Meaning, Purpose and Stories at the End of Life | Joel Carter | TEDxWinnipeg

[Music] I'll tell you something about stories you said they're not just entertainment and don't be fooled they're all we have you see all we have to protect ourselves from illness and death you don't have anything if you don't have the stories evil is mighty evil is mighty but not in the shadow of our stories some would choose to destroy the stories confuse them forget them or simply say that they just don't matter if we would let that happen if we would let that happen we would be defenseless Margaret was 54 years old and dying of one of the worst metastatic breast cancers that the dana-farber cancer doctors in Boston had ever seen it was a superficial tumor that was enveloping her and she had severe pain from her cancer and wounds on her chest I walked into her room to help as best I could during my training as a pain and palliative care physician her devoted husband sat quietly just behind her bed I made some changes in the medications to help her be more comfortable and I and I came back the next day with a medical intern who was training with me to be sure that she was doing better as we quietly entered the room we could see that Margaret was much more comfortable much closer to dying and husband was right by her side after a few moments I edged a little closer to her and I softly said Margaret you're 54 years old and she said yes I am and then I said so Margaret you've lived 54 years of stories and she said yes I have and then I asked so Margaret of all the stories you've lived what was one of the best and she said without hesitation and with one foot in both worlds when I met him so I said how did you meet and she said that I was a single mother working at a cash register and a local grocery store when he came through the line and asked me out I wasn't that interested but he persisted and he wore me down and eventually I said okay so then I said what did you do and she said oh we just went down the street to a local bar for a drink and then I said what did you order and she said a Guinness and as she's telling this story as she's sharing this story there is a palpable change in the energy of the room such that that in turn standing right next to me leans over and unprompted whispers in my ear you know this is better than any morphine we've given her all day so the next thing that intern and I did was race out of the hospital and down the street to find the closest liquor store we could and find the coldest Guinness and the nicest pint glasses and we ran back to that hospital and up the stairs and down the ward and into their room to build them one last Guinness to share together she died peacefully two days later her husband right next to her I'll never forget that moment it was a moment that began with a question about a story and I thought to myself that was a pretty good question I should ask it more often I also thought what if what if that in turn was right what if stories could be better than morphine at the end of life I also thought that I was an intern once I was never right but what if that intern was right what if stories can really protect us from illness and death what an absurd idea but I'd love absurd ideas and I thought that I should check it out so what I did was that I found a group of patients dying of cancer and I asked them of all the stories you've lived what was one of the best and I looked at their ratings of sense of well-being as well as sense of pain and I compared that to another group of patients dying of cancer where I did not engage with their story I did not ask them of all their stories he lived what was one of the best and what I found was interesting as far as well-being and each of these lines represents one patient during the time they were with me you can see that ratings for the controls the patients where we didn't engage in stories their sense of well-being did not change but if you engage with patients where you engage with their story their sense of well-being their ratings change significantly well what about pain what about pain for the controls the same thing nothing much happened but if you engaged the best story of their lives and deepen that story what we saw was that pain scores changed significantly even what we say is neuropathic pain neuropathic pain very difficult from tumor invading nerves themselves there was significant changes and so you might ask well if these stories could account for those changes if those stories could account for those changes well what were the stories they told what what are the best stories of dying patients and so what I did was that I kept track and I titled each of the stories told to me and these are some of the examples of what was shared title themes when we first met cheese and crackers with mother piano concert series in Boston family vacations and Cape Cod wedding day and daughter success with schizophrenia the day I got married stories of my five children infant son dancing mtv-style who's now in Berkeley adoption of twins after 12 years instant family singing with children my wedding day snowmobiling in Canada made the list marrying my wife when we first met well these stories really fall into four categories they fall in two categories of activities they fall in two categories of family spouse spouse and activities but for the most part all of these stories are about one thing in general they're about one thing they're really about reaching through sacred space to find the magic of connection with those we love when not much more matters when not much more matters that's what matters most that space that sacred space between a while back I assured some sacred space with a stoic Irishman with a great sense of humor and his family in exam room 14 of her Cancer Centre mr. Udall we get met when he was in the hospital weeks before with severe pain from his pancreatic stage for cancer mr. O'Donnell and I we had a deal I would help him with his pain and he would help me perfect my Irish accent thankfully his pain got better quite quickly sadly my Irish accent he didn't but he turned to me and he said in the only way that an Irishman could he said you know lad you gave it your best try and that's the most important thing he'd be happy to hear that mr. O'Donnell was much weaker now and time was getting short he was reflective of his life and the love of his family we now talked about how hospice could be of great benefit to him and his family as well the mood was somber but at clarity in the moment for mr. O'Donnell he even hummed a little Irish tune from his childhood and his eyes brightened a bit at the end I waited a moment or two and then I turned to him and the best Irish that I could muster and I said and so mr. O'Donnell would you be so kind and willingness to share with us a wee bit of a song and he looked at me and he looked at his family smiled took a breath and began to say Oh Danny Boy the pipes the pipes are calling from Glen to Glen and I'm sorry I have to stop for a minute I have to tell you a secret I'm not a very good singer just ask my 10 year old daughter and my 7 year old son you know the ones with the rolling eyes dad are you singing but they also teach me what they learn in school important lessons and they've said to me dad if you ever need some help or what you have to do is ask so perhaps perhaps we all could give it our best try together because that's the most important thing and we might just conjure up a wee bit of magic such as would bring a smile to the face of a stoic Irishman and honour and memory of his story are you all with me and this is your moment this is your moment let's just find a note together ooh Danny Boy the pipes the pipes are calling from when Duke went down the mountainside [Music] and the summer is gone and all the Roses falling it's you it's you must go and I must buy but come ye back when summers in the man [Music] or when the valleys hushed and white with snow and I'll be in sunshine Horace child Oh Oh Danny Boy Oh Danny Boy I love you so [Music] [Applause] as he finished as he finished his voice hung in the air and echoed throughout the examination room as tears streamed down the faces of all present and spilled over into the cancer center itself nurses and staff paused in the midst of his singing mr. O'Donnell got up slowly came over to me reached out his hand and shook mine hard and long and then let go he said goodbye turned and left with his family hard to find words for moments like that I believe those moments like the ones with mr. O'Donnell and Margaret lie beyond the constructs of medicine and healthcare it's really about how we choose to approach life there are windows available to us to open if we pay attention to our shared humanity and the secret spaces between one another perhaps we could even consider it the creative space of performance art that we have the opportunity to engage with each other each day on the grand stage of what matters most encounters that always contain elements of the unknown opportunities to shape-shift experience and creative process that finds its own way in the midst of life's mystery and in the magic of our stories I will tell you something about stories he said they're not just entertainment and don't be fooled [Applause]

Channel: TEDx Talks

Views: 5,044

Rating: 4.9480519 out of 5

Keywords: TEDxTalks, English, Canada, Humanities, Death, Health, Life, Medicine, Mental health

Id: 6inEsa7DCUM

Length: 18min 16sec (1096 seconds)

Published: Wed Aug 09 2017