Introduction

Story has always been a means of learning lessons and, from fairy tales to the Bible, young and old have been able to absorb messages through the use of both the analytical left brain and the imaginative right brain. Palliative care has been called the science of the anecdote, and through sharing these stories I hope readers interested in palliative care, as well as the community at large, will benefit in whatever way is appropriate for them. Some may say after reading these stories that they would have acted differently in the past; some may see events in a new light. Whatever the reaction, I hope the stories will prove to be useful as we all struggle to make sense of our complex existence. The names and circumstances of the people involved have been changed as my intention is to protect those who may choose to see things differently through the lens of memory.

These stories represent my personal reflections and the lessons I have learned from them. They reveal my character and personal journey, for I believe we take ourselves, warts and all, to our work. We cannot give away what we do not have. Therefore, if I am full of doubts and fears, those are probably what I will project. Health professionals frequently project their personal fear of death onto those in their care, just as people with problems of unresolved grief frequently react to their projections.

My Father's Death

When I worked at Mary Potter Hospice in the early years of my palliative care work, I had the desire to assist the nuns with funds to buy more preventative equipment when it came to skin care. Years later, I realized during a course of hypnotherapy that I had not dealt with my own father's death some eighteen years earlier. When my father became a quadriplegic through suffering a spinal injury, I was expecting the birth of my first child, a son, in England, and I was not permitted to fly home. Before my father died a year later, he had developed a bad bedsore and I remember my mother writing to say that she was buying him a sheepskin for protection. I felt very frustrated at not being useful and supportive to my mother. Shortly after his death, my daughter was born in Rochester, New York, where my husband was a postgraduate student. On returning to Australia, I had two more children in a short space of time, and with four young children, and being in a new city, my time was filled for the next few years.

My grief and unresolved emotions surrounding the memory of my father were put on hold. Still on hold, they sought to surface with the image of a dying man with a bedsore at Mary Potter Hospice. Sometimes I think hospice workers are wounded healers struggling with their own insecurities and lack of sound belief systems. Certainly, many admit to the pain of some loss and how the direction of their lives turned to work in this area following an experience of loss and grief. So, for the stories and the insight I have gained into my own and others' emotions, I thank the many people who have been kind enough to share with me the intimacy surrounding an important life event.

My Early Nursing Years

When I was a student nurse in the late 1950s, death was a mysterious and fearful event to be avoided at all cost. Dying patients were given frequent sips of water in the hope of keeping them alive until the next shift of nurses arrived. When death did occur, there was a dread on the part of the nurses of having to "lay the person out." This procedure involved a gown and a mask and a lot of cotton wool to pack orifices with the use of forceps. Strips of old linen were used to tie around the head to keep the jaw closed before the body was dispatched, via a wardsman and special trolley and as quickly and quietly as possible, to the hospital morgue. Death was somehow dirty and something that one didn't get too close to. A phone call was made to the relatives who were generally kept at arms' length and not encouraged to stay beside the dying person. They were not considered an integral part of the care as they now are since the modern hospice movement began in 1967 when Dame Cicely Saunders opened St. Christopher's Hospice in London.

After completing my nursing training at the Princess Alexandra Hospital in Brisbane, I travelled to Canada and worked in an orthopedic ward. I have no recollection of death ever occurring in what seemed to be an exciting new world. Following my Canadian experience I traveled to Edinburgh, Scotland, for midwifery training at the Simpson Memorial Maternity Hospital and experienced the joys and wonders of the birth of new life. The memory of the first birth I attended is still with me as I recall the proud young mother with her newly delivered baby talking to her husband on the bedside phone. I can now see similarities in the experience of a "good birth" and the experience of a "good death." Both are charged with emotion and signify a life change, which will not only entail long and sometimes arduous struggles but also bring rewards.

My career took me to London, where I worked as a private nurse and experienced death again. I was sent by a private nursing agency to nurse a fifty-year-old woman who was dying of breast cancer. This woman was being cared for at home by her only daughter who was in her mid-twenties, which was my age at the time. It was an experience now etched in my mind by its awfulness. I was instructed not to mention the word "cancer" and to express only hope for recovery and confidence in the doctor. Medications were not named or monitored; they were just given in blind faith because the doctor prescribed them. The tension of keeping up this pretense and not knowing what to say of comfort to the daughter and mother who were being parted was great. When the mother did die, the daughter was lost, as her mother had not been allowed to help her with practical instructions for a future without her. My heart went out to...