During my childhood I grew up in an apartment building in New York City. Our family lived on the sixth floor and my mother's best friend, Helen, lived on the fifteenth floor. As a young child I remember Helen either coming down to our apartment or my mother and I going up to her apartment a couple of afternoons a week. Helen and my mother would have their cocktails while I either listened to their conversations or watched television. I remember Helen's bright-colored wool suits-the prettiest shades of sherbet pink and robin's egg blue. Helen was my godmother; she was always my ally when life seemed too harsh.

    In my early teenage years, Helen was diagnosed with cancer. At the end of her illness, she remained at home, where her husband and a private nurse cared for her. Every day my mother collected the soiled laundry and returned it the next morning, clean and folded. This was her gift to her dying friend. Helen's passing was the first time I had lost someone close to me and it opened a Pandora's box of ambivalent feelings about death. As I look back, having now become a companion to the dying as a hospice volunteer, I realize that seeing my mother contribute to Helen's care while she was at home at the end of her life planted a significant seed within me.


    Ten years ago, life's mysterious passages led me once again into death's den when my close friend and lover died suddenly of AIDS. The trauma that unfolded in those brief two weeks catapulted me into an entirely new life direction. Recently I came across a book that validates precisely what this experience was like for me. Crossings: Everyday People, Unexpected Events, and Life-Affirming Change by Richard Heckler, Ph.D., describes the incredible journey that opens up for us after a catastrophic event. He tells the stories of those who confronted dramatic life-changing events and says that their "desire, to find a context that was big enough to contain their experience, prompted a quest and, unbeknownst to them at first, the beginning of a profound rite of passage."
Sooner or later it happens to all of us. Something or someone comes hurtling through the trance of our everyday lives and startles us...
     What if we consider these events to be signals or messages? What if we attempt to intuit a meaning to the unexpected, or at least acknowledge that something significant has occurred beyond what we ever believed possible? The stories that follow [in Heckler's book] show that when people do so, they cross into a profound and mysterious territory. If they can tolerate the strangeness and inevitable sense of dislocation it engenders, the experience can yield profound treasures-deeper insight, a clearer sense of purpose, and a greater understanding of the world and their place in it (pp. 2, 3-4, 13-14).
    One of the blessings of my passage, as I waded through endless days of grief, salvaging a new life for myself, is that death, dying and grief are no longer vague and dreaded silhouettes that haunt me amidst the churning leaves of autumn. At the time, I had no idea just how many bedsides I would occupy offering my companionship. After this sudden and untimely loss, I felt called to pursue training as a hospice volunteer, not only to find purpose beyond my grief but to serve those in this potent time of life.


    A hospice volunteer is a humble creature, having no professional status among hospice colleagues. However, since volunteers are not encumbered by an array of specialized tasks to complete during the course of a visit, perhaps this open-ended identity and flexibility, cou pled with extended time periods spent with the patient, help lay the foundation for companionship. What I have learned over the years in sitting with the dying is that it is never too late to begin a friendship.


    The blessings from such a newly formed friendship run both ways. For the person who is dying, it can be especially healing and validating to have a companion with whom there is no previous history or bag gage. The volunteer is able to accept the individual unconditionally, wherever he or she is right now. From this vantage point, the volunteer may be better able to fully attend to the patient and his dying process than family or close friends, whose focus may be divided between the patient's needs and their own issues of grief. Perhaps volun teers provide not only respite for the caregivers but respite for the patient-time away from his inner circle of caregivers, family and friends and the challenging dynamics that can permeate these relation ships.


    Of the many books I've read and learned from over the years, Intimate Death by Marie de Hennezel remains one of my favorite. She summarizes beautifully why caring for the dying can be so rewarding and counters the myth that this work is "depressing."
I hope to make some contribution to the evolution of our society: toward one that would teach us to integrate death into life, instead of denying it....
     I hope to be able to open my readers' minds to the rich rewards that come from being there to share the last living moments of someone close to them....
     Even when one enters final helplessness, one can still love and feel loved, and many of the dying, in their last moments, send back a poignant message: Don't pass by life; don't pass by love....
     ...I cannot deny the suffering and sometimes the horror that surround death. I've been witness to limitless solitude; I've felt the pain of being unable to share certain times of distress, because there are levels of despair so deep that they cannot be shared.
     But alongside this suffering, I feel I have been enriched, that I've known moments of incomparable humanity and depth....
     ...Yes, there was sadness, but there was also sweetness and often infinite tenderness....The space-time continuum of death, for those who accept to enter it and see past the horror, is an unforgettable opportunity to experience true intimacy (pp. xiv, 181-82).
    I wrote When Autumn Comes to help hospice volunteers and anyone who attends the dying feel more comfortable and confident in this important and rewarding role. If you are a hospice volunteer, are contemplating becoming one, or simply know someone who is terminally ill, you may find yourself pondering the following questions:


    How can I step up to the role of being a companion to a dying per son? How can I overcome my own awkwardness and fears in approach ing someone who is dying? How can I cultivate bonds of trust and intimacy with someone who is preparing for death? How do my beliefs, attitudes, hidden agendas and experiences support or hinder my ability to understand and serve the unique needs of the dying? How can I process and integrate the invaluable lessons about living from individuals who are dying? How do I balance the primary relationship with the person I am visiting with the secondary relationships I have with the caregiver and other family members? How do I reconcile professional boundaries with sometimes strong, personal sentiments toward my patients? And finally, at the end of the day, how does the volunteer or caregiver receive the wisdom and the grace to feel confident that despite any appearances to the contrary, she does make a difference in the living and dying of the people she serves?


    When Autumn Comes can help you find meaningful answers to these questions. It is my intention through each of the stories I share to give candid and compassionate perspectives about dying from the point of view of someone who is simply a companion to those in the final days of their lives. We are extremely fortunate to have so much literature emerging on the topic of death and dying. It is rare, however, to stumble upon material that is not written by a professional in the field. Hearing the voice of a layperson as she traverses this terrain can, I believe, help expand our collective awareness of the attitudes, beliefs and issues around death, dying and grief-and help us prepare for and cope with our own inevitable journey.


    Ultimately, we will all be called to tend to the needs of a loved one who is dying. We will all grapple with the tremendous impact of this grief and loss in our lives and we will all have the opportunity to offer them the compassionate care they deserve. The word hospice dates back to medieval times, when it described a house or shelter providing rest and nourishment for pilgrims. In serving the dying, we can all learn to be the open door that welcomes, accepts and comforts travelers making their final journey. It is my prayer that my heart's love and compassion will help ease the suffering and rekindle the wisdom of all who read this book.


    Note: Some of the stories I relate are based on my personal experiences with friends or family members. In these instances, I have taken greater liberties in my interactions with the patients and families and may have broached topics that would not be within my role as a hospice volunteer.

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