On November 20th 1791 Wolfgang Amadeus Mozart became bed bound. He began to have swelling in his hands and feet. He became listless and began to have fever and vomiting. On December 4th, a group of friends came to perform parts of the Requiem for him. His condition worsened through the night. On December 5th Mozart died at age 35. (Sounds like an episode of House.) He was officially diagnosed by his physician as having had miliary fever (which is apparently a catch all diagnosis for a fever with a rash). His body was buried in a common grave. Soon after his death the speculation as to the exact cause began. A recent New York Times article delves into the medical mystery surrounding the death of Mozart. (The painting is “Mozart 1756-91 Sings His Requiem,” painted in 1882 by Thomas W. Shields.)

The New York Times article discusses an article published in Medical Problems of Performing Artists. They summarized the known theories and came up with 118 different ones. Mozart himself once thought he had been poisoned, so that has been one theory. Others include renal failure from various causes, bacterial endocarditis, and congestive heart failure. Medical malpractice even enters the picture. While Mozart was on his death bed, his physician was sent for at the theatre. He apparently responded that he would be there after the show. (The painting to the left is Hermann Kaulbach's 1872 oil painting "Mozart's last days".)

If you're hungry for more information on this medical mystery, you'll be pleased. A quick Google search revealed a Wikipedia page, an article in the Annals of Internal Medicine, and a Medscape article to name a few. I had no idea there was so much interest in this topic.

To me the bigger question is not what actually killed Mozart, but why so many people care so much. A lot of people have spent a lot of time trying to figure this out. One theory given by the article is that a large proportion of doctors play musical instruments. (Really? They don't cite any studies on this, just mention one doctor who does. Very scientific.) From the article: "The very idea that remarkable individuals who gave life so much beauty could be brought down by ordinary physical ailments, particularly diseases that are now easily treatable, is inherently fascinating. That perception makes people of genius seem closer to us."

I don't really agree that doctors are interested because they play musical instruments and want to feel closer to genius. I think it is more likely that many doctors and others of the medical community like a good mystery. (I met a doctor once who did years of extensive research on the assassination of JFK.) And this is a good medical mystery with actually quite a few first hand accounts that one can sink ones teeth into. We can guess all we want, but given the age of the mystery and the fact that there is no available body, it seems there will never be an answer. Maybe that's really why the medical community enjoys researching this. If we can never solve the mystery for sure, then you can't be wrong.

So first a disclaimer. This is entirely my opinion. It is possible that someone may very well think that my least favorite funeral songs are their favorites. (I would love to hear which ones you like/dislike and why.) We have several times done lists of top movies and music we liked, so I figured I would hit on a list of dislikes.

When I was trying to think of why I liked some songs at funerals and not others, there are a few elements of the songs that seemed to sway me. 1. Do I actually like the song (of course)? 2. What is the intent of the song? 3. What thoughts does this song conjure up when I hear it?

These are songs that I have actually heard at funerals. So, in no particular order:

Somewhere Over the Rainbow-I actually do like this song as far as songs go. I don't think it is too emotionally heavy. My issue with it is that every time I hear it I think of Dorothy and the Wicked Witch. And then the next song that pops into my head is... Ding Dong the Witch is Dead. I've heard it at funerals a couple times and it just doesn't put me in a very funeral mindset.

Memory-I don't particularly like this song, but I dislike it for funerals for a similar reason as the above. Every time I hear it I think of dancing people dressed up as cats. Again, weird mindset for a funeral.

Holes in the Floor of Heaven by Steve Wariner-First I'm not a huge country fan but that is not why I don't care for this one. I put this in a group of songs that I consider to be emotional torture. They are the songs that you just know you will get people crying with. If the purpose of a song is to make people more sad and crying, why would you play it at a funeral where people are already sad and crying. (Again, completely my opinion.) If I'm going to cry at a funeral I think it should be for the person who has died, not for the manipulative song.

But in the end, it doesn't really matter what I or anyone else thinks. Writing this post, I looked through a lot of lists of music that are put out as suggestions for funeral songs. Disturbingly, the song my husband and I danced to at our wedding was on a list (Never Tear Us Apart by INXS). I think this just shows that songs take on different meanings to different people. If it gives you peace to play Another Bites the Dust at a loved ones funeral, then I think you should.

I just recently returned from a trip to Papua New Guinea. It is one of my favorite places on earth, and each time I go I encounter something new.

On this trip, as I was leaving the Western Highlands Provence city of Mt. Hagen, I intercepted with a large clan awaiting the return of the body of one of their "bikpela" men (well educated, well respected man).

Truck load after truck load packed full of clan members tumbled into the airport parking lot to await the body being flown in from the capital.

Everyone was covered in orange clay, faces and hands thick. They had also painted all their trucks and cars in the entourage with clay hand prints and the deceased's name with the

words "welcome home".

As I stood on the periphery an eerie song started, a mourning song half sung and half cried. Other woman took the role of mourner by wailing loudly. The process went on for nearly an hour until the plane landed. I had a recorder with me and below is a 30 sec. snippet of their singing/mourning.

Taking some time to research this practice, I realized that painting the body with clay is something practiced all over the globe. Ancient Egyptians, Australian aborigines, many North American Indians and African groups are all among those who paint clay on themselves to mourn. They often leave the clay on for a prescribed amount of time as an outward sign of a the mourning period.

The idea of physically altering one's appearance to denote mourning occurs in many different ways. Historically, in the Jewish tradition, ashes and sackcloths were used and in ancient Rome, a black toga was worn. In the Hindu tradition, usually pure white will be worn in the mourning period and in the US and Europe in the 1800's people used to wear black dresses and suits for a certain length of time.

There are some noted extremes of a more permanent nature. In PNG as well as other cultures, individuals will in fact amputate a distal part of their finger as an eternal reminder of that person's loss. I saw many people during my trip with missing joints of their pinkie finger or first finger. I was told that in some clans there is a significance to which finger is amputated, i.e the loss of one's child vs the loss of a parent.

Historically and continually many cultures have outward displays of their grief. While we set aside time in the US for a funeral, I wonder if there is something lost without any lengthy period of outward display?

Below is the recording I took - note the song, but also the wailers in the background.

Penn & Teller: B.S! is a Showtime documentary series. Magicians/comedians Penn and Teller set out, in a comedic way, to debunk various paranormal and pseudoscientific beliefs and common myths. Some of their topics have been ESP, astrology, lie detectors, and organic food. One of the most recent episodes, "Old People", takes on various myths and stereotypes faced by the elderly. It isn't meant to offend (something the show definitely doesn't mind doing), but rather point out how disrespectful American culture is of the elderly.

Myth: There is an "old person smell". They set up an experiment with 3 old and 3 young people and had blindfolded volunteers smell them. The smellers had to determine if the smellee was old or young. They were accurate only 56% of the time. Very scientific evidence against the "old person smell".

Myth: Older people can't drive (or drive poorly or slowly). They featured a 70 year old race car driver. They also pointed out that those in the age group 16-24 are more likely to cause a fatal accidental.

Myth: The elderly don't have sex. They interviewed several members of a retirement community about their active sex lives.

But in the end the show takes a serious turn. The last section deals with a controversial end of life issue, physician assisted suicide, or as they call it aid in dying (pointedly to take the word suicide out of the name). They interviewed a gentleman, Sheldon, with mesothelioma, who wants to be able to end his life when things become intolerable. Despite the fact that Penn and Teller clearly are in favor of aid in dying, they do give some screen time to a doctor who disagrees with them. And they didn't taunt him, much. They specifically recognize that it is complex issue, not just black and white.

One of their guests sums it up nicely at the end. "For us just to sort of say, 'Old people have come and gone. Let's sweep them under the rug,' it would be a terrible mistake of ours as a culture, as human beings. I think its unfair to deny them their essential humanity just because they've lived longer than us. That's insane." I know that in a blog frequented by hospice and palliative care professionals, this is preaching to the choir. But I do think it was an interesting topic for them to take on.

Just a year after his first album was released at age 29, self taught jazz composer and pianist Fred Hersch was diagnosed with HIV. Hersch was recently interviewed on NPR's All Things Considered.

"For at least the first number of albums I made on my own, I really had this kind of dramatic feeling like this is going to be my last statement and I just wanted to create enough of a body of work that if I died I might somehow be remembered. That was like the thrust."

In 2008, Hersch developed an AIDS related delirium. He developed pneumonia and septic shock. He required a feeding a tube. He states he was in a coma for 2 months. When he came out of his coma, he couldn't walk, talk or swallow. He suffered from vocal cord paralysis.

Now 54, Hersch has released more than 2 dozen albums. "...Now that I've been on the scene and achieved some degree of success and respect I don't feel the need to prove my self in any particular way. I can take more risks." He recently released the album Whirl, his first since his prolonged illness.

How did his illness effect his music? "I think in ways I may be better. I feel certainly more relaxed as a player. I think I'm digging deeper. There are a few little technical things that were easier before that now I have to compensate for, but the small technical things, nobody would notice but me."

Below is one of the songs from Whirl, "Still Here". It is not actually about Hersch himself. It was inspired by Wayne Shorter, jazz saxophonist and composer who is still playing and composing at age 76. (A couple more of his songs, "Snow is Falling" and "Skipping" can be heard on the NPR website, here.)


I find it amazing that Hersch not only recovered from such a serious illness, he went on to create terrific jazz. When I heard his NPR interview, it stuck in my head because of his interesting outlook on his illness. His health problems didn't hinder his music career. They seemed to spur it on.

Departures (2008) is a Japanese film that is a must see for those in the palliative care field. I first learned of it from a family member of a patient I was caring for. The son felt it so necessary that I see the film that he acted out part of the movie, dropping to his knees to act out a scene while I was rounding.

A death mask is a cast made of a persons face hours after death, a process that goes back to ancient times and was common until the mid 20th century. These are usually done in plaster or wax. The casts are then used as mementos of the dead or to create portraits. (J Edgar Hoover kept a death mask of John Dillinger in his office as a souvenir of his war on crime.) The History Channel made a documentary on the topic, entitled Death Masks.

The documentary focuses on the death and life masks (made while the person was still alive) of several famous historic figures, Abraham Lincoln, George Washington, Julius Caesar, William Shakespeare, Napoleon, John Dillinger . They then use modern computer scans to create life like images of how the person would look in real life. They go into the process of how the masks are made. A life mask made in Lincoln's time had to set about an hour on the persons face to dry. Not a big deal if you were already dead, but I would imagine a long hour if you were alive. (Below is a death mask of Shakespeare.)

Mostly the documentary focused on what the masks could tell us about the deceased. Was the man shot in Chicago really John Dillinger? Is the dollar bill an accurate portrait of George Washington? It seems that sometimes more than one death mask will surface for a particular person and it is a challenge to find which is the right one. The two life masks of Lincoln, taken 5 years apart (one before he became president and one just weeks before he died) shows a marked decline in his health. The last mask made has actually be confused for a death mask.

The documentary goes into some of the psychology behind the desk masks. "From ancient times, capturing the faces of the dead for all to see was a macabre reminder that we all end up as dust." Death masks were not just meant to be mementos but to serve as a warning to the living. "Death masks in particular are dark. This is not a living person. This is a corpse. In many ways they are a message to the living. They are about your mortality. About this is what you will become. They are designed to frighten in many ways." There are some very frightening death masks shown in the documentary.

The death masks reminded me a lot of the death photography. Both I find interesting but just a bit creepy. I'm not sure I would want either hanging in my living room. (Who wants a reminder of their own mortality hanging above their television?) I think I would much rather of a life mask of a loved one. Remember how they were before death, not after.

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.

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.

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

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.

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

weak

my mind races in place

and I never see the scenery

The next poem is by Anna Williams


"Dysphoria"

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.

Still...
they are not refined,
not smooth
to the minds
touch.

A finer grade
of sandpaper
is needed,

but...
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"

The exact origins of Memorial Day are not exactly agreed upon. Many cities claim to be the founders of this holiday. The tradition, however, dates back to Civil War times. At one time Memorial day was known as Decoration Day, as it was the day families and friends of fallen Civil War soldiers would choose place flowers and "decorate" the graves.

The first official Memorial Day was May 30th 1868, after the day was declared by General John Logan, commander of the Grand Army of the Republic (a veterans' organization). The holiday was adopted by Michigan and New York and then by all the Northern states through the late 1800's. The Southern states had there own days they observed and did not recognize this holiday until after WWI (several Southern states still have a separate Memorial Day type holiday to honor confederate soldiers). Apparently the date, May 30th was chosen as it was not the anniversary of any battle.

At first the holiday was just to honor the Civil War dead. After WWI, Memorial Day changed to honoring all of Americans who died fighting in any war. Now it is often seen as a day to remember all who have died. (I remember going to the cemetery to decorate the graves of family members on Memorial Day when I was young.) In 1967, the name of the holiday was officially changed to "Memorial Day" and in 1971 the National Holiday Act changed the date of the holiday to the last Monday in May, creating a very convenient 3-day weekend. There has been for several years a push to move Memorial Day back to May 30th in order to try to give some meaning back to the day (so it's not just the long weekend when the pools open).

The top photo is from Arlington National Cemetery. Every year around Memorial Day, the 3rd U.S. Infantry Regiment or The Old Guard, in a tradition called "Flags In", places small flags in front of all graves in the cemetery.

The Fredericksburg National Cemetary hosts an annual Luminaria each year for Memorial Day. Approximately 15,300 candles are placed by volunteers on each of the graves (80% of which are unknown soldiers).

I have often wondered about the significance of the red flowers being given out for donations around this time every year. Inspired by the poem, "In Flanders Fields" (poem below) by Canadian WWI veteran and poet John McCrae, the Veterans of Foreign Wars take donations for their "Buddy" Poppy every year around Memorial Day. Theses poppies are assembled by disabled and needy veterans. Since 1922 this program has been raising money for veterans and their families through the poppies.

In Flanders Fields

In Flanders fields, the poppies blow

Between the crosses, row on row,

That mark our place; and in the sky

The larks, still bravely singing, fly

Scarce heard amid the guns below...

We are the Dead. Short days ago

We lived, felt dawn, saw sunset glow,

Loved, and were loved, and now we lie

In Flanders fields...

Take up our quarrel with the foe:

To you from failing hands, we throw

The torch; be yours to hold it high.

If ye break faith with us who die

We shall not sleep, though poppies grow

In Flanders fields...

For clinicians looking for medical songs to pull out for discussion, you may want to add this song by French actress and singer Charlotte Gainsbourg. The song, IRM is from her new album of the same name. IRM, the album, was released Jan. 26, 2010 on the Elekra/Asylum label. Co-written, mixed and produced by Beck, the album is described by Michael Katzif from NPR as having "lyrical subtlety and layered details that unspool upon each listen"

The title song, IRM, is the french name for MRI, as in Magnetic Resonance Imaging. The background story is that in 2007 Charlotte had a skiing accident in the states. After the minor accident she began having headaches, and subsequent serial MRI's were preformed. Ultimately she required surgical decompression from a hematoma.

She says that during the MRI procedures, she'd listen to the whirring of the machine thinking what great background it would make for a song. While many of us may hear sounds in our daily lives that we randomly think could fit into a song- she did it. But it's not just background, the lyrics themselves are about the procedure as well. Below are the lyrics and then song:

Take a picture, what's inside?
Ghost image in my mind
Neural pattern like a spider
Capillary to the centre

Hold still and press the button
Looking through a glass onion
Following the x-ray eye
From the cortex to medulla

Analyze EKG
Can you see a memory?
Register all my fear
On a flowchart disappear

Leave my head demagnetized
Tell me where the trauma lies
In the scan of pathogen
Or the shadow of my sin.

Anyone who's had an MRI, or been around them won't have trouble hearing the machine sound. I even think the drum beat has the sound of a tachycardic pulse. The lyrics help contrast so well the impersonal world of medicine with the idea of being human, i.e. "can you see a memory?"

Here's the song from YouTube below.

Happy 2nd Anniversary!


Another year has come and gone, and we here at Pallimed Arts like to celebrate with top 10 lists. We did the top 10 palliative care films in 2008, and the top 10 palliative care songs in 2009. Although we are growing up- this is our 2nd anniversary- we thought we'd get "younger" with this years top 10. We're listing our favorite children's films that have good palliative care themes.



Plot summaries are courtesy of IMDB and the links will take you to a trailer of the films. As before we hope you comment with your own ideas of children's films we left off our list.



10. The Never Ending Story (A troubled boy dives into a wonderous fantasy world through the pages of a mysterious book)



9. My Neighbor Totoro (When two girls move to the country to be near their ailing mother, they have adventures with the wonderous forest spirits who live nearby)



8. Bridge to Terabithia (A preteen's life is changed after befriending the new girl at school)



7. Mr. Magorium's Wonder Emporium (Molly Mahoney is the awkward and insecure manager of Mr. Magorium's Wonder Emporium, the strangest, most fantastic, most wonderful toy store in the world. But when Mr. Magorium, the 243 year-old eccentric who owns the store, bequeaths the store to her, a dark and ominous change begins to take over the once remarkable Emporium)



6. Up (By tying thousands of balloon to his home, 78-year-old Carl Fredricksen sets out to fulfill his lifelong dream to see the wilds of South America. Right after lifting off, however, he learns he isn't alone on his journey, since Russell, a wilderness explorer 70 years his junior, has inadvertently become a stowaway on the trip)



5. Lion King (Tricked into thinking he killed his father, a guilt ridden lion cub flees into exile and abandons his identity as the future King)



4. My Girl (Vada Sultenfuss is obsessed with death. Her mother is dead, and her father runs a funeral parlor. She is also in love with her English teacher)



3. Bambi (Animated film about a young deer, Bambi, growing up in the wild after his mother is shot by hunters)



2. Old Yeller (A boy brings a yellow dog home. The dog loves the family as much as they love him, but can the love last?) *no trailer found, link is to a scene from the movie.



1. Charlotte's Web (Wilbur the pig is scared of the end of the season, because he knows that come that time, he will end up on the dinner table. He hatches a plan with Charlotte, a spider that lives in his pen, to ensure that this will never happen)

(NOTE ** Links to The Awakenings Project disabled secondary to possible malware on that site.  Pallimed Arts is clear of malware.** UPDATE Aug 22 2010 - links clear of malware)

Mostly, in my practice, mental illness is a sort of co-morbid condition to the reason I'm following. Some recent experiences have me thinking about the chronic, debilitating (and even, in a few cases, potentially fatal) nature of mental illness.

The Awakenings Project  is an initiative started with the mission to assist artists with mental illness with their art and to help them use art as a creative outlet. The project deals not only with art, but also with music, literature, and drama. Here I'm focusing more on the art.

The painting to the left is entitled "On the Threshold of a Dream" by Awakenings Project artist Kurt Taecker. Taecker had been living with mental illness since age 17 and died January 2010. His art "reflected the twists and turns in his mind". He once said the process of creating his art gave him "is a sense of healing, a momentary lessening of anguish."

The sculpture to the right, entitled "Peter's Brain" by Peter Austin is a tangled mess of roots. To the left is "Peter 12X24". Both images are self portraits. How the artist sees himself, his brain. His brain is almost spider-like, twisted. The faces are misshapen, each different from the rest.

The last painting is entitled "Smoothing the Shroud" by Trish Evers. She was a co-founder of the Awakenings Project and died from uterine sarcoma in 2000. Hands smooth out the somewhat blurred image of a face. All the different colored hands seem to be lending support and everything in the painting radiates from the face. What jumps out at me the most are the eyes. While almost every other feature is touched by the hands or the other rays of color coming from the face, the eyes seemed untouched.

Cordula Volkening was born in Germany, and attended the School of Art and Design in Kiel, Germany. She immigrated to New York in 1985, but it wasn't until she was diagnosed with stage 4 brain cancer that art changed from a passion to a career.

Prior to her diagnosis in the summer of 2007, she worked mainly in interior construction design and renovations and raised her two children. Once diagnosed and given a one year prognosis, she literally began sketching right in the hospital and then when discharged went to work painting- creating 30 new works in the first three months after her diagnosis.

She wrote on her Myspace page in Nov. 2007, "I paint in between my radiation, chemotherapy and my daily session of are you kidding me... "

She did multiple art shows, often with fatalistic titles such as "Would You Like an Invitation to My Destination?" and "Transition: May We Go to the Places that Scare Us"

In January of 2009 the disease had progressed, and when given the option to prolong life with more chemo, yet render her too weak to paint, the decision was clear; no more treatments. A true palliative decision, since she valued making art over quantity of days.

A quote from a New York Times article by Corey Killgannon profiling her in Feb. 2009 states, "She said the terminal illness has simplified things, washing away the worry and petty preoccupations that almost made life harder when she had plenty of it. And she has never felt more connected to the canvas and to her creativity."

Other quotes from the article:

"she calls every painting a "gift" from the cancer"

"her painting style is shaped by one thing, 'I have nothing to lose'"

Cordula died April 22nd, 2009.

To see more of her paintings visit a slide show "A Passion for Art, Through Cancer", or Cordula's MySpace page. Also, interviews with her on Youtube. This first set done earlier in her disease is quite a contrast to the NY Times video done a few months before her death.

No, not the game show or video game. When I first saw the name of this HBO film, You Don't Know Jack, I thought the title seemed a bit casual for a movie about Jack Kevorkian and assisted suicide. The word flippant came to mind. What I realized as I starting watching the film was that I really don't know Jack. So, maybe an appropriate title (and probably intentionally flippant). I have heard about his work, his court case but I never really knew anything about the man. This film focuses on the years Kevorkian spent as "Dr. Death" but also gives a lot of personal insight into his life, relationships, personality. It shows him as an eccentric man who knowingly gave up his freedom for his cause.

Below is the trailer for this film which just premiered on HBO this past weekend.

Today's post is a potpourri of sorts. We talk much on this blog about how grief serves as an impetus for art. We've reviewed poems, visual art, music and films that trace back to an individuals personal story. Today I am going to interview Susan W. Reynolds, someone acquainted with grief personally, and then take a look at both a piece of artwork and poem she's done. She's involved in a new concept for me, something called "Redesign". It's yet another tool to use in palliative care. In typical interview fashion you'll see the question followed by her response.

AC: Tell me about a bit about your story and your loss?

SR: My husband died at 59, due to lymphoma, five years ago. He died at our lake home, by the water and without our children present, just as he had requested. Hospice was not involved in his care, although a close family friend was an excellent hospice nurse.

I had been a physical therapist in the early years of marriage and loved patient education and working with the team approach in stroke rehab. Most of my married life I was a stay at home mom, having moved our family ten times due to his job changes. Three months before my husband died, both our daughters graduated from college and moved away from home. At 49 I was a widow and now truly an empty nester.

By chance I saw an article about interior redesign and staging and then enrolled in the program to become certified in both. I began doing one day room makeovers for clients, color consulting, transitioning some clients to smaller homes. As I reviewed my clients, I found that the majority of them had recently experienced a large loss, mostly from the death of a spouse or child and some from divorce.

AC: It would seem the process itself is like grief?

SR: Encaustic painting is a bit like life, layering experiences one upon another. In grief, the layers are all there and we are presented with a chance to reassess and decide which layers to expose or rediscover of ourselves. We may decide which ones to let go as well. My artwork here represents growth toward the surface from the bottom of a darker and murkier sea. Rising to the light also required me scraping some of the layers away and deciding what to keep so as to make my painting visually pleasing for me.

AC: You also use poetry as a form of expression. This piece entitled "On the Bolt, Fabric of Life" found on your blog, is at first glance about sewing and fabric. What did the poem symbolize for you?

SR: The salvage of the fabric is often overlooked and not deemed useful in sewing. In grief we salvage what we have learned from the past. We can stitch it down and cover it up without creativity or growth or in salvaging our lives we can accept our own frailty and weave new experiences into the old patterns. Another piece of beauty arises, incorporating both the old and the new.

AC: Finally, as someone on the grief journey, what comment/advice would you share?

SR: My trials and errors speak for themselves. Don't take yourself too seriously. I had no idea that writing would prove to be my greatest "healing" tool. Try something new. It may lead to an unexpected delight or to another door that opens. Do not limit yourself from the baseline of your past. Find what lifts your spirit now and know that this too can change. Allow room for change and some fun doing it!