October 1999: I decide to volunteer in a hospice around the time of my mother's birthday. She would have been 85. Lung cancer took her life three and a half years ago, and she did not "go gentle." She was frightened and angry, half out of her head. Hospice care couldn't give her a good death, but it did make her last days more comfortable. It was a haven, for her and for me. I tell friends what I've done and they are filled with respect. They say, "I could never do that," as if I'm endowed with special powers. I'm not. I'm drawn to the work—and I can't even say why.
November 4: Tonight is my orientation class and I'm scared stiff. Of reliving my mother's last weeks. Of making some ghastly mistake with a dying patient. Of failing, choking, quitting, copping out. Of my own death.
My fellow volunteers, I notice, are surprisingly young, and many of them have full-time jobs. All of them seem serious. Anyone frivolous will be weeded out by the two-page training checklist—reading, classes, meetings, fieldwork, even a final exam. It's like school, which is reassuring; I was good at school.
Marion Edmonds, supervisor of volunteer services at Jacob Perlow Hospice, goes over the basics: Hospice isn't a place; it's a program that supports patients who are terminally ill (a prognosis of six months or less) and their families, at home. In addition, hospices sometimes have an inpatient unit (IPU) where clients can stay temporarily if home care breaks down (during a medical crisis, for example). The Jacob Perlow unit is at Beth Israel Medical Center in New York City. That's where my mother died.
We pair off and practice a skill fundamental to hospice care: listening without interrupting, judging, or tuning out. It's harder than it sounds. You must be attentive no matter what a patient is telling you, Marion says—whether it is boring or fascinating, whether you're hearing it for the first time or the twentieth.
November 5: Back at Beth Israel, I embark on a bureaucratic obstacle course—being screened for tuberculosis (this very contagious disease poses a significant health hazard in a hospital) and acquiring a photo ID. I am treated like staff because I am staff: Volunteers are legally required to provide 5 percent of patient-care hours in any hospice program certified by Medicare.
It is starting to dawn on me that this is not a charitable walk-on. People will trust their hearts to me, and their bodies. I come across a section in my training manual on what to do when a patient dies: "Gently close eyes," it reads, "and prop head up with a towel or small pillow so that mouth closes." I am startled by the matter-of-factness. I can't do this! Can I do this? Volunteers may choose between working the inpatient unit and taking on home-care clients. At the moment, I'm cravenly drawn to the IPU, where I run little risk of being alone with a patient at the moment of death.