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The “Dying Journal”

The “Dying Journal” assignment

• Stage 4 Congestive Heart Failure resulting from Bacterial Infection of Heart following Influenza
One of the fun assignments in this course is to die. I mean, of course, to pretend to die. You will each be assigned a disease that people commonly die of within a span of a few months. You will pretend that you are dying of that disease during this semester and you will keep a journal about what it’s like to die.
Hopefully, this will help you get the feel of what it’s like to die – to walk in the shoes of a person with a terminal illness and develop genuine empathy (not just sympathy) for those who are dying. What we’re aiming for here is an emotional, not just an intellectual, understanding of what dying people experience.
This exercise is worthwhile only to the extent that you “get into it”. If you don’t put yourself into it, pretend that it’s real, and do some real work trying to get inside the head of a person with that disease, you won’t get much out of it, but if you try, you will be rewarded with a deep understanding of what dying people need.
Your journal should continue your thoughts and feelings about what it’s like to:
• hear your diagnosis
• try to understand what this disease means
• come to grips with your likely future
• endure the treatments and the side-effects of treatments
• experience the disease process
• feel what it’s like to relate your your family and friends as a dying person
• and, ultimately, to come to the end of the road and surrender yourself to dying
You should write in your journal regularly – daily would be good, weekly would be an absolute minimum and it had better be rich. Your journal will be graded on my perception of how deeply you got into it, how hard you tried, and what evidence the journal gives that you learned something from the assignment.
Creating and Keeping your “Dying Journal” for this Online 10-Week Course
You will keep a journal this semester in which you will write about what it is like to be dying of a terminal illness (assigned to you by the instructor). This is all pretend, of course, but the virtue of the exercise lies in how well you can pretend that you really are dying of this disease. Can you put yourself into the shoes of a dying person? Can you imagine what it is like to die – at your age – of this disease? What does it do to you? To your family? How do your friends react? How does it affect your work? Your finances?
I suggest you begin by imagining that you just got the word from your doctor that you have this disease and that you have about three months to live. Take it from there.
Perhaps you will want to begin by researching your disease and finding out everything you can about it.
When and how will you tell your family?
Get into it. Feel what it’s like.
Develop empathy for dying people.
It would be good to write here every day. At least write weekly.
Your journal will be graded on how well you integrate into your story the things we learn about death and dying this semester. In other words, how realistically you portray what it is like for a person to die. You can and should make it unique to you and your situation, but it must reflect the normal realities of this abnormal (in the sense of “unusual”) process
Dying Journal (1)
Dying Journal Rubric

Criteria Ratings Pts
Turned in a paper Full Marks
5.0 pts No Marks
0.0 pts
5.0 pts
Includes “stages of grief” All five
20.0 pts Four of five
16.0 pts Three of five
12.0 pts Two of five
8.0 pts One of five
4.0 pts None
0.0 pts
20.0 pts
Includes a description of “existential crisis” Yes
10.0 pts Alludes to it
5.0 pts No
0.0 pts
10.0 pts
Includes “search for meaning” Full Marks
15.0 pts Rating Description
8.0 pts No Marks
0.0 pts
15.0 pts
Well written Full Marks
10.0 pts Rating Description
5.0 pts Rating Description
3.0 pts No Marks
0.0 pts
10.0 pts
Adequate depth and scope Full Marks
10.0 pts Rating Description
5.0 pts Rating Description
3.0 pts No Marks
0.0 pts
10.0 pts
Includes some awareness of “needs of the dying” Full Marks
10.0 pts Rating Description
5.0 pts Rating Description
3.0 pts No Marks
0.0 pts
10.0 pts
Got inside the “head” of a dying person Quite well
10.0 pts Somewhat
5.0 pts Not really
0.0 pts
10.0 pts
Includes “family systems dynamics” Full Marks
10.0 pts Rating Description
5.0 pts No Marks
0.0 pts
10.0 pts
Total Points: 100.0

Reading Schedule for this Online 10-Week Course
• Required textbooks and readings
o Wit, DVD of Hollywood film starring Emma Thompson (This film is now available on YouTube if you prefer to watch it there.)
o Being Mortal by Atul Gawande (Metropolitan, 2014).
o Dying Well by Ira Byock (Riverhead, 1998).
o Death Be Not Proud by John Gunther (Harper, 1949).
o The Needs of the Dying by David Kessler (Harper, 2007).
o Closing the Chart: A Dying Physician Examines Family, Faith and Medicine by Steven D. Hsi (Univ. of New Mexico, 2008). ISBN: 082633038X.
o The Death of Ivan Ilyich by Leo Tolstoy (Bantam, 2004).
Reading Schedule
Week Reading # Pages
1 Wit – view all (more than once if possible) 1h:39m:00s
2 Gawande, Introduction & chapters 1-4 110
3 Gawande, chapters 5-8 & Epilogue 153
4 Kessler, Intro & chapters 1-11 + Epilogue 200
5 Byock, chapters 1-5 118
6 Byock, chapters 6-12 + Appendix 129
7 (catch up week – catch up on reading)
8 Tolstoy – all 113
9 Hsi, Foreward, Prologue, chapters 1-10 110
10 Hsi, chapters 11-20 + Epilogue 103

Week 1 – Online “lecture”
Podcast – “Your Own Experience With Death” (2:47)
Podcast – “Death Be Not Proud” (7′)
Podcast – “Toward a Biblical Worldview” (14:16)
Podcast – “Death in the Biblical Worldview” (11:11)
Podcast – “Suffering” (11:16)
Podcast – “Dying in America” (10:54)
Week 2 – Online “lecture” (3:00:00)
Video – “The Five Stages of Grief” (2:09)
Video – “Robot Chicken: Five Stages of Grief” (1:40)
Video – “Sprinkle the Goldfish: Five Stages of Grief” (4:32)
Podcast – “Four Stages and Four Tasks” (10:00)
Podcast – “Grief, Bereavement, Mourning” (22:42)
Reprint – “The Meaning and Value of Death” – Ira Byock, MD
Reprint – “Letter from a Dying Young Woman” – Maranda Church
Article – “The Ultimate End of Life Plan” – Katy Butler
Article – “A Letter from a Patient’s Daughter” – Elizabeth Hansot
Case Study – “Rosemary” – Hospice Doctor
Video – “A Good Death: Case Studies in End-of-Life Care” (45:22)

Week 3 – Online “lecture” (3:00:00)
Video – “Living With Dying” (87′) – #1 of “On Our Own Terms” by Bill Moyers
Video: “A Different Kind of Care” (87′) – #2 of “On Our Own Terms” by Bill Moyers

Week 4 – Online “lecture”
Video – “A Death of One’s Own” – #3 of “On Our Own Terms” – Bill Moyers – 87:00
Video – “A Time to Change” – #4 of “On Our Own Terms” – Bill Moyers – 87:00

Week 5 – Online “lecture”
Audio interview with Gayla Cauldwell, RN, palliative care specialist (50:00)
Video – “Dying with Dignity: The Sun City Choice” (14:59)
Video – “Grand Rounds: Palliative Care” – Dr. David Weisman (56:00)
Case Study – “Rosemary” – Hospice Doctor
Article – “A Letter from a Patient’s Daughter”
Article – “The Ultimate End of Life Plan”
Article – “How Doctors Die” – Ken Murray
Article – “Plain Speaking at the End of Life”
Article – “Being Accused of Murder” – Matlock

Week 6 – Online “lecture”
Podcast – “The Ministry of Presence” – DV (4:10)
Podcast – “How to be with the Dying and Those Who Love Them” – DV (16:30)
Article – “The Place of Dignity in Everyday Ethics” – O’Mathuna
Video – “Teens Dealing With Death” – Films Media Group (29:21)
Video – “The Dying Child” – Films Media Group (32:03)
Video – “Every Patient Comes to the Doctor for One Thing” – Jerome Groopman (1:29)
Video – “Abandonment” – Robert Jaffe (3:08)
Video – “Being Ill is a Transformative Experience” – Robert Jaffe (3:21)
Video: “Facing Death” (54:37)
Video – “It’s Good to be Alive” – Jack Rushton (9:57)
SoftChalk Lesson – “Offering Spiritual Support to Family and Friends” – Caring Connections
Offering Spiritual Support for Family or Friends

Week 7 – Online “lecture”
Article – “Comfort Always” – William E. Cayley
Article – “A Look at the New Field of Palliative Care” – Michael Vitez
Article – “Discussing Religious and Spiritual Issues at the End of Life A Practical Guide for Physician” – Lo, et al
Podcast – “Prayer and the Healthcare Professional” – DV (16:35)
Video – “A Good Death: Case Studies in End-of-Life Care” – Films Media Group (45:22)
Video Series: “Effective Palliative Care” – Three Segments (25:46 + 18:36 + 21:41)
Video – “Wrong Doctor” (3:51)
Video: “A Breath of Hope” (3:45)
Video – “Loss of a Spouse” (24:30)
Video-“Deep Listening”-Frank Ostaseski (3:06)
Video – “Living a Fully Human Life to the End” – Dr. Ray Barfield (51:13)

Week 8 – Online “lecture”
Here are the “lectures” for this week:
Video – Advance Care Planning The Professional Role and Responsibility of the Primary Care Physician – UCTV (58:41)
Video: TED talk: Peter Saul: Let’s talk about dying (13:16)
Video: “Living and Dying with Muscular Dystrophy” – FOD (12:36)
Video – “Children Die, Too” – FOD – (25:04)
Video – “Spirituality and Health” – Dr. Michael Rabow – UCSF (58:39)

Week 9 – Online “lecture”
Video: “Let Me Die” – FOD (01:13:35)
Video – TEDTalks: Sherwin Nuland—A Meditation on Hope (12:35)
Video: “Living With Dying” – BBC – (50:32)
Video – “Life and Death: Medical Ethics of the Schiavo Case” – FOD (12:16)
Video – “Euthanasia: Medical Ethics—Real-World Applications” – FOD – (24:48)

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