By Janet Coghlan, Palliative Care Outreach Social Worker
Dr. David Kuhl is the Medical Director of Palliative Care at
St. Paul’s Hospital. Several years ago he was successful
in obtaining funding from the Project on Death in America to research
issues around death and dying and he chose to focus on the personal
experiences of dying people. The result is a very readable book
written for the terminally ill but also a rich source of information
for caregivers, both lay and professional. In his introduction,
Dr. Kuhl talks about how he began as a “detective”
trying to find out what was wrong with a person medically and
then trying to fix it, but in the process of his research he became
a “witness” to people’s stories. Many of the
things he heard relate to universal human truths, which he illustrates
by interspersing his narrative with stories from myth and legend.
From the conversations with the twenty-one people he interviewed,
Dr. Kuhl identifies nine themes, each of which is the basis for
a section in the book. They are: Time and Anxiety; Bad News; Physical
Pain; Being Touched; Being in Touch; Life Review; Speaking the
Truth; Longing to Belong; Self- Realization; Who Am I and Transcendence.
These were issues which were important to some or all of the participants,
many of whom asked him to pass on the wisdom they had gained at
the end of life.
The book is being given a lot of attention in the media and
may well help to change popular attitudes to death and dying.
For social workers, there is reassurance that the psychosocial
and spiritual perspectives of terminal illness are being recognized
and while the information is probably not ground breaking for
us, the points are worth making and making again. Also, the book
is well written and gives some practical tips e.g. for starting
“life review” process, which was used as a research
tool. Certain themes emerged which Dr. Kuhl pinpoints as areas
to address in facilitating the process. There is also an appendix
for physicians on how to communicate with terminally ill patients.
I found the book life-affirming and certainly worth the effort.
