The Existential Dispatch, Issue No. 53

A Word from the Founding Director

This issue is about the distance between what patients carry and what clinicians perceive. A new study finds that nurses underestimate the spiritual and existential needs of people with cancer, and LGBTQ+ survivors and caregivers describe, in their own words, what would help. Elisabeth Kübler-Ross reminds us that the deeper danger is a life lived behind a façade. I also include a correction to the NIH funding date given in Issue 50.

Existential Thinker of the Issue

Elisabeth Kübler-Ross

“It is not the end of the physical body that should worry us. Rather, our concern must be to live while we’re alive – to release our inner selves from the spiritual death that comes with living behind a facade designed to conform to external definitions of who and what we are.” — Elisabeth Kübler-Ross, Death: The Final Stage of Growth (1975) (ekrfoundation.org)

Kübler-Ross, the Swiss-born psychiatrist who sat with dying patients when many hospitals preferred not to, is often remembered for her stages of grief, which she herself later described as tools rather than a fixed sequence. This passage names a different kind of death: the slow loss of self that comes from living to others’ expectations. For many queer and trans patients, that façade has been a lifelong cost, and serious illness can make the wish to be fully known urgent. Care that invites people to be who they are is itself a form of palliative care.

In Academia

Nurses underestimate patients’ spiritual needs. In a comparative study of 120 people with cancer and 120 nurses, published in BMC Nursing on October 24, patients reported greater spiritual needs than nurses perceived, especially religious and existential needs; the authors call for direct, patient-centred spiritual assessment and stronger nursing education. link.springer.com

Loneliness and depression among cancer survivors. An analysis of 70,620 US cancer survivors, published in PLOS One on October 21, found loneliness to be the factor most strongly linked to a lifetime diagnosis of depression (odds ratio 2.72), ahead of functional limitations and lack of social support. medicalxpress.com

In Film, Literature and Culture

Klara and the Sun. Taika Waititi’s adaptation of Kazuo Ishiguro’s novel, with Jenna Ortega and Amy Adams, is reviewed as uneven but moving: a story about mortality, loneliness, faith and the fear of being replaced, told through an artificial friend who understands human connection better than the people around her. theaureview.com

Whalefall. Adapted from Daniel Kraus’s novel and in cinemas since October 16, this survival thriller follows a young diver swallowed by a sperm whale a year after his father’s death, and turns out to be a film about unresolved grief and the closure that does not always come. musesofmedia.ca

In Healthcare (Global)

What LGBTQ+ cancer survivors and caregivers ask of clinicians. Ten focus groups with 52 LGBTQ+ survivors and caregivers, reported in The Oncologist, produced practical recommendations: recognise minority stress, make inclusion visible, use affirming language, do not avoid sexual health, and offer LGBTQ+-specific resources. academic.oup.com

Higher barriers for trans and bisexual survivors. Cancer Today reports a survey of 3,502 LGBTQ+ cancer survivors in which 28% of transgender and 18% of bisexual survivors faced high barriers to care, compared with 8% of cisgender lesbians and gay men, often delaying care because of cost, transport and time off work. cancertodaymag.org

Funding and Grant Opportunities

Correction: NIH Palliative Care Research Across the Lifespan (PAR-27-090). Issue 50 gave November 5, 2026, as the next due date. The reissued opportunity was posted on October 14, opens on January 5, 2027, and its first standard due date for new applications is February 5, 2027. apply07.grants.gov

NIHR Programme Development Grants. The UK National Institute for Health and Care Research is inviting researcher-led applications to develop future programmes of applied research; the call closes December 16, 2026, at 1 pm. nihr.ac.uk

Conferences and Events

HPNA 2027 Annual Conference, Orlando, September 22 to 24, 2027. The Hospice and Palliative Nurses Association opens its call for abstracts on November 9, 2026, covering adult and paediatric care; submissions close January 18, 2027. advancingexpertcare.org

SDAHO Post-Acute Care Conference, Palliative and Hospice Care Track, April 21 to 22, 2027. The South Dakota Association of Healthcare Organizations invites 250-word abstracts from clinicians, educators, researchers and interdisciplinary teams by November 15, 2026. sdaho.org

Startup and Innovation Watch

Psilocybin for existential fear at Ohio State. A new proof-of-concept trial at Ohio State University’s Comprehensive Cancer Center is recruiting 10 people with one of the more deadly cancer types to test whether a dose of psilocybin can help them face existential fears about death. Early interest is real, but so is the need for rigorous trials and careful attention to who gets access. post-gazette.com

To Close: An Existential Joke

A patient asked Kübler-Ross which stage of grief came after acceptance. “Paperwork,” she said.