When I tell people that I am an end-of-life doula, their first question is: what is that? The second question is why? The "what" is simple to answer: it is a volunteer who accompanies a person on their final journey. We are not hospice. We do not administer medication. We are there only to soothe the passage from the known world into whatever an individual believes awaits them.
The "why" is more complicated. I tell them: I do it because I can. I can "do" death. The dying process does not frighten me. It might when it is my turn to look death in the eye -- but for now -- I am unafraid.
When I was 41, a dear friend who I had known since grade school died of HIV/AIDS. I attended him in his final days. I was scared then. I was afraid of life without him, I was afraid of the actual cessation of his breath, I was afraid of being with a dead body. But my fear was unfounded. To the contrary, being able to be there with him during the last hours of his life was a gift from him to me. It informed me about living in a way that nothing had before.
I witnessed the miracle of life as I attended to his dying, playing the music he loved, massaging his hands and feet, bringing good, sweet smells to his bedside. I told him stories from our youth as the clock chimed his final hours. And then it was over. I sat with his sister until the wee hours of the morning, sipping red wine, reminiscing. He was a gentle soul and we basked in his spirit until the first light of dawn.
There is this bridge at the very moment of death when you see life leave the body. It's an inexplicable suspension of time, when a day, an hour, a lifetime passes in a flash. There is air in the lungs, the blood moves, the heart pumps. And then it doesn't. I think of this moment often when I am feeling sick or sorry for myself. I think: my heart beats, the blood flows, I am alive. Get up and get moving. Live in the world. Make the best of these numbered days of conscious being.
I was present for the death of both my in-laws. I could feel the palpable reluctance of my mother-in-law to leave. She did not wish to separate from her husband, to leave him on his own. We had to encourage him to lie down next to her in those last days, to hold her and warm her with his own body heat. Her spirit and her body struggled with each other days longer than her doctor anticipated. Surrounded by family, she finally succumbed. Two days later, the rails inside her closet collapsed, sending all her clothing to a jumbled heap on the floor. She did not go easily and she wanted us to know that. My father-in-law, on the other hand, at the age of 96, didn't want us to fuss. With his customary aplomb and determination, he left swiftly to join his beloved. Within five minutes of death, the house he shared with his wife of 61 years was cold and deserted.
As I sat beside an elderly gentleman during my last vigil, I noticed the birds gathering along the eaves of his home. When I pointed this out to his daughter, she told me he liked to feed them and had bird feeders set up throughout the yard. As the day progressed and his death drew nearer, the birds came by the dozens and perched on the branches outside the window. It was remarkable. I believe they came to witness and say thank you to a spirit that spoke to theirs. Each death is unique. Each death has something to teach us about living.
I liken the experience of being an end-of-life doula with that of being present at the birth of a baby. When a mother is in labor everyone runs to the hospital with outstretched arms. "Can I hold her?" they ask the nurse. "My turn," they insist. It is a natural instinct to want to welcome new life. When someone is dying, when they are leaving us for the last time, I think it is just as important to say "Can I hold her?" "It's my turn." To hold the hand of a dying individual is to see them out of this world in the same way we welcome a baby into it. They are both journeys of transition, ultimately experienced alone but not without company. To shepherd someone into this life or out of it is a truly rare opportunity, a remarkable experience, and in my humble opinion, an obligation.