Generous Orthodoxy  

Thursday, August 19, 2010

Death and dying: does hospice care hasten death?

One of my most recent posts, "Death, Dying, and Hospice Care" (in Tips, August 9, 2010), was written partly to challenge the widespread misapprehension that hospice care (a more intensive form of palliative care) shortens life. Many people think that choosing hospice signifies a form of weakness, even cowardice, in the "battle" against cancer and other diseases. First of all, it's important to know that a significant number of cancer patients dislike--sometimes intensely--the "battle" imagery that has become commonplace in describing a patient's ordeal. Second, far from being a form of "giving up," choosing hospice care can be very pro-active because it often permits the patient to initiate life-affirming experiences in the final months.

As if on cue, just today a new study appears. A headline in today's New York Times reads, "Palliative Care Found to Extend Life of Cancer Patients" (article by Donald G. McNeil, Jr.). The respected New England Journal of Medicine reports the findings. The report notes, among other things, that there is often conflict between surgeons and oncologists, who want to continue the "battle," and hospice/palliative care representatives who are regarded as "giving up." But those patients who choose hospice/palliative care soon after receiving a dire diagnosis have been shown in the study as living months longer. For one thing, it gets them out of the hospital ("dangerous places for very sick people") and into their homes. They report less depression and anxiety, less pain and nausea, more mobility and more interaction with family and friends.

Dr. Atul Gawande, a Harvard Medical School surgeon, calls the study "amazing." Dr. R. Sean Morrison, e head of the American Academy of Hospice and Palliative Medicine said it was "the first concrete evidence of what a lot of us have seen in our practices--when you control pain and other symptoms, people not only feel better, they live longer."

From the standpoint of Christian faith, hospice care often makes the patient comfortable enough to pray, listen to tapes and music, receive communion in a more participatory way, discuss dying and the hope of the resurrection, and in general to be more alive and responsive to the beneficence and care of nurses, clergy, friends, and family.

Monday, August 16, 2010

Inception (the movie)

When two young (12 and 13) persons of my acquaintance told me that Christopher Nolan's supposedly mind-bending Inception was the best movie they had ever seen, I thought it was my Christian duty to go to see it. It is rated PG-13. I am not opposed to some level of violence in movies (I rather liked Munich, for instance), but I was really shocked that the first twenty minutes of Inception was nonstop mayhem with no plot to speak of, no opportunity to identify with anyone or anything of value except "that's Leo DiCaprio, so that's who we root for." And it went on from there.

It is disturbing to think that our young people are completely inured to this sort of thing. They are hooked on action, spectacle, sensation, and special effects and have no concept of character development, moral complexity, or the logic of a story. They don't seem to respond to deep, searching themes, only to shock and violence. And as for anything in black and white, forget it.

David Denby of The New Yorker is not my favorite film critic, but I agree with him about this one. Here are a couple of excerpts from his July 26 review:

The theologians of pop culture, taking a break from The Matrix, will analyze the over-articulate structure of Inception for mighty significances. Dreams, of course, are a fertile subject for moviemakers. Buñuel created dream sequences in the teasing masterpieces Belle de Jour (1967) and The Discreet Charm of the Bourgeoisie (1972), but he was not making a hundred-and-sixty-million-dollar thriller. He hardly needed to bother with car chases and gun battles; he was free to give his work the peculiar malign intensity of actual dreams. Buñuel was a surrealist— Nolan is a literal-minded man. Cobb’s [DiCaprio's] intercranial adventures aren’t like dreams at all—they’re like different kinds of action movies jammed together...

Denby praises the visual technique in some of the scenes, but then concludes:

But who cares if Cobb gets back to two kids we don’t know? And why would we root for one energy company over another? There’s no spiritual meaning or social resonance to any of this, no critique of power in the dream-world struggle between C.E.O.s. It can’t be a coincidence that Tony Gilroy’s Duplicity (2009), which was also about industrial espionage, played time games, too. The over-elaboration of narrative devices in both movies suggests that the directors sensed that there was nothing at the heart of their stories to stir the audience. In any case, I would like to plant in Christopher Nolan’s head the thought that he might consider working more simply next time. His way of dodging powerful emotion is beginning to look like a grand-scale version of a puzzle-maker’s obsession with mazes and tropes.

"Powerful emotion" is not the only thing lacking in this movie. Unfortunately, youngsters who are addicted to the sort of stimulation that Inception provides are resistant to the great humanistic films about children and adults like Bicycle Thieves (directed by Vittorio de Sica) and Fallen Idol (Carol Reed). But let's keep trying!