Sunday, December 28, 2014
A physician, when asked how he wants to live at the end-of-life, states “I want to die in my own bed in my bedroom, holding my wife.” Yet how do most Americans die? In a hospital room after prolonged multi-system health issues, with a seemingly endless series of hospitalizations, procedures, tests, treatments and medications, and self-care regimens.
This discrepancy between the “ideal” view of death and the reality of death in America today is the challenge explored in the new award-winning documentary, Consider the Conversation 2: Stories about Cure, Relief, and Comfort. This is the second film by Michael Bernhagen and Terry Kaldhusdal, who produced Consider the Conversation: A Documentary on a Taboo Subject in 2011.
Over the course of Consider the Conversation 2 (CTC2), we learn from physicians and patients about the importance of communication in navigating the uncertainties and the many decisions associated with chronic serious illness. Palliative care and communication are forefront in this movie, which includes interviews with Palliative Medicine experts including Diane Meier, James Tulsky, Anthony Galanos and Jim Cleary.
While the perspectives and information provided by these medical experts is a critical element of this film, the most powerful messages about communication come from the patients themselves:
- Laura, whose journey through cancer treatment is prompting her to take care of things for her loved ones. She talks about cleaning out her basement and writing a note for her family: “Hopefully you will find this when I’m 94. But if not….” For Laura, statistics about her disease provide her with hope, and the motivation to achieve her goal of “being an old damn lady.”
- George, a federal highway administrator with lung cancer who is famous for his giant pumpkins. He faces his journey one day at a time. He didn’t want to look at the mortality tables for his disease, as he views himself as an individual, not a statistic. He just wants to know if something changes, but he doesn’t want the details.
- Greg, a younger man with advanced cancer who doesn’t want to know anything about his disease. This is illustrated as his wife talks about how he had to look away when they were completing the disability claim form question “what do you have”. We see this couple at an advanced stage in Greg’s journey, just a week or two before his death. One of the most touching scenes in the movie is when he is talking with his two young daughters over the phone, sharing “magic kisses” with each other.
Each of these people has a unique way of thinking about their diagnosis and their future, and of coping. We see how their physician, Dr. Toby Campbell, at the University of Wisconsin, tailors how and what he communicates, based on what he knows about them, and what they want to know. The film concludes with a story by Robert Fulghum, from his classic book All I Really Need to Know I Learned in Kindergarten. Seeing this iconic storyteller is both a rare treat and a powerful reminder of the importance of relationships in advanced illness.
With the release of this film, a big-screen premiere was recently held at the Oconomowoc Arts Center, near Milwaukee. The highlight of this event was a panel discussion that included several people who were featured in the film. George was there. He is still growing big pumpkins, and going through more treatments, living one day at a time. Greg’s wife was also there, eloquently sharing about her husband and their experience, using these types of speaking opportunities to help her heal and move forward. Toby Campbell shared his perspectives on the film and on communication, while Jim Cleary challenged us to consider the language we use when communicating with patients. Do we use words of war, such as “fight” and “battle”? Or, do we use words that can instill more peace in our patients, such as “journey” during the ups and downs of serious illness? It was a memorable evening to celebrate a remarkable film.
So how can YOU see Consider the Conversation 2 and share it with others, to get the conversation going in your area?
CTC2 is being aired on PBS stations across the US. You can also purchase the DVD through Amazon via the CTC website. The DVD pricing is $30 for personal use, $200 for educational use.
Beth Fahlberg is a nursing educator, researcher, and author interested in palliative care in heart failure and evidence-based, innovative teaching and learning approaches. She enjoys spending time with her daughter and husband, and her three guinea pigs, at their home in Madison and their family's lakefront cottage in northern Wisconsin.