Last night with my wife I attended La Boheme, an opera by Puccini showing how little attitudes about dying changed since 1896 when the opera was first performed.
DEALING WITH LOSS
In the third act, Mimi, the heroine, learns her lover, Rodolfo, rejected her because he believed her illness would lead to her death and he couldn’t accept the loss. Not the most stellar of personal attributes. So, as many people do with dying, instead of confronting their fear, he leaves her to fend for herself.
LEARNING TO BE HELPFUL
In my hospice experiences, I often heard stories from patients who felt rejected when friends and loved ones learned they were dying. While some took the rejection as a statement about them, I think we often aren’t as helpful as we want to be because we don’t know how.
That’s why I wrote, “I Have Cancer,” 48 Things to Do When You Hear Those Words. I think most people want to help in a health crisis, but run away either because they think they don’t have the skills to help a person who is dying or are afraid of confronting their mortality.
FACING DEATH
In the final act, Mimi makes her way back to Rodolfo’s apartment to die. Laying on his bed, looking out the window and surrounded by friends, she begins the process of dying. While everyone, except Rodolfo, understands what’s happening and says their final goodbyes, Rodolfo still pretends she’ll recover. Delusional, as many people are today when facing death.
If there was another act covering Rodolfo’s life, I’m sure Puccini would show him as someone filled with regrets about not saying or doing things showing his love for Mimi. I found the same in caregivers I counsel. The lesson? Don’t wait to tell someone how important they are in your life.
The performance by the San Francisco Opera was spectacular and a lesson in how attitudes on the acceptance of death haven’t changed over the last 118 years.
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Hi Dr. Goldburg, I am a hospice nurse in the Bay Area. I have a pt who is at the end stage of Alzheimers. Her son is taking his mother (who has always loved the opera) to see the same performance this weekend. He is doing this against the advice of the staff where she resides, other family members, and even some of the members of my team. To take this woman anywhere will require a taxing effort that may even cause her some discomfort and stress. I have had many discussions with the people opposed to this trip and was even “on the fence” myself. As I read your blog, I began to feel confident that this is going to be a good thing…..for him as well as her. My prayer is that she will have an incredible lucid moment and thoroughly enjoy hearing her last opera with her family. Thank you for all the work that you do.
I realize that my response will probably be too late for you patient. So, the advice can be used for other patients. To avoid anxiety caused by new situations it’s best to prepare the patient by introducing elements of the new setting. For the opera, I would have suggested listening to some arias, showing her photographs of the performance, and if possible even taking her to the building.
Basically, what you are trying to do is introduce some familiarity, and hoping elements will remain in her memory
Point well made, Stan. The same happens when people shun hearing of another’s problems. Too much for them to take in, but more likely too close for comfort. Have you read and listened to “Graceful Passages”, a small elegant book on death, containing two CDs, one with the messages from various people about death and their own dying, and the other with only music. I’m using some of those messages in a January 17th workshop I’m facilitating: “Transitioning into Death: A Personal Exploration”. This workshop is for men for I believe men in particular have a difficult time “letting go”.
I’m very familiar with Graceful Passages. It CD with music was often used in my hospice practice. And I think you’re right, about men having more difficulties dealing with openness than women. But I don’t think women’s acceptance of death is that much better then men. I think it’s more of a cultural rather than gender phenomenon–but that’s just conjecture. Your workshop sounds interesting.
ooops….sorry I spelled your name wrong.
Not a problem
Hi Dr. Goldburg,
I am a hospice nurse in the Bay Area. I have a pt who is at the end stage of Alzheimers. Her son is taking his mother (who has always loved the opera) to see the same performance this weekend. He is doing this against the advice of the staff where she resides, other family members, and even some of the members of my team. To take this woman anywhere will require a taxing effort that may even cause her some discomfort and stress. I have had many discussions with the people opposed to this trip and was even “on the fence” myself. As I read your blog, I began to feel confident that this is going to be a good thing…..for him as well as her. My prayer is that she will have an incredible lucid moment and thoroughly enjoy hearing her last opera with her family. Thank you for all the work that you do.
Hi Beth,
I realize that my response will probably be too late for you patient. So, the advice can be used for other patients. To avoid anxiety caused by new situations it’s best to prepare the patient by introducing elements of the new setting. For the opera, I would have suggested listening to some arias, showing her photographs of the performance, and if possible even taking her to the building.
Basically, what you are trying to do is introduce some familiarity, and hoping elements will remain in her memory
Take Care,
Stan
Point well made, Stan. The same happens when people shun hearing of another’s problems. Too much for them to take in, but more likely too close for comfort. Have you read and listened to “Graceful Passages”, a small elegant book on death, containing two CDs, one with the messages from various people about death and their own dying, and the other with only music. I’m using some of those messages in a January 17th workshop I’m facilitating: “Transitioning into Death: A Personal Exploration”. This workshop is for men for I believe men in particular have a difficult time “letting go”.
Hi Ken,
I’m very familiar with Graceful Passages. It CD with music was often used in my hospice practice. And I think you’re right, about men having more difficulties dealing with openness than women. But I don’t think women’s acceptance of death is that much better then men. I think it’s more of a cultural rather than gender phenomenon–but that’s just conjecture. Your workshop sounds interesting.
Stan, I just listened to Dr. Michael Fratkin’s TedTalk. Very moving. https://www.youtube.com/watch?v=WQgjgFoLirs