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A stage for end-of-life issues
Play finds place in medical students' curriculum

Aug. 16, 2007
By Mary Reed

An audience of medical professionals assembled in Baker University Center Theatre looks to a bare-bones stage that contains just three actors and a narrator. The performers sit on chairs and begin to dramatically read the script placed on music stands in front of them. An hour and 20 minutes later, the emotional impact of the play about a family coping with end-of-life issues is anything but bare bones.

Photos by John Sattler"I really felt for all the characters. I could understand each of their perspectives and what they were going through emotionally. I think that's probably what makes it a great teaching tool," said third-year medical student Kay Ritchey. "I'm glad other to-be doctors are learning this."

"Confessions of a Reluctant Caregiver" chronicles the experiences of a daughter taking care of her parents, both of whom die of cancer at home. A related palliative educational program brings the play to medical students as a teaching tool about end-of-life care. Palliative care seeks to provide comfort and treatment without seeking a cure, generally because a cure is not possible. 

While the play packs an emotional punch – with tears, fears, conflict and characters having to ask the Hospice nurse, "How much time?" – it's also a comedy. 

"Humans are funny," said playwright Merri Biechler, who just completed her MFA in playwriting while also working as a graduate assistant in the Ohio University College of Osteopathic Medicine's academic affairs office. "And there's a no more human experience than dying." Biechler ought to know. She based the semi-autobiographical play on her experience of caring for her own parents, both of whom died of cancer. 

In "Confessions," Mom is a psychologist who dies gracefully, always making things as easy as possible for those around her. "I like looking surprised," Mom says in response to news that she's penciled on her eyebrows a little too high after the loss of her real eyebrows to chemotherapy. Dad is a cranky, know-it-all chemist obsessed with actress Courteney Cox, his own bowel movements and Splenda sweetener. The daughter negotiates end-of-life care for both, realizing there is no one right way to do it. 

Photos by John Sattler"That's the whole point, there is no textbook," Biechler said during a talk-back session after the reading. The session is part of the program's educational component, which will take the play to medical professionals – mostly medical students here at Ohio University and then to an audience of professionals from around the state – along with a post-performance discussion and an attitudinal survey. One goal of the program is to measure the effects of using theater for medical education and to assess the knowledge and attitudes of medical students about end-of-life care. 

"I think two big points that I left with were, number one, the implications of communication ... I definitely walked away with a better sense of how things can get lost in translation," said third-year medical student Becky Teagarden. "And number two, it is more than just a patient-physician dyad. There are a number of different people (involved); your patient is not just your patient but your patient's family becomes your patient."

End-of-life care is difficult to teach to anyone who hasn't had to deal with it personally, said Tracy Marx, an assistant professor of family medicine, osteopathic physician and medical director of Athens County Hospice. Marx is a program facilitator for the Confessions of a Reluctant Caregiver Palliative Educational Program and the instructor for Addiction, Pain and Palliative Care, a required course for second-year medical students. 

The students in Marx's palliative care course are the first to see "Confessions" as part of their curriculum. In October, the play will be performed at the annual Consortium of Ohio Geriatric Academic Programs conference, which will draw faculty and students from the geriatric programs of all seven state-assisted medical schools. 

The play, along with the educational component, has earned funding from the Ohio University Trisolini Graduate Fellowship, the Ohio University Student Enhancement Award, the OU-COM Research and Scholarly Affairs Committee as well as the American Cancer Society. And among other recognitions, "Confessions" is the 2007 winner of the Jane Chambers Student Playwriting Award sponsored by the Women and Theatre Program, a division of the Association for Theatre in Higher Education. 


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Published: Jan 3, 2007 9:35:38 AM
 
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