The Practice of Prolonging Death, a reflection by palliative care physician Chris Schifeling

Christopher Hamblin Schifeling is a geriatric and palliative care physician in Denver. His creative work has been featured in JAMA and Annals of Internal Medicine. His multimedia piece “Calavera” appears in the Fall 2020 Intima.

Christopher Hamblin Schifeling is a geriatric and palliative care physician in Denver. His creative work has been featured in JAMA and Annals of Internal Medicine. His multimedia piece “Calavera” appears in the Fall 2020 Intima.

“Would we rather die too soon or too late?”

Deborah Starr poses this vital question in “Plain Talk,” her video featured in the Fall 2015 Intima. Accompanied by a series of blue neon sketches, she discusses the typical trajectory of death in the United States. The taboo of talking about death combined with a faith in the insomnia of medical technology leads many to err far on the side of dying too late. Starr highlights how more open conversations with friends, family and clinicians about death and what matters most can draw us back to the golden mean.

The drawings, by Ellen Stedfeld, are an effective complement to the narration. Their seeming spontaneity lends an accessibility to this heavy topic. At the same time, the bright blue, emphasized by the black background, is apropos of the subject’s hallowed nature.

A still from Deborah Starr’s “Plain Talk,” her video featured in the Fall 2015 Intima.

A still from Deborah Starr’s “Plain Talk,” her video featured in the Fall 2015 Intima.

Two contrasting images particularly capture the diverging paths of dying presented in the video. The first picture shows an ill-appearing patient in a hospital bed alone and surrounded by machines. A preponderance of vertical lines from the medical equipment and bed rails creates an imprisoning sensation. Likewise, the Argus-eyed knobs feel overbearing. In contrast, the second picture shows a person in bed in identical orientation but surrounded by people. With hardly any right angles, there is an openness to this image, and the absence of facial features allows the viewer to fill in the emotions of the scene.

The drawings, by Ellen Stedfeld, are an effective complement to the narration.

The drawings, by Ellen Stedfeld, are an effective complement to the narration.

Through the simple force of these sketches, “Plain Talk” invites us into a space where the gravity of death can be seen and bent.

In a similar vein, my piece “Calavera”seeks to illustrate through a narrated video the deadlock that traps both a patient and his clinician when neither dares to ask: Is it better to die too soon or too late.


Christopher Hamblin Schifeling is a geriatric and palliative care physician in Denver. His creative work has been featured in JAMA and Annals of Internal Medicine. His multimedia piece “Calavera” appears in the Fall 2020 Intima.

©2021 Intima: A Journal of Narrative Medicine