The
Broken Heart
Of Hospice
by Donna Kean
When I entered the hospice field twelve years ago, I was sure the only way to save my heart was to fortify it. I soon discovered however, that hiding behind professional boundaries for protection was like using an umbrella for Hurricane Floyd. As with most people, the assault of premature deaths was my greatest challenge. Many images remain, but particularly poignant are those of a twelve-year-old client crying softly while viewing her cousin’s prom pictures, and a forty-year-old single parent struggling to say goodbye to each of her five children. A haunting image also remains of a five-year-old dying behind the bars of his dark, inner city apartment. As much as my spiritual perceptions gradually expanded to have a more accepting view of death, those early days were particularly angry and helpless ones. But, something entered even then to let me know that that was far from the whole story. I couldn’t deny that even with the most externally tragic of situations there was something more than loss and despair in myself and in the families I served. There was most often a love and dignity that I felt guilty at first in perceiving. It almost felt disloyal and dismissive of the suffering observed.
At the same time, I was dealing with my own personal losses. During my second year with Hospice, I was to experience the death of five significant people in my life. The most difficult was the death of my best friend’s 33-year-old son from malignant melanoma. After his death, four of us stayed with our friend as she kept her son’s body at home for two days. We participated in the ancient ritual of bathing and preparing his body for internment. I’ve never done a more difficult or soulful thing in my life.
It seems to me that mind, body and spirit make their separate transitions.This has helped me understand how I can mourn on the emotional level and yet rejoice on the spiritual.
However, I have lingering regret from that time. The following week, we were walking by the ocean and my friend tentatively suggested we should go to the water’s edge and use the horizon as our wailing wall. We hesitated a moment too long, and let our culture inhibit our knowing. I hope I won’t miss this opportunity next time.
This mixture of spirit and despair most recently emerged while co-facilitating our Wellness Support group at Hospice. We were saying good-bye to one of our longtime members who was moving out of state. She was well loved by the group, always willing to put her truth out no matter how painful. She somehow has remained open to life while preparing for death; this is an awesome accomplishment. She was now returning to her family for the final phase of a progressive and deadly cancer. This recurrence sadly followed what had seemed like a possible remission. Dying is an incredibly lonely business but it usually helps when we can be alone together. During our last group meeting, we cried and celebrated our way through feelings and numerous chocolate desserts. She fantasized maybe she could fly us all back when it was her time to die. I barely stopped myself from blurting out we would be there, and instead resolved within myself to hold an image of her encircled in our arms and hearts. Every time we walk into that group room she is there, but nothing can numb the goodbye.
A recent article from the American Journal of Hospice and Palliative Care, explains this experience with the inevitable conclusion. If you are to remain emotionally alive, in Hospice or in life, you have to stay “raw and innocent” and be willing to have your heart broken again and again. That’s also when you’re most privy to sacred human resilience and spirit. Hospice workers are asked again and again, “How do you do it?” I know most of us would answer that we receive much more than we give, and that it’s through opening our heart that we ultimately save it.
Donna Kean is a licensed clinical social worker and the Executive Director of Hospice of San Luis Obispo County.
