Streams

The "New Grief"

Monday, August 22, 2011

Medical advances prolong life for those with terminal illnesses. Barbara Okun, professor of counseling psychology at Northeastern University, clinical instructor at Harvard Medical School and the co-author of Saying Goodbye: How Families Can Find Renewal Through Lossoffers a guide to what she calls the "new grief."

Guests:

Barbara Okun

Comments [19]

peggy from manhattan

This New Grief discussion was only touching on the iceberg for understanding the repercussions of any diagnosis of "life-threatening" illness. As a 4-yr "survivor" of a stage 4 cancer diagnosis, I think, why not really go to the heart of the philosophic dilemma modern medicine has produced, and some of the ramifications for loved ones? Perhaps there is some manner that people with stage 4 diagnoses or the like might call in to talk about it...

also, why not cover the crucial drug shortages that are tearing apart the basis for our continued "survival?" Much of the media seems to shy away from any real coverage, which likely goes to show that it is a problem of how capitalism works in this country. I have been resorting to medical tourism to obtain cancer medications, how many others do this?

Aug. 22 2011 08:44 PM
Harlan from Georgia

As a physician treating those with cancer and terminal conditions I find it somewhat offensive that your show seemed to take a tone that physicians may minimize the impact of treatments (e.g. on quality of life). We are interested in treating disease but a responsible physician (and most of us are) will discuss the untoward side effects of therapy at length with patients. Often times, it is a patient's biased recall of a discussion that may paint us as making little of a serious situation. Also, we do not have crystal balls to tell us how a patient will respond to therapy.

Aug. 22 2011 01:13 PM
MP from Brooklyn

To Mark in NJ - you are exactly right and thank you for the link. My mother and I have discussed these issues many times, and she has always said, "you know what I want," but I have always urged her to put it in writing. I don't want there to be any confusion or acrimony among my siblings when the time comes.

Aug. 22 2011 11:24 AM
Susan from nyc

Brian, I agree with all the comments that came before mine. Also, there are non-toxic treatments for cancer that the AMA and the Cancer Industry refuses to acknowledge because they can't make money on them. There's a wonderful book called "Outsmart Your Cancer" by Tanya Harter Pierce. You shoud interview her.

Aug. 22 2011 11:05 AM
nh from nyc

re: chemo

my mother had terminal breast cancer, and was given chemo, even when it was known it would not cure the disease. The hope was that it would extend her life a bit.

She was given chemo (of course it was her choice) until the about 2 weeks before she died. I think the doctor knew that she would die very soon (cancer was in spine and he knew), but continued to allow chemo so that she would feel like there was some hope.

in short , not worth it in this case, the chemo caused a lot of suffering.

I think there also are incentive$ for Doctors from drug and insurance companies to give chemo, EVEN WHEN IT IS LIKELY TO DO MORE HARM THAN GOOD, and this may out weigh quality of life concerns.

Aug. 22 2011 11:04 AM
Mark Gavagan from Mendham, NJ

Terrific discussion.

A key point is for loved ones to communicate openly, ask questions, listen, and finally WRITE DOWN DECISIONS once they're made (e.g., final arrangements, advance health care directives, organ donation choices, etc).

http://organizemyaffairs.com/

Aug. 22 2011 11:01 AM
Collette from Brooklyn

My father died after a prolonged cancer when I was 12. Even though we knew it was coming, it was hard to grasp as a young child. My mother was doing the best she could in a difficult situation, but I wish she or, even better, my father had talked to me about it. I think it's so important to include children in the process and not to assume that they are too young to understand or should somehow be protected.

Aug. 22 2011 11:00 AM
WB from new york

Ms Okun seems to assume everyone has a great family support system, and all families are supportive. That is too often not the case at all.
What about people without family support, and with nasty families? who is going to take care of medical, financial, etc decisions?

Aug. 22 2011 10:59 AM
Madeleine from Wilton CT

Your guest is exactly right. My husband got a diagnosis of ALS. He died in 2000. In the couple of years he lived after his diagnosis, we as a family were able to come together and make his and our quality of life so much better, so intensely loving and full, than you can imagine.
The day after we received the definitive diagnosis (we had been through years of misdiagnosis), he and I decided we wanted to do three important things: Renew our marriage vows in our church; Take a special trip to Italy with our son and his mother so that he and his son could delight in their common love of Roman history; and get a new puppy and love the new “child” together as long as we could.

Caring for him during that time gave our son and me a process and time for processing our feelings and needs.

Finally, the process of “anticipatory” grief that I went through during that time enabled me to deal with his actual death in a much more whole and caring way.

Aug. 22 2011 10:57 AM
Nikki

Part of the large problem
1- There is no clarity around when someone is "terminal" . Many MDs will not even mention that word, and there are unfortunately many diseases that cause so much grief but are not quite terminal, like alzheimer's. The way we have to cope with someone losing functionality over years is often much more difficult that somone passing quickly.
2 - Very few people get to die as they wish. Once someone enters a hospital as a terminal patient, it is almost impossible to leave. Hospitals also will not give up on a patient - so a patient is getting tests and treatments until the last day. This happened with my mother, who passed away after a long battle with metastatic breast cancer.

It is so heartwrenching to watch someone suffer slowly.

Aug. 22 2011 10:57 AM
Sophie from Poughkeepsie, NY

@Mr. Bad from IL

You got that right too!

Aug. 22 2011 10:57 AM
MP from Brooklyn

This is a very timely topic for me. My uncle died on Wednesday, exactly five weeks to the day of receiving a diagnosis of lung cancer. It had metastasized through his whole body. He refused any treatment and spent his last weeks at home, aided by hospice. He had no pain and little discomfort. He died at home, surrounded by his entire family at the age of 81. He told his family that he was at peace and because of that, they are, too. I am grateful he had a little time to say good-bye but not a long time to suffer.

Aug. 22 2011 10:57 AM
Sophie from Poughkeepsie, NY

And I might add, even with decent health insurance it's no guarantee of good treatment either. Maybe some of your bills get paid, that's about it.

Aug. 22 2011 10:55 AM
wanda bershen from nyc

Ms okun seems to assume that everyone has a family support system -- which is not the case. Also she seems to assume all families will be helpful and supportive -- also often not the case. What about the rest of us?? Who is going to take care of all the medical, insurance, financial, etc matters??

Aug. 22 2011 10:55 AM
Sophie from Poughkeepsie, NY

@hugh

You got that right!

Aug. 22 2011 10:53 AM
Mr. Bad from IL

This is the new denial, especially on the part of the medical establishment. This woman is clearly trying to pitch us on the superiority of endless medical care in service of bigger profits for insurance companies. The new grief is a sad, pathetic semblance of the old life, i.e. vacations, family gatherings, etc. Truly a horrible vision bereft of humanity. Death should be death, the ancients knew it, it if weren't for these dopes telling us we need to live forever, youthful and beautiful, happy and content, we could finally accept it and move one.

Aug. 22 2011 10:53 AM
Conlee

How about paying for the second opinions and the repeated tests and treatments -- without income or insurance?

Aug. 22 2011 10:53 AM
T. P. Stevens from Manhattan

Semantic naval gazing, repackaging, and professional opportunism. This has all been said and described before.

Aug. 22 2011 10:53 AM
hugh

The New Grief is obviously for those lucky enough to have health insurance and active family members. For a large swath of Americans the New Grief is the same damn thing as the Old Grief; being treated like a piece of meat in a system set up only for people who can afford it.

Aug. 22 2011 10:50 AM

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