Can death be portrayed as beautiful?

In this episode, we share the joy of talking with Wendy MacNaughton (artist, author, graphic journalist) and Frank Ostaseski (Buddhist teacher, author, founder of the Metta Institute and Zen Hospice Project) about using drawings and images as tools for creating human connections and processing death and dying.

You may know Wendy as the talented artist behind Meanwhile in San Francisco or Salt Fat Acid Heat. Our focus today, however, was on her most recently published book titled How to Say Goodbye. This beautiful book began as a very personal project for Wendy while she was the artist-in-residence at Zen Hospice. As BJ MIller writes in the foreword, “May this book be a portal -- a way for us to move beyond the unwise territory of trying to ‘do it right’ and into the transcendent terrain of noticing what we can notice, loving who we love, and letting death -- like life --surprise us with its ineffable beauty.”

Some highlights from our conversation:

• The role of art in humanizing the dying process.

• How the act of drawing can help us sloooow down, pay attention to the people and world around us, and ultimately let go…

• The possibility of incorporating drawings in research and even clinical care.

• The wisdom and experiences of hospice caregivers (who are often underpaid and undervalued).

• How to use the “Five Things” as a framework for a “conversation of love, respect, and closure” with someone who is dying.

And finally, Wendy offers a drawing lesson and ONE-MINUTE drawing assignment to help us (and our listeners) be more present and connect with one another. You can read more about this blind contour exercise from Wendy’s DrawTogether Strangers project. The rules are really quite simple:

• Find another person.

• Sit down and draw each other for only one minute.

• • NEVER lift up your pen/pencil (draw with a continuous line)

  • NEVER look down at your paper

That’s it! While the creative process is what truly matters, we think that the outcome is guaranteed to be awesome and definitely worth sharing. We invite you to post your drawings on twitter and tag us @GeriPalBlog!

Happy listening and drawing,

Lingsheng @lingshengli

Additional info:

• For weekly lessons on drawing and the art of paying attention from Wendy, you can subscribe to her Substack DrawTogether with WendyMac and join the Grown-Ups Table (GUT)!

• To learn more about Frank’s teaching and philosophy on end-of-life care, read his book The Five Invitations

If palliative care was a drug, one question we would want to know before prescribing it is what dose we should give. Give too little - it may not work. Give too much, it may cause harm (even if the higher dose had no significant side effects, it would require patients to take a lot of unnecessary additional pills as well as increase the cost.)

So, what is the effective dose of palliative care? On today’s podcast, we talk about finding an evidence-based answer to this dosing question with three leaders in palliative care: Jennifer Temel, Chris Jones, and Pallavi Kumar. All three of our guests were co-authors of a randomized control trial on “Stepped Palliative Care” published in JAMA this year.

We talk about what stepped palliative care is, how it is different from usual care or intensive palliative care, why these palliative care dosing questions are important, and dive deep into the results of their trial. We also discuss some of the other important trials in palliative care, including Jennifer Temel’s landmark NEJM study on outpatient palliative care and another study that gave an intervention we dubbed “fast-food palliative care” in an older GeriPal blog post.

Well-being and resilience are so hot right now. We have an endless supply of CME courses on decreasing burnout through self-care strategies. Well-being committees are popping up at every level of an organization. And C-suites now have chief wellness officers sitting at the table. I must admit, though, sometimes it just feels off… inauthentic, as if it's not a genuine desire to improve our lives as health care providers, but rather a metric to check off or a desire to improve productivity and billing by making the plight of workers a little less miserable.

On today’s podcast, we talk with Jane Thomas, Naomi Saks, and Ishwaria Subbiah about the concepts of wellness, well-being, resilience, and burnout, as well as what can be done to truly improve the lives of healthcare providers and bring, I dare say it, joy into our work.

For more on resources for well-being, check out the following:

1. Cynda Rushton, PHD, MSN, RN — Transforming Moral Distress into Moral Resilience
   https://www.youtube.com/watch?v=L1gE5G8WnTU

1. Tricia Hersey: Rest & Collective Care as Tools for Liberation
   https://www.youtube.com/watch?v=7OuXnLrKyi0

1. Beyond resiliency: shifting the narrative of medical student wellness
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10500407/

1. Fostering resilience in healthcare professionals during and in the aftermath of the COVID-19 pandemic
   https://www.cambridge.org/core/journals/bjpsych-advances/article/fostering-resilience-in-healthcare-professionals-during-and-in-the-aftermath-of-the-covid19-pandemic/0ADCA3737D12CAF308567A7F59EFC267

1. The Greater Good Science Center studies the psychology, sociology, and neuroscience of well-being and teaches skills that foster a thriving, resilient, and compassionate society.
   https://ggsc.berkeley.edu/?_ga=2.230263642.712840261.1724681290-1268886183.1680535323