The Existential Dispatch, Issue No. 49

A Word from the Founding Director

This issue is about speech and its absence. A new German guideline now asks clinicians to raise existential questions directly, a study of demoralisation shows how much distress goes unnamed in palliative oncology, and Audre Lorde reminds us what silence costs. I am interested in the conditions that make it possible for patients, families, and clinicians to say what is true, and in what we owe each other once it has been said.

Existential Thinker of the Issue

Audre Lorde

“My silences had not protected me. Your silence will not protect you.” — Audre Lorde, “The Transformation of Silence into Language and Action” (1977), in The Cancer Journals (awpc.cattcenter.iastate.edu)

Lorde wrote these lines weeks after being told a breast tumour was likely malignant, as a Black lesbian poet weighing what she had left unsaid. For queer and racialised patients, silence in the clinic is often learned as protection. Lorde’s point is that it rarely protects; clinical care can lower the cost of speaking by asking openly, listening without correction, and making room for partners and chosen family.

In Academia

Demoralisation in palliative oncology outpatients. A cross-sectional study by Ljuslin and colleagues in Psycho-Oncology found moderate-to-severe demoralisation in 43.3% of 164 outpatients with advanced cancer, often alongside adjustment disorder symptoms, and concludes that demoralisation captures a distinct existential dimension of distress. onlinelibrary.wiley.com

Self-compassion and spiritual well-being in caregivers. A study of 138 family caregivers in a palliative care unit, published in Palliative & Supportive Care on October 5, found a moderate positive correlation between self-compassion and spiritual well-being; 72.5% said they needed spiritual support. cambridge.org

In Film, Literature and Culture

Frost Will Come: Essays from the Bardo. Mary Cappello’s lyric memoir, out October 27 from University of Wisconsin Press, follows the months in which she and her wife moved into her mother’s Philadelphia apartment so that her mother, a poet with terminal ovarian cancer, could die at home. bookishbeck.com

Dance of Death at the Orange Tree Theatre. Richard Eyre’s new adaptation of Strindberg, reviewed on October 14, draws out the play’s dark humour as it confronts the fear of loneliness and death within a long marriage. playsinternational.org.uk

In Healthcare (Global)

Germany’s palliative care guideline adds chapters on spirituality and relatives. The revised S3 guideline on palliative care for patients with incurable cancer, led by the German Society for Palliative Medicine, recommends asking about spiritual and existential needs at the start of care and as illness progresses, with questions such as “What is most important to you now?” (report of October 10, in German). katholisch.at

Screening by anatomy for transgender and gender-diverse patients. A Charles Sturt University review of 13 international studies, reported on October 15, found no evidence that gender-affirming hormone therapy substantially raises overall cancer incidence, and urges screening based on anatomy and individual risk rather than gender identity alone. medicalrepublic.com.au

Funding and Grant Opportunities

CIHR Planning and Dissemination Grants, Institute Community Support (Winter 2027). The external application deadline is November 10, 2026. These small grants support planning meetings and knowledge dissemination, and suit early work on collaborative existential and psychosocial projects; check internal institutional deadlines, which come earlier. research-tools.mun.ca

Conferences and Events

EAPC 21st World Congress, Glasgow, May 20 to 22, 2027. Themed “Humanising the Future: New Generations, New Technologies, Enduring Values,” the European Association for Palliative Care congress opens abstract submission on November 1 and closes it on December 5, 2026. abstractsdue.ie

Health, Humanities, and Popular Culture at PCA/ACA 2027, Boston, March 24 to 27. Proposals of 250 to 300 words on how health is represented in popular culture are due October 31, 2026, with travel grant applications due November 15. commlist.org

Startup and Innovation Watch

SUPPORT+ (University of Hong Kong). In a randomised trial of 1,214 people with advanced cancer in home-based palliative care, published in JAMA Network Open, the app’s symptom tracking and nurse alerts cut unplanned admissions from 28.5% to 17.2% and average stays from 7.3 to 3.4 days. Staying home longer can also mean more time in the places and relationships that hold meaning. digitalhealthnews.com

To Close: An Existential Joke

A patient told his existential therapist, “I have decided to stop worrying about death.” “Wonderful,” she said. “How long do you plan to keep that up?”