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When Dr Mark Taubert, right, wrote an open letter of thanks to David Bowie following the singer's death, he had no idea of the international attention it would receive. The letter was shared countless times, featured in innumerable media reports and even prompted Bowie's son Duncan Jones to break his Twitter silence to share it.
In the letter, Mark, a Cardiff-based palliative care consultant, described how the late star's music had inspired a candid conversation with a terminally ill patient, and praised Bowie's last musical offering, the album Blackstar, saying it was a source of comfort to people living with terminal illnesses, as well as those who cared for them.
On 1 March 2016 - St David's Day, aptly enough - Dr Taubert spoke at a Byw Nawr (the Welsh arm of Dying Matters) event. Here is a transcript of his talk.
Today is St David’s day and also the first day of Spring. Spring, what a fitting time to talk about death and dying, no? Well, we think it is.
There are not really any perfect times to talk about death and dying. But, if the moment is right, should we not all feel comfortable to talk freely about it, without feeling guilty, inappropriate or morbid?
That is why I am grateful for the work and help of Byw Nawr and Dying Matters in Wales, to bring these conversations, which I have frequently with the people I meet in my professional role as a clinician, to more prominence.
We want these conversations to seem more normal.
The David I recently wrote a letter to was perhaps no Saint David, and I doubt he would have liked to be called that. He was, however, inspirational to many, and formed a soundtrack to many of our lives for many decades.
He died on 10th January 2016 in Manhattan. On Monday the 11th, I heard about his death on the radio. I was preparing breakfast, and I remember it stopping everything. I hadn’t expected this, and for a while was not sure if I believed it. I then experienced actual grief, for someone I’d never even spoken to. It was all quite bizarre.
Over the following weeks, I counted about five or six patients who talked about Bowie’s death in outpatient or inpatient settings. One of these conversations led to a very detailed discussion about a particular lady’s thoughts on death and dying, home death, not wanting resuscitation and other matters.
The woman I was talking to had just recently been diagnosed with widespread terminal cancer. This was our first encounter. We talked about David’s songs. Her favourite was Ashes to Ashes, from the album Scary Monsters. She was less keen on his Ziggy Stardust days, stating that she wasn’t sure whether he was a boy or a girl; this made us both laugh. It was this encounter and conversation that led me to write an open thank you letter to Bowie.
For a few days, when more and more people started reading and sharing it, the whole world seemed to talk about death, dying and palliative care. I received many emails, phone calls, letters and parcels from all over the globe. It was all very odd and a bit alien to me, but it demonstrated that there is an unmet need for many to discuss this important topic, and celebrity death seemed to be an acceptable way ‘in’ to the Big Conversation.
In this, my first big conversation with her, we established more about her preferences and wishes than she had ever been able to cover even with those close to her. Music and David Bowie became our connection to talk about something that you don’t usually chat about to strangers. This struck me, and I was grateful for it.
Of course, I am not saying that healthcare professionals should use celebrity deaths as a way into such conversations, but what I hope for is that we all make death and dying more speakable. Death, dying, palliative, these are sometimes seen as dirty words, and I hope that can change. On this morning with her, death became speakable, and my being there as a palliative care professional was welcomed and not objectionable.
A message from Australia about the Bowie letter read: “Someone else’s death is a tragedy, my own death is unspeakable… but celebrity death is very speakable.” Why is that?
I don’t know. But all of us working in healthcare in the community and in hospitals and hospices have found our conversational ways into this big topic. It has to be individualised, no conversations are ever likely to be the same, and we can all learn from each other. An example: I’m indebted to Byw Nawr, Dying Matters, NHS Wales and numerous patients/carers for their help in producing four videos on how to improve conversations about cardiopulmonary resuscitation and ‘do not attempt’ orders. These videos are on a website called #TalkCPR and also YouTube.
I was struck by what the late Christopher Hitchens said in his book Mortality, describing his cancer and life in what he describes as Tumourtown.
Telling someone else, with deliberate realism, that once I’d had a few more scans and treatments I might be told by the doctors that things from now on could be mainly a matter of ‘management’, I again had the wind knocked out of me when a doctor said, “Yes, I suppose a time comes when you have to consider letting go.” How true, and how crisp a summary of what I had just said myself. But again there was the unreasonable urge to have a kind of monopoly on, or a sort of veto over, what was actually sayable. Cancer victimhood contains a permanent temptation to be self-centered and even solipsistic. So my proposed etiquette handbook would impose duties on me as well as upon those who say too much, or too little, in an attempt to cover the inevitable awkwardness in diplomatic relations between Tumourtown and its neighbours.
(Passage from Mortality, Atlantic Books London, 2012)
Hitchens used the word ‘sayable’ and I used the word ‘speakable’ earlier. I will use it again; our goal must be to make the taboo topic of death and dying speakable, not unspeakable. Sayable, not unsayable. In the written online world of social media, perhaps ‘writable’ or ‘tweetable’, although not much there remains unsaid. And this may be awkward to start off with. We should try to live now, as Bowie did in his final, busy months, and also be clear with everyone that dying matters so much, that we need to plan for it, allow it to flow into everyday conversations, even on a beautiful Spring day
In this room here today at the Senedd we’re not perhaps Absolute Beginners when it comes to this topic, and a bit of Moonage Daydreaming often led to really remarkable things. I hope today marks a beginning, not an end.
Trafod, Cynllunio, Byw - Talk, Plan, Live