Monday, June 28, 2010

Scott Joplin "Bethena" (1905)

Thanks to Phyllis Lee for alerting me to this!

Scott Joplin is known as "The King of Ragtime", with such famous pieces as Maple Leaf Rag and The Entertainer. Born near Texarkana, Texas in 1867/68, Scott Joplin began playing the piano at age 7, at the homes where his mother cleaned and did laundry.

Ragtime was popular between 1897 and 1918, ironically paralleling Joplin's career. In fact it was the publication of Maple Leaf Rag in 1899 spurred the popular spread of ragtime.

Early in his career, Joplin lived in Sedalia, Missouri. He married Belle Hayden in 1899, the marriage lasting only a few years. Although they had one daughter, she died only a few months after birth.

It was on a trip back to Sedalia, traveling through Arkansas, that he met Freddie Alexander, falling instantly in love. He wrote the piece "The Chrysanthemum"(1904) for her, which many regard as one of his most beautiful pieces. Listen to a bit of this upbeat ragtime song, since we'll contrast it with another piece at the end.

The two were married in June 1904 in Little Rock, Arkansas and took a train back to Sedalia, stopping a few days at a time to play concerts. It took a whole month to travel home and upon reaching Sedalia, Freddie was feverish. What seemed to be the flu, slowly turned to pneumonia and in September 1904, Freddie died. Only married 10 short weeks, Joplin was devastated. He left Sedalia for good after her funeral.

In his grief, Joplin wrote "Bethena"(1905). Experts believe that this was in honor of Freddie, and quite the contrast from "The Chrysanthemum" written when he fell in love. On the original publication there is a picture of a woman, which some have even speculated is a picture of Freddie.

I think if you listen to this, you'll hear the grief but also a type of endearment. Ragtime in its nature is not sad or depressing. The ability for Joplin to take such an upbeat genre and still convey sorrow is truly remarkable. I'd heard this piece before, not knowing the background; Context, once again, is everything.

Scott Joplin developed complications from tertiary syphilis in1916, and required admission to Manhattan State Hospital in January 1917 due to a "decent into madness". He died there April 1, 1917.

Monday, June 28, 2010 by Amy Clarkson · 1

Monday, June 21, 2010


I first watched this movie at a slumber party when I was in my early teenage years. It was long before I ever got into medicine and even longer before I even knew what palliative care was. I haven't seen or thought of this movie in awhile. So when I pulled it out and watched it again recently my first thought was, wow, what crazy 1990's hair. My second thought was, this is not nearly as scary as it was when I was 13. My third thought was how interesting this movie is from a palliative care perspective.

Flatliners was released in 1990 with the tagline "Some lines shouldn't be crossed" (Flatliners. Get it?). A group of 5 medical students are trying to answer that truly age old question (not to be cliche), what happens after death?

Nelson, played by Kiefer Sutherland, is the ringleader and starts the movie off with the line "Today is a good day to die". When asked why Nelson would do this he responds, "...To see if there is anything out there beyond death. Philosophy failed. Religion failed. Now it's up to the physical sciences. I think mankind deserves to know." They go about this by inducing clinical death for one to several minutes followed by a quick resuscitation by their colleagues. At first things go well and they feel very reassured that there is something out there.

The movie is categorized as a Thriller. The trouble starts when the students who have experienced near death begin seeing physical manifestations of their pasts while they're awake. "Somehow we've brought our sins back physically. And they're pissed." Coming to terms with their pasts (and getting beaten up a bit by them) seems the price they have to pay for the knowledge they want.

It's interesting to put this movie into the context of the times . In a 1990 review of the film, Rita Kempley of the Washington Post stated, "Movies about dying, grief and life after death are cropping up like corn in the Field of Dreams as a response to on-screen violence, a reaction to AIDS, a desire for something beyond materialism." Is she saying this is backlash from the '80s? It would be interesting to know if that were really true. Were there really more movies about dying at that time? And for those reasons? Or maybe its just like why there are so many vampire movies, books, television series coming out now: it just cycles through.

Some critics felt that Flatliners really pulled the punch when addressing life after death. It doesn't really answer the question of what is out there, the question that the medical students risked so much to find out. Others felt we are meant to believe that after death is a purgatory, a place to atone for one's sins. I tend to think that a campy '90s thriller probably isn't the best venue for such a debate.

Interesting movie trivia: Writer Peter Filardi was apparently inspired by the near death experience a friend had while on the operating table.

Monday, June 21, 2010 by Amber Wollesen, MD · 0

Sunday, June 13, 2010

"Do It Again" by Nada Surf

One of my favorite bands, Nada Surf, recently came out with a new album of covers and to whet my appetite before I could get my hands on some digital mp3's I went back to some of their old albums and listened to them all the way through.  One song kept sticking out to me because a few lines really resonated with a convergence of work/family overload I recently experienced.  But as I dug out from that overload I started to see the song differently and through the eyes of some of the family members of patients who were dying.

Here is a video of Nada Surf performing "Do It Again" live in a record store (there is no official video and check out the cool drum box the drummer is using, it is called a cajon and is very fun to play!):

The main lyric that first caught my attention was near the end of the song when the energy picks up from the mid tempo relaxed arrangement used for most of the song.  The lyric is:

Maybe this weight was a gift / Like I had to see what I could lift
I spend all my energy / Walking upright
This resonated deeply with me in my own experience as I noted above, but again placing that lyric in the mindset of our patients' families makes the other lyrics start to come alive. 

The first verse perfectly describes a common situation I have seen where a family member or friend of a dying patient is attentive and wanting to help but doesn't have a good framework of what would help best for someone who is dying.  And during that time, they tell me they often feel exhausted, bored, anxious, on alert, and ineffective.  
Well I'd snap to attention / If I thought that you knew the way
I'd open my mouth / If I had something smart to say /
I bought a stack of books / I didn't read a thing
It's like I'm sitting here / Waiting for birds to sing
The last line of the first verse echoes many other references to birds and death as Amy has pointed out in a blog post on 'Bird hits the window.' 

The azalea reference in the second verse was one I was not familiar with until I started researching this song in depth for this post.  Some of the meanings for Azalea flowers include:
  • temperance
  • passion
  • womanhood (China)
  • take care of yourself for me
  • fragility
Placing the last two possible meanings with the other clues in the lyrics indicate someone caring for a sick person:
You're lying down / And the moon is sideways
And I like the masking noise quiet / Of your breathing nearby
Interestingly the name of the album is 'The Weight is a Gift.'  Which also echoes a sentiment I hear from patients, families and staff, which is that 'God will not give us more (weight) than one can handle.'  This saying may be rooted in I Corinthians 10:13:
No temptation has seized you except what is common to man. And God is faithful; he will not let you be tempted beyond what you can bear. But when you are tempted, he will also provide a way out so that you can stand up under it.
While it mentions temptations and not more specifically trials, you could see the basic sentiment exists that has launched many self-help books.  People endure many different hardships throughout their life and eventually most get through it but they have changed, some for good and some for worse.  How one emerges from the tough times is up to the individual and their support system, but it may sometimes turn out that 'the weight was a gift.'  Just don't tell that too them in the middle of their journey.  That is only something that should be self-discovered.

Lyrics: (2005 Barsuk Records - The Weight is a Gift)
Well I'd snap to attention / If I thought that you knew the way
I'd open my mouth / If I had something smart to say
I bought a stack of books / I didn't read a thing
It's like I'm sitting here / Waiting for birds to sing

Let's do it again
Come on let's do it again
Please let's do it again

The hum of the clock / Is a far-away place
The azalea air holding your face / You're lying down
And the moon is sideways / (From the hot to the cold It never gets old)

I spend all my energy / Staying upright
And I like the masking noise quiet / Of your breathing nearby

I want you lazy science / I want some peace
Are you the future? / Show me the keys

When I accelerate / I remember why it's good to be alive / Like a twenty-five cent game
Maybe this weight was a gift / Like I had to see what I could lift
I spend all my energy / Walking upright

Sunday, June 13, 2010 by Christian Sinclair · 9

Monday, June 7, 2010

Gallery: "Dysphoria"

After a great suggestion from a reader, in these gallery series, I will now let the art speak for itself. A poem related to the gallery topic will fill the space. All artwork is copyrighted to each individual artist, and credited in order at the end of the post.

If you are new to pallimed arts, there is an ongoing series in which I search for artwork titled after a common palliative care theme. Links to other issues are at the bottom.

The definition of dysphoria: An emotional state characterized by anxiety, depression or unease.

This poem is from "Dysphoria Quartet. Subtitle, Why God invented Lithium" by Anitra L. Freeman.

Body Language

I am clenched tight to ram my way through
fog in front of me
the skin of my arm jumps with the need
to flood out a thousand words
my fingers are frozen silent
my legs long to run
my feet are still
my mind races in place
and I never see the scenery

The next poem is by Anna Williams


I sand smooth
the rough
edges of my words,
over and
over again.

Running fingers
over them, only to
find flesh still snags.

I push harder
down upon them,
until blood
has coated ink

Turning red
the ebony lines
of dissatisfaction.

they are not refined,
not smooth
to the minds

A finer grade
of sandpaper
is needed,

will do nothing.

Artwork displayed:
Melanie A. Feerst (1999) "dysphoria(potatoes)"
Edwin Stolk (2007) "dysphoria"
Ron Blumberg (1948) "dysphoria"

Past gallery posts: "Last Breath", "Pain", "Afterlife", "Restless","Stillness" and "Grief"

Monday, June 7, 2010 by Amy Clarkson · 0