on a different level of seriousness about the importance of respect and personhood.

Taking into consideration Mazlow's Hierachy of Needs this song clearly fits into Esteem but also has roots in the Love and Belonging level.  One could also consider it as 'continuity of self' and 'maintenance of pride' in Chochinov's Dignity Conserving Perspectives model. (free full text)  For the patient with a potential life-altering illness it is difficult to consider being able to 'accept facts' under self actualization if everything in the medical system is designed to dehumanize you one interaction at a time.

The obvious dehumanizing example in the hospital is defining patients not by their name but by age, gender and illness and location as in: "the 54 year old female with lung cancer in the ICU."  In addition the gigabytes of data, text and images which define a patient via their ever expanding medical chart (paper or digital) serve a similar dehumanizing role.

Two questions I find very helpful in making a stronger connection with patients include asking about name preference and correct name pronunciation.  "Do you like/prefer to be called ______?" "What do your friends call you?" are two easy ways to address name preference.  Even if it is classically a term of affection like 'Doll'* or a family relation like 'Gramps' if that is the patients preference even for staff to address them I go with it. (*except when it is not a term they choose themselves - see Elderspeak below)

Correct name pronunciation is probably one of my biggest social pet peeves in medical care today.  It flabbergasts me to find highly skilled and well educated professionals stop short of pronouncing a potentially difficult name; often times it may come from a culture different than the majority of staff.  If you are going to take a patient for a cholejejunostomy, colonoscopy, phlebotomy, computerized tomography, sunitinib or a palliative extubation you can surely spend 30 seconds to understand how to correctly pronounce their name be it Lee Thi Nguyen or Wilhelmina Van Rijn (not patients of mine)

Another aspect is the singer's identification of personality which also is easily reframed to a patient navigating a complex illness.  How the medical system views a patient maybe 'she's quiet' but to the person with the illness she may consider herself in better times 'a riot.'  

And lastly the refrain "Are you calling me darling? Are you calling me bird?" resonates with current research in geriatrics demonstrating the use of Elderspeak has a demoralizing effect in geriatric patients.  Although calling a patient 'darling,' 'doll' or 'bird' may seem endearing it too becomes another way to dehumanize and individual by tagging them with a generic nickname.

I have left a few other gems in the lyrics for you to interpret on your own.  Tell me if you hear some of the same themes when you listen to "That's Not My Name."


"That's Not My Name" by The Ting Tings (Columbia Records UK-2008)
Lyrics:

Four little words just to get me along
It's a difficulty and I'm biting on my tongue and I
I keep stalling, keeping me together
People around gotta find something to say now

Holding back, everyday the same
Don't wanna be a loner
Listen to me, oh no
I never say anything at all
But with nothing to consider they forget my name
(ame, ame, ame)

They call me 'hell'
They call me 'Stacey'
They call me 'her'
They call me 'Jane'
That's not my name
That's not my name
That's not my name
That's not my name

They call me 'quiet'
But I'm a riot
Mary-Jo-Lisa
Always the same
That's not my name
That's not my name
That's not my name
That's not my name

I miss the catch if they through me the ball
I'm the last kid standing up against the wall
Keep up, falling, these heels they keep me boring
Getting glammed up and sitting on the fence now

So alone all the time at night
Lock myself away
Listen to me, Oh nah.
Although I'm dressed up, out and all with
Everything considered they forget my name
(ame, ame, ame)

Male background singing:
Song was my in my head and now its in my mind
call the preacher, get some words and get some time
You know I realized. I cannot emphasize
Sitting around with just a promise, nothing binding
Whatever, can't you see? Living so desperately
Standing and choking like a vocal one-liner
Instead of sing-along this song is monotone
I gotta get some soul. I gotta get some feeling

They call me 'hell'
They call me 'Stacey'
They call me 'her'
They call me 'Jane'
That's not my name
That's not my name
That's not my name
That's not my name

They call me 'quiet'
But I'm a riot
Mary-Jo-Lisa
Always the same
That's not my name
That's not my name
That's not my name
That's not my name

Are you calling me darling?
Are you calling me bird?
Are you calling me darling?
Are you calling me bird?

ResearchBlogging.orgWilliams KN, Herman R, Gajewski B, & Wilson K (2009). Elderspeak communication: impact on dementia care. American journal of Alzheimer's disease and other dementias, 24 (1), 11-20 PMID: 18591210

Monday, September 28, 2009 by Christian Sinclair · 0

Monday, September 21, 2009

Gallery: "Restless"

Having had many talks with families recently about the end of life phenomenon of terminal delirium or terminal restlessness, I wondered how this concept had been depicted visually in art. As with other gallery themes we've done on pain, the last breath and afterlife, I've scoured the Internet in search of interesting art.

This first piece is a collage, Copyright 2008 Catherine King, entitled "Restless II". What I like about this piece is the subject matter of hands. So often in terminal restlessness it is the hands that are reaching and picking and pulling off sheets.




On that note of pulling off sheets, take a look at this next painting by Doug Strickland entitled "Restless". What a great visual of the way sheets look after someone with restlessness has tried in vane to rest.




In the digital art/photography world is this piece by Luis Iga entitled "Restless". There is a face and some hands, but also the distinct impression of movement and disorientation. The distortion present again reminds me of that confusion and even hallucinations that accompany terminal delirium.













I will always try to find a sculpture as a part of these themed gallery posts. I did come across a sculptor by the name Lubomir Tomaszewski. His work often is inspired by nature and he even will incorporate rock and wood. I found this one labeled "Restless Spirit" which certainly depicts the movement associated with being restless.

It is always difficult to express a subjective experience visually.
Although all these works are entitled "Restless" adding in the idea of terminal restlessness would add another layer to the the visual experience. I couldn't, however, find any art work with the title "Terminal Restlessness"...perhaps one of our readers could be the first!

Monday, September 21, 2009 by Amy Clarkson · 2

Monday, September 14, 2009

What's So Hot about Immortality?

There is a vampire craze sweeping the nation. Can you think of a fictional monster that has been represented more in television, movies and books than the vampire? This isn't a new thing. From Dracula to Edward, vampires have been popular fiction for some time. It seems that new series are popping up all the time. The vampire is more and more becoming an icon of pop culture.

Before you think I'm being critical of this trend, here's my confession. I admit to watching True Blood. And perhaps I've read the books it is based on. I might also have read a little of Twilight...and the three other books of the series. I may have taken a day off work to see the Twilight movie the day it came out. It's a sickness, I know. I'm not the only one who has it. What is it that we see in these fictional beings? I mean, let's be honest, not exactly the most original stories out there. Mysterious, tormented vampire boy meets human girl. A difficult relationship ensues. That describes most of them.

There are a lot of different aspects to vampire lore that the media explores. Do they melt in the sunlight or just sparkle? Holy water? Crosses? Wooden stakes? There is a lot of variations out there. But one thing all the vampires do have in common is immortality. Is this the draw?

In a time of plastic surgery and anti-aging creams, it's not that surprising that we find the forever young and beautiful an interesting concept. In a society that often fears death, living forever seems alluring. This immortality is often depicted as a trade off for ones soul and bought at the expense of other's lives (drinking blood and all that). (I wonder how many people would trade their souls (or humanity, if you will) to be forever young and beautiful?)

I think what brought up this post now was a recent pondering of what the draw was for me. I am around death all day long. I wouldn't say I fear death (not as long as there is a good palliative care team around to adequately control my symptoms) or growing older. I never came up with a good philosophical answer. Probably just the romance and mystery paired with sexy actors, like everyone else. I tend to over think things.

Monday, September 14, 2009 by Amber Wollesen, MD · 0

Monday, September 7, 2009

Funeral Food

Bringing food to neighbors or friends after a death is a custom still seen as a part of our grieving practices. It may have started with the ancient rituals of bringing food for the deceased. In Egyptian history it was expected that the dead were given bread, beer, birds and beef. Even now, in Tibet, at all the Buddhist monasteries you will find piles of food gifts for the former Lamas.

Or maybe the practice stems from the long distances people used to travel to attend funerals. Weary and hungry, food became abundant. One thing is certain, this practice has been a part of wakes for centuries.

Michael Lee West author of "Consuming Passions: A Food-Obsessed Life" writes, "When you bring food to a neighbor or friend, you are wisely letting the food fill in the gaps. Sometimes we say all the wrong things, but food knows all languages"

The cultural and regional differences abound for what people typically bring. Fried chicken in the South and Jello salad's in the North. There are even names associated with foods like funeral beans, funeral potatoes and funeral pie.

Wanting to be culturally sensitive? Try a book entitled "Death Warmed Over: Funeral Food, Rituals and Customs from Around the World". This collection of 75 recipes by Lisa Rogak explores different funeral rituals of over a 100 ethnic groups.

Looking for some music on the subject? Kate Campbell actually wrote a folk song about funeral food. It's on her 2007 release "Sing Me Out". The lyrics are below with a link to a YouTube video of a live performance. I must say it's a very catchy song. The actual song starts about a minute and 34 seconds in, if you want to skip the talking... and as always you can go to the main pallimed site if the link doesn't show up.

Aunt Fidelia brought the rolls
With her green bean casserole
The widow Smith down the street
Dropped by a bowl of butter beans
Plastic cups and silverware
Lime green tupperware everywhere
Pass the chicken pass the pie
We sure eat good when someone dies

Funeral food,
It's so good
for the soul
Funeral food

Fills you up down to your toes
Funeral food, Funeral food

There sits mean ole Uncle Bob
Gnawing on a corn on the cob
And who's that walking through the door
I don't think I've ever seen him before
Isn't it a shame she passed away
She made the best chocolate cake
Let's hit the line a second time
We sure eat good when someone dies

Everybody's here for the feast
But come next week where will they be


Monday, September 7, 2009 by Amy Clarkson · 2