Sunday, April 6, 2008
In perusing some of the great (and not-so-great) general education resources from colleges and universities, I stumbled across a philosophy course by Professor Shelly Kagan on Death. Dr. Kagan has written a book called Normative Ethics, which is the study of what is ultimately right and wrong rather than what we believe to be right or wrong. If that doesn't confuse you then this free course might be right up your alley. (There is another session from Yale on Intro to Psychology for those who need a little brushing up.)
The course was originally recorded in the Spring of 2007 and the 26 hour-long sessions are available in mp3, QT, flash or transcript formats. I originally started watching the videos, but since Dr. Kagan does not write on the board much and mostly sits on his desk and talks, I switched to the mp3 formats and have been listening in my car/Ipod. The talks themselves are informative and provide a helpful background into centuries of thought in regards to our current existence and approach towards dying and thoughts of the afterlife. This lecture series is not for everyone, as it can sometimes get pretty abstract, and I occasionally found myself wondering, "Is this a good use of my time? Will this change my practice?" The answers I came to were: Yes and probably not.
I am unlikely to engage many families or patients deeply on issues of spirituality or afterlife as these conversations are usually brief and affirmative of whatever core belief of the patient and family. Rarely are these bedside discussions of spirituality drilled down to the nature of 'what is the soul?' and 'Did Plato's view on forms really support the argument on recollection as a valid theory of existence?' Nor am I likely to have these sort of deep philosophical discussions with staff as we are trying to solve the latest clinical or social challenge in our daily routine. "Yes, let's see if the nausea is better with phenergan...now Heather tell me do you think you are the same person right now as you are in the future?" So to find any value in these lectures I had to realize they help me internally process/understand the suffering/death/joy/relief seen in palliative care on a daily basis. So for those that have the time, enjoy some free Yale teaching! Although I would like to see more philosophical lectures in palliative care education or at national meetings for anyone who would be qualified to give these talks.
"MY LAST LECTURE"
No, not my last lecture but Randy Pausch, the professor from Carengie Mellon University who became an internet sensation when his 'last lecture' was posted to You Tube and seen by hundreds of thousands of people. He recently highlighted some of that talk in an article he wrote for PARADE magazine. (I know, I know...we always cite the New York Times, Washington Post or Newsweek, but hey PARADE is in my Sunday Kansas City Star and he was on the cover...oh never mind.) He was diagnosed with metastatic pancreatic cancer in September 2006 and is still alive today testifying before congress and raising funds for pancreatic cancer research. The video is about 75 minutes, and demonstrates a very constructive approach to such a life-changing event. (He is also a very good presenter, so take notes on his style, use of slides, speech and engagement with the audience.)
The AAHPM and the College of Palliative Care are continuing the Year-Long Mentoring Program and the deadline is May 19, 2008. I have been fortunate enough to benefit from this program in being mentored by Paul Glare with a focus on Prognostication. Because of the collaboration this mentor program facilitated, I have been able to co-author a textbook chapter, and write a few journal articles on prognostication, and will soon traveling to meet with Paul and discuss prognostic research and some editorial articles I am working on. As you can see this is a great opportunity, so if you are just a few years out of training, consider applying.
If anyone is interested in working on prognosis, Pallimed/medical blogs, or other topics, I'll throw my hat in to be available to work with someone as a mentor. The AAHPM could also help in identifying a mentor. Don't be afraid to aim for the stars, as I had initially asked Nicholas Christakis (author of a seminal palliative care book, Death Foretold), but he said he was no longer doing prognosis research and referred me to Paul Glare as the go-to guy in the field on prognosis. They both have been great and supportive.
Last week was the Fellowship Program Director annual meeting in Chicago, where we discussed the future accreditation of Palliative Medicine Fellowship Programs for July 2008. There is a lot of work to be done and forms to be filled out, and most importantly a lot of collaborating between hospice and hospitals to make sure that fellowships are well balanced. So what does it take to be a palliative medicine doctor and how do you know this is the field for you? If you are a palliative medicine fellow, recently finished fellow or faculty and want to write a guest post on what it takes, please email me at: