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‘The American People’?

by Joan L. Cannon

I live in a relatively small community in a very small city. It would be hard to find more variations among education, opinions, backgrounds, interests, and abilities in any geographical area. Every day during campaign seasons, and far too often for my taste on general days, there are too many mentions of ‘The American people.’

How in the world can anyone be so foolish as even to attempt to make some kind of monolithic entity out of that collective noun? Not only are nationalities and ethnicities and socio/economic circumstances that number in the hundreds involved here … not to mention languages and aspirations … the very total of the national population should suggest how foolish is a notion of ‘The American people.’

For most of my life I have been, to put it politely, apolitical. No matter what rhetoric we’re exposed to, however cleverly couched and insidiously targeted, the gaps in the logic or in possibilities are big enough for either an ass or an elephant to walk through without brushing an ear. Even the ‘town meeting’ style convocations broadcast on Public Television indicate that not every member of the flock is a sheep. I give thanks for the opinions expressed at venues like that. But what are the chances the majority (who don’t bother to think it out) will make an erroneous or befuddled decision in a voting booth?

Wouldn’t it be great if some leader could arise who called upon reason and even common sense as well as honesty to inform the electorate? Of course, in current practice, no one without almost unlimited financial means can even hope to attract attention. When money determines who can even afford to appear on TV or radio, or be heard in local meetings, it seems increasingly unlikely the best agenda will ever have a chance. Add to that the convention that the self-proclaimed parties must never ever agree on anything, and it’s hard to bother to get to a polling place.

You and your neighbor and your brother and aunt, and me too, are members of that collective. We’re American and we’re people, but it isn’t a syllogism that follows that all Americans can be lumped into one collective noun. Added to the inherent differences are those of socio-economic status, level of education, geographical accident, special circumstances like physical handicaps or traumatic backgrounds, to name a few.

I submit that there isn’t a politician of any stature anywhere who knows what ‘The American People’ want or need. Different groups of different people in different places need and want different things — with the possible exception of a few abstractions: Bill of Rights freedoms; satisfactory human relationships; satisfying work; hope for their children. The rub comes when some hubristic individual claims to know the single way to achieve those … as well as the physical ones like food, shelter, and health care.

It’s no easy task to find out what we need to know to make informed and reasonable choices among those offered. Now that there is virtually no limit to what can be spent to achieve victory in an election, it’s beginning to look as if the only criterion (if we’re honest with ourselves) will be wealth. Winner take all. Whatever the results are, ‘The American People’ cannot expect to be satisfied, even if some millions feel they’ve won.

©2012 Joan L. Cannon for SeniorWomen.com

Illustration from Wikipedia: A multi-axis political spectrum chart; a variant of the Nolan chart

June 11, 2012
Oooh-La-La: Posters of Paris

This summer, the Milwaukee Art Museum transports visitors to nineteenth-century Paris with its feature exhibition, Posters of Paris: Toulouse-Lautrec and His Contemporaries. Opening June 1, the exhibition brings together the finest French examples from the golden age of the poster.

Advertising everything from theatre productions to the debaucherous cancan, bicycles to champagne, brightly hued, larger-than-life-size posters with bold typography and playful imagery punctuated the streets of turn-of-the-century Paris. Posters of Paris features more than one hundred of these posters (including a few designs that were originally censored) by artists hailed as masters of the medium: Henri de Toulouse-Lautrec, Jules Chéret, Pierre Bonnard, and Alphonse Mucha, and others. These artists drew from an array of styles, from Byzantine and Rococo to Realist and Art Nouveau.

“These works celebrated the dawn of new entertainment, new products, and new technology,” said Mary Weaver Chapin, exhibition curator. “The posters were audacious, colorful, bawdy, and sometimes even profane. Art critics praised the artistic posters for bringing joy and color to daily life and for giving Paris a free ‘museum for the masses,’ ‘an open-air exhibition’ that changed daily as new posters were pasted up,” said Chapin. “Some critics went further, describing the posters as superior to the paintings found in exhibitions.”

Posters were the popular tools for advertising and communication at the time, similar to today’s social media. The arrival of a new poster was newsworthy and could draw a crowd. In some cases, police intervention was required. Billposting itself turned competitive and evolved into public theater, adding to the spectacle one encountered on the streets.

June 10, 2012
Three Bedrooms, A Fireplace, Two or More Baths: 2011 Cost, $272,900
Jim Blandings as played by Cary Grant: “It’s a conspiracy, I tell you. The minute you start they put you on the all-American sucker list. You start out to build a home and wind up in the poorhouse. And if it can happen to me, what about the guys who aren’t making $15,000 a year? The ones who want a home of their own. It’s a conspiracy, I tell you — against every boy and girl who were ever in love.” — A quote from IMDb, the 1948 film version of the novel, *Mr. Blandings Builds His Dream House.

Highlights of Annual 2011 Characteristics of New Housing by the Census Bureau

In 2011:. The single-family statistics include fully detached, semidetached (semiattached, side-by-side), row houses, and townhouses. In the case of attached units, each must be separated from the adjacent unit by a ground-to-roof wall in order to be classified as a single-family structure. Also, these units must not share heating/air-conditioning systems or utilities, such as water supply, power supply, or sewage disposal lines.
- The average single-family house completed was 2,480 square feet. In 2010, the average single-family house was 2,392 square feet.
- 33% of the new single-family homes sold in the US had vinyl siding as the principal type of exterior wall material. For attached single-family homes sold, it was 41% and for detached single-family homes sold, it was 32%.
- 88% of all single-family homes completed had air-conditioning. By region, the proportions were 81% in the Northeast, 91% in the Midwest, 99% in the South, and 62% in the West.
- 39% of single-family homes completed had 4 or more bedrooms. 48% of them had 3 bedrooms.
- Of the single-family homes completed with 4 or more bedrooms, 57% had 3 or more bathrooms.
- 19% of new single-family homes sold had a garage that could hold 3 or more cars.
- 30% of single-family homes completed had a full or partial basement, 53% had a slab or other type of foundation, and 17% had a crawl space.
- 54% of single-family homes completed had 2 or more stories.
- 48% of new single-family homes sold had 1 fireplace and 5% had 2 or more fireplaces.
June 8, 2012
Writing Britain: Wastelands to Wonderlands
As the world’s attention turns to the Olympics being held this summer in London, Writing Britain: Wastelands to Wonderlands explores treasures from the last 1000 years of English literature that have been shaped by the country’s unique spaces and places. From idyllic rural landscapes to gritty cities, the exhibition will showcase a literary map of the British Isles and highlight how writers, from William Shakespeare and Walter Scott to John Lennon and J K Rowling, have recorded the changing spaces of the British Isles in some of their greatest literary works, and in turn inspired their readers to explore the country in new ways.

Curated by the British Library’s English and Drama team, the exhibition will feature over 150 literary works, including first-time loans from overseas and personal loans from modern authors, such as Posy Simmonds, Jonathan Coe, Hanif Kureishi, and J K Rowling.

Sound recordings, letters, photographs, maps, song lyrics and drawings as well as manuscripts and printed editions will feature alongside newly commissioned video interviews on location with literary figures including Simon Armitage, Andrea Levy and Ian McEwan.

Highlights of the exhibition include:
- J K Rowling, Harry Potter and the Philosopher’s Stone – the original manuscript for Harry Potter and the Philosopher’s Stone, lent by the author, describes Harry Potter’s first encounter with platform 9 ¾ in London’s King’s Cross station. Carefully avoiding the stopping trains via Cuffley and Bayford (strictly for Muggles only), he should pass between Platforms 9 and 10 to reach a magical passage to a fantastic parallel world. This manuscript is part of the exhibition’s ‘Cockney Visions’ section, looking at literature inspired by London.
- John Lennon’s original draft for ‘In My Life’ – John Lennon’s original handwritten lyrics to ‘In My Life’ describe the bus journey from Lennon’s childhood home to Liverpool’s town centre, recording many landmarks passed en route. The final version of the song, which appeared on The Beatles album Rubber Soul (1965), became a general meditation on the past. The draft lyrics are included in the exhibition’s ‘Dark Satanic Mills’ section focusing on industrial and urban areas.
- Virginia Woolf, first edition of To the Lighthouse (1927) and childhood newspaper, ‘Hyde Park Gate News’ – Woolf’s modernist novel tells the story of the Ramsay family and their visits to a remote island in the Hebrides. While the novel describes a visit to the Hebrides, an edition of ‘Hyde Park Gate News’, the childhood newspaper produced by Woolf and her siblings, shows the inspiration was in fact a family trip to the Godrevy lighthouse of St Ives. This printed book and manuscript are featured in the ‘Waterlands’ section of the exhibition.
June 7, 2012
Summertime, When the Living Is … Easy? A Teacher’s Perspective

by Julia Sneden

The other day, I read an interview with Audra McDonald in which she talked about how hard it is to sing the beautiful lullaby “Summertime,” from Porgy and Bess, which comes at the end of the opera. The vocal demands of the song would be challenging at any point, but at the end of a performance, when the singer’s voice is tired from all that went before, soaring to those high, high notes and controlling the low, rich notes, demands an extraordinary amount of sheer determination.

I could relate to that, although I’m no longer much of a singer. It just brought to mind the way both teachers and students often waste a lot of time dreaming about the glories of summer, glories that lie ahead like a prize at the end of a race. But when we get there? Oh. Oops. That’s when we find we have to keep right on performing, albeit on a different stage.

Remember how, when you were a kid, you spent the last week of school in a kind of barely-controlled frenzy, desperate for the sound of the final bell? It’s about the same for teachers, except that they have to stay there a few days longer, filing things and taking down classroom decorations and bulletin boards, covering shelves to keep out summer’s dust. They fill out inventories and requisitions, submit work orders for the summer crew to consider, and write notes to parents who were nice enough to give them small thank-you presents.

A little aside about the latter, for anyone who is looking for a teacher-gift: the best one I ever received came from a parent who had recently acquired a pasta machine. She appeared at my classroom door late one afternoon during the classroom cleanup time, when I was elbow-deep in a bucket of water, washing something like 500 large, wooden “unit blocks.” She carried a bag of fresh, homemade fettuccine, a small container of shredded Parmesan, and a pint of homemade sauce. “Here’s tonight’s supper,” she said. “I thought it might be helpful at the end of a long day.” I managed not to embarrass us both by falling into her arms, but just barely. The last thing a teacher should have to consider, while winding up the school year and closing down her classroom, is what the heck to fix for her family’s dinner, especially when the last few days have seen an overdose of pizza/fast-food burgers/what’s-left-from-last-night suppers.

I’ve always contended that the very best of summer vacation comes before you’ve had a chance to squander even a minute of its glory. Coming home and — whether you were student or pupil — flopping on the sofa in a kind of mindless haze, or sitting on the porch with something cold and wet to drink, seems glorious. Oh, it’s nice to be able to sleep in the next morning, too, but when you do that, you’ve already wasted a few precious minutes of your freedom, and summer is already starting to run away from you.

The first nudges of reality usually come when you — full of energy and purpose — start on that list of must-do’s you have been keeping all year. The garden, which has already gotten a head start during the last couple of months, demands your attention first, and with incredible persistence. A garden in summer is the definition of a work (and work and work) in progress.

So are all the little, niggly household chores you have put off during the past frantic weeks, things like tackling the pile of ironing you ignored during exam week, which for you included making up the exam, providing a classroom review of the material covered, proctoring, and grading. Factoring in all that, “exam week” really counts as two or three weeks. Add in end-of-school parties and graduation and you have a long spell of household neglect.

Having taken care of the most pressing matters, you finally have that chance to: paint the bathroom; get behind the computer desk to straighten out and dust the cords; patch the chipped sink; wash the bedroom curtains which used to be white cotton eyelet but have somehow segued into an alarming shade of beige; tackle the very dirty basement; have an annual physical exam and perhaps dental surgery; etc. etc. etc.

If you have children, you must start the endless round of pick-up-and-deliver to day camp or swimming pool or tennis lesson. You gather the family to watch, i.e. to support, the youngest in his first baseball game, or the eldest in a diving meet, or the middle child at her dance or piano recital.

You will find yourself hosting the sleepovers you put off all winter, promising “we’ll do that in the summer, when school’s out and Mom has more time.” You’ll spend rather more hours at the grocery store, as well as in food preparation, not only trying to make up for all those “quickie” meals you threw at your family during the school year, but also because it can take a lot more time to prepare a nutritious, tasty, cold supper on a hot summer day than it does to drop something into the slow cooker on a cold winter’s morning, counting on the welcoming scent of a tasty meal when you walk in the door at day’s end, with leftovers for another night to boot.

You will also have to find a way to fit in your Continuing Education classes at the local college, earning the credits that every school teacher has to collect so that she’ll be ready when her teaching certificate comes up for renewal. It’s a fine way to help a teacher stay up on all the latest knowledge in her field, but it plays hob with a summer schedule. Think twice before you express envy for those of us who “only have to work for 10 months of the year.”

And along about August, when others are planning their Labor Day escapes, teachers are again revving up, thinking about new ways of sparking the natural curiosity that makes kids learn with energy and delight. Teachers will be planning new ways of organizing their classrooms, moving furniture around, creating new, interesting areas, as well as new, interesting lesson plans.

By the time the children show up, a good teacher will already have spent several days in the classroom, labeling things, setting out materials, sprucing up the place with posters and plants and all sorts of whiz-bang electronics that they have mastered over the summer.

A word of advice: don’t go by your child’s classroom during those “getting ready” days. You’ll probably find the teacher deeply involved in classroom preparation, wearing ratty old clothes and painting something that stands on a newspaper in the middle of the room. Of course, they’ll stop whatever they were doing, and try to be polite to the parent and welcoming to the child, but it really isn’t the time to socialize. Leave the moment of meeting until that glorious first day, when the room isn’t in chaos, and everyone, even the teacher, is clean and smiling. From there on, we hope, it’s all downhill until the next Summertime.

June 6, 2012
Ray Bradbury: Lunch With A Legend

Jean Pond met once more with the Ray Bradbury and wrote about that lunch in 2006: Before the birth of his first daughter he went to New York in 1949 hoping to interest book publishers in his work. They were looking for books, not short stories, but one of his contacts at Doubleday suggested he gather up some of his science fiction short stories and combine them in book form. That became The Martian Chronicles. He also sold them on his idea for The Illustrated Man. He received $700 each for the two outlines and turned in his Greyhound bus ticket for a train ticket back to Los Angeles.

Read more: http://www.seniorwomen.com/articles/articlesPondRay.html

June 6, 2012
George Soros On the European Union: A “fantastic object” – unreal but immensely attractive

June 02, 2012, Trento, Italy
Festival of Economics, OECD (Organisation for Economic and Co-operative Development)

A speech by George Soros

Ever since the Crash of 2008 there has been a widespread recognition, both among economists and the general public, that economic theory has failed. But there is no consensus on the causes and the extent of that failure.

I believe that the failure is more profound than generally recognized. It goes back to the foundations of economic theory. Economics tried to model itself on Newtonian physics. It sought to establish universally and timelessly valid laws governing reality. But economics is a social science and there is a fundamental difference between the natural and social sciences. Social phenomena have thinking participants who base their decisions on imperfect knowledge. That is what economic theory has tried to ignore.

Scientific method needs an independent criterion, by which the truth or validity of its theories can be judged. Natural phenomena constitute such a criterion; social phenomena do not. That is because natural phenomena consist of facts that unfold independently of any statements that relate to them. The facts then serve as objective evidence by which the validity of scientific theories can be judged. That has enabled natural science to produce amazing results.

Social events, by contrast, have thinking participants who have a will of their own. They are not detached observers but engaged decision makers whose decisions greatly influence the course of events. Therefore the events do not constitute an independent criterion by which participants can decide whether their views are valid. In the absence of an independent criterion people have to base their decisions not on knowledge but on an inherently biased and to greater or lesser extent distorted interpretation of reality. Their lack of perfect knowledge or fallibility introduces an element of indeterminacy into the course of events that is absent when the events relate to the behavior of inanimate objects. The resulting uncertainty hinders the social sciences in producing laws similar to Newton’s physics.

Economics, which became the most influential of the social sciences, sought to remove this handicap by taking an axiomatic approach similar to Euclid’s geometry. But Euclid’s axioms closely resembled reality while the theory of rational expectations and the efficient market hypothesis became far removed from it. Up to a point the axiomatic approach worked. For instance, the theory of perfect competition postulated perfect knowledge. But the postulate worked only as long as it was applied to the exchange of physical goods. When it came to production, as distinct from exchange, or to the use of money and credit, the postulate became untenable because the participants’ decisions involved the future and the future cannot be known until it has actually occurred.

I am not well qualified to criticize the theory of rational expectations and the efficient market hypothesis because as a market participant I considered them so unrealistic that I never bothered to study them. That is an indictment in itself but I shall leave a detailed critique of these theories to others.

Instead, I should like to put before you a radically different approach to financial markets. It was inspired by Karl Popper who taught me that people’s interpretation of reality never quite corresponds to reality itself. This led me to study the relationship between the two. I found a two-way connection between the participants’ thinking and the situations in which they participate. On the one hand people seek to understand the situation; that is the cognitive function. On the other, they seek to make an impact on the situation; I call that the causative or manipulative function. The two functions connect the thinking agents and the situations in which they participate in opposite directions. In the cognitive function the situation is supposed to determine the participants’ views; in the causative function the participants’ views are supposed to determine the outcome. When both functions are at work at the same time they interfere with each other. The two functions form a circular relationship or feedback loop. I call that feedback loop reflexivity. In a reflexive situation the participants’ views cannot correspond to reality because reality is not something independently given; it is contingent on the participants’ views and decisions. The decisions, in turn, cannot be based on knowledge alone; they must contain some bias or guess work about the future because the future is contingent on the participants’ decisions.

Photo: Angela Dorothea Merkel, Chancellor of Germany. All images are from Wikipedia

June 5, 2012
League of Women Voters of Florida v. Browning: Blocking Enforcement of A Restrictive Voting Law

Editor’s Note: On December 15, 2011, the League of Women Voters of Florida, Rock the Vote, and the Florida Public Interest Research Group Education Fund (“PIRG”) filed suit in federal court in Tallahassee challenging Florida’s onerous new restrictions on community-based voter registration drives.

The restrictions challenged in the suit were enacted by Florida legislators earlier this year as part of H.B. 1355, a broad package of election law changes. They include extremely burdensome administrative requirements, unreasonably tight deadlines for submission of completed forms, and heavy penalties for even the slightest delay or mistake. These restrictions are so unnecessarily harsh that they have forced the League of Women Voters and Rock the Vote, among other groups, to shut down their voter registration programs in Florida.

On behalf of these civic groups, the Brennan Center, the ACLU Foundation of Florida, and pro bono partners Paul, Weiss, Rifkind, Wharton & Garrison LLP, and Coffey Burlington asked the court to block Florida’s new restrictions on the basis that they violate both the US Constitution and the National Voter Registration Act. On March 1, Plaintiffs presented their argument for a preliminary injunction in front of Judge Hinkle of the Northern District of Florida.

A federal judge blocked enforcement of key provisions of a restrictive voting law in Florida at the end of May, a breakthrough victory for Florida voters and voting rights advocates nationwide.

The law included onerous restrictions on community-based voter registration drives, forcing the League of Women Voters of Florida and other groups to shut down their drives. In his decision, US District Judge Robert Hinkle found that the Constitution and federal law prohibit most of Florida’s recently-passed restrictions, and highlighted the law’s impact on the Plaintiffs’ constitutional rights.

“Together speech and voting are constitutional rights of special significance; they are the rights most protective of all others, joined in this respect by the ability to vindicate one’s rights in a federal court. … [W]hen a plaintiff loses an opportunity to register a voter, the opportunity is gone forever,” US Judge Robert L. Hinkle wrote in his opinion blocking most of the Florida law. “And allowing responsible organizations to conduct voter-registration drives — thus making it easier for citizens to register and vote — promotes democracy.”

“Today’s decision makes clear that laws that make it harder to participate in the political process should be rejected,” said Wendy Weiser, director of the Democracy Program at the Brennan Center, and co-author of the report, Voting Law Changes in 2012. “Florida’s law and others approved in the past year represent the most significant cutback in voting rights in decades. Today’s decision will help turn the tide. Rather than erecting senseless barriers to voting, we should make our voting system work by upgrading our ramshackle voter registration system.”

In 2011, a wave of suppressive laws passed that could make it significantly harder for millions of eligible Americans to cast ballots this fall, according to the Brennan Center’s comprehensive study, Voting Law Changes in 2012.

The Florida decision marks the first time a federal court has blocked one of these restrictive voting laws, and comes after the Department of Justice, in a separate lawsuit, opposed Florida’s law restricting voter registration and early voting. The Justice Department also rejected restrictive voter ID laws in South Carolina and Texas. A judge ruled that Wisconsin’s voter ID law violated the state Constitution.

June 4, 2012
Agnes Mary Clerke and The Transit of Venus

by Agnes M. Clerke

From Chapter VI, the Project Gutenberg eBook released in 2009; *see page 2 for details of watching the Transit of Venus event.

“Venus, on the other hand, comes closest to the earth when she passes between it and the sun. At such times of “inferior conjunction” she is, however, still twenty-six million miles, or (in round numbers) 109 times as distant as the moon. Moreover, she is so immersed in the sun’s rays that it is only when her path lies across his disc that the requisite facilities for measurement are afforded. These “partial eclipses of the sun by Venus” (as Encke termed them) are coupled together in pairs,[751] of which the components are separated by eight years, recurring at intervals alternately of 105-1/2 and 121-1/2 years. Thus, the first calculated transit took place in December, 1631, and its companion (observed by Horrocks) in the same month (N.S.), 1639. Then, after the lapse of 121-1/2 years, came the June couple of 1761 and 1769; and again after 105-1/2, the two last observed, December 8, 1874, and December 6, 1882. Throughout the twentieth century there will be no transit of Venus; but the astronomers of the twenty-first will only have to wait four years for the first of a June pair. The rarity of these events is due to the fact that the orbits of the earth and Venus do not lie in the same plane. If they did, there would be a transit each time that our twin-planet overtakes us in her more rapid circling—that is, on an average, every 584 days. As things are actually arranged, she passes above or below the sun, except when she happens to be very near the line of intersection of the two tracks.”

“Such an occurrence as a transit of Venus seems, at first sight, full of promise for solving the problem of the sun’s distance. For nothing would appear easier than to determine exactly either the duration of the passage of a small, dark orb across a large brilliant disc, or the instant of its entry upon or exit from it. And the differences in these times (which, owing to the comparative nearness of Venus, are quite considerable), as observed from remote parts of the earth, can be translated into differences of space —that is, into apparent or parallactic displacements, whereby the distance of Venus becomes known, and thence, by a simple sum in proportion, the distance of the sun. But in that word “exactly” what snares and pitfalls lie hid! It is so easy to think and to say; so indefinitely hard to realise. The astronomers of the eighteenth century were full of hope and zeal. They confidently expected to attain, through the double opportunity offered them, to something like a permanent settlement of the statistics of our system. They were grievously disappointed. The uncertainty as to the sun’s distance, which they had counted upon reducing to a few hundred thousand miles, remained at many millions.”

“In 1822, however, Encke, then director of the Seeberg Observatory near Gotha, undertook to bring order out of the confusion of discordant, and discordantly interpreted observations. His combined result for both transits (1761 and 1769) was published in 1824, [752] and met universal acquiescence. The parallax of the sun thereby established was 8·5776′, corresponding to a mean distance [753] of 95-1/4 million miles. Yet this abolition of doubt was far from being so satisfactory as it seemed. Serenity on the point lasted exactly thirty years. It was disturbed in 1854 by Hansen’s announcement [754] that the observed motions of the moon could be drawn into accord with theory only on the terms of bringing the sun considerably nearer to us than he was supposed to be.”

June 3, 2012
Intangible and Invisible: Caring for Critically Ill and Terminal Patients Can Generate Grief Reactions in Health Care Professionals

While all [Health Care Professionals] can potentially experience grief over patient loss, oncologists face unique pressures because they are legally responsible for the patients’ care and may be blamed when patients die. Editor’s Note: We have edited some of this editorial letter*.

Despite the evidence that grief over patient loss is an intrinsic part of clinical oncology, there are no qualitative studies examining the nature and extent of oncologists’grief over patient loss nor the impact of this grief on oncologists’lives. The objectives of our study were to explore and identify oncologists’ grief over patient loss and the ways in which this grief may affect their personal and professional lives.

Methods. A grounded theory approach was used. We recruited and interviewed 20 oncologists between November 2010 and July 2011 from 3 adult oncology centers in Ontario, Canada. We interviewed 3 groups of oncologists who were at different stages in their careers (ie, trainees and junior and senior oncologists) and varied in subspecialty, sex, and ethnicity. Exclusion criteria were the inability to speak English and never having had a patient die in their care. Approvals were obtained from the research ethics board at each participating center. Participants signed a consent form and agreed to the interview being audio-recorded.

Results.

Nature of Oncologists’ Grief. In addition to sadness, crying,and loss of sleep, oncologists’ grief had unique elements related to their sense of responsibility for their patients’ lives. These feelings could begin before the death of the patient, arising from holding hard medical knowledge such as awareness of poor test results or likely patient death before revealing this information to the patient himself or herself. Oncologists’ grief also included feelings of powerlessness, self-doubt, guilt, and failure.

The Impact of Patient Loss on Oncologists. While oncologists spoke about burnout, the single most consistent and recurrent finding in the interviews was the description of compartmentalization resulting from patient loss. Oncologists’ compartmentalization involved their ability to separate feelings of grief about patient loss from other aspects of their lives and practices and was described as both a coping strategy and an impact of continual patient loss. Physicians used phrases such as “denial” and “dissociation” in describing this process as patients died.

The Impact of Patient Loss on Affect. The theme of balancing emotional boundaries captured the tension between growing close enough to care about the patients but remaining distant enough to avoid the pain of the loss when the patient died. Few oncologists felt they had been able to do this entirely effectively, although they recognized that the inability to balance these boundaries might be problematic for them.

Impact of Patient Loss on Other Patients. Oncologists talked about the impact of patient loss on their treatment decisions, on their level of distraction with patients, and on their motivation to improve care for subsequent patients. Another impact was the strategy oncologists used to distance or withdraw themselves from patients and their families as the patients got closer to dying, including fewer visits in the hospital, fewer bedside visits, and less overall energy expended toward the dying patient.

Personal Impact of Patient Loss.Oncologists spoke about grief spillover as having difficulty separating their work life from their personal lives when the grieving came home with them. Many also talked about having a better perspective on life as a result of frequent exposure to patient loss.

Comment. To our knowledge, this study is the first qualitative exploration of the nature and impact of grief in oncologists.

We found that for oncologists, patient loss was a unique affective experience that had a smokelike quality.

Photo from Wikipedia: Thomas Eakins, The Gross Clinic, 1875, on display in Ward One of the US Army Post Hospital, 1876 Centennial Exposition in Philadelphia.

June 1, 2012