JOURNAL OF THE KYORIN MEDICAL SOCIETY

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This paper introduces a type of death education task called the “Guided Death Experience (GDE)”. The authors experienced this task at a lecture by Dr. Thomas R. McCormick of the University of Washington, Seattle, which was held at Kyorin University in March 2006. This task was widely carried out at the University of Washington, and at several hospitals and hospices in Seattle, Washington. First, participants are asked to list five important belongings on green cards, one per card. Next they write the names of five loved ones on pink cards, five favorite places on blue cards, five important goals on white cards, and five important experiences on yellow cards. While listening to a story in which “you” are dying, participants have to discard a few cards at each instance. Finally, they lose all of them at the moment of death. Through this process, they have had the virtual experience of dying. The effect of GDE is discussed from the following view points: noticing the importance of a balanced time perspective (past, present, and future), finding out what is really important by being released from beliefs, and noticing how the “self” is woven into relationships with others. The possibility of assimilating the GDE in medical education is also mentioned. GDE would be able to play the role of raising the medical staffs' awareness of how to support patients and family in the process of dying. It would also protect the medical staff from burnout syndrome.

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The present study examined the mechanisms of epidural block action in rats. Under anesthesia, Gutta-percha points was placed on dorsal root ganglion (DRG)s of the L4 and L5 in the rat, and the catheter (PE-10) was gently introduced rostrally into the coccygeal epidural space. Seven days after the surgery, rats were used for acute experiments if animals showed behavior indicative of spontaneous pain such as licking and raising hind paw on the injured side. In these 21rats, extracellular recordings from filaments of the sural nerve detached from the receptors were performed and spontaneous activity originated from DRG neurons was recorded. Application of lidocaine epidurallaly through the catheter suppressed their spontaneous activity in all investigated neurons. The results indicated that epidural lidocaine administration affected the somata of dorsal ganglionic neurons.

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