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The Four Things that Matter Most -- A Book about Living
by Ira Byrock, M.D. 2004 (Free Press: New York, NY)
[Answer 14 of 20 questions correctly to receive 7 hours of Continuing Education credit].


Chapter Two The Healing Power of Words (p. 9-17)
1. First and foremost, the best way to help someone who is ill, lonely, depressed, or dying is to
a. know the right thing to say to them.
b. promise them that they will get better.
c. just be with that person.
d. tell them that you believe in miracles.

Chapter Three -- Completing Relationships (p. 18-25)
2. In helping Mr. Polansky say "I love you" to his adulterous wife, what did his counselor, Lynne, NOT do?
a. She told him to imagine his wife as she once was, when he was "head over heals in love with her."
b. She told him to whisper very, very gently to his wife's back, "I love you" as they lay in bed at night.
c. She told him "What have you got to lose?"
d. She promised him that his wife would respond positively to him if he said "I love you" to her our loud.

3. Toward the end of his life, what prompted Herb Cahill at age 74, to go around making amends with his family, including apologizing to his daughter, Diane, for "not being much of a father"?
a. He lost an old Navy friend and his barber suddenly died.
b. His doctor informed him he had a terminal illness.
c. He had a long talk with his minister.
d. He had a strong premonition that he was going to die soon.

Chapter Four -- Transformations (p. 26-33)
4. As he was dying from emphysema from a lifelong smoking habit, what suddenly transformed Steve Morris from a quiet Montana cowboy into a man who became close to his family?
a. He asked forgiveness from the people he cared most about.
b. His health suddenly improved.
c. His adult daughters asked for his forgiveness.
d. His wife taught him how to be more affectionate.

Chapter Five -- Loved Ones Live On Inside Us (p. 39-49)
5. As her father was dying from pancreatic cancer, Carla shared many apologies and expressions of love with him. In contrast, her brother Paul was left with unresolved resentment after his father died. In what way can a counselor be helpful to Paul?
a. A counselor can help Paul to forgive his father for his mistakes and faults.
b. A counselor can help Paul forgive himself for his own regrets and mistakes.
c. A counselor can help Paul to decrease his anger toward his father by increasing Paul's compassion for his father's depression and final illness.
d. All of the above.

Chapter Six Resolving a Legacy of Pain (p. 50-57)
6. In final talks with her mother, what did Jennifer learn why she experienced so much of her mother's hatred, anger, physical punishment, screaming, criticism, name-calling, and cold-shoulder treatment?
a. Her mother told her she never wanted children and got pregnant by mistake.
b. Jennifer's mother learned much of her destructive behavior from her own mother (Jennifer's grandmother).
c. Jennifer's mother drank too much.
d. Jennifer's mother suffered from manic-depression.

7. What did Jennifer's mother say to her that had a profound healing effect on Jennifer?
a. "I know I passed things to you that my mother passed to me, that were destructive."
b. "I don't have to be destructive anymore. The bad stuff can stop. The good stuff can be passed on."
c. "You are the artist of my life. I am so proud of you."
d. All of the above.

Chapter Seven The Emotional Economics of Forgiveness (p. 58-68)
8. Avi's father had completely shut Avi out of his life. At age 45, Avi met with a counselor who convinced him to say the Four Things to his father as he lay dying from lung cancer. Avi found the courage to do so, even apologizing to his father for not being good enough. What was the father's response?
a. He was gruff and unappreciative.
b. With tears in his eyes, he hugged Avi and said, "I love you, too."
c. He said nothing.
d. He said "Thank you."

Chapter Eight -- Extreme Acts of Forgiveness (p. 69-77)
9. Who enabled Maeve to forgive her father who repeatedly sexually abused her from age 9 to age 13?
a. A women's support group encouraged her to forgive him.
b. Maeve's aunt, who was her father's sister, inspired her to forgive him.
c. A good therapist helped Maeve sort out what was normal and what was damaged. Also, her father apologized to Maeve for what he had done.
d. Maeve's minister encouraged her with true stories about the power of forgiveness.

Chapter Nine -- Forgiving Yourself (p. 78-86)
10. A piercing lesson we can all take from Susan's story is the lesson of
a. honesty.
b. self-acceptance.
c. loyalty
d. friendship

Chapter Ten -- Living with Uncertainty and Illness (p. 87-95)
11. Which attitude does the author promote in this chapter for us when we become ill?
a. We should allow family and friends to care for us if they want to when we become ill and cooperate with them as much as possible.
b. We should arrange for professional help outside our family and friends to care for us so we don't become a burden to them.
c. We should seek recovery as quickly as possible so we can regain our self-sufficiency and independence.
d. We should take measures now to delay or even prevent unnecessary illness.

Chapter Eleven -- Practicing Gratitude (p. 103-112)
12. Which statement was NOT made in this chapter?
a. By paying attention to the details of the ways people give us to us and show us care and consideration, we become more mindful of our own lives. We begin to focus on our own good fortune rather than our problems.
b. When we accept ourselves, we are likely to be delighted in and feel accepted by the world.
c. It is important to bring joy into your life on a regular basis.
d. It is very difficult for people who are terminally ill to experience a state of joy when death is so close.

Chapter Twelve -- The Unexpected Grace of Reconnection (p. 113-118)
13. Laurie's highlight with her Grandma was when
a. her Grandma acknowledged that she knew how much Laurie loved her.
b. they had a wonderful Thanksgiving together without the effects of Alzheimer's disease.
c. her Grandma admitted how much she missed her three sisters.
d. her Grandma willingly gave up her independence.

Chapter Thirteen -- The Family Dynamics of Gratitude (p. 119-133)
14. What did Arlene discover was the reason why her step-siblings acted so distant?
a. The step-siblings blamed Arlene's mother for the break-up of their parents' marriage.
b. Because of her social phobias, Arlene's mother had never invited them over for dinner in 25 years of marriage to their father, Conrad.
c. They were grieving the breakup of their parents' marriage.
d. They simply didn't like her mother nor were they ever going to like her.

Chapter Fourteen -- Creative Ways of Saying the Four Things (p. 139-146)
15. What expression of intimacy did Gunter share with his stoic Lutheran father?
a. a hug
b. a handshake
c. a shave
d. telling him "I love you."

Chapter Fifteen -- Loving the Body (p. 147-152)

16. How did Horace and Louise Whitman respond after finding out about their son's AIDS?
a. They immediately procured for Mike professional care.
b. They allowed Mike's friends to take him home and care for him.
c. They took Mike into their home and cared for him.
d. They turned him away.

Chapter Sixteen -- Living Every Day as If It Were Your First -- or Last (p. 153-162)
17. What finally enabled Yvette to celebrate her last moments with her daughter Gabrielle?
a. When Yvette stopped being angry at God for Gabrielle's illness.
b. When everyone left the room so they could be alone.
c. When they shared an embrace.
d. When Yvette was finally able to accept that her daughter was dying.

Chapter Seventeen -- Lives Intertwined with Love (p. 163-171)
18. What did Lisa ask forgiveness for from her sister, Linda?
a. For being two intertwined in her life and not giving her enough freedom.
b. For asking her to go through another round of chemotherapy, which prolonged her agony by two more years with renal dialysis.
c. For being angry with Linda's husband, Phil.
d. For not having been a more loving sister.

Chapter Eighteen -- Nothing Left Unsaid (p. 179-185)
19. What prompted John and Betty Williams to say The Four Things to their son, Matthew?
a. Matthew contracted a terminal illness.
b. They heard a powerful sermon.
c. Matthew was going off to war.
d. Matthew was getting married.

Chapter Nineteen -- The Mysterious Magic of Some Good-Byes (p.186-194)
20. Why did the author think 35-year old Sandy took so long to die?
a. Because he was exceptionally in good physical condition.
b. Because he had no known medical complications.
c. Because he wanted to give his parents a chance to express their love for him and his wife.
d. Because he received excellent medical care.