watching the wheels



Last month's House Organ cover story "Of Death and Dying at VUMC" made some people angry, made some people think, made some people cry, motivated some people to remove our issues from the racks, and motivated a spirit of giving in others.

When John Howser, my colleague who reported, wrote, and photographed the story and I began talking about it months ago, we had in mind a multidimensional look at death, but we had no idea the nerve the issue would touch.

As reported in the Oct. 8 issue of the VUMC Reporter in a storyby Nancy Humphrey and Carole Bartoo:

"Several hundred issues of the October House Organ were temporarily removed from racks in patient care areas at the Monroe Carell Jr. Children's Hospital at Vanderbilt last Friday, after a parent complained about the issue's content and cover.

"Following a meeting between Children's Hospital staff and the Office of News and Public Affairs on Monday, the issues were restored to some of the racks and the News and Public Affairs office has agreed to return the rest of the issues with a posted note on the racks containing information about Medical Center resources regarding death."

Nancy and Carole's story also quotes Pat Chenger, administrative director of Nursing and Clinical Support at Children's Hospital: "In terms of content, the description of the morgues could have been upsetting as well. The remainder of the article does not appear to conjure up any thoughts for me that could be a problem; however, I am not the parent of a dying child or a family member. I do understand this may be a concern for somebody in this situation."

As it happens, I received a letter from a staff member who had recently suffered a death in her family and who was upset by the cover: "While I think it is admirable that you are trying to examine the subject of death, I am here to tell you that putting an image of a dead body under a sheet with a toe tag on the cover of your publication is quite insensitive...I am writing to ask you to have some sensitivity in the future about your cover."

A longtime VUMC nurse also wrote about the cover: "I need to share my concern that it was in very poor taste...I am assuming that the picture was staged and was not a real individual, but our patients, families, and guests don't know that...[S]eeing a picture of a corpse with a toe tag is certainly very distasteful, if not anxiety provoking...I think you owe the Vanderbilt community an apology!"

The second writer's assumption is correct: the photo does not depict a real body; it was a photo illustration--and was labeled as such--but the writer is also correct that some people may not have realized that.

Another writer said: "I just think there are some things about this issue that could have been done differently and more appropriately since patients and families are also the audience, not just staff."

You may remember that the introduction to "Of Death and Dying at VUMC" was a story of an elderly woman who was dying in the Medical Intensive Care Unit. She had four wishes: not to have extraordinary measures taken to keep her alive, not to be in pain, not to be left alone, and to hear gospel music. The first three were arranged, but the music took some imagination; since there were no gospel CDs around, staff members formed an impromptu choir and sang to the dying woman.

            That story was related to John by the nurse manager of MICU, Julie Foss. After the issue was published, Julie wrote to John again with this update:

"I was in my office trying to find the top of my desk and the phone rang. It was a woman who is being seen at Vanderbilt as a patient, a total stranger to me. She talked about spending time in the Cancer Infusion Center, Radiation Oncology and the Neurosurgery clinic...she picked up the House Organ and read your article. She was very touched by the article, especially the part about the gospel music... She wanted to give the MICU some CDs of gospel music! Talk about being touched, I got a little misty-eyed! I want to thank you for taking the risk to write this article and even for the picture on the cover. While it was offensive to some it touched others who are either dealing with their own mortality or working with patients who are."

Another reader wrote, "It was written in such a compassionate, respectful and informative manner...I learned many interesting facts about Vanderbilt's role in this final event of life."

That comment was echoed in a letter from Monroe Carell Jr., for whom Monroe Carell Jr. Children's Hospital at Vanderbilt is named: "Your insight in how these various conditions are confronted and what is done with the remains, donations and autopsy is all very interesting and informative. I am always very proud of Vanderbilt Medical Center for what it does for the living and I see now that the same consideration is given for the dying."

Chancellor Gordon Gee wrote to John: "A note to tell you how much I appreciated your powerful report, 'Of Death and Dying at VUMC,' in the latest issue of the House Organ. I read it, and then reread it because it had an enormous impact on my own thinking. I am taking the opportunity to pass it a bit wider to several friends."

As I have individually written to those who wrote me with concerns, I am very sorry that some readers were offended or hurt by the issue. To those who ask that I keep in mind that our patients and families see the magazine as well as staff and faculty, I think that's a good point that I'm not likely to forget soon.

I am also very proud that this issue has affected people and gotten them talking and thinking about death and how it affects our institution, our people and our lives.

Comments? Write to Wayne at wayne. .


November 2004


What about Buddy?

Buddy the squirrle has been a pet to the people in Pediatrics surgery for years- but his friends are moving away.


From beauty pageants to medical school

Jessica Sparks is helping pay her way through medical school with scholarship money she earned competing for Miss Mississippi.

Employee Celebration Month

A photo trip down memory lane, even if you can't quite remember the Night Owl Howl.

The Territory Ahead

Two medical students spent the summer hiking to raise money for and awareness of HIV. A report from the trail.

Remembering Dean Chapman

Longtime friend Jan Lotterer tells some stories on Dr. Chapman, who died last month.




Hold the Stuffing and get a prize

Hold the Stuffing is an annual event encouraging staff and faculty to maintain their weight from Thanksgiving through the first week of January. The typical American gains weight over the holidays, but last year Hold the Stuffing participants lost weight. Almost all that completed the event in 2003 (783) met the goal of maintaining their weight (17 percent), losing weight (57.6 percent), or gaining no more than 2 pounds (19.4 percent), according to figures compiled by Health Plus, the staff and faculty wellness program which conducts Hold the Stuffing.

Participants weigh in the week before Thanksgiving, and then again the first week in January. To participate in this year's event, simply weigh in with Health Plus at any of the Hold The Stuffing stations the week of November 15-19. Those who maintain their weight, hold any gain to less than two pounds, or lose weight over the holidays win a prize from Health Plus. This year's prizes are a choice of a Border's Bookstore gift certificate or an exercise tube, complete with workout plan.

People who are trying to gain weight can participate, too;   Health Plus can work your individual goals into this program.

Contact Health Plus at 343-8943 for more information.



Flu vaccine update


At press time, VUMC continues to await delivery of available stockpiles of influenza vaccine. Per direction from the Centers for Disease Control and Prevention, Aventis-Pasteur Pharmaceuticals is attempting to fill partial orders of flu vaccine for hospitals and health care providers who were to receive their vaccine from Chiron. Additionally, VUMC expects to receive a supply of FluMist, the nasal spray flu vaccine.  

FluMist is a live virus vaccine which may be used by most

health care workers, but cannot be used by those with personal medical conditions placing them at increased risk, or by people age 50 and older.  In addition, FluMist cannot be used in reverse isolation units (e.g. bone marrow transplant units).  Guidelines for the use of FluMist will be forthcoming. At this point we do not have any FluMist. 

When vaccine does become available, through a Targeted Vaccine Plan VUMC's highest risk patients will be vaccinated according to CDC guidelines. Only faculty and staff designated highest risk will be vaccinated initially. As additional vaccine becomes available, additional faculty and staff will be vaccinated. This tiered vaccination process, designed and administered by the Occupational Health Clinic, the departments of Infectious Diseases and Preventive Medicine, and the department of Emergency Preparedness, will continue until all flu vaccine is used.   

The Medical Center will employ its Syndromic Surveillance System, which generates reports on a daily basis, to effectively monitor the onset and impact of influenza cases on the Medical Center.

As flu season approaches all faculty and staff are urged to maintain impeccable hand hygiene and other infection control techniques. Individuals with high-risk health conditions who are not health care workers should take advantage of vaccine clinics through their local health department until their personal physician's office can obtain vaccine.


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