OVERVIEW

I have been writing since 1990 and working in healthcare for 30 years. I am needing a great literary agent to develop a long-term relationship with and to guide me in developing a consistant writing style. I am bright, personable and spiritually matured. I live by two words: love and responsibility.

My platform is palliative care and end-of-life in the heatlhcare field. I am a Certified Hospice and Palliative Care Nurse (CHPN) and was the former Palliative Care Program Director at a two-hospital Sysytem in Bel Air, Maryland. I have lectured to state-level organizations and to audiances as large as 400. Outside of my healthcare writings, my focus is to bridge daily life with a tangible sense of spiritual reality, it's proofs being the very lives we are living.

I live in Minneapolis, Minnesoata, and will gladly travel for lectures and book signings. I can travel weekedays Monday through Thursday.

My unique key clinical care premise is this: subjective closeness is the key to improved clinical competence, and to living meaningfully. I declare "That the 'Softer side of Sears' approach is the clinical imperative to feeling and being competent in your clinical practice, especially in light of patient suffering and end-of-life care."

I have created local, regional and state-wide conferences with attendance from 60-400 healthcare attendees.

My talent is to help an audiance re-humaize healthcare and to do the same thing to their personal lives.

MORE DETAILS

My writings are unique and dynamic, but they need a good editor to tighten up the concepts, flow and message. My writing style is to offer a premise and then exemplifying it with stories from several sources: my patient care experiences, from my outer life or with inner experiences, dreams, contemplations or intuitive knowing. My style of story telling can be called "tangible spirituality," where I use a subjective experiences in emotional and daily life, link them to an underlying spiritual law or principle. I neither infer nor speak from evangelic power nor a blind faith - this is a knowing that uses our outer world experiences as a template to verify spiritual realities. The result? A joy and trust in life not formerly known.

My healthcare career path has been bold and diverse, meeting face-to-face with trauma and tragedy. In the past 30 Years (a nurse for 22 of those years), I have worked in psychiatry, burn ICU, head trauma ICU, heart transplant ICU, home health, cancer care, hospice and palliative care. I have always been, and remain, a very lively and happy soul, despite this trek through these anguishes along side others. My writings help answer the question I have been asked so many times over the years: "How are you able to be so pleasant and kind while be around all this suffering?"

I have a skill for converting life turmoil and complex medical care into tangible, vital and enriching expereinces, for fellow staff, for patients and their loved ones. This vitality in me creates a kind of similar vitality in others. Professional health care audiences have been spellbound, yes by some charm and enchanting story-telling, but also by the fact that they are finally hearing someone talk about suffering, a passion for life, and a tangible spiritual reality that makes them feel that they have been accumulating their own clues of meaning all along, and that NOW it is all being said in a way that pulls the threads together in a substantially meaningful way. My aim is that my audiance has a life-changing shift in how they engage life. My confidence inmyself is that I have seen it happen hundreds of times in the past three decades of my life.

Cell: 612-834-0122

Email: TLBivona@live.com

Street address:

3267 Berwick Knoll

Minneapolis, Minnesota 55443 USA

FaceBook: Terry Bivona

YouTube: Terry Lee Bivona

Website domains: mybivona.net

palliative.us.com

Book and manuscript titles:

Three Ways to Experience Divine Love [mss]

Medical Miracle: How Palliative Care is Changing the World of Healthcare and Compassionate Medicine [mss]

SAMPLE writing from Professional's Guide to the Dying

Preface. My Offer to You.

Few clinicians truly enjoy working with those patients, clients or even acquaintances who are confronted with the prospect of a premature or unwanted death. Those professionals who seem proficient at it often are, instead of being elevated to a podium to teach their great insights, thrown the difficult cases from retreating peers, given praise for their abilities and skills after others have recoiled from the dying person's newfound angst. There are masters of this domain of death and dying. Caring for the terminal is that nebulous field of interactive experience between the clinician and patient where the unknown seems to disturb almost every active participant. I am, strangely, not afraid of standing in this domain of death with a dying person. I am even eager to stand along side someone who is seriously considering the implications of physical death, after-life (or not) and the whole universes of learning that can only take place while looking over this cliff of physical death and all its potential implications. Why? Because I will also, someday, find my physical body lifeless. Physical death awaits me . . . and you, too. That is a guarantee, contracted in with the gift of birth into the physical body. Our patients are unintentionally offering us, as their clinical care providers, an opportunity to learn through them, with them and for the benefit of all participants. They are hungry to tell of the journeys, insights and wisdom that only the walk towards physical death can offer. Though often tragic, sad and lonely, our understanding and management of the dying patient through each of our clinical expertise is also a gift and honor, to be allowed to participate in the greatest mystery of each individuals life.

Burnout is so rampant with physicians, psychologists, case workers, nurses and the clergy in dealing with the dying patient that rehearsed sympathies, helplessness and simple avoidance erupt within us when a newly diagnosed client awaits our arrival. What can you do? Read this book. Consider the ideas within it. If you are truly a Ablack and white, analytical thinker who claims death is too emotional, too subjective, then you must (if you are a reliable thinker in this way) account for the scientific studies included in this material regarding the frontiers of consciousness, quantum science and physical death. If you get too far out of your comfort zone in this material, openly choose not to think through the material that is too challenging, leaving it for contemplation at another time, or maybe leaving it behind altogether. But, at least, read it. This book contains good science, clear understandings and powerful tools to help you improve your clinical acuity, enhance your patient rapport (which means less likely lawsuits, as well) and bring about an unexpected new confidence in your eyes as you see your next terminally ill client. At times you will even look forward to the next rounds with those who are dying because you, too, are finally good at it.
Each patient physically dies completely only once. Thereafter, you will have no further opportunity for him to lean on you, to teach you nor to share the gift of time with you again. Your time with the dying is a unique clinical trial . . . to them, for you to share in their "Spiritual Graduation." Read this book fully, and see if, in the end, my claims above hold true for you, as well.

Death Regarding Body and Soul

...Let me glide noiselessly forth;

With the key of softness unlock the locks - with a whisper,

Set ope the doors O soul.

Walt Whitman, The Last Invocation

I am ready for my Maker. Whether my Maker is prepared for

the ordeal of meeting me is another matter.

Winston Churchill, at his 75^th birthday

Since we have established that, medically, perception at any level seems to come through a physical body, with a dying person, we must confront the greatest question set against the face of humanity: "What happens to me at the point of physical death?"

To look at a patient and see her or him independent of his views of an afterlife is like looking at a cell free of its DNA - each is the key to its orientation to the past present and future. Whether in Islam, Christianity, Eckankar, Jainism, Buddhism, Judaism or Hinduism, all major and most minor world religions refer to an afterlife of some sort. This means that all such followers pass through their days of living outwardly while silently their fundamental beliefs orient around the idea that some version of a soul, or Soul, departs from the physical body at the point of physical death. Significant? Not, usually, unless confronted with death, either their own or of someone close to them.

A brief and incomplete list of some definitions of Soul follow, with the purpose of demonstrating the vast interpretations to what such a terms implies. Here are some sample definitions:

1) Christianity generally defines soul as the self which rests in darkness until the second coming of Christ. At that time, the individual soul will be awakened and rejoined with its physical counterpart and be joined with Christ forever.

2) Buddhists believe in reincarnation and define soul or self as unifying oneself with eternal bliss or Nirvana. Soul is defined more so as conscious union with Universal Mind, having the ability to know all things. Since one is reincarnated, one's past lives are accounted for and good and bad karma are carried forward, like a checking account. One's purpose is to advance spiritually to such a degree that the individual can choose, at death, to either remain in the bliss of Nirvana, or return to earth to aid in the advancement of other's salvation.

3) Dr. Larry Dossey, in his book, Recovering The Soul: A Scientific and Spiritual Search, defines soul in a totally different way, using the recent studies of quantum physics and his favored concept of the principle of non-locality. Dossey points out that science is finding that there is, in fact, reality that is beyond physical space and time. This domain is usually referred as "the spiritual," but Dossey diverges in a different direction - he concludes: "The mind can penetrate to the cellular level of the body and modify 'mindless' bodily processes...The soul [itself] is a holistic concept. It is not made of stuff at all. Where is the soul located? Nowhere. To talk of the soul as being in a place is as misconceived as trying to locate the number seven, or Beethoven's Fifth Symphony: Such concepts are not in space at all."

4) Theosophy, and other Eastern-based religions, define soul as one of three key components in the makeup of human life: spirit, soul and matter. Said more familiarly: body, mind, spirit. Soul, here, can be defined as �The vehicle on a higher plane for the manifestation of spirit.�

5) My own definition that I use at the patient bedside is based on my personal experiences of spiritual reality, and upon my study of the various religious and scientific literature in consolidating a definition of Soul that is easily comprehendible, true no matter the realm of conscious activity, and can be tested easily by anyone. The three elements of Soul are:

1. Consciousness - the ability to be aware of one=s surroundings and one=s physical and inner activities.

2. Creativity - the ability to think, feel, consider, imagine, anticipate and so on. In essence, this creativity is the ability to use your awareness in linking your inner and outer worlds in a way that seems meaningful.

3. Free Will - the ability to make choices at some level in a given circumstance. To chose to think, to weigh out, to move a finger, to look about, to imagine by choice or intent - these are examples of the use of free will.

In summary, the central point to keep in mind when looking at death of the physical body is that it is essentially universal to suspect that your patient has some reference point in his history to imagine that some thing - soul - leaves the body at physical death. That "thing" is his Self, or her Self. Self, or Soul, is who you are, what you think, your meanings and understandings, your values and your uniqueness that people can define when you are not physically present in the room.

SAMPLE writing from Medical Miracle

Those Who Care

His eyes looked straight into mine, intensely, piercingly, hearing my words but trying so hard not to take them as his own. Interpreting my white shirt and tie, he wants to have agreement with me. He nods, and yet his eyes gloss over a bit, so that he can say that he hears me, yet to not let it soak into his being. It's just too much to hear, and to have another's face right there, looking back into your very Soul, asking, with eyebrows raised, if he really heard what I was getting at: The medicines are all at maximum dose, his lungs are so damages that they probably can�t recover, and the new pneumonia is from a bacteria that is resistant to all the current antibiotics we have in the arsenal. I then say:

"What I am saying is difficult to hear, I am sure, and it's probably the biggest thing to ever hear someone say about you, that this end of aggressive treatment means that our focus now is on your comfort, and of easing your distress, so that getting to the heavens is less of a struggle for you. With your breathing, I know that you stay awake just to try to keep getting enough air. This fatigue of yours and this air hunger are my main things to deal with right now." His eyes are glued to my lips and every word, as he laboriously breathes at 50 breaths a minute through a oxygen-filling face mask with a balloon-like sack on the end. The oxygen flow is so loud that is hard to have such a tender and fragile talk when "That wind!" is rushing between us.

I keep my eyes to his, and think of him in a caring way, as I would a beloved brother. He feels it. We both press a very subtle grin to the edges of our lips. He takes the smallest of sighs and he nods, and in that nods asks my permission to end the talking for now. I nod affirmatively to him. He turns his head and looks to his wife: "You okay with all this, Hun?" "I am if you are," she reflects. She means it. "I know there's a seat in heaven waiting for him, so I'm alright with that." She keeps her stoic exterior, to not burden him with her tears of loss, her pending loneliness that she has prepared for weeks to confront, to know, in an unwelcome but resolute way.

This was one of three family scenarios I dealt with that afternoon as the only hospital system in Harford County, Maryland, just outside of Baltimore, up the Interstate 95 Corridor. About 800 patients a year get referred to our little hospital's Palliative Care program. I have talks like this one above for about half of those patients. The other half are referred to assist with pain and other distressing symptoms, offering the benefit from a symptom specialist's eyes and knowledge, to help ease the patient distress. These are the core issues in the patient care area now called Palliative Care.

About half of the hospitals in the United States have some version of a Palliative Care program, yet the word, and the concept seems unheard of, or only vaguely familiar to, many Americans and others across the planet.

The very weighty and authentic talk above is not unique to a clinician of palliative care, but like a skilled and trained craftsman or clergy, practice and care just seems to to help them do it better, and more willingly. This will, to stand face-to-face with suffering and maybe even death, discussing the potential for a person "heading to the heavens", or laboring over chronic pain issues, these are the realms of this specialty healthcare arena of Palliative Care. It's about the compassionate perspective first, then addressing the medical aspects of the situation, much the inverse of the way medicine and healthcare has been delivered for the past 100 years.

Who Are Those Who Care?

In my 30 years in healthcare, from trauma intensive cares, to cancer care, to hospice, and now being in my second hospital system delivering palliative care, I have crossed paths with hundreds of doctors, nurses, PAs (Physician Assistants) and other smart and attentive people. When we can take the time to talk together, to really talk, I have learned that the image of them seeming not to care is just that - a false image of someone watching them fly into the crises of the moment, having way too many patients to care for in way too high of an acuity for just one person to manage, and way too little time to really do what they wish they could do, to slow down, to sit in a chair and listen to herself breath as she discusses care and medical issues with a patient and family. The clinical stereotype of three-minute visit, though often true, is not at all desired by the healthcare professional. Once a matter of "doing the right thing", this slowing down to talk, patiently, is now deemed a luxury that most clinicians can't afford. In the following pages we are going to take a look at how the patient care view and unique philosophy of palliative care is affecting EVERY aspect of medicine, bedside care and even the decision perspectives of a surgeon's action plan in the operating room. These people DO care, but that's hard to see in a cyclone of social acceleration and the shocking staff shortages of crisis proportion in our modern world. We are going to see in this book how the Palliative Care movement may be the very finger in the dyke that prevents to dam from bursting. A finger, shall we say, of the compassionate perspective, staving off even more crisis, yet pointing to the water of life that can quench the thirst of a soul desperate in its suffering of body and spirit, laying itself at the door of the doctors and nurses, pleading silently "Can you ease my suffering, my fears?" We can and we do, and we do it best when the compassionate perspective of Palliative Care is known, understood and used in its proper and powerful place, in the direct care of the patient and family.

The History of Palliative Care.

5,000 years ago.

As far back as 3000 b.c., man had reached to something outside of his family and personal self to allay his suffering of body, mind or spirit. He looked to his understanding and belief in the Gods. There was a time when the Egyptians thought there were twelve Gods that made up the God-head. The God of War, Menthu, and Goddess, Menhit, could be thought of as our medical approximation today of an oncologist, one who fights against cancer and death, just as that God of old had done. The Goddess of victory, magic powers and healing, Isis, and the God, Khansu, also for healing, has in many modern ways been replaced by so many variations of healers, herbalists, surgeons, and accupuncturists, nurses, physical therapists, to name a few. When one was faced with an inevitable confrontation with the unseen worlds we affiliate with the experience of physical death, then the God, Osiris, was beckoned and beseeched. Today a contemporary in the physical world might very well a hospice physician and his team of care providers in a hospice, perhaps even delivering that care at one's home. The orientation and tools of those beseeched has changed in 5,000 years but the goal of the one in distress is the same, to extend a rich life on earth as long as possible, and if the release from the physical wrappings appears inevitable and near, then one years for solice, ease of suffering and to be surrounded by those who retain a compassionate perspective to him and his loved ones. This is the domain of unique, dear and powerful realm of healthcare called Palliative Care.

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SAMPLE writing from Medical Miracle

Those Who Care