Bríd Phillips // Communicating with a terminally ill friend can often feel daunting and full of fear and anxiety. What will we talk about? Will I say the wrong thing? Or is there actually anything left to say as you both stare into the void? Recently, I had this experience when a work colleague developed a terminal respiratory condition and became hospitalized many times before his death with severe breathing difficulties. During these times I visited occasionally and texted often. My friend was ex-Navy personnel in the catering corps and started sharing his memories of this time. He shared that although his formal education was perfunctory, he had a love of Kenneth Slessor, an Australian poet. He used to print poems by Slessor on the back of the place cards every week in the Officer’s Mess which apparently went down very well with his recipients.
And then my friend became palliative and was admitted to a palliative care ward. Visits became a weekly source of dread – how would I find him? How would we communicate as his breath became a precious and elusive commodity? Then I remembered Slessor and his modernist Australian poetry. Slessor’s work is redolent of the wonder of Australian life and his war despatches captured the shifting fears and frenetic atmosphere which marked World War II. As I read, I started to understand why my friend would be drawn to this poet.
Feeling a little self-conscious, I arrived at my friend’s room, pulled out my book, and offered to read a poem if he would like. His face lit up and he nodded and asked me to choose. As I read ‘The Night Express’ – ‘Out of the night, immense and shrill,/ It comes with cloudy fire…’, (Slessor 59) I could see his breathing become easier, his face relaxed and his eyes closed. I finished and thought he had fallen asleep, but instead he began slowly and quietly reminiscing about his past. He managed to talk without getting distressed and then asked me to read another. I was invited to overstay the fifteen-minute visit limit designed to prevent the distress of breathing difficulties arising from efforts to talk.
Could this be a social approach to the problem of communication in sickness and how we might find a way to open dialogue through a platform built on the medium of literature and, in particular, poetry? Montello and Lantos state that “[l]iterature can help equip us to travel with those who are dying, right up to the last moments, and to live beyond the loss” (121). I would extend this thinking to ideas of communication in death and dying. This is of course not a way of thinking about death and dying but more a way of communicating through the experience of death and dying. The period between diagnosis and death can often be a void which is filled with silences or even avoidances. I offer the idea of shared reading as a way to fill this void.
Literary works can impose structure on human existence. Garro and Mattingly assert that “[n]arrative is a fundamental human way of giving meaning to experience” (1). We can create meaning where often it can be difficult to uncover and death, which is often viewed as the limit of human life; this can be an uncomfortable space to approach and inhabit. So, for many the question is what language can we bring to bear in this space that creates a meaningful exchange/dialogue between those forging relationships in the liminal spaces at the threshold of death? Rather than searching for an explanation for the dying, use it as a connection to the living and those parts of life that can continue to be shared.
In 2018, Elizabeth A Davies published a paper entitled “Why we need more poetry in palliative care.” She suggests through her research that there is, within palliative care, a long-standing interest in how poetry may help patients and health professionals find meaning, solace, and enjoyment (my emphasis). For me, this thinking builds on the valuable research carried out by Christina Davies. Davies et al. entitled “The art of being mentally healthy: a study to quantify the relationship between recreational arts engagement and mental well-being in the general population.” Here they found evidence of an arts-mental health relationship in this study. Those who engaged in 100 or more hours per year of arts engagement (i.e. two or more hours per week) reported significantly better mental well-being then other levels of engagement (8). In the study, arts was used as a broad term encompassing a wide variety of arts-based activities. Therefore, the corollary to communication improvements is the fact that the act of engaging in an arts-based activity will bring a greater sense of well-being.
During this time with my friend, I did mix it up a bit and I introduced him to some of my favourites such as Seamus Heaney, William Shakespeare, and also a few other Australian poets that might have some resonance for my friend. He texted often about the poetry and, for both of us I think, it made for great visits. The measure of the worth I have of this experience is that my friend asked me to read a poem at his funeral. We had found a way to communicate through words, but not much speaking for him, through his end stage respiratory failure, and his struggle to find breath.
Davies, Christina, et al. “The art of being mentally healthy: a study to quantify the relationship between recreational arts engagement and mental well-being in the general population.” BMC Public Health, vol. 16 2016, pp. 1-10. Proquest Central, doi:10.1186/s12889-015-2672-7
Davies, Elizabeth A. “Why We Need More Poetry in Palliative Care.” BMJ Supportive & Palliative Care, vol. 8, no. 3 2018, pp. 266-270. Proquest Central, doi:0.1136/bmjspcare-2017-001477
Garro, Linda C. and Cheryl Mattingly. “Narrative as Construct and Construction.” Narrative and the Cultural Construction of Illness and Healing, edited by Cheryl Mattingly and Linda C. Garro, University of California Press, 2000, pp. 1-49.
Montello, Martha and John Lantos. “Postmodern Death and Dying: A Literary Analysis.” Health Humanities Reader, edited by Therese Jones, et al., Rutgers University Press, 2014, pp. 113-121.
Slessor, Kenneth. “The Night Express.” Kenneth Slessor: Poetry, essays, war despatches, war diaries, journalism, autobiographical material and letters. Edited by Dennis Haskell, University of Queensland Press, 1991.