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Humor and Spirituality Near the End of Life Marvin E. Herring, MD Clinical Professor Family Medicine...

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Humor and Spirituality Near the End of Life Marvin E. Herring, MD Clinical Professor Family Medicine UMDNJ-SOM [email protected] Slide 2 Humor and Spirituality Near the End of Life Objectives Attendees will be able to: 1. Understand why spirituality and humor are bound to any processing of end-of-life issues 2. Begin or revisit exploring personal concepts of End- of Life issues. 3. Appreciate faith-based contributions to end-of-life care, illustrated by Japanese and Jewish precepts. 4. Recognize applicability to Palliative Medical Care. Slide 3 Aspects of Mortality Death is Universal Slide 4 Aspects of Mortality Knowledge of Mortality Slide 5 Immortality is not an option. Slide 6 Knowledge of Mortality Fear and Uncertainty Slide 7 Tell me, Father, is there a 'Next-To-The-Last' rites?" Slide 8 Knowledge of Mortality What Comes Next? No Proof Slide 9 Slide 10 Fear from uncertainty leads to the hope of something more to come, an afterlife. Slide 11 Coping with Dying and the Fear of Dying Denial Humor Faith Acceptance and Embrace Slide 12 Denial Slide 13 Humor and Faith Humor eases fear and anxiety Humor makes angst manageable Humor provides a communication interface. Uncertainly breeds hope of an afterlife Faith diminishes anxiety Faith - The promise of an afterlife becomes an assurance of an afterlife. Slide 14 Slide 15 Slide 16 Slide 17 Faith and Mortality - The Japanese Japan Until the 5th century, Shinto Belief Systems. Death from smallpox, scarlet fever, measles, typhoon, flood,drought, famine, blindness, war. Living past one year a milestone. Talismanic prayer - lucky gods, symbols of long life, immortality. Gosho Ningyo - fat chubby child- figurines given as gifts- happy, fat = healthy. Slide 18 Faith and Mortality - The Japanese Adoption of Buddhism as a promise of a next life being better - Zen, fatalism, and acceptance of death as a blessing, a bridge, a "that's it." Death poems. Although the consciousness of death is in most cultures very much a part of life, this is perhaps nowhere more true than in Japan, where the approach of death has given rise to a centuries-old tradition of writing jisei, or the 'death poem.' Such a poem is often written in the very last moments of the poet's life." Crossing The Rubicon http://northernva.typepad.com/crossing_the_rubicon/2006/01/japan ese_death_.html Slide 19 Faith and Mortality - The Japanese A bright and pleasant autumn day to make death's journey. Fukyu Age 79 The owner of the cherry blossoms turns to compost for the trees. Utsu Age 50 This final scene I'll not see to the end... my dream is fraying. Choko Farewell... I pass as all things do do dew on the grass. Banzan Slide 20 Faith and Mortality- Judaism and the Afterlife The Jewish religion, a monotheistic religion based on the laws and teachings of the Holy Scripture and the Talmud. (Webster's New World Dictionary) Holy Scripture - the Torah (Five books handed down to Moses at Sinai) Talmud - The compilation of discourse, dialogue, rabbinical teaching, with major emphasis on being measured by ethical living, deed-doing, preserving tradition and study of Torah. 1st- 6th centuries CE. Slide 21 Torah Handed Down To Moses At Sinai Slide 22 Faith and Mortality- Judaism and the Afterlife The Biblical Era - Death comes to all, with little hinting at afterlife. The Rabbinic Era - Punishment, even of the pious, and the reason for "discovering" resurrection in the teachings. (Destruction of the Temple 70 CE).Sadducees.Pharisees.Essenes Slide 23 Faith and Mortality- Judaism and the Afterlife (After Josephus Greco-Roman Historian 38-100 CE ) Sadducees Rigorous fundamentalists. Re: afterlife - "the souls die with the bodies." We come we live, we go. That's it! Slide 24 Faith and Mortality- Judaism and the Afterlife (After Josephus Greco-Roman Historian 38-100 CE ) Pharisees - tradition is molded by contributions from a "continuous succession of fathers. Souls have a deathless vigor.beneath the earth there are rewards (virtue) and punishments (vice). For the latter, everlasting imprisonmentthe former shall have the power to revive and live again (..on account of which, they are able to persuade greatly the body of the people). Slide 25 Faith and Mortality- Judaism and the Afterlife Pharisees: One sub sect - We are resurrected body And soul. Another - We are clothed at The resurrection.. Slide 26 Faith and Mortality- Judaism and the Afterlife (After Josephus Greco-Roman Historian 38-100 CE ) Essenes- a Platonic belief that the souls, freed from the body, "rejoice and mount upward." Slide 27 Faith and Mortality- Judaism and the Afterlife Kabbalah - Mystic Judaism - Kabbalah became a reference to doctrines of esoteric knowledge concerning God, God's creation of the universe and the laws of nature, and the path by which adult religious Jews can learn these secrets. Hasidism - Jewish religious movement founded in Poland in the 18th cent. by Baal-Shem-Tov. Its name derives from Hasidim (The Pious), which stressed the mercy of God and encouraged joyous religious expression through music and dance. No fear of death - Embraced the joy of passing on, a triumph of faith over fear. Slide 28 A Hasid Looks at Mortality. Slide 29 Humor and Faith Promise of Resurrection Acceptance and Embrace Humor eases death fear and anxiety. Humor makes death angst manageable. Humor provides a communication interface. Uncertainly breeds hope of an afterlife. Faith diminishes and conquers death anxiety. Faith - The promise of an afterlife becomes an assurance of an afterlife. Slide 30 Spiritual Dimension of Mortality Death is simply a shedding of the physical body like the butterfly shedding its cocoon. Elisabeth Kubler-Ross Dr. Elizabeth Kubler-Ross visited the Maidenek concentration camp in 1946. When she got to the children's barracks, it was particularly sorrowful, with toys and shoes strewn about, but there was something else, too. The walls were covered with hundreds of butterflies, scratched and etched with fingernails and pebbles Slide 31 Spiritual Dimension of Hospice It was the inability of the medical model to deal with the reality of patients who die that motivated Dame Cicely Saunders and the interdisciplinary team she gathered in London in the 1960s at St. Christopher's Hospice. Accepting that death is a normal part of human life, Dame Saunders and her team established a system of comprehensive care that embraces the physical, emotional, spiritual, existential, and relational dimensions of dying. Park Ridge Center for Health,Faith and Ethics http://www.parkridgecenter.org/Page515.html Slide 32 Humor and Faith at the Clinical Bedside Humor and Faith, both tangible aspects of the human spirit, are allies in the clinical management of those souls and their loved ones who are dealing with life-limiting illness. Longer a part of the healer's tools than the modern sophisticated interventions, they have demonstrated potency, and stand as cornerstones of palliative care. Slide 33 Resources Japanese Death Poems: Written by Zen Monks and Haiku Poets on the Verge of Death. Yoel Hoffman The Death of Death: Resurrection and Immortality in Jewish Thought. Neil Gillman Wikipedia The Free Encyclopedia Google Search - Wikipedia Press Search

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