I originally sought out the Kindred Hospice opportunity because I wanted to learn more about death. It was foreign to me: all my other grandparents’ deaths came to me through my parents’ sad words. Both my classmates’ deaths had been sudden. I had little idea as a doctor what I would say to a patient who was anticipating their death. I wanted to join the hospice since I wanted to grow as a caretaker for patients (I’d only been an ER volunteer previously), and in understanding what it was like to face death.
I cared for four patients: “Sally”, “Emily”, “Jennifer”, and “Mary”. For each, I’d have to adjust my care. Sally spoke little English and could not walk, so I kept her engaged and used whatever resources I could, such as hand gestures, enunciation, Google Translate, to try to communicate. Emily was older and felt alone without her deceased husbands, so I asked about and celebrated her life. Jennifer loved to talk and was very alert, so I listened and let her talk. Mary, who was grave, hard of hearing, and an outstanding artist, I shouted into her ear, and cheered her up about her book.
It was less about mortality and more about simply being a companion to patients, who happened to be closer to the end of their lives. We took joy in the small things: celebrating a 100th birthday, seeing the beautiful day outside, drinking coffee with cream. The mortality came only once; after my first visit, I received a short email informing us about one patient’s passing. It was that sudden. But life just went on after that.
The reflection meetings helped me continue learning. My fellow volunteers shared such different experiences from my own. Some met with patients who were confused and could not articulate their work. Some had patients who shouted at them to leave. Some worked with patients who were asking why they hadn’t died yet. This was a safe space for us all to learn from each other how to become better at approaching our patients. We learned how to listen and validate them. We learned to be what they needed.
I engaged most directly the difficult questions about mortality in the readings. Atul Gawande’s Being Mortal showed how by acknowledging death, the doctor and patient can work together to control the narrative. One patient decided to plan that his last days would be at home, visited by friends and family. Just a few hours before his death, he said that these were the happiest days of his life. In a different case, the doctor found himself asking the question too late: the elderly patient had always wanted to go to Disneyland with her children, but the treatment had now prevented her from that. Another set of slides taught us about the cultural aspects of dying — how some cultures would refuse to speak the issue, while others wanted to acknowledge and prepare for it. For Western cultures, it was productive to broach the issue, but not necessarily for all of them.
Through volunteering at the hospice, I’ve learned how to meet patients where they are. Whether it’s as a listener, as a caretaker, or as a bundle of joy, I’ve learned how to be the companion that patients need. For me, this care has been less about death and more about all of the life that still happens before death, even if it needs more hand gestures or a louder voice than usual. Death may await us all, but life continues before and after it.