1. The GreatestGift
The Mystery of Life/Death
There’s just something special about being with a person who has just passed away. In
some ways, there is a mystique to it. I consider myself to be a fairly spiritual person. It is
interesting to consider that, possibly the two moments we experience on Earth, in which we are
closest to God, or closest to whatever spiritual force may or may not exist, is when we are born
and when we die. We all make up one of the greatest mysteries that ever existed. No one will
ever know every aspect of any other human being; but at least, when dealing with people who
are alive, awake, and active, we have the capability to try. We have the capability to try and learn
about others and the mystery that surrounds them, through talking to them; through being their
friend. Lately, in my work, I have been lucky enough to spend time with a number of actively
dying patients, and in the last two weeks, two that had just recently passed away. As I described
previously, the turnaround in my hospital is so great that I often meet many people for the first
time when they are actively dying and unresponsive. The mystery that surrounds these people
might be the greatest mystery the world has come to know; the mystery of exactly how someone
feels, days, hours, or minutes before their death. It’s truly fascinating to be with a person at this
stage of life, as they are surrounded by this great mystery. It is also an amazing privilege. It is
considered such a sacred moment in life to so many and to get be around when that moment is
almost a reality is such a gift. And then, after a person passes away, all of the mystery is lost, and
will never be discovered. Who knows what is next for that person? Not a single one of us. Yet,
when that person is gone, and all there is left on Earth is there body, one can only wonder.
Our Story
This past May, my father lost a yearlong battle with lung cancer. Unfortunately, he was
diagnosed just before my high school graduation, so the following school year, my first at Saint
Joseph’s University in Philadelphia, I obviously spent less time with him then in any other
previous year of my life. I was never able to truly see his disease progress, or his day to day
struggles. I felt guilty about not being there for him when he needed me most. Dad was a hard-
working, extremely caring individual. He was everything a father should be and more, and now,
I couldn’t be there to care for him, just as he had cared for me in my first 18 years. Yet, the most
challenging part of the experience was, since I was at school and didn’t get to see the progression
of my dad’s cancer; I didn’t have any clue about when exactly my father was going to die.
When doctors found the cancer, it had already progressed to stage 4, so I knew that he
wasn’t going to be cured and could take a turn for the worst at any time. At first, I didn’t think
Dad would make it to Halloween, or then to Christmas, but he did. It turned out there were a few
months during that year-long fight when the medicine he was on was, in fact, slowed the
cancer’s progression and it seemed like he wasn’t even sick, when I did get to see him. As I
reminisce about this time, it reminds me a significant deal of some of the dreams that I have
about my father, now that he has passed away. In the dreams, he isn’t a ghost; he is alive. Then I
remember that if he is still alive, then he is still sick, suffering, and dying. When others ask me

2. what I think about these dreams, I tell them I only want my dad to be alive again if he isn’t
dying.
During my second semester, Dad’s health did start to decline fairly quickly. He was in
and out of the hospital and other recovery facilities for the majority of his time in 2013. He and
my mother separated when I was 13, so his older sister, would often come to see him, while I
was going to school, and my then 17 year old brother was splitting his time between my mom
and dad. It wasn’t until the end of my semester when my brother and I could see him again on
more of a daily basis. Less than three weeks after finals, Dad told me they were going to put a
stent in his heart to help him to breathe.
When a person is suffering from lung cancer; suffocation becomes a looming thought.
Images of choking or drowning would often surface in Dad’s mind after many restless nights,
waking up alone, and needing to catch his breath. Dad didn’t sleep much toward the end of his
life. He knew that he could manage his breathing better if he was conscious. Dad feel into a
vicious cycle of anxiety and panic about his breathing, which would then trigger panic attacks
and shortened breath, and finally lead to more death anxiety.
As doctors tried putting the stent in, something frightened Dad so badly that he suffered
a small heart attack. At that point, the general panic regarding his breathing, brought together
with his death anxiety was at an all-time high. Within days Dad was on a ventilator, and then
finally in the hospice unit. In my last exchange with Dad, he was in a daze, but for some reason;
he kept trying to lift his head from his pillow, as if he was going to get up. I put my face close to
his and said Dad you have to relax and lay down, ok? He nodded his head “yes”. It wasn’t much
longer before Dad died with my brother, our aunt, and me at his bedside.
I do remember telling my dad that I was going to start visiting people who were on
hospice. There were countless times in my life when I would tell him about something I was
involved with, that I thought was important. He didn’t always understand why I wanted to plant
trees, go into bad neighborhoods and clean up, or go visit people who were suffering, but I knew
that he was proud. Before my dad passed away in May of 2013, I didn’t know anything about
death or about what dying truly meant. As, Sharon Browning, founder of JUST Listening, a new,
upcoming communication program in the Philadelphia area, would have explained it, prior to last
May, I’d had one second tier death, a few first tier deaths, and I hadn’t been to many funerals. In
some of her lectures, Browning uses these tiers as a simple way to describe the degree to which a
death may affect our lives. A first tier death may be a parent, sibling, or another close family
member or friend. The second tier death may be someone who may not have been as close as a
parent or sibling, but someone who has still made an impact on your life. Then, a third tier death
would be a pet or someone you met just a few times.
Something I will never forget for the rest of my life is the two saddest people at Dad’s
viewing; my neighbor across the street, Tom, and my dad’s other buddy, Mario. Everyone who
has ever seen their dad, grandfather, or uncle cry knows that seeing a grown man with tears
pouring down their face is a heartbreaking sight. We view these older men as symbols of
strength, they cry, and with the tears, the tough guy image melts away. In retrospect, not only
was seeing a close friend of many years lay dead before them a heartbreaking struggle, but the
fact that they were all so close in age, and that it could have been either of them, could have
easily gave Tom and Mario a frightening feeling of mortality. On a lighter note, it was good to

3. see that my dad had some friends. Honestly, he didn’t have many. If there was one thing my Dad
was it was cool; but sometimes, to him, cool meant antisocial. These relationships my father
created, while few, were special, precious, and irreplaceable to his friends. Everyone needs pals.
Before I saw Tom and Mario that day, I didn’t understand what a truly personal impact
someone’s death could have on the world they had created around them. Working in hospice,
the most significant part of my experience is all of the meaningful relationships that I have been
able to observe and be a part of and I thank God that I have come to learn how important they
are.
Working in Hospice
Hospice chaplain and spiritual guru, Woody Sheetz-Willard, had my attention from the
first time he used the word companion. I always loved the word almost. When I think of what
makes a noteworthy companion, I think of someone caring, and understanding, but simply
enough, they are there with you and there for you. They are with you on a deep level because
they make the conscious effort to listen to your suffering, be with you in that suffering, and be
open to anything else you may want or need. The one thing Woody said that I’ll never forget is
that when we are working in hospice we are “companioning the inner essence” of another
person. I thought this was extremely important. In order to have meaningful relationships with
others, we must embrace this concept to companion each other’s inner essence, each other’s
truest self. We had previously talked about how the dying should be treated with dignity. They
are not dead, so they should be treated as if they are still alive. Of course precautions should be
taken if someone has a disease, but generally it is important to treat the person as if they weren’t
even sick. Having a terminal illness comes with a negative stigma that is important to realize,
and it is our job to break it. When we companion the inner essence of someone, we are looking
past their outer problems, and being with the components of who a person really is. This is
important because it allows for meaningful relationships to be had. These ideas do not just apply
for those who are dying, but they also apply to anyone who may have a negative stigma dragging
them down. We must look deeper inside of these people, learn what is important to them, how
we can help them, and then let them help us in return.
Throughout the semester, we read constantly from doctor and author, Ivan Byock. Byock
was the author of several informative articles as well as the book Dying Well. One of the themes
that Byock covers indirectly was the importance of human relationships. In one article, he
discusses the idea that we are all social animals, and basically, that it is our instinct to want to
interact with others. He believes that it is natural for us to want to be together, physically and
socially. Since we have this natural tendency to build these connections, it is easy to say that
these connections bring us a significant happiness. This can even be associated with the idea of
longing for other people, and why we do not want to die alone. We long for others, according to
Byock, because it’s our instinct to want to be with them, especially after we connect ourselves to
them. This “inner desire to be social” does not die and stays embedded in us from our first day
until our last. We do not want to die alone, we want to remain with others until we can’t any
longer.
The other way in which Byock presents the importance of relationships is his emphasis
on mending broken relationships before a person dies within the case studies of his book. In one
case, a woman, Anne-Marie Wilson, is estranged from her sister because it was believed there
was an affair occurring between her husband and the sister. After Anne was diagnosed with a

4. terminal illness, she wasn’t necessarily keen on telling her sister, but she felt as if she had to. To
make a long story short, Anne moved in with her sister and their relationship was rectified before
she passed away. A similar thing actually happened with my father and his sister. When I was in
high school, they got into several arguments when my aunt didn’t want to come see my brother
and I act in our shows. My dad was a very stubborn man, and before his diagnosis, he went
without talking to his sister for well over two years. When someone close to us is dying, we
typically take time to examine whatever relationship we have with that person. If there is
something wrong with the relationship, we have the tendency to want to fix it. We don’t want
someone to die without fixing any unresolved problems because the relationship that has been
formed is important to us, and carries meaning and happiness into our lives, so by fixing it, we
can bring those things back, making everyone’s life or death better. My aunt and my dad were
able to make up, and as his big sister, she was able to help take care of him from time to time
before he died.
People always hypothetically ask “what is the meaning of life?” After taking this course,
my answer would be “to build meaningful relationships with the people who come into our
lives.” The strong connections we share with others typically bring great senses of joy, feeling,
and meaning to our lives. There is nothing quite like seeing someone you love for the first time
in a year. We have bonded with that person so closely that we develop a sense of longing for
them. When they are returned to us, a great deal of happiness occurs. This does not even have to
go strictly for someone we haven’t seen in a while. When we truly love someone, we love being
with them, and our desire is to continue to share in that happiness that comes along with them,
and to hopefully bring that joy to them as well. Additionally, when two people break up after a
serious romantic relationship, the emotional pain and mental suffering can be terrible. Yet, this is
because we are losing, in one way or another, this strong connection with someone we love and
value. It is because we cared for that person so deeply, or we loved them so much that make the
pain of losing them so difficult and so intense, but this is when we know our relationship is
meaningful. The same concept is easily associable with when someone we care for dies. Whether
we like it or not, it always becomes clear how much a person means to us after they are gone.
Again, this is not a bad thing. It is important to embrace those hard feelings that come with
another’s death and reflect on the relationship that was had. Chances are they would be doing the
same if you were the one that died.
Though our amazing connections may be the cause of pain at times, meaningful
relationships are still what we should strive for with everyone. In class, we constantly discussed
the notion that nobody wants to die alone. This is because, as I mentioned, connections with
others is associated with a sense of a meaningful life. When a person dies, they are leaving a
lasting impression on those around them for better or worse, and that is an amazing gift.
Meaningful relationships make our lives. They are composed of our parents, siblings, best
friends, and potential soul mates, but there is no reason these connections should be limited. We
have the potential to form these relationships, and spread love and happiness to everyone we
meet. Hospice has taught me this because not only am I able to see the power of loving
relationships right before my eyes, but I was also able to learn that I can build meaningful, loving
connections with people after a half hour of talking, or just by sitting bedside with someone who
is unresponsive, if my intentions are in the right place. While this may make things more difficult
when that person dies, I can still carry this lesson over to my daily life and make the most of the

5. relationships I can build with the people around me. I was lucky to be able to create some of
these connections with patients in hospice.
Dot
On my first day of volunteering at Mercy Fitzgerald Hospital in Darby, Pennsylvania, I
was naturally very nervous. After all, it was my first day at a steady placement, and I knew that I
would have to come back every week whether I liked it or not. Every week when I go to Mercy,
my “supervisor”, Debbie, gives me a list of the patients in the unit, their age, and their condition.
The first day she did this, the last patient she mentioned she said was very social. Her name was
Dorothy, and Debbie said that she would love to talk to me, and it would be perfect to visit her
because it would give the nurses a break. I had no idea what I was in for.
When I first met Dot, she thought I was Debbie’s son, so I was greeted with a hug and
kiss. When I told her who I really was, she was overjoyed with the fact that I was there just to
visit and talk with her. Honestly, Dot was exactly who I needed on my first day there. We sat
together for about an hour on that first visit, and she opened up right away. She told me about the
good and bad of her lifetime. Dot is in her mid 80s, and has the beginning stages of dementia and
bipolar 2, so she often goes off on tangents from the story she begins with, which of course is
okay. This was humorous because whenever she got off topic, Dot asked me to say “Bingo!” I
only ever really said bingo when she was talking about something I knew was important to her
that I know she wanted me to know about her. She talked a lot about how grateful she was for
her life every day, and grateful for her relationship with God. Dot knew she was lucky to have
had her husband, her kids, and to live such a long healthy life. It was very satisfying and
inspiring to see. People like that give you something to aspire for.
Something else that was amazing about her was how she treated everyone that entered
her room. Dot knew everyone by name, and greeted every visitor, whether it be a nurse,
chaplain, or janitor, as if they were a lifelong friend of hers that she hadn’t seen in a few years.
This was also inspiring. This woman was over 80 years old, and had been living with cancer
alone in her house for years. Yet Dot, at some point in her life, learned how precious other
people and her relationships with others were. She appreciated everything good, and everybody
who cared for her. Through watching her, and interacting with her every week, Dot taught me
that it doesn’t matter where we are in our lives, because we can always be kind to everyone, and
we can always make a new best friend. Dot was the social animal that Byock sees in all of us,
and I am starting to see it in everyone too. Dot transferred out of Mercy. I still try to call her new
facility periodically to check in and have a chat.
Steven
During one visit to Mercy, Debbie described my friend Steven as a young man with three
children who has had a rough year, and I think that was a good way of “putting it”. When I went
into talk with him, I introduced myself and he apologized because he couldn’t shake my hand.
Steven had extremely debilitating pain in his right shoulder to the point where he couldn’t use his
entire right arm. He seemed to be glad that I was there. We began talking about sports. He told
me he liked basketball more than football and about how his team was the Miami Heat. I wanted
to give him hell for that, but I figured I’d pick on him some other time. Then I was able to start
asking him about his condition. He told me he was diagnosed with cancer about 8 or so months

6. prior to our meeting. Steven and I talked about his pain, his arm, and his kids. He also told me
about how he felt scared and then depressed after his diagnosis. I was very happy that he was
able to open up to me. He is such a nice man, I hoped that his family was coming to visit when
they could, and he said they were.
The next time I saw Steven, he greeted me with a smile and a handshake. He told me I
looked familiar, and I reminded him who I was, and we were both excited that he could use his
arm again. It was nice that he associated my face with something he could smile about. We
picked up right where we left off talking about sports, yet after that week, there wasn’t much
talking anymore. Steven became unresponsive, and to date he has had probably one of the most
difficult and prolonged processes I have witnessed. On Thanksgiving, the nurse had me read him
scripture that his wife had requested for the holiday. That day I was present in the room when a
nurse was asking him a question; he tried to answer, but he wasn’t clear. Similarly to how I got
close to my dad’s face to tell him to lay down, I got close to Steven’s, asked him the question,
and got the answer for the nurse. Today I saw Steven, and he was barely hanging on. His body
has eaten away at nearly all of his fat, and now he is truly all bone. I sat with him a while and
took his hand. He was cold as ice. I thought to myself, why do I decide to build relationships
with people who are dying? It is important to have these relationships because, as I have said, it
gives our lives a meaning. I try to companion Steven’s inner essence, that same man who I
bonded and connected with because I know that he is in that body somewhere. He’s my friend,
and that’s what friends do.
Tom and Grace
I’d like to go back to the beginning of my experience this semester and talk about my
first companion, Tom. Tom is a perfect of example of someone who taught me how precious
relationships can be all around us. When I began volunteering with Main Line Health’s hospice
program in September, actually starting to go into the field and working with patients was
difficult because of scheduling conflicts. I had set aside Tuesday mornings out of my weekly
schedule to do my service, but by the nature of Main Line’s system, a patient or patient’s family
would have to specifically request a need for a volunteer on Tuesday mornings for me to go
which, of course, was rare. Thankfully Michele, my volunteer coordinator with Main Line, came
to understand my unique situation as a student. Needless to say when she offered me the
opportunity to go and companion Tom at Bryn Mawr Extended Care, I was very excited. After
reading his information before my first visit I learned that Tom was 92 and married to a woman
named Grace who often came to see him. This was it! My first hospice service experience, it was
going to be so exciting…and then I got there.
When I first met Tom and his wife Grace, it WAS exciting, as every first interaction with
a new companion is, yet my excitement died shortly after. Tom was an old man in a wheel chair
who had the beginning signs of dementia. He didn’t talk much, especially when his wife was
there. Grace did most of the talking for the both of them. She was a sharp, endearing, lovely
woman in her mid 80s who was still able to drive to see her husband almost every day. When
Grace was there with Tom and me, the visits was easy. Grace would ask me about myself and
Tom would just kind of sit there and doze off, but when she wasn’t there the conversations
between Tom and I were definitely forced on my part at first. Something that I didn’t initially
understand was volunteering in hospice is not exciting because of any of the physical work that
you are doing. Often times you don’t do much except sit with someone. This is why, in my first

7. few visits with Tom, my excitement wasn’t there yet, because I thought I would be doing a lot
more with him, or at least he would be more interested in doing things with me. Now I
understand that the excitement and fulfillment in working in hospice comes in the relationships
you are able to build with a person and their families. We build these relationships by sitting and
being present, listening, and being compassionate toward others, all of which, I learned, can be
exciting in their own way.
One day when I was sitting with Tom in his room, a psychiatrist from Jefferson came in
to evaluate him for depression. He asked a series of questions about Tom’s health, his family,
and his activity. I learned that these were some of the questions that I could also ask him; about
his family, about Grace. I must have asked Tom once a visit how he met Grace, and every time
he would tell me it was through another friend of his. He enjoyed talking about Grace, and he
enjoyed talking to me about the girls in my life. Tom liked being social, as Byock would predict.
That was one of the only times I believe he inquired about me. I would tell him about a girl I was
seeing who moved to Chicago and he would ask if I would still be with her. Again, we could
have the same conversations over and over because of his dementia. I didn’t mind, I liked talking
to him whenever he would talk to me. Another day I was there with him and I was able to get
him some milk and ice cream. He was impressed that I was able to get it so easily, I made a joke,
and he smiled very big for the first and really only time that I ever saw. I was glad we were
connecting.
On one of my most significant visits with Tom, his wife wanted to show me what she
called the “love birds” in the atrium at the facility. I wheeled Tom down the hall with his wife.
Now, something that I have yet to mention is that, while I knew him, Tom had very little control
left over his legs. This made pushing Tom in a wheel chair extremely difficult because he could
not keep his feet on the foot rests. When I was wheeling Tom down the hall, his feet kept sliding
off and we would have to stop pushing him. Grace would tell Tom to focus and to try harder to
put his feet up, but he just could not do it. This created tension and an argument between them.
When we got down to the atrium, Tom kind of just sat there and dozed, as he often did, but
Grace was enamored with the love birds. She explained how there were two birds in the atrium
that never left each other’s side. When one bird would fly away, the other would follow it shortly
after. From that point on I could easily associate the love birds with Grace and Tom. They were
together forever, and Grace, although she could not always take care of him, always wanted to be
at his side. This trip to the atrium showed me how romantic Grace was and I could only imagine
the amazing times they could have shared on their honeymoon, as they raised their children, and
how they grew old together.
Tom displayed how important his relationship was with his wife with me in a much
sadder way in our later visits. When I asked him how he was feeling, Tom would openly say he
was depressed and when I asked him what was wrong, it was always because his wife was not
there. He constantly wanted me to call her and asked me if I had her phone number all the time.
Tom would get confused at why Grace wasn’t there. When she did get there, he would always
ask her when she was coming back. It was clear as day how important and dependent Tom was
on Grace; even though he may not have necessarily been into the birds, he still loved his wife
with all his heart.
One morning before my service, I received an email from Michele that Tom had been
transferred to Lankenau. I responded by asking her the reason for the transfer, and continued to

8. Mercy. Later that day when I left, the response I received was that he was actively dying, but
Michele was originally incorrect. Tom was transferred to Bryn Mawr Hospital, not Lankenau,
which meant another 15 minutes down Lancaster Avenue. I drove to Bryn Mawr as fast as I
could, but there was a lot of traffic. When I got there, Tom’s hospital door was closed. I knocked
and saw Grace standing over Tom in tears. She told me that he had passed within the last five
minutes. I couldn’t believe it. I had seen Tom just 6 days earlier, and as quickly as that, his
health deteriorated. The last time I spoke with him, I promised to bring checkers for our next
visit. I came into the room, and Grace thanked me for coming. I gave her a hug and I shook
hands with his three children, whom I had never met before. She thanked me for my service with
her husband, and I told her what a pleasure it was to get to talk with them both. When I left the
hospital, I couldn’t believe how upset I was. My first long-lasting companion was dead.
In a way, the realization of how much I cared about Tom truly resonated with me. He was
a man who I probably spent no more than 15 hours with, but through our connections over life
and even women we had formed a meaningful relationship. We listened to each other. At times
we both showed interest in each other’s lives and each other’s well being. This is important
because I only spent a few hours a week with Tom, but there are so many people we spend
countless hours with every day, and I’m sure we barely know anything about them. Every
relationship has the potential to generate the same mutual caring that Tom and I shared. We do
have these bonds with our family and our close friends, but there is no reason the strength in the
relationships we have with some cannot be carried over to everyone else.
Sharon Browning said that the connections we have with others are, in some way
physiological, and that when someone close to us dies, the body’s response is as if that person is
ripped away from us. Although I, myself, was upset about Tom’s death, the thing that brought
me the greatest sadness was thinking about how Grace felt. She was with Tom for over 60 years;
they were love birds. The ripping feeling she must have felt, and continues to feel to this day
must be unimaginable.
One of the most popular selections from singer, Ben Folds, is titled “The Luckiest”. One
line in the song says “Next door, there's an old man who lived to his 90's and one day, passed
away in his sleep. And his wife, she stayed for a couple of days and passed away
I'm sorry, I know that's a strange way to tell you that I know we belong.”
. Now that her life-long companion has died, Grace’s passing will now become easier. I
consider that to be the last gift Tom gave to Grace. I also consider their relationship to be one of
the greatest examples of the ultimate human relationship that exists. While their relationship was
romantic, their companionship is something that every person can strive to have in their lives,
and that is the greatest gift that hospice has taught me. We all have the potential to be like Tom
and Grace, to be love birds, and to be lifelong companions with everyone we meet.