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With a turn this week to betterment and health, we are kicking off the week with a FACES of Nashville featuring the women behind The Gift Initiative.  We wanted to know more about Harriet Karro and Denise Alper and what makes them tick, while also discovering more about the Gift Initiative itself.

Can you explain what The Gift Initiative is?

It’s a community-wide education collaborative led by Alive Hospice with partners from Vanderbilt University, Saint Thomas Health, Minnie Pearl Cancer Foundation and a growing list of individuals who recognize the need for education about the benefits of advance planning for serious illness and end-of-life care. (Click these two links for more info: op-ed#1, op-ed #2)

Are there any misconceptions that you are trying to change?

Misconceptions abound, ranging from misguided notions about hospice, to widespread confusion about resuscitation, ventilation, nutrition and hydration, to a lack of familiarity with palliative care (which relieves suffering from pain and other symptoms at any stage of an illness), to the misperception that hospice is only available during the last days of life, when, in fact, it is available for patients and families with an expected prognosis of up to six months. These complex issues involve intensely personal decisions. The Gift Initiative was formed not to espouse a particular position, but to help individuals understand, prepare for and exercise options.

What are the biggest challenges you have seen in the past decade with end-of-life options and discussions we must have? Americans avoid the subject of death. Even in the face of terminal prognosis and significant suffering, death is often viewed as a medical failure – as an option, not a certainty. Understandable. Part of being American is to believe that anything is possible. But despite the ideal death most envision — at home, pain-free, surrounded by loved ones — over 60% of us will spend final days, weeks, even months in a hospital, in pain, unable to live the way we would choose.

Baby boomers transformed giving birth in this country – opening the door to dads, video cameras and all manner of changes to the birth experience. This group will not likely stand by and accept the status quo for end-of-life care. For all the miraculous medical advances, there’s growing recognition that we are ‘doing’ death poorly. With the number of Americans 65 and older doubling by 2030, we must break down barriers to this difficult subject and recognize the importance of discussing and documenting our personal priorities early on, before we are faced with a life-threatening illness or emergency, so that as we near life’s end, we’ll know that our individual values and priorities will be respected.

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A panel discussion related to this topic will be held at 5:30 on April 10th at Montgomery Bell Academy’s Paschall Theater. RSVP to [email protected].  Invitation and additional information available here:  www.stagepost.com. The Gift Initiative website is under construction. Many other resources are available including: www.ahc.umn.edu/

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What led you to The Gift Initiative?

(HK): I served for seven years on the Board of Alive Hospice, where I was surrounded by incredibly inspiring people – staff and fellow board members. The theme that continued to emerge from their stories involved patients and families who so often said, “if we had only thought about it and talked about it sooner, we could have been spared so much anguish.” (The “it” being their individual values and priorities concerning quality of life and end-of-life care.)

(DA): I became inspired by the work of Alive Hospice – seeing families dealing with serious illness, talking about how ‘they wish they had known about hospice sooner.’ There are too many myths and misunderstood notions about palliative and hospice care. It is obvious to me that we need to equip ourselves with information and compassion and not more technology when making decisions about end-of-life care.

What is the event you are most looking forward to attending this spring in Nashville?

(HK): That’s easy – The Gift Initiative’s Panel Discussion at 5:30 on April 10th in the theater at MBA. (Please come!)

(DA):  The Women’s Fund Luncheon, the TEDx conference and playing board games with my kids (ages 19 and 23) at the kitchen table.

How do you re-energize?

(HK): I love to go on solitary walks in the mountains, sans iPod, or in town with music that could range from Jobim to Jacqui Naylor; Stan Getz to Sting. Throw in some Bill Withers, Leon Russell, and Marvin Gaye and I’m fixed for a week.

(DA): Coffee, Pilates, connecting with friends, going to great lectures around town.

Favorite lunch spot?

(HK): Madison’s Wine Garden at The Old Edwards Inn in Highlands. They feature farm-to-table “sustainable cuisine” and fresh mountain air. Madison’s would still be a favorite even if the menu were limited to PB&Js. (Happily, it is not.)

(DA): Kalamatas

Favorite Saturday night date place?

(HK): The “billiards room” in our quirky 100-year-old house where we gather with friends to shoot pool, sip red wine, swap stories about new-empty-nesterhood, and sing too loud to old favorites.

(DA): I’m single, so I’m kind of curious about that myself.

Best piece of advice ever given?

(HK): My parents have both given me so much good advice that it’s hard to choose a “best” but one thing my mother always encouraged me to do was recognize the truth in Anais Nin’s words: “life shrinks or expands in proportion to one’s courage.”

(DA): I keep vast lists of words to live by. Off the top of my head, I had great ‘aha’ moments when I heard:





 “Happiness comes when you stop taking other people’s inventory.” “

When someone shows you who they are, believe them…the first time.” “

Perfect is the enemy of good.” “

Industry is the enemy of melancholy.

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Books on your bedside table?

(HK): Ira Byock’s latest, The Best Care Possible and, because short stories are, for me, like little squares of dark chocolate, I always have an anthology on my bedside table. Right now, it’s a thirty-year-old edition of The Stories of John Cheever.

(DA): Which stack? Atul Gawande’s Checklist Manifesto, Unbroken, Dr. John Sergent’s Healing Words, The Guernsey Literary and Potato Peel Pie Society. And, though I’ll never get through it, The Singularity is Near.

Favorite thing about Nashville?

(HK): The synergistic way that circles overlap – philanthropically, professionally, socially.  As a southerner, when we moved here nine years ago, I prepared my big-city Canadian husband for the way that southern hospitality can sometimes run a mile long and an inch deep. To our mutual surprise, we found true “depth” across the board in Nashville. So much so, that when faced with an opportunity to either cement a career out-of-state or retire and stay put in Nashville, we chose the latter. (And never looked back.)

(DA): When I was younger, there was zero cool factor telling people you were from Nashville. Now I boast about it. (And thank you to those who gave me bragging rights)

Favorite Cookbook?

(HK): My mother’s old Charleston Receipts – including a dozen different ways to prepare hominy (which to this day she refuses to acknowledge has anything at all to do with “grits”).

(DA): Friend’s recipes, especially when they are doing the cooking.

Any weekly rituals?

(HK): A booth in the bar at Bricktops for brunch with my beloved and, when he’s home, our college freshman. Saturdays at 11:30 – set your watch by it.

(DA):  CBS Sunday morning news and the Sunday NY Times.

Three things you can’t live without?

(HK): Stories, music, and flowers.

(DA): A sense of humor, my glasses and Rapid Rewards on Southwest Airlines.

Thanks to Ashley Hylbert who each week provides StyleBlueprint with amazing photos of all our FACES of Nashville. To see Ashley’s website, click here.

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