Dying well, living longer draw interest at local book festival

The recent Hawaii Book and Music Festival was another great success.

It was the first time that the Wellness in Hawaii Program extended for two full days. Throughout the weekend, prominent authors, athletes, community leaders, meditators, politicians, physicians, allied health providers, academicians and insurers offered insights and guidance during 13 fascinating panels. Panel topics included homelessness, the opioid crisis, teenage suicide, climate change, breast cancer, dementia, wellness tourism and what’s next for Obamacare. Especially well attended were panels on dying, living longer, mindfulness and integrative medicine.

Dying well

This panel, now in its third year, always has drawn a standing-room-only group of deeply sincere and articulate participants. We spoke about what “dying well” means to each of us, how we might feel more safe as we look toward the inevitable, and what preparations might be made to minimize the experience of pain, fear and suffering in favor of a conscious passing. To this end we discussed the role of palliative care and hospice and a new Hawaii law that allows for medically assisted death. The majority of participants endorse the legislation in hopes of retaining some manner of control at the death time. Personally and professionally, I remain avidly opposed to this bill and discussed my position during the panel and in previous columns.

Regenerative medicine

To my surprise, this panel — offered for the first time — left no empty seats. Although regenerative therapies including stem cell treatments are still in their formative stage, there appears to be substantial public awareness and high hopes both for extending longevity in general and for regenerating specific tissues damaged by injury or worn by age. One question of intense interest was whether, moving forward, it will be possible to reduce the need for surgery such as joint replacements. This panel reviewed the current literature, costs and access to care for such services as well as the current status of Food and Drug Administration oversight.

Meditation is not what you think

Jon Kabat-Zinn is a nationally renowned researcher who has brought mindfulness into the practice of medicine and psychology. He showed, in an enjoyable, practical way, how we can optimize well-being through mindfulness. Kabat-Zinn is an old friend who has presented before in Hawaii. At the HBMF he approached “rock star” status during his panels and book signings. Maya Soetoro-Ng, director of the Matsunaga Institute for Peace at the University of Hawaii at Manoa, a conscientious “rock star” in her own right, moderated this panel.

Integrative medicine in the Obamacare era

This panel was held this year because it encompasses so much that was included in many other panels — not the least of which are dying well, regenerative medicine and mindfulness. Whether managing obesity, diabetes, chronic pain, heart disease or cancer, the richness of a well-coordinated, team-based approach to health care is profound. Panelists discussed methods, scientific evidence and the potential for expanding integrative medicine in the era of Obamacare.

This look back at the highlights of another successful year at the Hawaii Book and Music Festival offers potent social commentary. The people of Hawaii would seem to hold dear the prospect of living well and for longer, while wishing to retain a measure of control when the time comes to die and to minimize fear and suffering. There’s a broad realization that fear and suffering are best addressed not only by access to specific services, but also through spiritual development engendered by mindfulness that refines one’s perspective. Finally, integrative medicine offered by a multidisciplinary team continues to be seen as a way to bring together the best of modern medicine — traditional healing arts with a whole-person approach.

The Hawaii Book and Music Festival will be held again next year at the Civic Grounds of the Honolulu Hale. See hawaiibookandmusicfestival.com.

Ira “Kawika” Zunin, M.D., M.P.H., M.B.A., is a practicing physician. He is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. His column appears the first Saturday of every month. Please submit your questions to info@manakaiomalama.com.