{"id":148064,"date":"2010-01-07T02:01:08","date_gmt":"2010-01-07T07:01:08","guid":{"rendered":"http:\/\/www.stanforddaily.com\/cgi-bin\/?p=1036783"},"modified":"2010-01-07T02:01:08","modified_gmt":"2010-01-07T07:01:08","slug":"the-good-death","status":"publish","type":"post","link":"https:\/\/mereja.media\/index\/148064","title":{"rendered":"The Good Death"},"content":{"rendered":"

Part 2 in a series of 2<\/h3>\n
\"Stanford<\/p>\n

Stanford Hospital\u2019s decedent care chaplain Reverend Susan Scott lays down some ground rules on the volunteer-patient relationship to volunteer Heida Earnest. (RYAN MAC\/The Stanford Daily)<\/p>\n<\/div>\n

\u201cHas everyone been to the bedside of someone who\u2019s dying?\u201d asked Judy, a clinical care nurse.<\/p>\n

Eight new volunteers responded, thrusting their hands into the cold air of Room HO147. On a cold and rainy Monday night in October, these eight hopefuls convened in a converted break room in Stanford Hospital\u2019s basement for a new volunteer orientation session for No One Dies Alone. Some had driven from work straight to the meeting, while others only had to make the short trip down the elevator from their jobs upstairs. They all listened intently to the revolving presentations of hospital chaplains and program organizers.<\/p>\n

One by one, chaplains and nurses gave short talks, each speaker ending with a profuse outcry of thank yous directed at the hopefuls. After all, it was death they would be dealing with.<\/p>\n

Among the new volunteers was David Bowman, a 70-year-old retiree with wispy white hair and an accompanying white beard. An ordained minister of 40 years with the United Church of Christ, Bowman had given his fair share of last rites. Still he jotted down every bit of advice from the chaplains.<\/p>\n

\u201cA dying person\u2019s body temperature will get cooler, so you will need to feel for a pulse.\u201d Quick scribbles of a pen.<\/p>\n

\u201cWet their mouths with a small sponge if you see that their lips are dry or chapped.\u201d Noted.<\/p>\n

\u201cYou\u2019re never alone in this process.\u201d Word for word.<\/p>\n

Across from Bowman was Jim Chan, 49, a single father who had come straight from his 9 to 5 at Sun Microsystems where he worked as a lead engineer. Jim regularly volunteered in the hospital\u2019s E.R., working the Saturday shift from 10 p.m. to 1 a.m. every week.<\/p>\n

Bill Strewby sat in a chair separated from the table, a self-inflicted punishment for arriving late.<\/p>\n

\u201cI asked like four people and none of them knew where this place was,\u201d he said.<\/p>\n

With a handlebar moustache and a purple and green windbreaker, he listened for 40 minutes before his restlessness succumbed to a bout of doodling on his volunteer worksheets. By meeting\u2019s end, he had created his fair share of hieroglyphics \u2014 yin-yangs, stars and hearts.<\/p>\n

It was a quiet group, according to Allison, a social worker who gave the first presentation. The room was often filled with awkward silence, broken only by Strewby\u2019s crunching of trail mix, as presenters waited for questions. Surely, not everyone could be that confident in dealing with death.<\/p>\n

Allison continued anyway, discussing the importance of the volunteers\u2019 mental health, because in this business, \u201cyou can\u2019t take care of someone until you can take care of yourself.\u201d Yet, she struggled to find words to explain the need for distance between what\u2019s inside the hospital walls and what\u2019s outside. They had to realize the sensitivity and intensity of the matters they would deal with. She hazily explained the program\u2019s support system for affected volunteers and waited for questions, which never came.<\/p>\n

\u201cI know that these things are nebulous,\u201d she said. \u201cIt\u2019s hard to recognize when these things are going to be relevant.\u201d<\/p>\n

Yet, in discussing the responsibilities of the program, Allison became resolute and clear: volunteers should not and could not take on grief because of their experiences. While their job required compassion, volunteers were expected to stem their emotions once they stepped out of the hospital room.<\/p>\n

\u201cThe key is recognizing that you have a role in this end process and that your role is pretty confined,\u201d Allison said. \u201cYou haven\u2019t caused their death or their lack of family. These are problems that you can\u2019t own.\u201d<\/p>\n

But for David Bowman, something wasn\u2019t right. How could he be expected to show concern for a dying person, then forget about that person when he left the bedside or as soon as the person died? And what about the families who wanted to know more?<\/p>\n

\u201cWhat if a family that was around didn\u2019t want to let the caregiver go?\u201d he asked.<\/p>\n

Susan Scott explained that neither the volunteers\u2019 phone numbers nor their full names would be given out to relatives. No volunteer would be expected or encouraged to maintain ties to the family of the deceased. The program was about care within a strict standard protocol.<\/p>\n

\u201cYou are scheduled for a shift,\u201d Scott told them, \u201cand when that shift ends, you have to leave.\u201d<\/p>\n

—–<\/p>\n

Susan Scott had her reasons for the strict volunteer-patient relationship. She\u2019s based her whole career on staying within the boundaries, and as decedent care chaplain, it\u2019s the only way she can withstand the 40-hour workweek. In her current position at the hospital, Scott handles all death certificates, which average two or three a day. She talks with families whose relatives have died or are dying, and can refer them to the funeral home that\u2019s best suited for their needs.<\/p>\n

A self-described introvert, she is quiet but firm. She wears a charm on her necklace that reads, \u201cLive With Grace.\u201d Susan believes that her profession is one meant to provide comfort within a certain reality, describing it almost as a placeholder for grief. \u201cI think you need a certain amount of patience with people and compassion for people,\u201d she said. \u201cAnd I think part of what I do is hold it for a while for people. I don\u2019t ever try to say, \u2018It\u2019s going to be O.K.\u2019 But I try to be with them . . . until they can kind of gather their resources and take care of themselves.\u201d<\/p>\n

After 23 years of being a reverend, she\u2019s learned that she\u2019s not there to keep their grief. It\u2019s an understanding that she emphasizes every time a new volunteer joins No One Dies Alone, and the restrictions have been put in place as a constant reminder. For Scott, it\u2019s the only way humans could have any chance of handling death, something she has learned from her own experiences.<\/p>\n

_____<\/p>\n

It was 1993 and Susan Scott had only been on the job a few months at Lucile Packard Children\u2019s Hospital, when she was summoned to the neonatal intensive care unit to perform a baptism. Weaving her way through the buzzing incubators of the sterile ICU, she arrived to find a baby boy only a few weeks old, still lying on the operating table wired to a ventilator. Doctors rushed back and forth monitoring the baby\u2019s vital signs and examining the aftermath of heart surgery.<\/p>\n

\u201cIf you\u2019re going to baptize this baby, you\u2019re going to have to do it right away,\u201d a nurse whispered.<\/p>\n

Gathering herself between the whir of the machines and the newborn\u2019s labored breathing, she glanced around the windowless room as the parents and grandparents stood silently around the surgery table. She was Lutheran and they were Roman Catholic, and the service would be in English, not their native Spanish. But it didn\u2019t matter. This was an emergency, and any ordained Christian minister could perform the rite. Opening her Bible, she began the Lord\u2019s Prayer:<\/p>\n

\u201cOur father who art in heaven, hallowed be thy name. Thy kingdom come, thy will be done . . . \u201c<\/p>\n

As family, nurses and doctors recited the prayer, the reverend concluded with the ceremonial dash of water upon the baby\u2019s forehead. He died minutes later.<\/p>\n

Scott retreated to a private hospital room with the family. The nurses brought in the baby\u2019s body, clothed and wrapped in blankets. Picking up the baby from its basket, the mother wept; she passed the body to the grandmother, who began to cry as well. Unable to bear the sight, the family placed the baby back in the basket. Susan looked on, unable to comprehend the Spanish between the sobs, and was caught up in her own thoughts as she focused on the baby\u2019s face. And in that moment, she was no longer in the room.<\/p>\n

It was 1959, and she was a 9-year-old girl at a funeral home in Delaware. Her brother Michael had died before she had ever known him. He was seven months old.
\nViewing the body in its casket only five feet away, Susan clung to her grandmother as she listened to the priest\u2019s service. She could only understand the basics. She knew that her brother had been born with dysfunctional intestines while her family was living on a U.S. Army base in Rome. Her father, a sergeant, had spent the greater part of the year shuttling Michael and her mother back and forth from the hospital, sometimes having to fly to stations in Germany to find better doctors and treatment.<\/p>\n

The oldest of four children, Susan had seen little of her baby brother and had often talked to a nun at her Catholic school about her troubles at home. There wasn\u2019t much else she could do.<\/p>\n

With Michael\u2019s condition deteriorating, her parents decided it would be best that the family return to the States. Boarding a military plane with her father and the rest of her siblings, she arrived earlier than her mother and brother\u2019s flight, and waited anxiously for their plane to land.<\/p>\n

Her brother never made it. He died over the Atlantic.<\/p>\n

Looking back, Susan often tells this flashback to new volunteers of No One Dies Alone to explain how the smallest things can trigger the memories of death or traumatic experiences. She tells her volunteers that death isn\u2019t something that should be dwelled upon, but rather part of the process of life. In her line of work, it\u2019s the only way to find closure.<\/p>\n

Yet, in those long nights sitting next to the bedsides of her patients, she cannot help but think about Michael.<\/p>\n

\u201cFor me, it\u2019s also about accepting that death is a reality in life,\u201d she said. \u201cSometimes, when I\u2019m sitting with someone and they\u2019re very quiet and I\u2019m sort of in my own thoughts as I watch them, I will think about that someday when I will be the one in the bed.\u201d
\n_____<\/p>\n

It takes time for people to realize that death is just a part of life. Some people never come to this understanding. Others simply don\u2019t want to. For Susan Scott, who has lost count of the number of sick and dying she\u2019s sat with, it\u2019s what has allowed her to shoulder the burden that comes with being at the hospital day after day of signing death certificates.<\/p>\n

She\u2019s hoped to establish this understanding with her volunteers, but it has never been that easy. Susan\u2019s volunteers are normal people with normal jobs, who have dedicated two hours of their time to deal with something that defines her profession.<\/p>\n

Heida\u2019s attempts to reach this understanding are founded on her belief that death is just a transition. As a Catholic, she doesn\u2019t view death as an end, and that\u2019s what\u2019s allowed her to step into the hospital room when she gets the call.<\/p>\n

\u201cIt would be nice to think that you have loved ones waiting for you and a lot of people do believe that,\u201d she said. \u201cYou will frequently hear people say \u2018I get to go see Mom and Dad again. I\u2019ll be with my brother again.\u2019\u201d<\/p>\n

There is a fine line in handling religious matters in No One Dies Alone. The program prides itself on being non-religious and non-proselytizing, and its patients come from many different faiths. Volunteers are constantly advised to avoid religious conversation, unless prompted by the patient, and to defer any religious questions to the overseeing chaplains.<\/p>\n

But religion still plays a large part in the lives of those involved. Susan Scott is not only the decedent care chaplain, but also a Lutheran reverend and handles patients for spiritual care specific to that faith. For Heida and Penny Barrett, religion has provided a means of processing their individual experiences in the program.<\/p>\n

Heida frequently referred to her involvement with the program as \u201ca calling,\u201d spurred on by her Catholicism and the memory of her father\u2019s death. Penny, a Christian Scientist, maintained that religion helped define her perception of patients. \u201cFrom a doctor\u2019s perspective, yes, they are sick,\u201d she explained. \u201cBut from my perspective, it\u2019s a hospital filled with God\u2019s children, and I view that as my job to make sure that I maintain that. I don\u2019t think I could have done this for eight years if I viewed them as sick, broken people.\u201d<\/p>\n

Not everyone can step into that hospital room. Even fewer can step out, accept what they\u2019ve experienced and move on. It all comes down to the perception of death. While Heida has sat with four different patients in No One Dies Alone, she hasn\u2019t yet fully made the connection that death is just a process of life. But every time she steps in the room, she\u2019s getting a little closer to this realization. And it\u2019s her religion that\u2019s helping get her there.<\/p>\n

\u201cFor me, to think that this is it,\u201d she said. \u201cIt\u2019s too unbearable . . . I think a lot of people, especially people of faith, spend their whole lives preparing themselves and behaving in ways so that there is something more.\u201d<\/p>\n

Do you think there is something there after death?<\/em><\/p>\n

<\/em>\u201cI hope so; that would be wonderful.\u201d
\n_____<\/p>\n

Today, the No One Dies Alone Program has 70 active volunteers. Yet, there have been even more who signed up and attended the volunteer orientation sessions, before realizing that it\u2019s just not for them.<\/p>\n

\u201cNo, not everyone can become a volunteer,\u201d said Sandra Clarke. \u201cEveryone has to find their level of comfort. Volunteers wanted to get involved, but they couldn\u2019t do it.\u201d<\/p>\n

Jim Chan still has yet to sign up for a shift, citing a lack of time and some communication problems. Jim Bowman, on the other hand, couldn\u2019t come to terms with the religious restrictions put on volunteers. \u201cThe program is run by a chaplaincy, but it\u2019s a very secular program,\u201d he said. \u201cI can\u2019t even go in and say, \u2018My name is David Bowman, and I\u2019m here to be with you,\u2019 and I can\u2019t say I\u2019m a retired clergyperson, and I can\u2019t introduce myself as a minister.<\/p>\n

\u201cI wouldn\u2019t want to impose, but I would like to be freer to use my own good judgment,\u201d he added. \u201cI want to emphasize that I think it\u2019s a good program \u2014 it\u2019s just not my cup of tea.\u201d<\/p>\n

Of course, many volunteers have stayed. Penny has had a lifetime of volunteering, and despite initial doubts about the program, she has cherished every session with patients. Heida, motivated by her own personal experience on her first shift with Peter Pan Lady, sees herself doing this for a very, very long time.<\/p>\n

Heida dug around for the prayer book in her pre-packed program bag with one eye on Peter Pan Lady. With the harp player gone, she needed something appropriate to read to her patient. Locating the book at the bottom of the bag, she picked it up and began thumbing through it for Old Testament prayers. \u201cStick to the Psalms,\u201d she was advised by the previous shift\u2019s volunteer. \u201cShe\u2019s Jewish.\u201d<\/p>\n

As 5 o\u2019clock rolled around, she continued to read from the book, picking and choosing small passages. With the next volunteer, Repeka Iemeria, waiting outside, Heida finished Psalm 73 and bid Peter Pan Lady a warm farewell.<\/p>\n

But she didn\u2019t leave immediately. She helped get Repeka settled, explaining what could be read, what music should be played and how best to comfort the patient. Yet, looking back at Peter Pan Lady, she noticed something was different: The woman\u2019s chest no longer rose as when she was softly breathing. \u201cYou know what \u2014 ,\u201d Heida said, \u201cI don\u2019t think she\u2019s alive anymore.\u201d<\/p>\n

Heida quickly retrieved a doctor and waited with Repeka as he searched for a heartbeat. When the doctor was sure, he turned to the women and looked at them sternly. \u201cShe\u2019s not here anymore,\u201d he said.<\/p>\n

Despite the preparation and the knowledge that these people would die, Peter Pan Lady\u2019s death still came as a shock to Heida. No training could completely shield her from the emotions of death. \u201cIt was disbelief, I think, because in my head, I had committed to being a part of the program for a long time,\u201d she said reflecting on the experience. \u201cI knew eventually that I would be with someone that would die. But I did not expect it to happen the first time.\u201d<\/p>\n

Leaving the hospital room with tears in her eyes, Heida made the long walk down to the hospital basement and the Spiritual Care Offices. Fittingly, in those moments after the death, Heida was never alone, accompanied by Repeka as she cried and held prayers. But these weren\u2019t tears of sadness or grief.<\/p>\n

This program is Heida\u2019s calling, and she believes that she\u2019ll be there for many other dying patients as they close their eyes for the last time. Hopefully those experiences will be as moving as her first.<\/p>\n

\u201cIt was beautiful,\u201d she said. \u201cEverything went right.\u201d<\/p>\n

\u2014 Part one ran in yesterday\u2019s issue of The Daily.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Part 2 in a series of 2 Stanford Hospital\u2019s decedent care chaplain Reverend Susan Scott lays down some ground rules on the volunteer-patient relationship to volunteer Heida Earnest. (RYAN MAC\/The Stanford Daily) \u201cHas everyone been to the bedside of someone who\u2019s dying?\u201d asked Judy, a clinical care nurse. Eight new volunteers responded, thrusting their hands […]<\/p>\n","protected":false},"author":56,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-148064","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/148064","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/users\/56"}],"replies":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/comments?post=148064"}],"version-history":[{"count":0,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/148064\/revisions"}],"wp:attachment":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/media?parent=148064"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/categories?post=148064"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/tags?post=148064"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}