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The article is entitled" Cancer Doctors Dodge the Death Talk" published on the CNN.com/health website. Citing recent research, the authors highlight four points:
-Most cancer doctors do not discuss end-of-life care
-Those who had end-of-life talks are less likely to be on breathing machines
-About 7 percent of all patients in the study develop depression
-Sometimes doctors have trouble accepting that the end is near
The research supports the efforts being made to encourage doctors and patients to have end-of-life talks as early on in the treatment process as is possible and appropriate. From the perspective of a chaplain, I believe it would also be important for doctors to suggest chaplaincy resources to the patient and caregivers, so that they can receive the benefits of holistic care in the context of advanced care planning.
The CNN artcle can be viewed at: http://www.cnn.com/2008/HEALTH/conditions/06/15/cancer.talk.ap/index.html
Faith in God and belonging to a religion may reduce stress and anxiety in family caregivers, a new study suggests.
Read the article at NaturalStandard.com blog page
Spirituality and Medicine: Frontiers of Care is a free forum open to the public. It will take place on Sunday April 27, 2008, 2:00 - 5:00p.m. at St. John's Persbyterian Church, 5020 W. Belfort Ave., Houston, TX (just off Loop 610). Forum panelists include: Phil Johnson, Memorial Herman
Susan Lange, Interface Samaritan Counseling Centers
Cheryl Smith, First United Methodist Church, Pasadena
Steven Spidell, Prebyterian Outreach to Patients
Pamela Taylor, texas Children's Hospital
For more information, call Rev. Dr. James S. Curie, associate dean of the Houston Extension Program at 713-965-0766.
A web-based educational program is available through EndLink, as a resource for end of life care education. Sponsored by the Robert H. Lurie Comprehensive Cancer Center, the site was developed with funding from a National Cancer Institute Grant. Rather than providing answers, the site attempts to offer frameworks for thinking about caring for the dying individuals and their families. The content of the site was written primarily for health care professionals who work with the dying patients and their families. The material presented encompasses the complex, multidimensional considerations involved in caring for individuals at the end of life. You can reach this site through the following web address: http://ednlink.lurie.norhtwestern.edu/index.cfm
Modern medicine has accomplished incredible things in the last fifty years or so. Developments in vaccines, antiobiotics, surgical interventions, prevention and treatments of major illness have been extraordinary. Everyone knows someone who has been blessed by medicine. There is every reason to believe that future advances are still in the pipeline. In a strange way, however, the very scientism of medicine has contributed to the undoing of an appreciation for the spiritual dimension of human experience. On the positive side, if one becomes ill, the problem is reduced to a "matter" of chemistry, tissues, and organs that can be physically treated. At the same time, the experience of illness is reduced only to matters, viz., chemistry, tissues, and organs. The ill person, therefore, need see nothing of spiritual significance in illness in order to be successfully treated. God, in a sense, is removed from the equation. You see, the spirit never shows up in the test tube. And yet, the true spiritual foundation of life pushes through. Human beings are not finally content for their lives to be reduced to samples on a slide. The Spirit which is within us all cries out for God to be found within matter itself. We want to know that our lives matter, have significance, and purpose, maybe even our diseases. In an ancient twist of logic, it is that very longing to see God's work in everything that led people to say that God "caused" illness, or "permitted" it to happen, or even "intervened miraculously" to bring about a cure. I think what we really wanted to affirm is not that God causes illness or tragedy but that God is involved in every aspect of our human experience. God truly is sovereign over all not because God makes everything happen but because God cares for everyone and everything that does happen. Science on one extreme took God out of everything; religion on the other made God the puppet master. Both missed the point. The spirit cries out that we are more than matter. We see meaning and purpose, even promise in every illness, every injury. God meets us where we live, in the good and the bad and the ugly. And that is what we truly mean by the providence of God, that God provides all that God's children need to face life with love, with wonder, and with hope. Medicine has been a blessing and a challenge. Yet the traditional view of Western medicine is being expanded to include spirit along with matter. When we stop putting things in separate boxes we will see the unity, the sacred unity of all things. Then we will understand that in medicine, in illness, and in treatment the work of God is being done.
- Steven Spidell DMin , BCC
What happens when the professional caregiver is diagnosed with a life-threatening disease? This is precisely what happened to chaplain Debra Jarvis. Jarvis has written a realistic story of cancer survivorship that is refreshing, inspiring, and informative. Debra Jarvis is an ordained minister in the United Church of Christ. She has worked as a hospice spiritual counselor and currently serves as a general oncologist chaplain for the Seattle Cancer Care Alliance. She is a commentator for National Public radio and frequently speaks at conferences and workshops on caner, death and dying, medical staff care, and spirituality.
I found her book to be authentic and engaging. It is worthwhile reading for those who are survivors as well as caregivers. She reflects: "I learned much about cancer from being a patient, and probably the most astounding thing to discover was only a small part of the cancer experience is about medicine. Most of it is about feelings and faith, and losing and finding your identity, and discovering strength and flexibility you never knew you had. It's also about looking at life and staring death in the eye. It's about realizing the most valuable things in life are not things at all, but relationships." These words are reflected in the title of her book, to remind caregivers that cancer is a mixture of curse and blessing - and the blessings are experienced as gifts that are not often apparent to the naked eye of the observer.
The author uses her personal journal, shared from the moment she received the news of her demise, and expands upon her entries to paint a vivid picture of her life as a cancer patient, including excerpts describing her interactions with those around her. She is real about the personal and social dilemmas faced when having to ask for help. She wrestles with her faith, seeking assurance from the Almighty when she faces a deep sense of powerlessness. Her writing style includes an internal dialogue which she places on the pages in order to engage and the reader to enter the drama for the sake of learning and finding inspiration.
Having been employed as a chaplain in a large metropolitan hospital, I found many aspects of Jarvis's journey to be universal in the sense that I have heard those common themes associated with the cancer journey to be reflected in so many patient and caregiver stories. Jarvis has a way of giving those themes life and substance, depth, and color which portray the rich basic elemental aspects of human life, when disease threatens to annihilate one's existence. I recommend It's Not About The Hair to those who are seeking strength and encouragement when life's journey includes an encounter with cancer.
Reviewer: Rev. David Jenkins
Make room on your calendars for the Living Fully With and Beyond Cancer Conference, sponsored by M. D. Anderson Cancer Center's Anderson Network.
This year, the conference will be held at the Houston Marriott Westchase, 2900 Briarpark Dr., Houston, on September 6-8th.
For additional conference information, call the Anderson Network at 800-345-6324 or 713-792-2553 or visit : www.mdanderson.org/patientconference
 Back in April 2006, I recommended a devotion entitled "Disrupted" by Rev. Dr. Virgil Fry. Dr. Fry has just published a companion book, entitled: "Rekindled, Warmed by Fires of Hope". Once again, Virgil has used his considerable experience as a chaplain and writer to create another rich devotional resource, drawing upon scriptures, wisdom sayings, and personal experience in the pastoral care ministry. The prayers he includes are real, and express the deepest spiritual longings of the heart.
I am pleased to announce that M. D. Anderson Cancer Center was awarded a 2007 IMPACT Award from the Houston Human Resources Association at the award banquet held at Reliant Center, Tuesday, March 27, 2007. We received recognition for our institution's pilot program conducted in the Palliative Care unit measuring the positive impact of leveraging spirituality as a dimension of diversity to improve workplace productivity. The Houston HR Association, known as HR Houston, is the Houston affiliate chapter of the Society for Human Resource Management.
What motivated you to enter Chaplaincy as a career?
I experienced a spiritual "calling" to enter Chaplaincy as a career.
What's the most challenging part of your work?
Staying spiritually centered within me so that I can consistently offer a non-anxious, open, and gentle presence.
What's the most rewarding part of your work?
Hearing, sensing, seeing, and experiencing the inner beauty, struggles, and growth of others journeying with Cancer.
What do you find to be the most helpful when visiting with a cancer patient?
My ability and capacity to be fully present, attentive, and available to my patient's world.
What spiritual or religious resource do you find most personally helpful?
I find prayer, listening, the scriptures, humor, and the spiritual traditions of lament most personally helpful.
What personal characteristics do you believe make an effective chaplain?
Humility, playfulness, empathy, and discerning wisdom.
Are there spiritual/religious topics you personally wrestle with?
I struggle with issues around religious pluralism, racism, and the on-going process of dying to self.
What would you like cancer patients and their families to know about M. D. Anderson?
That MDACC is a complex, competitive, compassionate, comforting and conflicting place at times.
I recently published an article in the Austin Theological Seminary Doctor of Ministry magazine, Windows, which describes how clinical pastoral educators train future chaplains how to hear and interpret the stories of patients at our hospital.
The full article is available in the Winter 2007 edition of Windows.
A practical skills-building workshop for clergy and lay leaders. Presented by Partners in Healing of the Mental Health Association of Greater Houston. Workshop participants will be able to: indentify scriptural support to help congregants deal with life problems; promote a healthy and whole Christian lifestyle; identify next steps for building caring and supportive congregations. The workshop will take place on March 22,2007, 9am to 1:30pm at Fifth Ward Missionary Baptist Church Multipurpose Center, 4300 Noble st., Houston, TX 77020. Program fee is $10.00, including breakfast and lunch. To register call: 713-523-8963.
Episcopal Chaplain Marshall Scott has an interesting post on chaplaincy volunteers:
I ended my last reflection on volunteers with the question, "So, what can volunteers do?" For those of us who do call for a high level of quality of care for patients in health care institutions, that is not a simple question. I have suggested that there are a variety of qualifications that we might consider for a person who wishes to volunteer. But, as I have noted, the variety of qualifications simply begs the question.
Or, perhaps it only appears to do so. I say that because the variety of qualifications suggests that volunteers can do what they’re asked to do and trained to do. That is, there are people out there, and perhaps available, who have one or more of the various qualifications I suggested. Granted, there will be more un- or underemployed folks with CPE who might volunteer in major metropolitan areas. I have a colleague who has a Board Certified Chaplain serving on a volunteer (unpaid) basis. However, the other sorts of preparation I mentioned, from seminary courses to education programs for lay ministry, are widely available, and may well reach into small towns. We speak of folks as "volunteers" because we're not prepared to pay for their service. But that in and of itself doesn't describe the limits of what a given volunteer, with certain individual talents and preparation, might be able to do. Rather, it clarifies the question from "What can volunteers do?" to "What do we want volunteers to do?" At M. D. Anderson Cancer Center, the chaplaincy department offers qualified volunteers an opportunity to participate in our interfaith lay volunteer programs. These programs are designed to help augment the work of our board certified full-time chaplains by providing a spiritual presence to cancer patients and their families through the compassionate presence of trained interfaith volunteers. If you are interested in serving in such a program, please contact our office at 713-792-7184, and as for our Coordinator of Community Chaplaincy Programs, Rev. Mirjam Berger.
A UK blogger raises concerns about chaplaincy downsizing in Britain:
I managed to listen to most of the Jeremy Vine show today without ranting. (Well I did bang the desk and shout Right On Brother Sheridan at Tommy). But I was really disturbed by the story about the NHS Trust which is saving £100,000 by cutting 6 out of 7 chaplains. More here
This disturbs me quite a lot. I'm not religious in the slightest, but I can see the benefits of a strong chaplaincy system in the NHS. I may not be religious, but many people are. Speaking from my own religious background it is important for Catholics to have the last rites, and I don't know that I could say now that when my time comes I won't feel that I need that. We must respect the strong religious faith that many people have, particularly at such a sensitive time in their life and possibly end of their life.
Chaplains also offer support to relatives and to staff. It can't be easy for (as an example) a nurse on a children's cancer ward - surely it is good staff management to offer support to people who do a difficult job.
Houston breast cancer survivor Teresita Ladrillo was feeling the usual side-effects of surgery, chemotherapy and radiation when she elected to try a different kind of pick-me-up: yoga.
Enrolled twice weekly in a class offered at the University of Texas M.D. Anderson Cancer Center, Ladrillo performed exercises aimed at calming tension and recovering lost mobility, problems stemming from her treatment.
"It proved very helpful," says Ladrillo, 52, a dentist from the Philippines now preparing to take U.S. licensing exams. "Learning to breathe deeply and slowly gave me relief when I would get tense and some of the poses gave me back the elasticity and flexibility that radiation takes away."
The classes are part of M.D. Anderson's efforts to incorporate yoga into treatment plans for cancer patients. On Sunday, center researchers reported the ancient discipline can help cancer patients function better physically and feel better about their health.
There's more at the Houston Chronicle. For more information on the Complementary/Integrative Medicine Program see http://www.mdanderson.org/departments/cimer/.
Related:
M. D. Anderson Announces Collaboration with India's Largest Yoga Research Institution to Gain Scientific Evidence of Yoga Benefit to Cancer Patients
Short Course of Tibetan Yoga Improved Sleep in Cancer Patients
Large National Cancer Institute Grant Will Test the Effect of Tibetan Yoga on Women with Breast Cancer
Do Mind/Body Techniques Work?
The chaplains at M. D. Anderson Cancer Center Chaplaincy Department have found this to be a very helpful resource for cancer patients and families. Virgil's book is available for purchase online.
David Jenkins, Director of M. D. Anderson Chaplaincy found the following article to be informative because it supports the notion that spirituality is essentially the human capacity to experience the trans-empirical. That means that every person, regardless of whether they consider themselves religious or not, is capable of exercising their spiritual capacity. "The spiritual care I received at the hospital helped me find the strength in myself to deal with the disease," says Ora Haviv, 62, who developed lung cancer following exposure to asbestos. Haviv does not define herself as religious, and says she does not believe in God. Nevertheless, reading the Bible and other texts helped her contend with her illness, she says.
"I was told I had half a year to 11 months to live, and 30 months have gone by since then," she says. "I found myself reading verses from Psalms - like 'I will lift up mine eyes unto the mountains: From whence shall my help come?' - and analyzing them in a non-religious manner. But beyond studying the texts, the spiritual care enabled me to emerge from the great loneliness that stems from the inability to share my plight with friends and family."
MD Net Guide has a piece on the Medical blogosphere that includes several interesting links and a great introduction to blogging: ...there comes a time in every physician's life when he or she just wants a place to tell a funny story, scream to the heavens about the frustrations of HIPAA compliance, complain about a recalcitrant patient, or otherwise blow off steam. "That's the beauty of blogs. If they want to be self-indulgent, they can," says Kevin Pho, MD (blog home: www.kevinmd.com). "This is not for business. It's for patients, but it is also for myself and other doctors, too." Dr. Pho, whose own blog is visited by some 200 readers each day, adds that "It's a way to argue and debate medical issues, whether it's the cost of practice or universal healthcare, [but] it's also just a way to keep in touch with writing" Wikipedia has an entry on blogosphere for those of you who are unfamiliar with the term: Blogosphere is the collective term encompassing all weblogs or blogs as a community or social network. Many weblogs are densely interconnected; bloggers read others' blogs, link to them, reference them in their own writing, and post comments on each others' blogs. Because of this, the interconnected blogs have grown their own culture. Other terms in use include Blogtopia, Blogspace and Blogistan.
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The following links are external sites not affiliated with MDACC or the Department of Chaplaincy.
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