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Since late June, something a little unusual has been up on the wall of a local bar called Alibi in San Diego.

Photo by Holly Yang, Sept. 21, 2012 ~7:45 am

It something called the Before I Die project, and it is the second time this dynamic public bucketlist it has come to San Diego. The installations last for varying periods of time, and people walking by write on them with chalk. After it is full, the board is wiped clean and it starts over again. Funny, ambitious, heartbreaking, profound, crass, inspirational and huh? are all words to describe what I have read on the board. It isn't far from my work, so I'll check it out and add photos periodically. This is a global project started by Candy Chang in New Orleans after the loss of a loved one, but the work has traveled far and wide. There are now Before I Die walls in multiple countries and many in the U.S. If there isn't one near you, you can purchase a starter kit on their website, or just make one yourself. It has gotten a lot of press in San Diego and nationally (Atlantic, Salon, NBC News, and even Oprah). Candy is a TED Senior Fellow and has received numerous awards, and a "Before I Die" book is in the works. You can follow along on Twitter too (@BeforeIdiewall). Just thought I'd share one of the coolest crowdsourcing/community art projects I've seen.

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Textile art is not something I see a lot of, so had to share this.

Jacqui Parkinson, also known as Jacqui Frost, is a textile artist who lives in Devon, England. In 2007 she lost her first husband, Rev. Rob Frost to cancer. In the midst of her isolating grief, she felt the urge to do something both artistically and physically. She took up running and during those long runs had the time to start processing ideas to link her grief experience into art.

She initially used vintage handkerchiefs, stitching words and ideas onto it like a canvas. The colors were mostly blacks, grays, and reds and when finished the handkerchiefs were stretched and then fastened to metal frames and exhibited in Exeter Cathedral in Devon.

The response was so positive, many people identifying with the images and words, that photographs of the textiles were taken and a book entitled "Good Grief?" was published by Threads Publishing. The book includes the photographs of the textiles, but also a textile figure, lino prints and words all working together to communicate the pain of Jacqui's personal journey.

The words that match the textile art are more like poems, for example a detail photograph of a textile piece with a clock bordered by the words 'time does not heal' and in red large print "presentfuture" that is stitched below has an adjacent page with the written words, "Thoughts of ageing alone into the years ahead so strange/ unbelievable /a borderless page with no words/ a stiff canvas with no paint/ a stretch of fabric with no stitch/ so how to begin the years ahead/ alone."

In the past we've mentioned other artists who use a medium reflective of grief itself, like Motoi Yamamoto who uses salt, representing tears of grief and Julie Williams who photographs water, again reflective of tears.  Here is yet another artist, using handkerchiefs which themselves symbolize grief.

To see sample pages of Jacqui's book follow this link.  Photographs of the textiles displayed in the cathedral exhibition can be seen here.

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Araya Rasdjarmrearnsook is an art teacher and one of Thailand's' foremost female artists.  She had her first solo show in New York last month with a video exhibition showing historic art history pieces from western culture to rural and religious people in Thailand in an exhibit titled "Two Planets/ Village and Elsewhere"

However, for me, it is her previous work I wanted to touch on for this post.  Araya first made headlines in the US with an group exhibit in 1996. More controversy came in late 1990's and early 2000's when her exhibits began incorporating corpses.

In works such as "The Class II" Araya is seen on video lecturing a classroom of corpses. The topic for this lifeless class? Death.  You'll see her ask the dead bodies, "Did you die in autumn?"  You can see this video on YouTube here. I was struck by the seriousness of her tone as she interacts with the class on a topic they surely must know.




 In "Conversations I, II and III" she meanders through a room of corpses humming.  In "This is Our Creations" she actually lies down next to the bodies and is heard saying, "I came here to know you, lying here motionless. Once my father sent me a postcard from very far away. Its sentence: only a still pond can reflect the starts."

My first thought was, what experiences has this woman had with death that has led her to express herself in this way? I had to do much searching to find the answer, but in an interview in 2005 with Oliver Benjamin, she told her story.

Her father was a physician, and at the age of 3, as her mother labored in childbirth with her father as physician, her mother died.  A week later the young sister born also died. In the following 3 years she lost a step sister aged 18 months, her grandmother and great grandmother. As she said in her interview, "From this reason, I guess, I have been interested in examining death"

When you look back, even to her etching "The Dream of Mother" in 1990,  you can see the processing of her life events.

Sometime in there, her father then died of cancer. In response, new pieces such as "The Dinner with Cancer I" and "Th Dinner with Cancer II" were done.

Araya has used art as a way to deal with death. Specifically in her words, "I choose art as process of thought for the meaning of death".  Araya spoke of that meaning in an interview with Brian Curtin in 2007 saying "In reality, life and death should not be understood as opposites. People deal with death by trying to hide it. They hide death behind ritual or hope to prevent it with medicine. I want people to have more imagination and confront reality!"

In the interview with Oliver Benjamin in 2005 she concluded talking about the topic with, "I'm tired of death! May be too much."  That's the goal isn't it? To work with our patients and families to process through it? For now the artist does seem done with death, as her art has moved on to exploration of different ideas.

Whether you are repelled or connected to Araya's work with death, it's what I love about art - a vehicle to express ideas which then stimulate the viewers mind.

To see works listed up until 2002 visit this site. For those 2002 and on visit here.


Oliver Benjamin interview published in Citylife magazine Oct. 2005
Brian Curtin interview published in Art Signal Oct. 2007
Works in order of appearance "Conversation I" (2005),  "The Dream of Mother" (1990) and "The Dinner with Cancer I" (1993)

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In 2005, artist Christina Symanski fractured her neck diving into a swimming pool. She was pulled out by her boyfriend but has been a quadriplegic since that time.

Symanski continued her art, using her mouth and an iPad. More of her art can be seen here. The effect her injury had on her art is obvious.

She wrote about her experience in her blog, Life; Paralyzed. She also wrote a book about her experience. In April 2011(not posted until December), Symanski wrote a blog post entitled Quality vs. Quantity. In that post, she writes about what quality of life means to her and discusses the importance of having an advanced directive, how she wished she had had one prior to her accident.

"Because I didn't think things through before hand, or have a living will, I created a very difficult life for myself (unintentionally), by having to live within the confines of paralysis. Living with paralysis (at my level-C4/C5 complete) means I have very few options. In order to stay alive, I HAVE to take medications, accept help from others (for EVERYTHING), and tolerate unbearable (to me) treatments, like having an indwelling catheter, and bowel program. I HAVE to do all of those things, just to survive. That doesn't include coping with the loss of freedom, lack of privacy, loss of sensation, loss of dreams, aspirations and having to deal with constant compromise. It also doesn't account for the physical pain, discomfort, and sickness, that comes along with living with paralysis, and ultimately autonomic dysreflexia.

I have come to a point in my own life, where I'm struggling with the question "is this life worth living for ME, or am I just prolonging my own suffering?"

It is a very interesting and well thought out post about her life and the decisions she was making.

Christina Symanski's life made headlines when she died on December 1, 2011 after she decided to stop eating in order to end her suffering.

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I don't really mean to be on a skeleton kick... but was exploring this very old work done by Hans Holbein the Younger in the 1500's, and thought I'd share it.

Holbein, a German artist, was really known in the 16th century as one of the great portraitists of his time. Many of his portraits, such as of Sir Thomas More and Henry VIII are housed in the great museums of the world.

However, at least initially in his career, much of his money was made doing religious commissions. These works were often done as woodcuts for easy reproducible printing. The work I found interesting was his "The Dance of Death" published in 1538.

Experts agree the engravings were done 12 years earlier in 1526, which was very close to the reformation and peasants' rebellions of 1524.  These events are reflected in the thematic elements of justice in his work, as well as the top down approach of death's activities.  The message is very clear; summed up in the words from the book, "De la Necessite de la Mort qui ne laisse riens estre pardurable" translated "The necessity of death leaves nothing and is eternal". Another way of saying this is, no one will escape death.

The book consists of a series of 41 woodcuts depicting death as a skeleton robbing people of life in the midst of every day activities.  The first 4 woodcuts are regarding Adam and Eve, as if to provide the foundation of death itself. Then symbolically all people are included, starting from the most powerful (the Pope) to the lowliest (a child). Accompanying each etching are Latin quotes based on scripture.


I enjoyed scrolling through the images as they provide a glimpse of societal structure at the time.  There are duchesses, emperors, attorneys, doctors, senators, clergy, etc. Holbein is known for his symbolism as well as sarcasm, so many of the pictures depict this. For instance the nun is caught with a lover, as death extinguishes the religious candle. The doctor is depicted with death having brought him a dying patient, as if to mock the doctor's attempts at staving off death.

Besides this rich body of work, there was a version of this dance of death done as an alphabet by Holbein in 1526 but not published until 1538.  The same characters from the book are depicted with letters of the alphabet. Wouldn't this be a nice children's learning tool?

Take some time to scroll through the work in entirety on the Project Gutenberg site.  This other web site has the alphabet and contrasts each letter to the referenced Dance of Death book image.

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Art collector Richard Harris, while visiting an art fair in 2001 in the Netherlands about the inevitability of death, had an epiphany of sorts. Why not start collecting art that deals with death as its theme? More than a decade later Harris now owns over 1500 pieces of art and artifacts that deal with the subject of death.  I think Harris should be an honorary pallimed member, since our mission has been to explore all things art and humanities, related to the subject of death.

Harris's art works are really a Memento Mori or "remember you will die" collection. The representation of death is that of a skeleton, rather than a depiction of the process of dying itself. The symbolism still invites the viewer to examine death and contemplate mortality, while still being somewhat removed.  Harris, age 74, told an interviewer that the collection also provides him with inspiration, he said that, "before I do die, before death does come to me...I should put together something of an overall view of death from my perspective."

The collection spans over 6,000 years in time, with historical as well as contemporary works. There are artifacts and photographs and cultural materials all exploring death. Starting January 28 and running through July 8 some of Harris's massive collection will be displayed at the Chicago Cultural Center in an exhibit entitled, "Morbid Curiosity: The Richard Harris Collection"

To read more about the exhibit and learn more about Richard Harris visit the Chicago Cultural Center.  To see a few more images of his collection go here.

 All images are part of the Richard Harris Collection. 

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I am often drawn to artists who have experienced death and then use their work to process the loss.  Julie Williams is just such a person.  She is an Australian photo-artist, who in 2004 lost her partner.  In an effort to work through her grief, Williams began to visit familiar places in nature.  One spot she kept returning to, was a waterhole in the Hartley Valley.  It seemed that as a drought back in 2004 the valley ended, and the River Lett began to flow again, her grief also moved with it.  She picked up her camera and began to photograph the water, the light, and the movement.

                                                                   
Each time she returned over the next weeks, months and then years, the waterhole was different. A metaphor for her journey, that grief seems to change moment by moment, just as the water flow changed.  The subject matter itself, being water, is somewhat symbolic of grief - as we think of tears being shed, of streams down someone's cheeks.  Williams herself has pointed out that even the images, elusive and inexplicable, can be like grief itself. 

These works were on display this fall, entitled "When first knew this place" at the Western Plains Cultural Centre in Dubbo, NSW, Australia.  Williams says of the title, "The grief pulled me up, the water drew me in and that was when I began to really see. It was when first I knew this place."   When asked about her upcoming plans, Williams told an interviewer that she wasn't done with the waterhole yet, that it continues to keep drawing her back.

Personally, I enjoy seeing images of every day surroundings,  portrayed in such a way that they appear magical, moving, or unrecognizable.  These images then to me, are aesthetic and mean even more in the context of grief.

To see a complete collection of the artists works, visit her page here.
The above images are "Untitled # 3" and "Untitled # 21", both copyright 2011 Julie Williams

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Happy Halloween everyone!  Traditionally here at Pallimed Arts we've used the Halloween holiday to focus on skeleton art.  In years past we've looked at the incredible drawings of Laurie Lipton and the breathtaking work of Kris Kulski which incorporates skeletons.


Even more broad, this year I decided to just find some great pumpkin art.  Using skeleton's as a theme, this is a compilation of pumpkin skeleton carvings.  If you've procrastinated this year and need some ideas, perhaps one of these will interest you.

In an effort to provide something educational, does everyone know the history of carving pumpkins?


This tradition stems from folklore told in Ireland, Scotland and England. The tale goes that a man by the name of "Stingy Jack" tricked the Devil into promising not to take his soul when he died. The nature of these tricks varies from region to region. In one story, Jack carved a cross in a tree the devil had climbed, trapping him until the promise was made. Jack ultimately dies and because of his orneriness is not allowed into Heaven.  The devil holds his bargain as well, not allowing Jack into Hell.  He's left to wander the earth as a soul. Jack begs for a light as he wanders, and the Devil kindly tosses him an eternal ember from Hell.  Jack then carves a lantern out of a turnip for the light.  He henceforth becomes known as Jack of the Lantern... or Jack -O-Lantern. The lantern became a part of rural superstition, as carved faces in the lantern were meant to ward off evil spirits as one walked in the dark. The lanterns were then placed on porches to guard the house overnight.  On the left is an example of a traditional carved turnip lantern.
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As people from the British Isles immigrated to the US, their autumn traditions continued, however instead of turnips, they used the more abundant and larger pumpkins. As time went by the carved pumpkin became associated with the Halloween holiday.  Now, as the pictures suggest, this creative decor has evolved into elaborate creations!

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There are multiple ways an artist may choose to deal with personal grief.  Some allow the theme of their work to capture their feelings. Artist Motoi Yamamoto has taken his grief work one step further by choosing a medium that itself is symbolic of death.

Yamamoto was in art school in 1996 when his 24 year old sister died, just two years after her diagnosis of brain cancer. Immediately he began to use art as a way to deal with his grief. His exploration led him to the medium of salt, which is a part of the death ritual in Japan. At the end of funerals, mourners are handed salt to sprinkle on themselves as a way to ward of evil spirits.

Not only is salt a funeral ritual, it is also allows his masterpieces to be impermanent. When the exhibit is finished, the piece is destroyed, and visitors are encouraged to take some salt and place it back in the sea. Symbolic, I think, of human life; a masterpiece that must come to an end, and the body returned back to the elements from which it was formed.

To create the works, Yamamoto uses a simple plastic bottle, often taking 50 hours or more to complete. The amount of salt used is expansive, in the range of 2000 pounds and up.

When you look at his installations, it is obvious that the process is tedious and time consuming. This too is intentional, as Yamamoto said in an interview with the Japan Times, "I draw with a wish that, through each line, I am led to a memory of my sister... That is always at the bottom of my work. Each cell-like part, to me, is a memory of her that I call up"

I find the work breathtaking in both the intricacy and the overall finished project.

To see a video of Yamamoto at work see below or follow this link.

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I came across this inspiring story of artist Casey Shannon.  Casey is an artist that lives in Carmel Valley, California. At the age of 36, already a mother, wife and high school art teacher, Casey had a massive left hemispheric stroke.  The stroke was debilitating, leaving her aphasic, wheel chair bound and with no use of the right side and little use of her left side.

She writes about the loss of identity and longing for her old self on her website here.  As a part of her recovery she learned about Wabi Sabi which is the Japanese tradition of celebrating the beauty in what's flawed or worn.  She also turned to art, writing that, "as soon as I could sit for more than just a minute in my wheelchair, I began practicing holding a pencil in my left hand and started doodling and scribbling and such. I intuitively knew that, for me, I needed to get drawing again. And fast, if I was going to save myself"

She ended up drawing 5 pictures a day, having incorporated it into her daily home rehab program. The act of creative expression helped to improve her self-worth and self-esteem.

It's been 19 years since her stroke, and Casey has regained her speech and the ability to walk, though has lost the use of her dominant right arm.  She continues to paint, teach and inspire other stroke survivors with her story.

Casey graciously includes art work on her website from before the stroke, during recovery and current pieces. The first piece above is a sketch done in the year or two prior to her stroke. Her drawings from her recovery period, are taken from about 4 years post stroke. At that point in her process she combined inspirational sayings with her drawings, like the picture to the right.

As she has recovered,  her style completely changed, not only because she now uses her left hand, but because she now does contemporary sumi-e paintings. Sumi-e painting incorporates meditation before painting. As Casey describes on her artist's page, "I concentrate on trying to capture spirit as the ink is transferred to the paper with the stroke of the brush....If your intention is correct, the object in the picture seems to 'breath and take on life'"

I find Casey's story a good reminder of the power art can play with our patients dealing with debilitating disease.

For more of Casey's paintings check out her galleries here.

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Artist Ray Johnson is mainly regarded as a correspondence artist, having founded something called the The New York Correspondence School, which basically is an ever changing group of people who send each other art work through the mail.

During 1963-65 Johnson produced 12 unbound pages of mail art for something called "A Book About Death". He sent these one page essays about death to other artists in the correspondence school. Johnson committed suicide in 1995 and in an effort to commemorate him the art project "A Book About Death" was started.
In 2009 artist Mathew Rose, taking inspiration from Johnson's death themed art pages, organized a massive exhibition of similar mail art.  The call went out to artists all across the world to submit postcards on the theme "A Book About Death".  The artists were to create 500 postcard copies of their pieces and mail them to the gallery of the exhibition.  During the show, which was held in September 2009, visitors could then collect postcards from the hundreds of artists and take the postcards home to create their own unique book about death.

Since the original ABAD show, there have no been 23 installments, as the project continues to move around the world with new additions continually.  Each ABAD exhibit is slightly different, some like the recent exhibit in May at the Willo North Gallery in Phoenix, Arizona called for postcards with a memento accompanying it.


The most recent ABAD project is open now, July 31- Sept 2 at the Second Avenue Firehouse Gallery in Long Island.  This unique exhibit is entitled "A Book About Death: The Ties That Bind".  The curator of the event LuAnn T. Palazzo asked artists to submit larger works on pages, one copy to be displayed on the wall for the exhibit and the other to be bound in a book on display during the show.


I've enjoyed browsing the images for the different shows, a few which are included here.  The interpretations on death are as diverse as they come.  Some of the pieces are accompanied by poems, like this piece below with image on one side, and the poem on the back of the post card.


I wonder if there would be a place to do some collage work as a self care session for hospice and palliative care in this way, or perhaps a work shop at a national convention resulting in a Hospice and Palliative Medicine edition to A Book About Death?

Art work credits from top to bottom:
Steve Dalachinsky
Laura Sharp Wilson
"The Call" Sophia Oldsman
"Sustenance" Kim Triedman

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British graphic designer Ross Mackintosh lost his father in 2009 to prostate cancer.  Like many artists before him, he turned to art to process the events. In fact, he told Deborah Vankin in an interview for the Los Angeles Times, "I created the comic for myself, as a way of removing pictures and phrases from the maelstrom in my head. The secondary purpose was a subconscious need to express to my mom and brothers that the awful events didn't just happen quietly"

The medium he chose, however, was not his usual computer based work, but that of cartoon. Many of his memories and experiences were so visual that he decided to draw them out. The outcome is a stunning and beautiful tribute to Mackintosh's father. The graphic novel, published by Com.x in April is entitled "Seeds".

I was drawn immediately to the images;their minimalist nature serves the heavy topic well. The reader journeys from time of diagnosis to time of funeral. Interspersed in the narrative of the events are deeper concepts such as genetics, relationships and purpose.  Also accompanying the story are the very real moments of humor and tragedy. It is this combination that allows the reader to connect and perhaps even find their own personal stories in this work.

Mackintosh's father spent time in hospice and there is a great conversation where the physician communicates prognosis by saying "When people in your father's position deteriorate monthly, they usually have months to live....When they deteriorate weekly, they usually have weeks to live.... Your father has been deteriorating daily..."

The medium of cartoon really forces the themes and concepts to be whittled down to absolutes... gone is the ability to hide in verbose prose or get lost in mundane details. This really makes this graphic novel quite raw, and most of the reviewers I read mentioned reading with lumps in their throats, as the images and few words struck familiar nerves of mortality and loss.

This certainly is one that should be considered for our personal and/or palliative medicine libraries and it may very well attract unsuspecting readers going through the experience of loss.

All images are Copyright Ross Macintosh.

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According to the National Funeral Directors Association, the cremation rate in the United States in 2009 was 36.86%, that's up from 25.04% in 1999.  The NFDA also predicts that the cremation rate will be just shy of 59% in 2025! With the rising trend in cremations, it's about time we did a post on urns.  We already know that we can be creative, as explored in our post on custom coffins, so it should be no surprise that custom urns also exist.

The urn itself is simply a vessel or vase without handles. The urn was used in ancient Greek and Roman times for oils, as well as cremation ashes.

Today after cremation, the options are quite diverse on what is done with the ashes. Many people scatter ashes, so have no need for an urn.  Other people use the urn for the ashes and have the entire thing buried in a cemetery plot or placed above ground in the cemetery columbarium (a specific place within a mausoleum for urns). Just like eco-friendly coffins, they also make bio-degradable urns. Another choice is to bring the urn with the ashes home, keeping the departed's remains with you at all times.

When an urn is used, there really is no industry standard. The typical size for an individual may be to hold 170-350 cubic inches, whereas the popular couple urns hold 400-500 cubic inches of ashes. Materials used range from paper, glass and wood, all the way to metals, ceramics and marble.  And if you thought shape mattered, this too is up for negotiation. Urns can look traditional and vase like, or look like an item. I even saw examples for photo frame urns and music box urns.

Looking around online I found several types of urn dealers.  First there is the mega market dealers.  These urns offered on these sites can be very unique, like these cowboy boot urns, and it's true that these mega market dealers have a lot of inventory, but you can also find these same urns on multiple sites. Therefore, the uniqueness is more in design and not truly a one of a kind urn. The urn's from these large scale dealer's are some of the most economical.


Next are the hand made artisan urns. These urns are made individually by artists. Sybil Sage, for instance does mosaic urns, embedded with personal items such as business cards and photos.

Portrait urns like the kind done by artist Ruby Lindell, are hand painted ceramic urns such this example on the right.

Then, of course, there are the eco-friendly urns. Traditionally eco-friendly urns are made of paper. Though I did find sand  urns meant to place in water.  There is also company known as the "Great Burial Reef" which designs an urn made of natural concrete. The idea is that the urn can be placed on the ocean floor and can foster marine life for future generations.

Unlike coffins, urn's offer an extremely wide variety of creative options, allowing a very personalized urn if desired. What I find interesting is that some of the urns look so much like traditional home decor, that the memorial could easily blend in, completely disguised to house guests.

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This post topic came to me thanks to my Google alerts (a way you can get email updates on your choice of topic). It's a great way to get updates on topics you are interested in without having to periodically Google them.

Fereydoun Ave, a modern Iranian artist recently displayed his newest works, entitled "Recent Works" at the Khak Gallery in Tehran. Ave's work before this had included collages that merge the figures of Iranian wrestlers with ancient reliefs of Persian kings and warriors. He had focused a lot on ancient masculine figures. So what does this have to do with palliative care, you may ask?

This show marks a departure from Ave's earlier work. This show illustrates his own personal history after surviving a long illness. I couldn't find exactly what his long illness was (the doctor in me sooo wanted to know). I only found that this work is meant to tell that story.

Ave's latest show includes 11 mixed media pieces and 7 sculptures. "Each of the mixed-media works begins with haphazard schemas and splashes of watercolor. The artist then prints familiar snapshots of daily life. Finally he over-paints them with new watercolor splashes." His sculptures have an archaeological feel to them.

I leave the interpretation of modern art up to the reader. Ave doesn't provide any explanation for each piece. His different pieces show flowers, a world map with superimposed flowers, a photo of a chair by a window with blinds, a chalice, and a family portrait. I would be interested to know what you think.

More of Ave's work can be seen here at the Khak Gallery website.