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The mellow surf folk of Jack Johnson can make you feel relaxed to the point where you listen to the lyrics and may miss the point completely. This happened to me with the song "Go On" from his most recent album "Sleep Between Static" released in early 2008. (Song from iMeem below is not the album version, YouTube Video is not the official video)



The song was on my iPod along with many other Jack Johnson tunes for my trip to Australia so when I picked up a Rolling Stone with Jack on the cover, I was surprised to read the story behind this song.

Jack and his family had cared for his wife's cousin Danny Riley, a 19 year old who died from a brain tumor in October of 2007. The album itself has a dedication "In Loving Memory to Danny Riley." In caring for him Jack found many parallels between caring for a dying loved one and raising his own children. "It's about learning how to let go of someone you love," he says, "watching them swim away."

As a father of toddlers, I could see so much how in raising them I am slowly having to let go, which parallels so much of what hospice tries to help teach families and patients as they face death and dying. After learning of the meaning behind this song, a young man I was caring for died. As the family was preparing for his funeral services, the songs dual meaning for parents losing their child seemed appropriate to suggest to them. They took the song and made a wonderful video tribute to him.

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Have you heard people talk about this? At the hospice place where I work, I sometimes hear a nurse, or even a family member say, "A bird hit the window this morning, I'm sure mom's getting ready to go soon." In fact, it's not unusual to have a day when several rooms have a constant barrage of tapping from birds flying into the glass.

I was surprised to see how entrenched this symbol of the bird is in our culture. In case it's a new idea for you let me explain:

"Bird flies at the window, Death knocks at the door" is a phrase that has been repeated by kids for centuries. The roots of this reach far back. Because of their ability to fly, birds have eternally been connected with the heavens/afterlife. Birds aren't just associated with death, but life as well, as in the common story that a Stork delivers new babies into this world.

There really is no culture exempt. In Egypt, China and Japan the Phoenix symbolizes rebirth, from ancient myths of the bird constantly being reborn. In Syria, Eagles are on tombs to lead the souls in the afterlife. In the Jewish and Christian culture, it is the dove that represents the soul. Both the Celts and Greeks believed the soul would reappear as a bird after death. There is an Islamic tradition that believes that dead souls remain as birds until judgment day, whereas the Hindu's use birds to symbolize the form the soul takes in between earthly lives.

With so many cultures viewing birds as the representation of human souls, you can guess when a bird suddenly acts strangely, we take notice. Before there were glass windows, the superstition was that if a bird flew into your house and perched on someone's chair, then a death would occur within that home in a year's time. Now, not too many birds make it inside, but all it takes is the unusual event of a bird trying to get in, hitting the glass pane, and then when an untimely death occurs the two events become connected.

Such was the case for Lucille Ball, who at the age of 3 recalled that a bird flew in her house and became trapped the day her father died. She was so convinced of this superstition that she refused to stay in hotels that had bird wallpaper or pictures of birds on the walls.

Some may wonder is one type of bird more ominous with this superstition? It seems there are several to worry about. In the Cherokee tradition it is a red bird that provides the connection with the deceased. The Red Bird Center provides the story behind this belief. The other birds to be leery of if they are trying to fly in your house are the sparrow, the robin and the raven.

Anyone with stories of their own?


References:
http://www.snopes.com/oldwives/bird.asp
http://www.mythencyclopedia.com/Be-Ca/Birds-in-Mythology.html

Pictures used: "Bird in Hand" Victor Schrager has an entire collection of these here
"Start to finish" from Two Dresses Studios here

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I remember when I was 4 or 5 years old going to the movie theatre with my family. I watched as Bambi ran toward the thicket away from the hunters and then turned around looking for his mother. My little 4 year old brain had no idea what was going on. I remember whispering to my mother in the theatre "What happened to Bambi's mommy?"



Does anyone else get teary eyed when they see this scene? Maybe I was just a slow child but I think there was a reason a four year old wouldn't get what happened in this scene. The death scene in Bambi is very subtle. They never come out and say, "Bambi's mother died" and they never show anything close to a death. How was young Bambi even to understand what happened? "Your mother can't be with you anymore." So, she had to go out of town? The response of my nephew (who was 5 at the time) was, "She's ok, right Mom. She's just hurt but she'll be ok." Denial.

Now compare that scene to this more contemporary Disney death scene.



Big difference. In The Lion King, nothing is subtle. You watch as Mufasa plunges to his death. In a totally heart wrenching scene you see the dead Mufasa as Simba tries to wake him up. Nothing left to the imagination. On a positive note, the grief response in The Lion King is much more appropriate. Poor Bambi gets just one tear then he has to turn around and walk away. You've had a whole 2 minutes to grieve, Bambi. Now it's time to move on.

This big shift in how death is dealt with in Disney films happened around the 1970's. Movies that were made before that (Bambi 1942) tended to have more implicit death scenes. After the 1970's, (The Lion King 1994) death scenes were more explicit, showing the actual death and/or the deceased. Maybe the thought was to shelter children from violence and death. Which approach is better?

In one study, Disney movies were taken at random and their death scenes analyzed. They found 23 death scenes in 10 movies. In these scenes, they looked at several different things including who died (antagonist vs protagonist), how the death was depicted (implicit vs explicit, permanent vs temporary), the emotional response, and the cause of the death (accidental, justified vs unjustified). While the study had relatively small numbers, they did find some interesting things. 39% of deaths lacked any emotional response. Although most of the deaths overall are portrayed as permanent, half of the protagonists that died come back in some way.

As the study points out, death in Disney movies is not all bad. The Lion King has been used as a tool to help teach children about death and grief. Movies can be used as a more comfortable way to bring up difficult discussions. But they could also send confusing messages to children about death and grief.

References: Cox M, et al. Death in Disney films: Implications for children’s understanding of death. Omega. 50(4). 2004-2005. 267-80.

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I enjoy taking pictures. Some might say too many pictures since I often have my small digital camera with me everywhere I go. But I was amazed to hear the story of Jamie Livingston who took 6697 Polaroid photos, one a day, from March 1979 to October 1997. Chris Higgins, a writer for the mental_floss blog discovered a website with all of these photos and started looking into the back story of Jamie. He had already deduced from the photos that he was a film maker, Mets fan and obviously an artist who made a photographic diary of his life.

When I look through these pictures and see a life laid out in singe frames through a Polaroid lens, I as myself lots of questions.

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I have great respect for poets. They have the ability to say beautifully, in few words, what many of us spend a lifetime trying to convey. There are two poets I want to mention in this post... two poets whose lives were intertwined.

Jane Kenyon was a student at the University of Michigan when she fell in love with her writing professor, Donald Hall. Though 19 years her senior, they married in 1972 and began a successful life together as poets. They spent the majority of their 23 year marriage on Donald Hall's family farm in New Hampshire.

In 1989 Donald was diagnosed with metastatic colon cancer. He underwent resection and chemotherapy and was given a 1 in 3 chance to survive another 5 years. It was utter tragedy then when Jane herself was diagnosed with Leukemia in 1994.

As she battled and lost a rugged 15 month fight with leukemia, she and Donald worked on "Otherwise: New and Selected Poems" published soon after her death. One of the few poems she wrote referencing her illness:

"The Sick Wife"
The sick wife stayed in the car/while he bought a few groceries./Not yet fifty,/she had learned what it's like /not to be able to button a button.

It was the middle of the day-/and so only mothers with small children/or retired couples/stepped through the muddy parking lot.

Dry cleaning swung and gleamed on hangers/in the cars of the prosperous./How easily they moved-/with such freedom,/even the old and relatively infirm.

The windows began to steam up./The cars on either side of her/pulled away so briskly that it made her sick at heart.

Another poem from the book is a reflection of a loss in Jane's life:

"What Came to Me"
I took the last/dusty piece of china/out of the barrel. /It was your gravy boat,/with a hard, brown/drop of gravy still/on the porcelain lip. /I grieved for you then as I never had before.

If you read through Jane's book first and then move on to the book Donald Hall compiled in the days and weeks before and then following his wife's death, you may find yourself grieving with him. His compilation of poems entitled "Without" are an exquisite look into the lives of this couple dealing with dying.

Here are 3 different poems by Donald Hall dealing with the medical world, faith, and saying goodbye.

First the physical struggle:
"As Dr. McDonald plunged/ the tube down her throat, her body thrashed/on the table. When she/ struggled to rise, the doctor's voice cajoled,/ "Jane, Jane," until/ blood-oxygen numbers dropped toward zero/ and her face went blue./ The young nurse slipped oxygen into Jane's/ nostrils and punched/ a square button. Eight doctors burst/ into the room, someone/ pounded Jane's chest, Dr. McDonald/ gave orders like/ a submarine captain among depth charges,/ the nurse fixed/ a nebulizer over Jane's mouth and nose-/ and she breathed.

Meanwhile,/ understanding that his wife might be dying/ before his eyes, he stood still,/ careful to keep out of everyone's way."

Second the spiritual struggle:
"When the minister,/ Alice Ling,/ brought communion to the house/ or the hospital bed,/ or when they held hands as Alice prayed,/ grace was evident/ but not the comfort of mercy or reprieve./ The embodied figure/ on the cross still twisted under the sun."

Lastly, the emotional struggle:
"One by one they came,/ the oldest and dearest, to say goodbye/ to this friend of the heart./ At first she said their names, wept, and touched;/ then she smiled; then/ turned one mouth-corner up. On the last day/ she stared silent goodbyes/ with her hands curled and her eyes stuck open."

Often we find in art that some of the richest creations come from places of deep despair and tragedy. It is certainly true of the poems of these two connected souls, Donald Hall and Jane Kenyon.

If you are looking for more check out Bill Moyers documentary "Donald Hall and Jane Kenyon: A life together" produced just before Jane's diagnosis. Donald Hall also has a more prose filled book called "The Best Day and the Worst Day: Life with Jane Kenyon"

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Have you ever wondered what other people might be saying about a particular subject you see on any of the three Pallimed blogs? But to actually remember to go back and check the post is something you never get around to doing?

Well for Pallimed readers who subscribe via RSS* we now have a Comments Only Feed that will keep you up on the latest conversations on the posts. Each Pallimed blog (Main, Arts, and Cases) has its own individual subscription link in the left hand column.

Pallimed: Main Comments Only Feed (About 5-10/week)

Pallimed: Arts Comments Only Feed (About 2-4/week)

Pallimed: Cases Comments Only Feed (About 1-2/month)

We rarely get spam comments 2-3/month and we delete them within 2-4 hours usually, so this should not be a big deterrent. The 'Comments Only' subscription is not available for email subscribers at this time, but if you would like an email subscription option then email me directly or post a comment.

This post will be cross-posted to all three Pallimed Blogs. My apologies in advance for readers who see it multiple times.

*Really Simple Syndication.

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A recent Google search on a completely unrelated topic, lead me to a hospice website. I found some photos there of a Memorial Quilt that they had made. As an amateur seamstress myself from a family of professional seamstresses, this peaked my interest.

After additional searches, I came upon the AIDS Memorial Quilt. I remember hearing about this years ago. I even saw a few pictures. But I don't remember really looking at it and trying to see what each block was saying about the person it memorialized.

The AIDS Memorial Quilt was first established in 1987 to not only remember those who had died but to build awareness for HIV/AIDS. It was meant to give names to the numbers. It is the largest community art piece in the world, containing approximately 48,000 panels that would cover 185 basketball courts (2007 statistics). The panels have now been photographed and archived on the group's website and can be viewed there.

Some of the 3X6 foot panels are very simple, with just a plain background and a name. They are very profound in their simplicity. Others are more ornate with pictures of the deceased or religious or other symbols. I think the Olympic flame on this block is not only representing an Olympic athlete. Like the flames seen in memorial monuments and grave stones, it is an eternal flame. There is actually a lot of similarity in the symbolism of the Olympic torch (that burns continuously through the Olympic games) and the eternal flame. The ship, also found in this block, is sailing off into the sunset. On it's sail are symbols that represent the deceased.

While the AIDS Memorial Quilt may have slowed down in the past few years, as less people are dying from AIDS, more blocks are still being added and parts of the Quilt are on display around the country. More recently, memorial quilts have been made in honor of those who died in the 9/11 attacks.




There really aren't any fixed rules when making a memorial quilt. You can find memorial quilts made from t-shirts and other fabric belonging to someone who has died. Photos and even documents such as letters can be printed on to fabric to be added to quilts. This quilt has printed pictures (intentionally blurred), parts of t-shirts, and fabric from the deceased clothes. Like the AIDS Quilt, they are often mixed media, with paint, needle work, and pretty much anything that can be sewn on.



I found this quote talking about the AIDS Memorial Quilt, but I think it's a great description of all such works of art. "The Quilt has redefined the tradition of quilt-making in response to contemporary circumstances. A memorial, a tool for education and a work of art, the Quilt is a unique creation, an uncommon and uplifting response to the tragic loss of human life."

References: http://www.aidsquilt.org/

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In the early nineteenth century, as the medium of photography was coming into existence, postmortem photographs began to appear. These portraitures, taken soon after death were cherished keepsakes for families to possess. Usually it was the only photograph ever taken of the individual, young or old.

Even before photography existed, paintings of the deceased occurred. In the sixteenth century paintings of a recently deceased would be made of the person, usually a nun or clergyman, sitting up or lying in bed. This influence is seen in some of the early photographs, depicting their subjects also propped up in bed or in a chair.

The other customary paintings in the early nineteenth century were of young children whom had died. These paintings actually depicted the child alive, but a symbol of some sort was included to indicate that the child had in fact died. Examples of symbols used include a rose held downward, or a broken stem. Sometimes a prominent watch with the time of death was included.

As photography evolved, photos rather than paintings of the deceased became important. Interestingly, as the cost of photography lessened, the price for a postmortem photograph actually increased, indicating it's value, as well as popularity.

Most of the postmortem photos are of children, secondary to the high infant mortality rates. The earlier photos often depict the subject in a sleeping posture, as if to depict the impermanence of sleep, rather than the finality of death. As the role of the undertaker became more central to the dying process, more elaborate photo's of coffins and flowers ensued.



The official practice of postmortem photography began to disappear in the early twentieth century. Many reasons for this exist. The photograph itself lost some of its prominence as the snapshot was developed and photo's became more common place. Death also became more scarce, and our societies began to shun any reminders mortality.

The art of postmortem photography is all but gone. The palliative care movement that is slowly bringing the acceptance of death back into society's focus, is also helping to spur a resurgence in portraiture's of deceased infants. The current name now is "remembrance photography".

A very big difference is that remembrance photography is generally donated. Unlike the high prices of postmortem photography, today's tribute is a gift to families to help in the grieving process. One terrific organization that connects families with photographers is "Now I lay Me Down to Sleep". This current photo is taken from their gallery, full of tributes to children.

This picture of James Dennis isn't much different than photos taken almost 100 years ago. Spend some time reflecting on both genres, there's a great sight on Flikr with a large collection of postmortem photos and the Now I lay Me Down to Sleep gallery.


Reference: Memento Mori: Death and Photography in 19th Century America by Dan Meinwald

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Through life’s meridian bound,
In silent pain I weep;
What joy on earth is found!
Too slow the minutes creep.
O death! Thy aid I crave,
Advance to my relief;
Consign me to the grave,
And banish all my grief.
(An Invocation to Death 21-28)

This is an excerpt taken from the poem "An Invocation to Death" by Jane Cave Winscom. In the 1790s, Winscom wrote three poems ("Written the First Morning of the Author’s Bathing at Teignmouth, For the Head-Ach", "The Head-Ach or An Ode to Health" and "An Invocation to Death") describing living with chronic headache pain. In the above lines, she describes the silent agony she is feeling. The pain is so bad, she craves the "aid" of death to relieve her suffering.

Jane Cave Winscom is somewhat of an obscure poet. Not much is known about her life outside of her poetry. Winscom first published "The Head-Ach" in a newspaper in 1793 as a plea to readers.

Live’s one on earth possess’d of sympathy,
Who knows what is presum’d a remedy?
O send it hither! I again would try,
Tho’ in the attempt of conqu’ring I die.
(The Head-Ach 45-48)

Although written over 200 years ago, some of Winscom's sentiments may seem familiar to modern times. In her three poems, she describes her agonizing pain, multiple treatments she has tried, and a frustration with the medical community who apparently promise much but deliver little.

Physicians, and ye crowd,
Who boast of physic-skills;
I may proclaim aloud,
You’re but a splendid ill!
In vain I’ve sought for cures,
As tortures still confine:
What fruitless pounds are yours!
What pain and anguish mine!
(An Invocation to Death 9-16)

Something that strikes me about Winscom's poetry is the evolution of hope. In the first poem, she seems hopeful that her pain can be can be relieved by bathing in the Teignmouth (a popular treatment at that time for many different illnesses).

I chid my fears—my cowardice was nipped,
And next below the wave my head was dipped:
A strange sensation—in a second o’er,
And I quite braced, much happier than before;
When I bathe next, I’ll have two dippings more.
(Written the First Morning of the Author’s Bathing at Teignmouthlines 18–22 )

By the time she writes the last poem, her hope has changed. She no longer believes in the physicians or other practitioners who have tried in vain to relieve her pain. She now places her hope in death. Through dying, she may finally be at peace.

And ye of tend’rest tye,
To whom I yet am dear!
Heave not a fruitless sigh,
When you behold my bier!
But join me to the dead:
Rejoice my days are o’er;
And say,—“that peaceful head
Shall bow with pain no more.”
(An Invocation to Death 41-48)

Winscom is not alone in using poetry to express physical pain. The American Pain Foundation has more contemporary poems written by those suffering from chronic pain.

References: McKim, A. Elizabeth, "Making Poetry of Pain: The Headache Poems of Jane Cave Winscom" Literature and Medicine 24, no. 1 (Spring 2005) 93–108

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There is a certain theme surrounding much of the art and music discussed on these pages; that creation is often born of personal suffering. Perhaps no better example of this exists than the life and work of Frida Kahlo.

Born in 1907 in Mexico, Frida was aspiring to be a doctor, when at the age of 18, a tragic bus accident forever changed her life course. Having been impaled by a metal pole, suffering a fractured pelvis among other injuries, she spent her recovery time exploring the world of painting.

She later met and married a man 20 years her senior, a famous painter himself, Diego Rivera. Much of the tragedies she encountered during her life have been portrayed masterfully in Frida's surrealist paintings. Diego called her art, "agonized poetry", and certainly agonizing is one of many words people use to describe her work.

Frida had several great losses in her life. Due to the bus accident, she discovered she wasn't able to carry a pregnancy to term. Desperately wanting to be a mother, both the loss of actual pregnancies as well as the loss of the idea of being a mother come across in her works.
The painting "Henry Ford Hospital"(1932) was painted after one of her miscarriages. This was the very first time in art history that an artist created a painting specific to the death of an unborn child. The painting communicates more than this loss. It also portrays Frida's suffering and isolation which followed. Represented here are 6 objects symbolizing different aspects of her anguish: Model of female reproductive system, a male fetus, a snail (represents the slowness of miscarriage), pelvic bones responsible for the loss, an orchid (symbol of fertility) and an autoclave for surgical instruments.

Although the bus accident happened at age 18, Frida continued to have problems with her spine requiring extended periods at home in traction. This next painting "The Broken Column"(1944) was painted during a 5 month period that she wore a steel orthopedic corset. She wrote in her diary, "To hope with anguish retained, the broken column, and the immense look, without walking, in the vast path...moving my life created of steel".

Notice the cracked iconic column in place of her injured spine and her flesh pierced with nails. The background landscaped is also cracked and open as tears fall from her eyes.


The final painting of suffering to look at is "Without Hope"(1945). The name itself should give indication to the feelings portrayed in this painting. Here again is Frida, stuck in her four poster bed that she spent so much time in. The landscape has become even more barren than the 1944 picture. Above her is a funnel, force feeding her all types of meat products. Again the classic white tears fall.This time of constant pain and isolation from surgeries was more profound knowing that in 1940 she and Diego had divorced. He had not only been caught being unfaithful many times, but in fact had a yearlong affair with Frida's younger sister Cristina. This then was yet another huge loss in her life.

As she became more and more ill, she became very aware of her own mortality. She had had over 35 operations in her lifetime. She wrote of her own death, "I hope the departure is joyful, and I hope never to return". Frida Kahlo died in 1954, thought ultimately to have died of a pulmonary embolus.

If you're in California, the San Francisco Museum of Modern Art is hosting a Frida Kahlo exhibit until Sept. 28, 2008. For Online I suggest The Art History Archive which has over 70 of her works.

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If you're looking for a feel good movie, this is definitely not for you. The Seventh Seal is a 1957 Swedish film directed by Ingmar Bergman. There is a lot going on in this movie, so I'm writing about some of the main points. You could easily analyze each scene.

A knight and his squire return from the crusades to a plague ravaged Europe. When Death comes to take the knight, he challenges Death to a game of chess, with the stakes being the knight's life. The scene below is taken from the beginning of the movie and sets up the plot of the movie. (In subtitles for those who don't speak Swedish.)



The title of the film comes from the first line of the movie, which is a taken from the book of Revelations. This passage is repeated at the end of the movie. The movie is full of religious references and symbolism, as the knight struggles with death and his belief in God.

The chess game is worked in throughout the movie as the knight travels through the countryside, witnessing the horrors of the plague and how people react with facing their own mortality. Groups of people roam the country whipping themselves in penance and begging for God's mercy. A women accused of being a witch is burned for fear that she brought on the plague. (Did I mention this was a dark movie?)

In the end, the knight distracts death so that others may escape. After the chess match, he asks Death to reveal his secrets. Death responds "I have no secrets...I am unknowing." When death comes back for him, he is welcomed into the knight's home with a mixture of fear and awe (maybe even some happiness) by the knight and his friends.

I see the knight as a man who has essentially just gotten a terminal diagnosis. He makes a wager with Death, bargaining for his own life. He tries to buy more time.


But in the end, no one escapes Death (or death).

So, what are the pieces on our modern day chess board? Are modern medicines just more moves to buy time in a losing chess match? Interesting movie, but it doesn't leave you with the most pleasant thoughts.

As a side note, the painting referred to by the knight in the film clip is one in the Taby Kyrka, a medieval Swedish church, painted by Albertus Pictor in the 1480's. This is said to have inspired Bergman in the making of the film.

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Knowing the context of a composition can transform the listening experience, especially for classical music, that has no words. Such was the case for me when I heard a brief history of Gustav Mahler's 9th symphony prior to listening to the Chicago symphony preform it. Perhaps you will say the same after this post.

Let us look at an intricate interconnection of events that eventually leads to the final complete symphony of Mahler. First we must look back to a German poet named Freidrich Ruckert. In a 2 week span Ruckert lost two of his five children to scarlet fever, Luise age 3 and Ernst age 5. As a way to grieve their loss he wrote a series of 425 poems in a collection called "Kindertotenlieder" or Songs on the Death of Children completed in 1834. These were of a private nature, and only published after his death in 1872.

Gustav Mahler came across these poems and found in them an inspiration for composing his own 5 song cycle entitled Kindertotenlieder (1901-1904). This was an unusual time for Mahler to be writing songs about children dying. He had just married Alma Schindler in 1902, and the birth of two daughters soon followed: Maria Anna(1902) and Anna (1904). Many found it difficult to understand his ability to be interacting with his own new young children and yet focused on such a haunting theme in composition. Mahler's wife was even appalled, "What I cannot understand is bewailing the deaths of children who were in the best of health and spirits...hardly one hour after having kissed and hugged them." (Gartenberg)

It was Ironic then when in 1907, his beloved daughter Maria Anna contracted diphtheria and at the young age of 4, died. 1907 was also the year Mahler himself was diagnosed with infective endocarditis. Grief stricken and with a new life limiting illness he began work on symphony No. 9.

We are not surprised then to hear these themes in Mahler's 9th symphony. Listen to the beginning of this 1st movement. It begins subtlety, even hesitantly. Can you envision Mahler at a picnic with his daughters, the merriment of life abounds. Then the intrusion begins, an ominous discord like a storm on the horizon. The climax is ushered in with trombones piercing the calm, as death appears in the midst of joyous life. The strings then follow as a voice crying in sorrow.

It is in the 4th movement that Mahler finds his conclusion. He uses a theme from his earlier Kindertotenlieder cycles in this movement. Although when he originally wrote it he had to imagine the loss, it was now more poignantly real. The poem of that 4th cycle speaks to the recognition of the tricks the mind can play when we've lost someone dear. Yet in the lines that follow you'll note the resolution, in the term "those heights" which Mahler changed to a German word meaning "heaven". From cycle #4. Oft denk' ich, sie sind nur aus gegangen:

"Often I think they've gone outside! / Soon they will get back home again! / The day is lovely! Don't be anxious, / They're only taking a long walk / .... They've only gone out before us, / And will not long to come home again. / We'll catch up with them on yonder heights / In the sunshine! / The day is fine on yonder heights!"

As you listen to this part of the 4th movement, hear the words of the poem. The sadness behind the strings slowly resolving into resolution. Mahler himself perhaps finding his own peace, not only in the loss of his little girl, but in his own mortality. Do you hear the theme saying, "It'll be okay", the grief is still present, but "the day is fine yonder heights"


Sources: Gartenberg, Egon. "Mahler:The Man and his Music" (New Tork: Schirmer, 1978), 288.
Rushing, Randal "Gustav Mahler's Kindertotenlieder: Subject and textual choices and alterations of the friedrich ruchert poems, a lecture recital, together with three recitals of selected works of F. Schubert, J. Offenback, G. Finzi and F. Mendelssohn" Here
Works: Mahler, Gustav "Symphony No. 9"

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In 1995, American artist William Utermohlen was diagnosed with Alzheimer's. In an interview, Utermohlen's wife commented, “From that moment on, he began to try to understand it by painting himself.” He began a series of self-portraits that demonstrate not only the physical effects of the dementia on his brain, but also how he saw himself through the eyes of his illness.


The first self-portrait was done in 1967, while he was healthy. The other three were done after his diagnosis.


As his disease progresses, you can see how his artwork has less fine details. The lines are more blurred. In the second photo, Utermohlen's face is greyed, maybe showing what he felt was going on in his mind. Like there is a shadow cast over his face.

Later in his disease, his image becomes more and more distorted and abstract. His images also become more flat. They definitely lack the depth seen in the first.

In the third, he seems to focus on certain facial attributes, like his ear and nose. His eyes seem to be more prominent than in the second. His brow seems furrowed. The background looks almost architectural. Maybe attempting to create a space?


In the last painting, there are very few recognizable features left. The entire image is very abstract. His nose and ear are still somewhat prominent. His eyes are absent or distorted. His mouth is barely penciled in.


Per the New York Times article, William Utermohlen no longer paints. As of the time of the article, he was living in a nursing home. An exhibit of his art has been on tour around the world entitled ‘Inside Alzheimer’s: Portraits of the Mind'.

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Many hospice organizations have printed up little booklets for families to read giving a "what to expect" of the dying process. This idea is by no means a new concept. In fact, one of the first books printed with movable type back in the 1400's was just such a book. "Ars Moriendi" (The Art of Dying) was a book written by an anonymous Dominican friar in 1415. It was THE book on how to prepare to die and how to die well. You can be the judge of how relevant such a book would be for today.

The book describes the five temptations that dying people face. In 5 different scenes a devil invites the temptations of lack of faith, despair, impatience, vanity and greed. The next 5 scenes depicted are the solutions to these temptations, what one must seek to die well: Faith, hope, patience, humility and generosity. This line drawing is from the artist Master E.S. from 1440, one of the earliest depictions of the Ars Moriendi text, entitled "Impatience". Note the chachetic look of the dying man, his ribs clearly visible. See the table knocked down and the dying mans leg kicking a caregiver in the back. When I see this picture I think of delirium, or terminal restlessness that we see in the dying process. I suppose labeling it impatience was the best reason they had to give such extreme behavior.

The artist Hieronymus Bosch also depicted this theme in his painting entitled "Ars Moriendi"(1490). In this illustration he attempts to depict the struggle between good and evil. The angel is on the dying man's deathbed attempting to direct his eyes upward to the crucifix illuminated in the window by divine light. Meanwhile a little devil is attempting to give the man a purse of money. We are left not knowing which path this man will take, as death sneaks into the room with an arrow in his hand.

What would a picture of Ars Moreindi look like today? How would we in modern times communicate what it means to die well? Perhaps the ideas of faith, hope, patience, humility and generosity are still components of the process even now.

Works: Master E.S.(1440) "Impatience"
Bosch, Heronymus(1490) "Ars Moreindi"

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I wanted to write a follow-up on a movie I had posted on previously, "The Sea Inside". As I was writing about "The Sea Inside", Amy (who is much more musically inclined than I) pointed out to me the significance of the song playing during the dream sequence. The song (or aria, to be more precise) is entitled Nessun Dorma or None Shall Sleep. It's from the final act of Giacomo Puccini's opera Turandot.

Here's the plot in a nutshell. Turandot is a princess in ancient China who challenges her suitors with three riddles. If they can answer, they win her hand. If not, they are beheaded. The Prince of Tartary falls for Turandot and correctly answers all three of the riddles. Turandot is very upset that he has succeeded, so the Prince gives her an out. If she can guess his name by morning, he will be put to death. If she can't guess, she will have to marry him. The Princess declares, "This night, none shall sleep in Peking! The penalty for all will be death if the Prince's name is not discovered by morning." The song is Nessun Dorma is sung by the Prince awaiting the morning.




Below is Luciano Pavarotti singing Nessun Dorma. In 1990, Pavarotti's version of this song actually hit #2 on the UK Singles Chart, which is said to be the highest ever achieved by a classical recording. (Songs that made it up to #1 on UK charts that year included Ice Ice Baby, Turtle Power, and Hangin' Tough. Hard competition for Nessun Dorma.)





Puccini died from complications of throat cancer prior to finishing the opera and it had to be finished to by one of his contemporaries, Franco Alfano. Although Alfano did have some of Puccini's sketches to work from, no one knows exactly how Puccini would have ended the opera. There have been a couple different reworkings of the ending since that time.

I recently heard (thank you NPR) that the ending was going to be rewritten again. Apparently, the opera Turandot was never played in China as they believed the blood thirsty Chinese princess cast a bad light on the country. To celebrate the opening of the National Center for Performing Arts in Beijing, a Chinese composer, Hao Weiya, was hired to rewrite the end of Turandot. It seems to have been met with some mixed reviews.

Here is the common translation of Nessun Dorma.

No one sleeps, no one sleeps
Even you, o Princess,
In your cold room,
Watch the stars,
That tremble with love
And with hope.
But my secret is hidden within me;
My name no one shall know, no, no,
On your mouth I will speak it
When the light shines,
And my kiss will dissolve the silence
That makes you mine.
No one will know his name
And we must, alas, die.
Vanish, o night!
Set, stars!
At daybreak, I shall conquer!

As the Prince stays awake all night, he awaits a morning that might bring his own death or the fulfilment of his dream (desire) to be with the Princess Turandot. Ramon Sampedro felt that he was being denied "sleep", but in his case, it was the sleep itself he desired. What an appropriate choice of music!

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How much of our temperament is based on genetics, and how much is experiential? For Edvard Munch it may have been more of his life circumstances that shaped his morose outlook on life, than the fiber of who he was at birth. Born in 1863 in Norway, Edvard was the second child of five. His early life was tainted with the death of his mother at age 5 and his beloved older sister when he was 14. As if this weren't tragedy enough, a younger sister was diagnosed with mental illness and institutionalized most of her life. His father, a physician, dealt with the loss of his wife by instilling religious fear into the hearts of the remaining children. Edvard considered himself ill as well, and wrote, "Without anxiety and illness, I am a ship without a rudder....My sufferings are part of my self and my art. They are indistinguishable from me, and their destruction would destroy my art."

Although Munch is best known for his painting "The Scream"(1893), his other works are worthy of examination. Because of his early experiences with death, many of his pieces explore his emotional responses to the memories of his childhood.

Could this be Munch working through the memory? Often painful things at first are recalled with intense emotion, and as we replay and retell things, while still significant, the initial emotional response can lessen.

What does the piece say about child grief? Experts use words for young children experiencing death such as confusion, disorientation, and fear. Those words fit well for these pieces don't they?

Edvard Munch said "The angels of fear, sorrow and death stood by my side since the day I was born". Because he was shrouded in early life with the losses of important people in his life, many of his works focus on sickness, death or mental anguish. In upcoming posts we'll take a look at these other dark themes, and how Munch's choice of paintings reflect his inner struggle.

Source: Lubow, Arthur "Edvard Munch: Beyond The Scream" Smithsonian Magazine (2006) Here
Works:Munch, Edvard. "The Scream"(1893)
Munch, Edvard. "Dead Mother and the Child"(1897-1899)
Munch, Edvard. "Dead Mother" (1899-1900)

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Songs about loss are rarely upbeat enough to get you moving in your car, but for me "Starlight" by the English alternative/progressive rock band Muse manages to combine sorrow and loss with rock and roll supported by a driving bass line to make a catchy song with some deeper meaning. Muse is a band whose music leans towards more sullen material, and some critics of the band chastised this song for being too pop-oriented. Overall their music style is defined by the music genome project as frequent use of minor key tonality, subtle use of piano and some electronica influence. This song exemplifies these traits well with simple piano and guitar melodies, with more space-rock bridges breaking the song into two very different feels.

Here is the video from YouTube. The visuals of the video below are not highlighted in this post. Pay more attention to the audio and lyrics.

(If the video does not display click the title of the post)

In "Starlight" the band makes use of outer space, a common theme on this album, as a metaphor for loss and distance. The ship taking the singer 'far away' could be an allusion to disease, especially one like Alzheimer's which erases the memories of the important people in your life. Or more generally, the decreased level of consciousness as someone gets closer to death.

"Chasing a starlight" can have multiple meanings in reference to end of life. On a very obvious level 'seeing the light' is commonly perceived as an experience of someone near death. And then when combined with star, the light could be a thinly veiled reference to the 'stars in heaven.' But why would the protagonist of the song be 'chasing the starlight?' Here you can start to explore many different questions.

Could the 'starlight' be thought of an ideal, perfection, purity or some unobtainable goal? This impression makes more sense when he wonders if the effort "is worth it anymore." Is trying to be good and perfect the reason to get to a wonderful afterlife? Or is the person reflecting on the good (starlight) he has striven for which now appears to 'mean nothing' since he is dying? I will note the band stated this is a "a love song about missing someone, friends, family, someone you love" and therefore not explicitly about dying.

The bridge/chorus gets more aggressive with crunchy guitar chords, as if he is fighting the loss, with the lines, "I'll never let you go, if you promise not to fade away." This line switches the perspective as most people working with Alzheimer's see the patient as the one slipping away, but if you (as the patient) are slowly losing your memory and ability to communicate, it can also seem like everyone else is fading away from you. Much like some weird palliative care Doppler effect; who is fading from whom?

"Black holes and revelations" is the name of the album and also a key lyric in "Starlight." This is made even more important when paired with the line of "our hopes and expectations." Palliative care is about finding 'hope' and managing 'expectations' when discussing the uncertainty of the future of a medical illness. But when patients and families 'hopes and expectations' are not managed well it may seem like 'hope' get dashed into a 'black hole' never to escape. Any information contrary to current 'expectations' then becomes a dramatic 'revelation.' Other influences regarding spirituality and end of life issues could be made with the Biblical Book of Revelations, or the unknowable of what exists in a black hole, echoing the uncertainty about what happens after death.

For those who liked this song, some of Muse's other songs highlight issues relevant to palliative care and spirituality including "Thoughts of a Dying Atheist," "Sing for Absolution," "Time is Running Out" and others.

"Starlight" by Muse (Bellamy) from the album "Black Holes and Revelations" (2006) from Warner Bros. Records.

Lyrics

Far away
This ship is taking me far away
Far away from the memories
Of the people who care if I live or die

Starlight
I will be chasing the starlight
Until the end of my life
I don't know if it's worth it anymore

Hold you in my arms
I just wanted to hold
You in my arms

My life
You electrify my life
Let's conspire to re-ignite
All the souls that would die just to feel alive

But I'll never let you go
If you promised not to fade away
Never fade away

Our hopes and expectations
Black holes and revelations
Our hopes and expectations
Black holes and revelations