Death, Dying, Humor, and Medicine, EPS 199

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On episode 199 (can you believe it?) of RNFM Radio, Kevin and Keith delve into deep conversation with author and physician Margaret Overton in relation to her new memoir, “Hope For a Cool Pillow“.

This profound and often funny book is a meditation on death, dying, and how to navigate these issues as both a healthcare provider and the family member of an ill or dying loved one. Margaret’s sardonic, wry sense of humor can be found throughout the book, as well as stories about her parents’ illnesses and deaths, her family dynamics, as well as her practice as an anesthesiologist at a Level I trauma center in Chicago. From a weird situation involving the exsanguination of an anonymous patient to Margaret’s father’s pragmatic approach to his own death, this book will lead you on a journey that is at once profound, funny, entertaining, and page-turningly readable.

Margaret states that she wrote “Hope for a Cool Pillow” because she hopes to see a change in end-of-life care that is supported by the general public, and because she’s witnessed first hand how hard it is for many people to have this conversation with their loved ones (and the devastating consequences when they don’t). Margaret holds an MFA in Writing from The School of the Art Institute of Chicago (which is very apparent in terms of the very high quality of her writing), and we’re lucky to have had her on RNFM Radio.

Here are some of our favorite quotes from the book:

• “How do you watch someone die backward, regressively, from old age to infancy, without wanting to scream out loud at the injustice?”
• “I did not bother me to buy Depends in the grocery store. They are just large sanitary napkins with bad branding.”
  
• “My mom’s dementia taught me to open my heart again—nothing breeds humility like helplessness.”
• “The hardest thing—when I was young—about practicing medicine was learning to find the right distance, invoke the proper boundaries. It was learning to adopt the proper degree of anesthesia. And then once I found it, I had to let it go. Someone asked me recently if I believe in miracles. I do, I answered. But I don’t depend on them.”
  
• “Where does the doctor end and the daughter begin?”
  
• “It takes chutzpah to be a doctor. It requires something like courage or astonishing insensitivity to invade privacy to the extent that you do, to invade the boundaries of normal interpersonal relationships. It takes a strong stomach, a poker face, and an ability to think on your feet. A sense of humor helps enormously because people can be very odd.”
  
• “The Study to Understand Prognoses and Preferences for Outcomes and Risk of Treatments” (SUPPORT) found that 50% of patients who were conscious at the end had moderate to severe pain at least half the time in the last three days of their lives. DNR orders were written two days before death 46% of the time. Only 47% of patients’ physicians knew what their preferences were with respect to DNR. This is poor communication and poor planning.”
  
• “The profit motive remains a powerful and insidious reason to extend life at all costs, without concern for quality for either patients or their families. I couldn’t help but come to an important conclusion: capitalism had ruined healthcare. But did capitalism ever belong in healthcare in the first place? It certainly does not belong in death and dying.”
  

Photo credit: Peter Hoffman

Please find Margaret on her website, MargaretOverton.com, and on Facebook.

Here are links to some of the books and resources referenced during our conversation with this fascinating and erudite physician author (and some that weren’t mentioned but you need to know about since we like them and/or Margaret recommends them):

• Aging With Dignity: a resource for end-of-planning, including digital and print versions of The Five Wishes document.
• The Conversation Project: a resource for helping people have those difficult end-of-life conversations.
• Compassion and Choices: an organization dedicated to supporting the rights of the terminally ill and the dying.
• “Being Mortal” by Atul Gawande”How We Die” by Sherwin Nuland
• “Dying: A Natural Passage” by former RNFM Radio guest, Denys Cope

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