I laid my hand on the forehead of a dying woman today as she stared into the distance at something only she could see. “Mama, wait for me, I’m coming,” she mumbled again and again. Then, I fed dinner to a 93-year-old woman who doesn’t have long to live and has lost all ability to communicate coherently. Miss Ruby, who is 99 years old, pleaded with me to help her (which she spends about ten hours of every day doing…) I put my hands on her shoulders and said “I love you, Miss Ruby,” and she finally smiled, and looked up at me with the glad eyes of a child for a moment. After Mr. Richard spent half an hour trying to eat his bib and mumbling “Mnmhynmhm,” his wife of 53 years came to visit, and she put her head on his chest and whispered quietly to him. As I passed the table, I heard her say “I love you so much,” and he distinctly replied, “I love you, too.” Meanwhile, Miss Bertrice is starting to go downhill fast… she’s not eating anymore and she probably won’t last much longer…
The point is, I sometimes feel like this:
That’s Neil Gaiman’s Lady Death, of course, and she’s a really cool character. But I’ve seen a lot of people die too, working in hospice… and I always seem to get the same reaction whenever I tell people where I work. There’s this sort of horror, and then some version of “Oh my GOD I could never do that, isn’t that the most depressing thing in the WORLD??? How can anyone DO that???” Implicit in these comments (it always seems) is the idea that working with death and NOT being hideously depressed is somehow not normal. So… what’s normal?
I’ve heard it said that our society is rather anomalous, compared with other societies throughout history, in not thinking of death as a normal part of life.
“Most people came to terms with it fairly well. They accepted it as something beyond their control. The thing to do was to pack as much life as you could into the time you had, to waste none of it, to find someone to love and something to build, to win your immortality the best way you could, by creating something or by creating someone, and keeping yourself healthy…”
That’s pretty much my attitude, I guess. Probably similar to a lot of people’s.
Pretty much everything about life is at its core an attempt to avoid death (individually and en masse). Cheating death is why we have all this medicine, these complex institutions, massive civilizations, multicellular organisms, etc because complexity and cooperation help you cheat death better than simplicity and isolation. So when you say what is a ‘normal’ attitude towards death, to me the answer seems to be the fact that most everything in life is in one form or another an attempt to cheat or delay death on one level or another. Evolution and (largely) human civilization are driven by efforts to cheat death. I don’t know. In a way its like living and dying in a restaurant or a farm and asking what is a normal attitude towards hunger.
But from what little I do know of (seeing people I know die) if you feel you lived a decent life and all the people you identify with and grew up with are already gone, its really not as scary as man people seem to think. At least not as scary as it would be to a 40 year old with kids and a mortgage.
And if people feel their deaths serve a higher cause, or the unit they are part of will live on (military unit, political unit, family unit, etc), they really don’t seem to mind nearly as much. But again, couldn’t that just be the same as the first part? You don’t mind when a few of your cells die because your body as a whole lives on.
Anise, my experience with hospice has been so positive. I am more grateful than you can know for people like you who helped ease my mother-in-law out of her diminished, painful life.
I think people who say your work is so depressing are thinking of their own experiences with (or ideas of) death and extrapolating that hospice work = going through horrendous, personal grief every day.
I just realized that, while most of the people back home (central northern Spain) think of death as A Bad Thing in general, most also view “working at the local old folks’ home cum hospice” or “working as a home-visits nurse” (most of that is hospice work) as fine jobs and fine callings. It’s stable work and they figure people wouldn’t do it if they didn’t like it. Many of us would never want to do it but then, most people wouldn’t want to be a wedding singer either and there’s plenty of those too. Different jobs for different folk.
A friend is the dietician at the local old folks’ home; most people’s reaction is “oh, that’s nice. I hadn’t ever thought there would be such a job but of course it’s got to be needed! Is it very difficult to deal with all the different diets and medications? How much contact do you have with the people living there?” SiL, a doctor, says that her own home visits have taught her more about life than she’d learned in her first 30 years; one of the things she’s learned is to let those who are ready to die go and to fight like crazy for those who are fighting. My father died having made his peace; hers, fighting until the last breath.
Her father (who died of ALS) used to be under a regime called “home-based hospital care:” they’re patients who need monitoring and nurse care but who would be at a high risk of hospital infections, so they are at “Room Theiraddress,” with monitors sent over from the hospital and a nurse going once a day. The nurse liked to leave him for last and take the chance to go over their common cases with SiL over coffee. One day she mentioned that at the previous patient’s house there had been a visitor who’d told her “you must hate this” “ hate it? no, it’s my work and I do it because I like it. Well, I don’t like the ‘cleaning up poo’ part, but it’s not like I’ve ever met someone who likes that part.” The visitor clearly hadn’t believed her; she’d also assumed that the nurse did this as some sort of lottery rotation and had just gotten the bad duties for that day. She didn’t even seem to wrap her head around the notion that you’re perfectly likely to have someone die on you in pretty much any duty other than office visits.
This was rare enough to leave both the nurse and SiL completely bemused at the attitude. Most people are grateful; some may occasionally ask (mostly if someone they know is thinking of going into a medical field) how do you deal with a patient’s death and how likely are families to take it badly/blame it on the doctors. But this assumption that someone would be doing a job that’s “utterly depressing”? If your job (be it hospital custodian, factory manager or kindergarten teacher) depresses you, start looking for another.
I strongly second this statement. Lost my father to cancer 15 years ago. His last couple of days were at San Diego Hospice, and their entire staff was amazing. Dad was treated with respect, tenderness, and kindness. We were complete strangers to these people, yet they acted like my Dad was their own father.
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My grandparents owned a funeral home and what my family learned was that the reaction to death runs the entire gamut of human emotions. There are as many different customs as cultures, and people react very individually.
I sat by my mother’s side and literally held her hand as she breathed her last. I’ve had people ask me how I could bear to do that. Me, it would be unbearable NOT to do that. You know, neither reaction is right or wrong, it just is.
If working at a hospice and NOT being depressed is somehow not normal, then it’s probably not normal in a positive way, at least as you describe it. Great athletes, great scientists, great anything aren’t normal either, but that sort of “not normal” is seen as good. Perhaps you have a trait that enables you to do this for those who are dying, who are in great need of comfort and help. If only that was the norm…
There’s no “normal.” It all depends on the situation.
Personally, I’m going down kicking and screaming, and I might even rise from the grave as a zombie. But that’s on principle; I just want to get every minute I can. I’m okay with knowing it’s gonna happen.
There’s certainly something to be said about the age of the person involved. When my 72 year old dad died a few years back I didn’t shed a tear. He had cancer, had lived a good life and then died. Sure, it’s a shame he didn’t last another 10 years or so, but overall he did well.
When my mom eventually goes, I won’t feel sorrow or remorse. I’ll miss her, just like I miss my dad, but that’s pretty much it.
Now, if I had to bury one of my kids I’d be a basket case for months, a cripple for years, and a totally changed person forever.
Same here with me and my Dad. I adored the man, and felt honored to “see him off.” There was a heartbreaking beauty about it that’s hard to describe.
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I agree . . . except that I don’t know when or how he will come for me, or what condition I’ll be in at the time. Perhaps I’ll welcome him. Both of my parents were very strong people in many ways, yet I had to sit there helplessly and watch them die without putting up much of a fight. I can imagine both of them skull-fucking the Grim Reaper, but at a certain point they had to accept the inevitable. I have also accompanied so many of my friends and lovers who died from AIDS . . . people who had been young and vibrant and strong, and should have been enjoying the best years of their lives, but instead were rotting away physically and mentally . . . and begging for a quick way out of their misery.
I know what my intentions are when the time comes, but I’m not making any predictions. Sometimes “going gently” is the bravest thing to do.
I have a disease that could take me in a week, or a month, or a year, or ten years. It does a number on ya.
Interesting though, that whole question begs the very similar question "What is a “normal attitude” about life? It amazes me at how people waste their (limited)lives and the (limted) lives of many other people. Prime examples are the individuals that right tax code…or the ones that spend a lot of time choosing a nail polish color. Normal people seem to act like they are going to live (virtually) forever.
Yes, but every society throughout history thought of death as something to be avoided and feared. Otherwise, there would not have been the elaborate rituals of religion surrounding death and all the folk superstitions about how to avoid it, and the devoutly believed promises of a life after death to the point of fanaticism.
From observing my friends and acquaintances who work in the medical profession, I have noticed they have developed the ability to separate job and outside life.
Not that these people are heartless by any means, but if members of the medical profession were to treat each death as if a member of their own family or friend had passed, we would not have much of a medical system.
Not quite the same as a hospice, but the OP reminded me of what I’ve heard about chevra kedisha’s. I’ve read personal accounts about how working with the dead totally changes their perspective on life, and becomes meaningful instead of morbid.
My best friend is the merriest and kindest of souls. She volunteers in a hospice. I’ve often wondered how she could do it. Your post has helped me to understand. I am so grateful for you gifts.
My mother will be 97 next month. She lives in assisted care. Such little things are important to her! Winning a bar of candy at Bingo makes her day. And someone who takes an extra moment to tease her about her boyfriend at the nursing home will give her the giggles.
She is still so alive and so much in love.
Her old age has allowed me to forgive her. In her heart she’s still seventeen.
Thank you for all that you do.
As for me at 66, with some important friends gone, I’m not as afraid, but I still have some fight left in me. I haven’t been to Ireland yet.
I’ve seen enough of death and dying to know that you can find comfort and satisfaction in seeing someone die a dignified, painless death. That death can be a blessing and a release. That death can be welcomed rather than shunned, and that there is such a thing as a good death.
I know I can empathise with my dying patients and their loved ones, and feel sad when they die, but it isn’t on the same level as a personal bereavement.
When you’ve done what you can, and done it well, and you made a positive difference and if it was the right time for someone to go, death needn’t be depressing.
If it is sudden, and unexpected and no one is prepared- the the only comfort I have and that I can give is knowing that I honestly did everything I could to save them. Those deaths are hard, but again, not like the death of a loved one.
So… I’m with you Anise.
If you’re not normal, then neither am I, and I’d say neither are any medical or nursing professionals.
Some people don’t discuss death at all until they have to. When my father died, we knew what he wanted with regard to where he was to be buried and what his epitaph should be. Some of my friends found it odd that I had discussed any of these with him, he wasn’t suffering from a long term illness.
hate it? no, it’s my work and I do it because I like it. Well, I don’t like the ‘cleaning up poo’ part, but it’s not like I’ve ever met someone who likes that part.” The visitor clearly hadn’t believed her; she’d also assumed that the nurse did this as some sort of lottery rotation and had just gotten the bad duties for that day. She didn’t even seem to wrap her head around the notion that you’re perfectly likely to have someone die on you in pretty much any duty other than office visits.