OPENING UP ABOUT DEATH
Jehanne Gheith’s Duke students hovered over pieces of paper during their last class of the semester and concentrated on writing a letter to their future selves.
The personal paragraphs were sealed in an envelope. Its contents revolved around what they’d hope to remember four years from now about Gheith’s class on hospice care, about the difficult and somewhat taboo topic of death and dying.
Gheith works in the Slavic and Eurasian Studies department, and her research, which began with gender roles in Russian literature and then interviews with the survivors of Gulag labor camps, has led to examining hospice care in both Russia and the U.S.
During a game of “Death Jeopardy” that Thursday afternoon, students picked topics such as Hospice, Death with Dignity and Memoirs, and battled for points, recalling what they learned that semester. True or false – Buddhists believe that life inevitably involves suffering. True. How many states have legalized physician-assisted suicide? Four – Oregon, Washington, Montana and Vermont.
Gheith also practices what she preaches. On top of teaching, she is 500 supervised hours away from receiving her clinical social work license, and she has worked at Duke Hospice Bereavement Services.
It’s getting more important for the baby boomer generation to think about end-of-life care, she said. More people are discussing death in meetups and Internet forums. More states are debating physician-assisted suicide programs. Gheith brings what can be an uncomfortable conversation to a group of Duke freshmen, who, on their first day of class, have to draw out their ideal death.
“There’s this whole cultural conversation that we don’t have about death and dying and loss, and I see so many people having to make critical conditions when they’re in crisis,” Gheith said. “... The analogy I use with the students is if a hurricane’s coming, you have a choice, right? You can bring in the lawn furniture and buy the milk and bread or pretend it’s not going to happen.”
This class makes most of her students think about their death experience for the first time. Most didn’t draw themselves in a hospital, even though more than 60 percent of Americans die in hospitals. One student drew her family in the next room during her death, to shield them emotionally. Another wanted to die outside, but on a raised platform -- she was afraid of bugs.
The students become more comfortable with the topic, Gheith said, to the point where some were talking with their parents over Thanksgiving about their advance directives, or what type of medical care they’d like to receive if they were too sick to express their wishes.
Being a hospice worker herself, Gheith said some people like cooking or going to the gym as hobbies. Hers is having real conversations with people.
“Because loss is so not talked about, people are often very surprised by how hard it hits them and feel like they’re going crazy and feel like they should be able to handle it on their own,” she said.
This was the second class of its kind held at Duke. The students visited Hall-Wynne Funeral Home this semester, and tackled projects about the role of optimism in cancer care or the role of artwork displayed in funeral homes. They asked serious questions, such as, “Would you want to know if you had a terminal diagnosis? What if your family member had a terminal diagnosis? Would you still want to know?”
Gheith’s Russian research background now compares hospice care in both countries. For example, in Russia, religion is deeply intertwined in hospice care. In the U.S., it’s optional. In Russia, only stage 4 cancer patients can go to a hospice. In the U.S., a variety of patients go into hospice care, such as those with dementia or congestive heart failure.
Next year, Gheith said she is going to study at hospices in St. Petersburg and Moscow for six weeks at a time, examining different care methods and setting up an exchange program, where Russian hospice workers may end up visiting Durham.
This mission is personal for Gheith. Her younger brother passed away suddenly in 2003, while she was studying in Russia. He was only 33 when he died from an arteriovenous malformation, which acted quickly like an aneurysm. She ended up attending a grief group at the bereavement center where she now works, and decided to go after her master’s in social work.
“It also felt like getting the whole degree felt like a way to honor my brother,” she said. “I felt like I made this choice because of him, and so it’s a way I can kind of carry him forward a little bit.”