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

UMDNJ-SOMherrinmg@umdnj.edu

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.

Aspects of Mortality Death is Universal

Aspects of MortalityKnowledge of Mortality

Immortality is not an option.

Knowledge of Mortality Fear and Uncertainty

Knowledge of Mortality Fear and Uncertainty

“Tell me, Father, is there a 'Next-To-The-Last' rites?"

Knowledge of Mortality –What Comes Next? No Proof

Why We Fear Dying

• We fear the unknown.

But that the dread of something after death,The undiscovered country from whose bournNo traveller returns, puzzles the will,And makes us rather bear those ills we have,Than fly to others that we know not of.

Shakespeare - Hamlet

Fear from uncertainty leads to the hope of something more to come, an afterlife.

Coping with Dying and the Fear of Dying

DenialHumorFaithAcceptance and Embrace

Denial

Humor and Faith

Humor eases fear and anxietyHumor makes angst manageable Humor provides a communication interface. Uncertainly breeds hope of an afterlife Faith diminishes anxietyFaith - The promise of an afterlife becomes an assurance of an afterlife. 

Humor – Quotes about Death

• We're philosophers when we're feeling good; we're frightened when we're feeling ill.

• Death is Nature's way of telling you to slow down.

• Life is pleasant. Death is peaceful. It's the transition that's troublesome. Isaac Asimov

Humor – Quotes about Death

• Death and taxes and childbirth! There's never any convenient time for any of them.

Margaret Mitchell Gone With The Wind.

• If I think more about death than some other people, it is probably because I love life more than they do.

Angelina Jolie

Humor – Quotes about Death

• I don't want to achieve immortality through my work. I want to achieve it through not dying.

• It's not that I'm afraid to die. I just don't want to be there when it happens.

Woody Allen

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.

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/japanese_death_.html

Faith and Mortality - The Japanese

A bright and pleasantautumn day to makedeath's journey. Fukyu Age 79

The owner of the cherry blossomsturns to compostfor 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

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.

Torah Handed Down To Moses At Sinai

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

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!

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 imprisonment…the 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).”

Faith and Mortality- Judaism and the Afterlife

Pharisees:– One sub sect -We are resurrected bodyAnd soul.Another - We are clothed at The resurrection..

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."

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.

A Hasid Looks at Mortality.

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.

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

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

Humor and Faith at the Clinical Bedside

Humor and Faith, bothtangible 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.

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