{"id":30965,"date":"2018-11-23T03:48:45","date_gmt":"2018-11-23T11:48:45","guid":{"rendered":"http:\/\/www.jewishindependent.ca\/?p=30965"},"modified":"2018-11-20T16:15:01","modified_gmt":"2018-11-21T00:15:01","slug":"teaching-about-death","status":"publish","type":"post","link":"https:\/\/www.jewishindependent.ca\/index.php\/2018\/11\/23\/teaching-about-death\/","title":{"rendered":"Teaching about death"},"content":{"rendered":"

Dr. Jessica Zitter has both written a book and a movie about death and dying. (photo by Rikki Ward Photography)<\/em><\/strong><\/span><\/p>\n

Dr. Jessica Zitter, who works as an attending physician at a public hospital in Oakland, Calif., struggled with her job\u2019s protocols for years. Until the day a nurse opened her eyes to the possibility that there was a better way, one that involved more compassion in the treatment of patients.<\/p>\n

Zitter comes from a long line of doctors.<\/p>\n

\u201cThey were into the art of medicine,\u201d she said of the mentors she had when she first began her studies. \u201cBy that, I mean the art of surgery and intervening, and of doing things in a very precise way. There was something about that that I found heroic, and I wanted to be part of that world.<\/p>\n

\u201cSo, I went to medical school \u2013 pulmonary and critical medicine \u2013 which I thought of as the most heroic of the specialties. I went on to start to focus on the machines, technologies, protocols and things that were part of the trade of being a pulmonary critical care physician. I tried to really perfect them … [thinking that,] if I use these perfectly, I\u2019ll be able to help a lot of people.\u201d<\/p>\n

But, as she went along, she started to think differently. At first, she suppressed the feeling. \u201cIt was truly uncomfortable,\u201d she said. \u201cIt caused me a lot of suffering.\u201d<\/p>\n

Zitter was using techniques and protocols on people who were not going to benefit from them, knowing full well that they would not benefit from them. Not only was she following her training, but she also wanted to please her patients \u2013 give them mainly good news and information about various procedures, instead of telling them the whole truth about their condition.<\/p>\n

\u201cI didn\u2019t want to tell them, \u2018Hey, I don\u2019t think you\u2019ll survive,\u2019\u201d said Zitter. \u201cI didn\u2019t want to say that because it\u2019s too sad. I would communicate about things that were more practical like, if this happens, we will try this.\u201d<\/p>\n

A pivotal moment<\/strong><\/h4>\n

Zitter\u2019s approach changed after an encounter in the intensive care unit with a nurse from the family support team, called Power to Care.<\/p>\n

\u201cOne day, I was about to put in a line [catheter] into someone who was really, really sick and likely dying, and the woman who headed that family support team was standing in the doorway watching…. I was about to put the needle in and she put her hand up to her face and she said, \u2018Call the police,\u2019 on a pretend telephone…. She said, \u2018Call the police. They\u2019re torturing a patient in the ICU,\u2019\u201d said Zitter. \u201cAnd that was my epiphany moment. All these moments, I had this doubt. This was like a relief \u2013 you\u2019re right, I am torturing the patient. What the heck? There was a clarity there that was really powerful.<\/p>\n

\u201cBut, the sad truth is that I still put that needle in. I still put that catheter in that woman. The force of what I call the end-of-life conveyor belt is so powerful … not only the conveyor belt itself, but the drive to \u2018protocolize,\u2019 heaping on treatments \u2026 the culture in the hospital. It\u2019s hard to break out. It\u2019s hard to stop and take a pause, and say, \u2018Wait a minute. What the heck?\u2019\u201d<\/p>\n

The intervening nurse, Pat Murphy, in some ways became Zitter\u2019s mentor on what it meant to be a doctor.<\/p>\n

\u201cI came to it late and from a place of profound dissatisfaction and moral distress, and I was just extremely lucky that I happened to be in one of four hospitals where this movement was starting to take hold,\u201d Zitter told the Independent<\/em>.<\/p>\n

\u201cAnd, I happened to have been open to it,\u201d she added. She was able to get over her \u201chuman defence of not wanting to look stupid or like I didn\u2019t understand \u2026 and to be able to say, \u2018OK. Teach me.\u2019<\/p>\n

\u201cI feel lucky that those two things were in check at that time,\u201d said Zitter. \u201cNot to say that I wasn\u2019t filled with shame and embarrassment about what I\u2019d been doing all that time, but the psychology\u2026. Once you admit there\u2019s a problem, then find a way to fix it.\u201d<\/p>\n

After years of immersing herself in this new paradigm, Zitter felt ready to share what she had learned. She published a book about it, called Extreme Measures: Finding a Better Path to the End of Life<\/em>, in 2017.<\/p>\n

As she was writing it, Zitter realized that, if a picture can impart a thousand words, maybe a movie would be able to convey even more. So, she put together a 24-minute documentary, Extremis<\/em>.<\/p>\n

Of the award-winning film, Zitter said, \u201cIt really shows the issues that come up in an ICU\u2026. There is also a discussion guide that goes with it, so people can watch it and then come away from it with some lessons learned.<\/p>\n

\u201cThis movie reaches a wide audience about really advanced care planning,\u201d she said. \u201cA lot of synagogues are using it, medical schools and nursing schools.\u201d<\/p>\n

Death education<\/strong><\/h4>\n

Zitter was asked to teach sex education at both of her daughters\u2019 schools.<\/p>\n

\u201cI want them to be able to make the best decisions they can make about their bodies and their health, and to be empowered to live the best they can,\u201d she said.<\/p>\n

But what about death education?<\/p>\n

Extremis<\/em> came out in late 2016. \u201cIt was nominated for the Oscars and a lot of my kids\u2019 friends were watching it. And all these kids were really blown away by the movie and they were having a positive response to it,\u201d said Zitter. \u201cIt made me think, \u2018Why the heck aren\u2019t we teaching kids about death? Why aren\u2019t we having a conversation in high school, just like with sex ed?\u2019 So, a friend of mine designed \u2018death ed.\u2019 We did it in her kids\u2019 and my kids\u2019 schools. It was really impactful.\u201d<\/p>\n

Zitter would love to see such a class in every school in the United States and Canada, along with other heath education classes, so everyone can have the opportunity to learn about a range of issues and discuss them.<\/p>\n

Both the teachers and the students appreciated the lesson on death education, said Zitter. \u201cThere were no negative responses. Although some kids cried, and it was terrifying at first, they would then say, \u2018That was sad, but I\u2019m OK.\u2019<\/p>\n

\u201cI was like, \u2018It is sad that we are all going to die.\u2019 But, you know what? It\u2019s really good for these kids too, [because] it\u2019s part of life. If we pretend no one\u2019s going to die and don\u2019t let our kids go to funerals, etc., we aren\u2019t doing anyone a service.\u201d<\/p>\n

So far, Extremis<\/em> has been translated into 90 languages and has been shown in 160 countries.<\/p>\n

\u201cWe\u2019ve got to tell people what\u2019s actually happening and try to understand,\u201d said Zitter. \u201cI use myself as a prime example\u2026. Why was I putting that catheter into a woman I knew was dying? What are these factors that are propelling me to do things that don\u2019t make sense to me? The idea is to be more conscious of it, aware of it, and change it.\u201d<\/p>\n

For more information about the movie and the book, visit jessicazitter.com<\/a>. The film trailer can be found on YouTube<\/a>.<\/p>\n

Rebeca Kuropatwa<\/strong> is a Winnipeg freelance writer.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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