August 20, 2001
Media Mix
By SHARI ROAN, health writer for the Los Angeles Times
A Few Months to Live:
Different Paths to Life's End
By Jana Stanton, Roger Shuy and Ira Byock
Georgetown University Press Cloth and paperback 358 pages, cloth, $70; paperback, $26.95 *
There are many books and studies on death and dying, but few are as different as "A Few Months to Live." The book is based on a study of nine people living in Missoula, Mont., where a larger pilot study is underway called the Missoula Demonstration Project: The Quality of Life's End.
Although it may seem hard to believe that profound lessons in death and dying can emerge from a few people in one particular town, this thoughtful research project may break new ground on important issues. Certainly, this book--the stories of how nine people died--is captivating.
The book is aimed at professionals who work with dying patients, but terminally ill people and their caregivers will find much here to consider.
Each chapter focuses on a specific area of the dying experience, such as planning, doctor-patient communication, care-giving and grief.
Most of the observations, however, are made by the nine patients themselves or by their caregivers. The authors mainly provide context on the patients' circumstances and ask the questions to which patients reply. The result is a book by people who talk about what it's like to die. The subjects include a 39-year-old man with a rare form of cancer, a 70-year-old man with chronic obstructive pulmonary disease and an 87-year-old woman with breast cancer.
The final chapter is the authors' analysis of common themes they found among their nine subjects. These themes include previously ignored issues in the death-and-dying literature, such as how changing doctors and nurses affects patients and the profound importance of maintaining a normal life (including being at home among their personal possessions) while dying. They also note that the perception of pain varies greatly according to how the patient is engaged at any particular moment. For example, pain seems to lessen when visitors drop by.
"A Few Months to Live" does not offer quick fixes, but it performs a valuable service by showing death as a meaningful experience for nine people who tell us, as best they can, what that experience is like.
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