Children sense when we're lying. That gap creates confusion.
In the Azores, a Portuguese nurse and educator named Paulo Marques has offered children something most adults have withheld from them: an honest conversation about death. Through a children's book built around the metaphor of an elephant in the room, Marques challenges the silence that surrounds mortality in Portuguese culture, arguing that palliative care is not about surrendering to death but about honoring life until its end. His work is both an act of tenderness toward young readers and a quiet wager that a generation raised in clarity will one day build a more compassionate society.
- Portuguese culture has long treated death as unspeakable, leaving children to sense adult discomfort without ever receiving the words to understand it.
- Paulo Marques launches his children's book at a national palliative care conference, deliberately placing a story for six-year-olds at the center of a professional and political debate.
- The book's young elephant protagonist refuses the non-answer adults offer her, mirroring what Marques believes children actually do — they know when they are being misled.
- Marques argues that the real damage of silence is not protection but confusion, and that speaking plainly about death reduces anxiety rather than creating it.
- The long-term ambition behind the story is civic: a generation fluent in 'death literacy' may grow into voters who demand that governments fund adequate palliative care.
Paulo Marques, a nurse and educator at the Polytechnic Institute of Castelo Branco, has written a children's book called "Mel, a elefanta na sala" — Mel the Elephant in the Room. The title borrows a familiar expression to name exactly what Portuguese society has long refused to confront: death, and the silence built around it. In the story, a young elephant named Mel asks her teacher what death is, receives an evasion, and sets out to find the truth herself.
Marques wrote the book because he believes palliative care is widely misunderstood. Most people associate it with dying and giving up. He sees it as the opposite — a practice centered on living well for as long as possible. The wall of silence adults construct around death, he argues, does not protect children. It confuses them. They sense the discomfort, detect the dishonesty, and are left without language for something they will inevitably encounter.
The book launches at the Fifth Research Conference of the Portuguese Association for Palliative Care in the Azores, a setting that underscores its dual purpose. In the short term, Marques is calling on politicians to invest in palliative care services. In the long term, he is making a generational argument: children who grow up understanding death as a natural, discussable part of life will become adults who ask harder questions of their governments and demand better care for the dying.
Woven through Mel's journey is a final message about love and memory as the ordinary ways humans carry those they have lost. It is not consolation through fantasy, but through truth. Marques calls this work of cultural change slow and long — but he believes it begins here, with a story, and with a child who refuses to accept that the elephant isn't there.
Paulo Marques, a nurse and educator at the Polytechnic Institute of Castelo Branco, has written a children's book that does something Portuguese culture has largely avoided: it talks directly to children about death, and it does so without flinching or resorting to euphemism.
The book is called "Mel, a elefanta na sala"—Mel the Elephant in the Room. The title plays on a Portuguese expression borrowed from English, one that describes the obvious problem everyone pretends not to see. In Marques's story, a young elephant named Mel encounters death and asks her teacher what it is. The teacher, caught off guard, deflects: it's "an elephant in the room," she says—a way of avoiding the question in the moment. But Mel, like any curious child, refuses to accept that non-answer. She sets out to find the truth.
Marques wrote the book because he believes Portuguese society has it backwards when it comes to palliative care. Most people, he argues, associate palliative care with death and dying. But that misses the point entirely. Palliative care, in his view, is about life—about supporting people through the end of life, yes, but fundamentally about living well for as long as possible. The problem is that adults have constructed such a thick wall of silence around death that children grow up confused, sensing the discomfort without understanding why. Marques wanted to dismantle that wall, at least for young readers.
The book is aimed at children six years old and up. It launches tomorrow evening at the Azoris Royal Garden hotel in the Azores, as part of the Fifth Research Conference of the Portuguese Association for Palliative Care. The timing is deliberate. Marques is making a two-pronged argument: in the short term, politicians need to fund better palliative care services. In the long term, society needs to stop treating death as unspeakable. If children grow up understanding that death is natural, that it can be discussed openly, that it deserves thoughtful care—then when those children become adults and voters, they will demand that their government provide it.
Marques is candid about why adults dodge these conversations. We try to protect children by hiding the truth, he says, but children sense the dishonesty. They know when we're lying. And that gap between what we say and what we feel creates confusion and anxiety. His book offers an alternative: speak plainly, but with care. Acknowledge that death is real and that it matters. Show that we can talk about hard things without falling apart.
The story carries a final message woven through Mel's journey: love and memory are how we keep the people we've lost close to us. It's not magic in the fairy-tale sense. It's the ordinary magic of how humans actually live with loss.
Marques believes that improving what he calls "death literacy"—the ability to think and talk clearly about mortality—will eventually shift the political landscape. When people understand what palliative care actually does, when they see it not as giving up but as a form of care, they will ask harder questions of their elected officials. They will demand better. The book is his contribution to that long, slow work of cultural change. It starts with children. It ends, perhaps, with a society that has finally stopped pretending the elephant isn't there.
Notable Quotes
Palliative care speaks of life, not death, even as it accompanies people through dying— Paulo Marques
Love and memories are how we keep those who have left always near us— Message from the book
The Hearth Conversation Another angle on the story
Why write a children's book about this? Why not a policy paper, or an op-ed?
Because children are the long game. A policy paper reaches politicians and administrators. A book reaches a child who will be a voter in twenty years, and she'll carry this understanding with her. You change the culture by changing what feels normal to the next generation.
But isn't death frightening to children? Won't a book like this upset them?
Children are already sensing the fear. They see adults change the subject. They feel the discomfort. What's frightening is the silence, the sense that something is so wrong we can't even name it. Naming it, explaining it honestly—that's actually less frightening.
The book uses the phrase "elephant in the room." That's a dodge, isn't it? The teacher doesn't answer the question.
Exactly. That's the point. The teacher represents what we all do—we avoid. But Mel doesn't accept that. She goes looking for the real answer. The book is about refusing the dodge.
You mentioned that palliative care is misunderstood as being about death rather than life. How does the book convey that distinction?
Through Mel's journey. She discovers that palliative care isn't about giving up or accepting defeat. It's about making sure someone is comfortable, supported, surrounded by people who care. It's about living as fully as possible, right up until the end.
What do you hope happens after a child reads this book?
That they grow up without the shame and silence around death that their parents have. That they ask better questions. That when they're adults, they expect their government to fund these services properly, because they understand why it matters.