SlideShare une entreprise Scribd logo
1  sur  13
Practical Thanatology

Frank Meissner, MD, FACP, FACC, FCCP




       US Hospital, Zagreb
Gilgamesh, where are you wandering?
The [immortal] life that you are seeking all around you will
  not find. When the gods created mankind they fixed
  Death for mankind, and held back Life in their own
  hands. Now you, Gilgamesh, let your belly be full! Be
  happy day and night, of each day make a party, dance in
  circles day and night! Let your clothes be sparkling clean,
  let your head be clean, wash yourself with water! Attend
  to the little one who holds onto your hand, let a wife
  delight in your embrace. This is the true task of mankind.
                  The Epic of Gilgamesh, ca. 1700-1300
  B.C.


              US Hospital, Zagreb
A Humanistic Model of Medicine

           SOCIAL

  BIOLOGICAL   PSYCHOLOGICAL

          SPIRITUAL

CULTURE

     US Hospital, Zagreb
LIKE GILGAMESH, MANY
 s   Foolishly chase for every second of life
 s   Fail to treasure the life we have
 s   Fear the inevitable
 s   Ignore the ‘perfection’ of the PRESENT
 s   Deny MORTALITY


         US Hospital, Zagreb
Sudden death vs Expected Death
 s Many say ‘I wish to die sudden’
 s Death less fearful than a life of pain &
   suffering
 s Grief work harder for survivors of
   SUDDEN Death
 s Epected death can be ‘managed’
 s Sudden death must BE endured


         US Hospital, Zagreb
Anatomy of Dying
  s Disbelief/Denial
  s Rage/Anger
  s Bartering/Negotiation
  s Acceptance/Preperation
  s General emotional responses NOT a
    rigid progression


       US Hospital, Zagreb
NOT everybody is ON the same wavelength

   s   Hidden agendas
   s   Past & secret guilts
   s   Emotional dysynchrony
   s   Impossible expectations
   s   Unrealistic Faith


           US Hospital, Zagreb
Family Dynamics
  s Consensus is VITAL
  s Consensus is HARD
  s Dying does NOT enoble or transform, IT
    amplifies basic personality traits
  s Meissner’s 1st Law of Thanatology-
    Terminal Cancer does not make
    EVERYONE noble


        US Hospital, Zagreb
Stages of Bereavement
  s   Shock & Denial

  s   Depression & Disorganization

  s   Reorganization, reengagement, and

      redefinition

          US Hospital, Zagreb
Pathological Bereavement

  s   Delayed grief
  s   Inhibited grief
  s   Chronic grief
  s   Bereavement overload


          US Hospital, Zagreb
What DO I Say!
  s Say what comes naturally
  s Say what YOU feel
  s Share of yourself
  s Give meaning to the death if possible
  s Ask for a precious memory of the loved
    one
  s ACCEPT Intense emotions


        US Hospital, Zagreb
Facilitative vs Nonfacilitative Communication
    s   ‘This must be painful for you’ vs ‘I KNOW how
        you feel’
    s   ‘This must be hard to accept’ vs ‘God had a
        purpose‘
    s   ‘Many feel angry at God at these times’ vs
        ‘Life MUST go on’
    s   ‘Tell me how you are feeling’ vs ‘Lets not deal
        with it now’
    s   ‘May I help?’ vs ‘He/She lead a full life’

              US Hospital, Zagreb
Conclusions

  s   Deal from you Heart not your Head
  s   Listen, Listen, Listen, Listen
  s   Accept ‘Scary Emotional Intensity’
  s   Understand Cultural Differences



          US Hospital, Zagreb

Contenu connexe

Tendances

Films That Accurately Portray Mental Health | Herrick Lipton
Films That Accurately Portray Mental Health | Herrick LiptonFilms That Accurately Portray Mental Health | Herrick Lipton
Films That Accurately Portray Mental Health | Herrick LiptonHerrick Lipton
 
Are you Better or Bitter?
Are you Better or Bitter?Are you Better or Bitter?
Are you Better or Bitter?GICMATL
 
Death and Dying
Death and DyingDeath and Dying
Death and Dyingtbrame
 
Sex is Sacred and Sexy
Sex is Sacred and SexySex is Sacred and Sexy
Sex is Sacred and SexyViolette Meier
 
Invitation draft v7
Invitation draft v7Invitation draft v7
Invitation draft v7Nan Lin
 
Dec 06, Sermon Am
Dec 06, Sermon AmDec 06, Sermon Am
Dec 06, Sermon AmGeo Acts
 

Tendances (10)

We Thank U
We Thank UWe Thank U
We Thank U
 
Ethics problems
Ethics problemsEthics problems
Ethics problems
 
Films That Accurately Portray Mental Health | Herrick Lipton
Films That Accurately Portray Mental Health | Herrick LiptonFilms That Accurately Portray Mental Health | Herrick Lipton
Films That Accurately Portray Mental Health | Herrick Lipton
 
Are you Better or Bitter?
Are you Better or Bitter?Are you Better or Bitter?
Are you Better or Bitter?
 
Class #07
Class #07Class #07
Class #07
 
Death and Dying
Death and DyingDeath and Dying
Death and Dying
 
Sex is Sacred and Sexy
Sex is Sacred and SexySex is Sacred and Sexy
Sex is Sacred and Sexy
 
Invitation draft v7
Invitation draft v7Invitation draft v7
Invitation draft v7
 
New Moon
New MoonNew Moon
New Moon
 
Dec 06, Sermon Am
Dec 06, Sermon AmDec 06, Sermon Am
Dec 06, Sermon Am
 

En vedette

Death, Types of Death and Brain death
Death, Types of Death and Brain deathDeath, Types of Death and Brain death
Death, Types of Death and Brain deathArya Anish
 
death and p.m changes
death and p.m changes death and p.m changes
death and p.m changes dr_hoss
 
Postmortem changes
Postmortem changesPostmortem changes
Postmortem changesGopi sankar
 
Procedure of autopsy
Procedure of autopsyProcedure of autopsy
Procedure of autopsyFarhan Ali
 
Forensic medicine changes after death
Forensic medicine   changes after deathForensic medicine   changes after death
Forensic medicine changes after deathMBBS IMS MSU
 
Autopsy internal examination, Forensic Medicine, Post-mortem Examination
Autopsy internal examination, Forensic Medicine, Post-mortem ExaminationAutopsy internal examination, Forensic Medicine, Post-mortem Examination
Autopsy internal examination, Forensic Medicine, Post-mortem ExaminationAishwarya Sinha
 
Post mortem examination(autopsy)
Post mortem examination(autopsy)Post mortem examination(autopsy)
Post mortem examination(autopsy)Avinash Bhondwe
 
Acute Coronary Syndrome
Acute Coronary Syndrome Acute Coronary Syndrome
Acute Coronary Syndrome Frank Meissner
 
Therapeutic hypothermia
Therapeutic hypothermiaTherapeutic hypothermia
Therapeutic hypothermiaFrank Meissner
 
Differential Dx Chest Pain
Differential Dx Chest Pain Differential Dx Chest Pain
Differential Dx Chest Pain Frank Meissner
 
Chronotropic Incompetence
Chronotropic Incompetence Chronotropic Incompetence
Chronotropic Incompetence Frank Meissner
 
Point of Care Cardiac U/S
Point of Care Cardiac U/S Point of Care Cardiac U/S
Point of Care Cardiac U/S Frank Meissner
 

En vedette (20)

Death, Types of Death and Brain death
Death, Types of Death and Brain deathDeath, Types of Death and Brain death
Death, Types of Death and Brain death
 
death and p.m changes
death and p.m changes death and p.m changes
death and p.m changes
 
Postmortem changes
Postmortem changesPostmortem changes
Postmortem changes
 
Procedure of autopsy
Procedure of autopsyProcedure of autopsy
Procedure of autopsy
 
Autopsy
AutopsyAutopsy
Autopsy
 
Autopsy.ppt
Autopsy.pptAutopsy.ppt
Autopsy.ppt
 
Forensic medicine changes after death
Forensic medicine   changes after deathForensic medicine   changes after death
Forensic medicine changes after death
 
Post Mortem Changes
Post Mortem ChangesPost Mortem Changes
Post Mortem Changes
 
Autopsy internal examination, Forensic Medicine, Post-mortem Examination
Autopsy internal examination, Forensic Medicine, Post-mortem ExaminationAutopsy internal examination, Forensic Medicine, Post-mortem Examination
Autopsy internal examination, Forensic Medicine, Post-mortem Examination
 
Post mortem examination(autopsy)
Post mortem examination(autopsy)Post mortem examination(autopsy)
Post mortem examination(autopsy)
 
Acute Coronary Syndrome
Acute Coronary Syndrome Acute Coronary Syndrome
Acute Coronary Syndrome
 
Dining With Cannibals
Dining With CannibalsDining With Cannibals
Dining With Cannibals
 
Shock 2011
Shock 2011Shock 2011
Shock 2011
 
ChemBio Tutorial
ChemBio Tutorial ChemBio Tutorial
ChemBio Tutorial
 
Big Data In Medicine
Big Data In Medicine Big Data In Medicine
Big Data In Medicine
 
Therapeutic hypothermia
Therapeutic hypothermiaTherapeutic hypothermia
Therapeutic hypothermia
 
Differential Dx Chest Pain
Differential Dx Chest Pain Differential Dx Chest Pain
Differential Dx Chest Pain
 
Chronotropic Incompetence
Chronotropic Incompetence Chronotropic Incompetence
Chronotropic Incompetence
 
Point of Care Cardiac U/S
Point of Care Cardiac U/S Point of Care Cardiac U/S
Point of Care Cardiac U/S
 
Pe final
Pe finalPe final
Pe final
 

Similaire à Practical thanatology

Cancer article
Cancer articleCancer article
Cancer articlestevieee
 
Cancer article
Cancer articleCancer article
Cancer articleSteven Lim
 
Who do you want at your deathbed
Who do you want at your deathbedWho do you want at your deathbed
Who do you want at your deathbedDr.Felicia Chang
 
Grace Full Grieving
Grace Full GrievingGrace Full Grieving
Grace Full Grievingccurless
 
A Path Through the Valley
A Path Through the ValleyA Path Through the Valley
A Path Through the ValleyBruce Kalish
 
TNEEL-NE Theoretical Perspectives Learning Activ.docx
TNEEL-NE Theoretical Perspectives   Learning Activ.docxTNEEL-NE Theoretical Perspectives   Learning Activ.docx
TNEEL-NE Theoretical Perspectives Learning Activ.docxherthalearmont
 
Grief and Loss
Grief and LossGrief and Loss
Grief and LossNorthTec
 
Presentation Handout On Grief And Loss
Presentation Handout On Grief And LossPresentation Handout On Grief And Loss
Presentation Handout On Grief And LossNorthTec
 
Hypnosis for-cancer-a-hypnotists-guide-to-helping-those-in-need
Hypnosis for-cancer-a-hypnotists-guide-to-helping-those-in-needHypnosis for-cancer-a-hypnotists-guide-to-helping-those-in-need
Hypnosis for-cancer-a-hypnotists-guide-to-helping-those-in-needLutvi Guevara
 
When the one i love pass on
When the one i love pass onWhen the one i love pass on
When the one i love pass onDr.Felicia Chang
 
Grief Psychology: A Masculine Way of Grieving
Grief Psychology: A Masculine Way of Grieving Grief Psychology: A Masculine Way of Grieving
Grief Psychology: A Masculine Way of Grieving David Grinstead, MA
 
Prayer Service
Prayer ServicePrayer Service
Prayer ServicePaulinaa95
 
Surviving Suicide: A Layman's Guide to Keeping Oneself Motivated in the Face ...
Surviving Suicide: A Layman's Guide to Keeping Oneself Motivated in the Face ...Surviving Suicide: A Layman's Guide to Keeping Oneself Motivated in the Face ...
Surviving Suicide: A Layman's Guide to Keeping Oneself Motivated in the Face ...Health Education Library for People
 
090315 Beat Him, Join Him, Or Crucify Him 03 Frowning On Fun
090315   Beat Him, Join Him, Or Crucify Him 03 Frowning On Fun090315   Beat Him, Join Him, Or Crucify Him 03 Frowning On Fun
090315 Beat Him, Join Him, Or Crucify Him 03 Frowning On FunPalm Desert Church of Christ
 

Similaire à Practical thanatology (20)

Cancer article
Cancer articleCancer article
Cancer article
 
Cancer article
Cancer articleCancer article
Cancer article
 
Who do you want at your deathbed
Who do you want at your deathbedWho do you want at your deathbed
Who do you want at your deathbed
 
Grieving Ministry
Grieving MinistryGrieving Ministry
Grieving Ministry
 
Grace Full Grieving
Grace Full GrievingGrace Full Grieving
Grace Full Grieving
 
A Path Through the Valley
A Path Through the ValleyA Path Through the Valley
A Path Through the Valley
 
TNEEL-NE Theoretical Perspectives Learning Activ.docx
TNEEL-NE Theoretical Perspectives   Learning Activ.docxTNEEL-NE Theoretical Perspectives   Learning Activ.docx
TNEEL-NE Theoretical Perspectives Learning Activ.docx
 
suicide
suicide suicide
suicide
 
Grief and Loss
Grief and LossGrief and Loss
Grief and Loss
 
Presentation Handout On Grief And Loss
Presentation Handout On Grief And LossPresentation Handout On Grief And Loss
Presentation Handout On Grief And Loss
 
Stolen AngelsExcerpts
Stolen AngelsExcerptsStolen AngelsExcerpts
Stolen AngelsExcerpts
 
Grief & loss
Grief & lossGrief & loss
Grief & loss
 
Hypnosis for-cancer-a-hypnotists-guide-to-helping-those-in-need
Hypnosis for-cancer-a-hypnotists-guide-to-helping-those-in-needHypnosis for-cancer-a-hypnotists-guide-to-helping-those-in-need
Hypnosis for-cancer-a-hypnotists-guide-to-helping-those-in-need
 
When the one i love pass on
When the one i love pass onWhen the one i love pass on
When the one i love pass on
 
Grief Psychology: A Masculine Way of Grieving
Grief Psychology: A Masculine Way of Grieving Grief Psychology: A Masculine Way of Grieving
Grief Psychology: A Masculine Way of Grieving
 
Essay On Death And Dying
Essay On Death And DyingEssay On Death And Dying
Essay On Death And Dying
 
Ana & Isa Stenzel
Ana & Isa StenzelAna & Isa Stenzel
Ana & Isa Stenzel
 
Prayer Service
Prayer ServicePrayer Service
Prayer Service
 
Surviving Suicide: A Layman's Guide to Keeping Oneself Motivated in the Face ...
Surviving Suicide: A Layman's Guide to Keeping Oneself Motivated in the Face ...Surviving Suicide: A Layman's Guide to Keeping Oneself Motivated in the Face ...
Surviving Suicide: A Layman's Guide to Keeping Oneself Motivated in the Face ...
 
090315 Beat Him, Join Him, Or Crucify Him 03 Frowning On Fun
090315   Beat Him, Join Him, Or Crucify Him 03 Frowning On Fun090315   Beat Him, Join Him, Or Crucify Him 03 Frowning On Fun
090315 Beat Him, Join Him, Or Crucify Him 03 Frowning On Fun
 

Plus de Frank Meissner

Plus de Frank Meissner (20)

BigDataInMedicine.pptx
BigDataInMedicine.pptxBigDataInMedicine.pptx
BigDataInMedicine.pptx
 
Eating D/O
Eating D/OEating D/O
Eating D/O
 
Bipolar D/O
Bipolar D/O Bipolar D/O
Bipolar D/O
 
EKG Patterns of SCD - Can't Miss EKG Patterns for Generalist & Psychiatrist
EKG Patterns of SCD - Can't Miss EKG Patterns for Generalist & PsychiatristEKG Patterns of SCD - Can't Miss EKG Patterns for Generalist & Psychiatrist
EKG Patterns of SCD - Can't Miss EKG Patterns for Generalist & Psychiatrist
 
PE case
PE casePE case
PE case
 
Pediatric delirium
Pediatric deliriumPediatric delirium
Pediatric delirium
 
Taktosubo cardiomyopathy verona june2018
Taktosubo cardiomyopathy verona june2018Taktosubo cardiomyopathy verona june2018
Taktosubo cardiomyopathy verona june2018
 
Drug induced brugadda apa
Drug induced brugadda apaDrug induced brugadda apa
Drug induced brugadda apa
 
Curanderos presentation
Curanderos presentation Curanderos presentation
Curanderos presentation
 
Pills & Thrills
Pills & ThrillsPills & Thrills
Pills & Thrills
 
Verona sleep hx presentation
Verona sleep hx presentationVerona sleep hx presentation
Verona sleep hx presentation
 
Burns zagreb presentation
Burns zagreb presentationBurns zagreb presentation
Burns zagreb presentation
 
Hemmorhagic fever zagreb
Hemmorhagic fever zagrebHemmorhagic fever zagreb
Hemmorhagic fever zagreb
 
Tropical cardiology
Tropical cardiologyTropical cardiology
Tropical cardiology
 
Schistomasis
SchistomasisSchistomasis
Schistomasis
 
Onchocerciasis
OnchocerciasisOnchocerciasis
Onchocerciasis
 
Malaria
MalariaMalaria
Malaria
 
Visceral leishmanasis
Visceral leishmanasisVisceral leishmanasis
Visceral leishmanasis
 
Chest pain perals
Chest pain peralsChest pain perals
Chest pain perals
 
Cardiomyopathy
CardiomyopathyCardiomyopathy
Cardiomyopathy
 

Dernier

Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowSonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowRiya Pathan
 
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...Miss joya
 
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbersBook Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbersnarwatsonia7
 
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls ServiceCall Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Servicesonalikaur4
 
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdfHemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdfMedicoseAcademics
 
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.MiadAlsulami
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalorenarwatsonia7
 
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowKolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowNehru place Escorts
 
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiCall Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiNehru place Escorts
 
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service LucknowVIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknownarwatsonia7
 
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment BookingCall Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Bookingnarwatsonia7
 
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original PhotosCall Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photosnarwatsonia7
 
Asthma Review - GINA guidelines summary 2024
Asthma Review - GINA guidelines summary 2024Asthma Review - GINA guidelines summary 2024
Asthma Review - GINA guidelines summary 2024Gabriel Guevara MD
 
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Modelssonalikaur4
 
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort ServiceCall Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Serviceparulsinha
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...narwatsonia7
 
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...narwatsonia7
 
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Availablenarwatsonia7
 

Dernier (20)

Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowSonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Sonagachi Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
 
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
Russian Call Girls in Pune Riya 9907093804 Short 1500 Night 6000 Best call gi...
 
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbersBook Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
Book Call Girls in Kasavanahalli - 7001305949 with real photos and phone numbers
 
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls ServiceCall Girls Thane Just Call 9910780858 Get High Class Call Girls Service
Call Girls Thane Just Call 9910780858 Get High Class Call Girls Service
 
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdfHemostasis Physiology and Clinical correlations by Dr Faiza.pdf
Hemostasis Physiology and Clinical correlations by Dr Faiza.pdf
 
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
Artifacts in Nuclear Medicine with Identifying and resolving artifacts.
 
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service BangaloreCall Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
Call Girl Bangalore Nandini 7001305949 Independent Escort Service Bangalore
 
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call NowKolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
Kolkata Call Girls Services 9907093804 @24x7 High Class Babes Here Call Now
 
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service ChennaiCall Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
Call Girls Service Chennai Jiya 7001305949 Independent Escort Service Chennai
 
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service LucknowVIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
VIP Call Girls Lucknow Nandini 7001305949 Independent Escort Service Lucknow
 
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Hosur Just Call 7001305949 Top Class Call Girl Service Available
 
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCREscort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
Escort Service Call Girls In Sarita Vihar,, 99530°56974 Delhi NCR
 
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment BookingCall Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
Call Girl Koramangala | 7001305949 At Low Cost Cash Payment Booking
 
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original PhotosCall Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
Call Girl Service Bidadi - For 7001305949 Cheap & Best with original Photos
 
Asthma Review - GINA guidelines summary 2024
Asthma Review - GINA guidelines summary 2024Asthma Review - GINA guidelines summary 2024
Asthma Review - GINA guidelines summary 2024
 
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking ModelsMumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
Mumbai Call Girls Service 9910780858 Real Russian Girls Looking Models
 
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort ServiceCall Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
Call Girls Service In Shyam Nagar Whatsapp 8445551418 Independent Escort Service
 
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
Russian Call Girls Chickpet - 7001305949 Booking and charges genuine rate for...
 
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
Call Girls Service in Bommanahalli - 7001305949 with real photos and phone nu...
 
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service AvailableCall Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
Call Girls Jp Nagar Just Call 7001305949 Top Class Call Girl Service Available
 

Practical thanatology

  • 1. Practical Thanatology Frank Meissner, MD, FACP, FACC, FCCP US Hospital, Zagreb
  • 2. Gilgamesh, where are you wandering? The [immortal] life that you are seeking all around you will not find. When the gods created mankind they fixed Death for mankind, and held back Life in their own hands. Now you, Gilgamesh, let your belly be full! Be happy day and night, of each day make a party, dance in circles day and night! Let your clothes be sparkling clean, let your head be clean, wash yourself with water! Attend to the little one who holds onto your hand, let a wife delight in your embrace. This is the true task of mankind. The Epic of Gilgamesh, ca. 1700-1300 B.C. US Hospital, Zagreb
  • 3. A Humanistic Model of Medicine SOCIAL BIOLOGICAL PSYCHOLOGICAL SPIRITUAL CULTURE US Hospital, Zagreb
  • 4. LIKE GILGAMESH, MANY s Foolishly chase for every second of life s Fail to treasure the life we have s Fear the inevitable s Ignore the ‘perfection’ of the PRESENT s Deny MORTALITY US Hospital, Zagreb
  • 5. Sudden death vs Expected Death s Many say ‘I wish to die sudden’ s Death less fearful than a life of pain & suffering s Grief work harder for survivors of SUDDEN Death s Epected death can be ‘managed’ s Sudden death must BE endured US Hospital, Zagreb
  • 6. Anatomy of Dying s Disbelief/Denial s Rage/Anger s Bartering/Negotiation s Acceptance/Preperation s General emotional responses NOT a rigid progression US Hospital, Zagreb
  • 7. NOT everybody is ON the same wavelength s Hidden agendas s Past & secret guilts s Emotional dysynchrony s Impossible expectations s Unrealistic Faith US Hospital, Zagreb
  • 8. Family Dynamics s Consensus is VITAL s Consensus is HARD s Dying does NOT enoble or transform, IT amplifies basic personality traits s Meissner’s 1st Law of Thanatology- Terminal Cancer does not make EVERYONE noble US Hospital, Zagreb
  • 9. Stages of Bereavement s Shock & Denial s Depression & Disorganization s Reorganization, reengagement, and redefinition US Hospital, Zagreb
  • 10. Pathological Bereavement s Delayed grief s Inhibited grief s Chronic grief s Bereavement overload US Hospital, Zagreb
  • 11. What DO I Say! s Say what comes naturally s Say what YOU feel s Share of yourself s Give meaning to the death if possible s Ask for a precious memory of the loved one s ACCEPT Intense emotions US Hospital, Zagreb
  • 12. Facilitative vs Nonfacilitative Communication s ‘This must be painful for you’ vs ‘I KNOW how you feel’ s ‘This must be hard to accept’ vs ‘God had a purpose‘ s ‘Many feel angry at God at these times’ vs ‘Life MUST go on’ s ‘Tell me how you are feeling’ vs ‘Lets not deal with it now’ s ‘May I help?’ vs ‘He/She lead a full life’ US Hospital, Zagreb
  • 13. Conclusions s Deal from you Heart not your Head s Listen, Listen, Listen, Listen s Accept ‘Scary Emotional Intensity’ s Understand Cultural Differences US Hospital, Zagreb