November 2, 2001

Tarpley discusses mystery of death

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Dr. John Tarpley addressed the crowd at last week’s Pastoral Care seminar. (photo by Dana Johnson)

Tarpley discusses mystery of death

Dr. John L. Tarpley knows two things for sure: death remains a constant. Yet we know very little about it.

“Death has been written about for a long time, yet we don’t know much about it,” Tarpley said. “There’s a lot of opinion, but no data about what happens after you die. Socrates said nobody knows exactly what death is, ‘yet people fear it as if they surely knew it to be the worst of evils.’”

Tarpley, professor of Surgery and Bonnie Miller-McLemore, professor of Pastoral Theology and Counseling at the Vanderbilt Divinity School, each spoke at last week’s Pastoral Care Fall Seminar, “Valuing Life’s Passages: Transitions of Dying and Adulthood.”

Tarpley said that over the past few years supervisory groups such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the American College of Surgeons have begun to issue guidelines to make sure that health care professionals don’t ignore end of life issues as part of a patient’s rights.

The American College of Surgeons, in fact, issued a set of principles in 1998. They included: respect the dignity of both patient and caregivers; be sensitive and respectful of the patient’s and family’s wishes; use the most appropriate measures that are consistent with the choices of the patient or the patient’s legal surrogate; ensure alleviation of pain and management of other physical symptoms; recognize, assess and address psychological, social and spiritual problems; provide access to appropriate palliative care and hospice care; respect the patient’s right to refuse treatment; recognize the physician’s responsibility to forego treatments that are futile.

Tarpley said that it is necessary for physicians to weigh quality of life vs. quantity of life.

“We have to keep these issues before ourselves and our housestaff all the time,” he said. “We can’t explain everything. We don’t know everything. Health care professionals can’t offer immortality, but we can offer hope. But we must also realize that healing is not always synonymous with cure.”

Tarpley said that health care professionals can offer three P’s to a patient facing the end of his or her life—presence, pain relief and prayer.

“I know what I, John Tarpley, a Christian, can offer. God gave us one mouth and two ears, maybe by design. We need to sit, not be in a hurry, ask and listen, talk with, hold a hand, touch a brow. Relationship trumps efficiency in my mind.”

Tarpley said that during the 20th century, the practice of medicine “veered” from the art side to the science and technology side, but it’s heading back toward the “middle of the road.”

“It’s a ‘both, and,’ not ‘either or,’ situation,” he said.

Many physicians suffer from burnout, perhaps because they don’t take the time to practice what led them into medicine in the first place — a love of science and people, Tarpley said.

“Many physicians give, give, give and never re-fuel. We get caught up in the practice and everything goes to that, and we don’t allow our patients to give back.”