Humanity In Medicine - Mayo Center for Innovation

Dying Gracefully

Post Written By Megan Zimmerman

We do not talk about death. When thoughts of mortality become salient we feel scared, sad, and anxious and we avoid talking about it with our families. Because we do not talk about death or how we want to grow old, it is hard to have end-of-life conversations with our care providers. A company called Common Practice is addressing our fears and changing the way we view death and dying by simply playing a game.

At the Mayo Transform Conference, Nick Jehlen told Nezea’s story. Nezea Twigs was fifteen years old when he was diagnosed with cancer. He had over fifty tumors removed from his body but the cancer kept spreading. He was nearing the end of his life and his doctor nor his family knew how to have a conversation about what Nezea wanted at the end of his life. How do you talk about death and end-of-life care with your fifteen year old son?

Nezea’s oncologist told his family about the game called, “My Gift of Grace.” This game facilitates a discussion about death and dying among family members and healthcare providers. Nezea along with his parents, oncologist, and social worker came together to play; they found that it facilitated an honest conversation about how Nezea wanted to spend the rest of his life and how he wanted to die.

The game requires that everyone answer the questions. This gave Nezea the opportunity to learn about what his parents wanted for the end of their lives and what they valued. In this way, it was not just a list of questions Nezea had to answer, but a conversation about how they all want to live the end of their lives. Nezea was concerned that he would be forgotten after his death. While playing My Gift of Grace, he learned that his father constantly carried a picture of his father around in his pocket. This gave Nezea comfort and proved that he will be remembered by his father after his death.

At the Transform 2015 Conference, I had the opportunity to play My Gift of Grace with three other women. We all found the questions to be very thought-provoking. The cards asked questions such as: “What music do you want to listen to on your last day alive?”, “Think about the last time you got angry at someone. What did you do?” and “In order to provide the best care possible, what three non-medical facts should your doctor know about you?” These questions do not simply pertain to the logistics of planning a funeral. They ask deeper philosophical questions about who you are as a person and what you value. To answer the last question, I want my doctor to know that family is always welcome, quilts and blankets make me happy, and I love the Harry Potter books.

When I am nearing the end of my life, these are the questions I want my doctor to ask me. I want to think about my health, my family, and how I want to spend the rest of my life. Telling a patient they are dying is the hardest conversation a doctor will ever have with their patients. When medicine can do no more to help, this is the conversation we need to have. This is the humanity of medicine; this is what we ask when we cannot change the circumstances; this is what we should do to improve the quality of life for all patients.