Death was never an end, to me. Because of my spiritual foundation, I have always looked at death as a misunderstood gateway to another state, a new existence that no one quite fully understands. As I went through this program, I realized my one-sided and inexperienced perspective of death was deficient in much of the intense confusion and emotions that are inevitable. My most vivid experiences in hospice volunteering revealed to me how essential emotional healing is for both the patient and the physician. Without this aspect in our end-of-life care, we fail to bring comfort to the whole human existence.
My first intense experience that shook my ignorance on the dying process was through a family member of a hospice patient. As a nurse and I made our rounds to turn and tend to the patients, we could tell this young woman was having a difficult time; she was about as unresponsive as the sickly boyfriend lying on the hospital bed, rocking back and forth with rigid body and gritted teeth. His ragged breathing and swollen body shook even me, yet his sister sat by his side and held his hand with a faint smile on her tired face. Their starkly different demeanors confused me; how could their reactions be so different? Soon after, we heard a blood-curdling scream come from the room. The girlfriend ran out of the room in her socks, jacket in hand, cursing the hospice and all of us in it. The patient had not died yet, but something inside her must have. It was at that moment I truly understood the necessity to healthily cope with death: death of another, death of one’s own body. To emotionally fight against fact and ignore the reality of a circumstance will pull and bend the inner-workings of the mind until it breaks. Family members are just as affected by the emotional burden of mortality as the dying, even more so as the process extends past the incidence of death. My heart broke for this woman, knowing her anguish was even more amplified by her refusal to accept what is, as the sister seemed to. For those who are unable to reach acceptance on his or her own, counseling is absolutely essential to this experience. Time may heal all wounds, but the mental scar tissue that remains prevents the individual from ever regaining full function. As is massage or physical therapy, grief counseling can be initially painful but ultimately essential for full independence again.
My second most vivid memory from my time at the in-patient unit was another insight into the emotional experience of dying. An elderly man, dying of cancer, was in need of feeding. Through weak and slurred speech, he cheerily greeted me and another young volunteer. Through bites of sherbet (dessert first), he began to tease us about his handsome and single grandson. As we shared our life experiences with him, he shared strikingly profound words of inspiration and determination to live to our fullest, to take advantage of the now endless opportunities for women, to live without fear. We were there to comfort him, but the entire encounter consisted of him uplifting us, even through his exhaustion. In that moment I felt he had adopted us into his family, and he felt responsible as a senior to ensure we reached our fullest self. His story, amazingly, was more of the normative rather than the outlier throughout my hospice experiences. It seems, as those draw close to the veil, the self becomes less selfish. Living is no longer for worldly success, but for reflection and an intense need to share life’s insights with others.
I am honored to have met such amazing patients and medical professionals through the hospice program. It has changed my limited view of death and allowed me to contemplate what society so often urges us to shun. Through the love I have developed for these people, in just minutes of encounters for some, I have come to truly understand Atul Gawande’s words: “[O]ur most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life”. Emotional closure — through grief counseling, family, and even volunteers in a hospital — is essential to healthily close one’s personal story and transition into the unknown.