Place as Patient? Contemplating the possibilities of landscapes near the end of life

Abstract

Palliative care is fundamentally different to other forms of medical treatment. Accepting patients cannot be healed in a physical sense, it turns its attention to what it means for an individual forced to contemplate the possibility, probability or inevitability of dying. The physician’s role is to assist with this journey, helping individuals, and the people who love them, to navigate the end of life on their own terms. Critically, then, palliative care is not a capitulation to the prospect of death but a reorientation towards care, perhaps even “exquisite care.” Sociologists MacArtney et al (2017), have written about the ways that accepting the transition from curative to palliative treatment unlocks the capacity to negotiate and occupy contradictory positions. This speaks less to a calm acceptance of mortality and more a willingness to remain open and agile to “the productive possibilities of being in different states, in different ways, at different times.” This paper questions why we imagine negotiating mortality is a distinctly human experience and not also a more-thanhuman experience? It interrogates the potential of palliative care as an ethos, to navigate the complex emotions and losses wrought by climate change. Considering place as patient accepts that particular places, such as Kiribati, Tuvalu, the Marshall Islands and others, may already find themselves on a palliative trajectory; one concerning not months or years but centuries and millennia. As Kiribati scholar Katerina Teaiwa (2019) observes, “climate change threatens not only the land … but the spiritual and cultural spheres associated with these landscapes … the impacts will cut across … everything that shapes our identities and relationships.” This paper explores whether embracing the idea of place as patient could encourage a transformative shift from the detached positions of managing, directing and transacting with the landscape, to caring for it differently in the present?