緩和ケアと医学

抽象的な

Sarahs Journey through the End of Life: A Literary and Pictorial Analysis

Anat Romem, Jorunn Opstad Carmel and Chaya Greenberger

Coming to grips with End of Life (EOL) is a stressful and emotionally draining experience. Coping with the circumstances is extremely challenging both for patient and caregiver. The ability to express one’s thoughts and feelings is paramount to a successful and meaningful closure. Often, unfortunately, this goal eludes both the individual and his or her caregivers. Alternatives to verbal modes of communication, such as diarizing, need to therefore be explored.

The purpose of this report is to present an abridged version of excerpts from a diary written by one of our patients, with an accompanying pictorial interpretation of these excerpts chosen from the paintings of Edvard Munch. Munch is an early 20th century Norwegian painter, some of whose major themes relate to disease, emotional turmoil, death, and separation. They reflect a life overwhelmed by recurrent family tragedy and the artist’s attempt to relieve his profound sadness and grief through an artistic medium. With the family’s permission, our palliative care team uses this diary and parallel expressions from selected paintings by Munch in its staff training seminars. Group reflection on the writings and paintings has proved to be a successful avenue for enabling our staff to better understand the journey through end of life and to empower the facilitation of patients’ therapeutic description of their unique journeys. It is our hope that the report will inspire additional professionals to utilize similar techniques for staff development in their care units.