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.
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3. A Humanistic Model of Medicine
SOCIAL
BIOLOGICAL PSYCHOLOGICAL
SPIRITUAL
CULTURE
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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
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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
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6. Anatomy of Dying
s Disbelief/Denial
s Rage/Anger
s Bartering/Negotiation
s Acceptance/Preperation
s General emotional responses NOT a
rigid progression
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7. NOT everybody is ON the same wavelength
s Hidden agendas
s Past & secret guilts
s Emotional dysynchrony
s Impossible expectations
s Unrealistic Faith
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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
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9. Stages of Bereavement
s Shock & Denial
s Depression & Disorganization
s Reorganization, reengagement, and
redefinition
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10. Pathological Bereavement
s Delayed grief
s Inhibited grief
s Chronic grief
s Bereavement overload
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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
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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’
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13. Conclusions
s Deal from you Heart not your Head
s Listen, Listen, Listen, Listen
s Accept ‘Scary Emotional Intensity’
s Understand Cultural Differences
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