Yet the work seems so crucial. Hospice workers often talk about the mistreatment of the dying, by which they mean not cruelty but the natural human tendency to shun death, to avoid the dying and retreat from even thoughts or discussions about it.
Hospice families tell me all the time about the pain of having friends stop calling or visiting, of seeing them turn away from them at the supermarket, simply flee in the face of death's awesome finality.
So we leave them, often quite alone, to their fates, to the struggles with our health care system, to a culture too busy and distracted—or uncomfortable—to pay much attention.
The last thing these people need is some well-meaning volunteer who attempts to cheer them up, offer suggestions on how to die, or tell them how to grieve. All we can do is provide some companionship and comfort along the way. It's a humbling mission.
To bring a dog into these homes seemed an even greater challenge. Patients are often in emotional or physical distress, hooked up to oxygen or IVs, and taking potent medications. Lots of dogs do therapy work, but hospice requires something a dog really can't be trained to do—figure out for himself how to be loving, appropriate, and sensitive to the dying.
To be a hospice dog, Izzy had to be tested by a vet, who issued a certificate attesting to his temperament. I did considerable calming training, praising him for being calm, practicing moving around furniture and other obstacles. We tried him out in several strangers' homes and in a nursing home with a PA system and lots of medical equipment around. And, of course, he attended all our training sessions, where nurses and social workers were watching him carefully.
But the truth was, I had no clear idea how to prepare Izzy. His own instincts and personality, I thought, would prove more critical than any training in determining whether he could do this work. All I could do was bring him along, into patients' homes and lives, and see what he could offer.
All through the spring and summer, we trekked to Fort Edward, with a sandwich and fruit in a paper bag for me and a few biscuits for Izzy. Keith kept a water bowl in the annex kitchen for him. The volunteers were an extraordinarily generous group of people who seemed quite willing to accept us both, and Izzy was happy to see each of them at every session.
I was daunted at first, by the detailed thoroughness of the training, though I would soon enough be grateful for it. We practiced what to say, what to look for, how to listen. We learned to fill out forms and reports. There was a long list of things to avoid saying—like "Buck up! You'll be OK!" The sessions were wearying, but also gratifying. By the time they concluded, I felt ready.
I can't say I know for certain why I wanted to sign up. Perhaps weathering middle age makes one more aware of death, more thoughtful about it. Perhaps, as my work life intensified, I wanted to make sure I had a grounding, a meaningful commitment to help me see life in perspective, to keep my spiritual self alive. Maybe I wanted see if there was a way to share this work with a dog. Maybe all of the above.
While we were learning, it was hard to avoid the sense that Keith and the social workers were watching us pretty carefully. Whatever our reasons for coming, we volunteers had to talk about them. Stan had just lost his dad. Rita had lost her husband a few years earlier, down South. Donna, it emerged—slowly—had also lost someone, though she hadn't said whom.
On the surface, direct experience with grief would seem a perfect qualification for hospice volunteers, but the staff pointed out that it could also be a problem. We had to set our own losses aside, not add to the sorrow the patients and their loved ones already felt.
Donna and I were paired for role-playing during the second week of training. She was a kindly woman, quietly but deeply religious, and eager to help others. "What better way," she asked, "than to help people leave the world comfortably, with dignity?"
In this exercise, one of us played the volunteer; the other pretended to be a person who had lost someone dear. I drew the volunteer role, which meant my job was to listen, to affirm the feelings I was hearing, not challenge them or add my own or try to change anyone's mind.
Donna, playing the family member, sat opposite me and said she had a sick child, a son dying of leukemia. It was horrible, she said softly, to watch her son suffer, wither, and fade. "I'm not doing enough," she lamented. "I feel like I'm not doing enough, no matter what I do."
It was useful practice because under normal circumstances I surely would have reassured her, told her that of course she was doing enough, and urged her not to be so tough on herself. This "character" was, after all, sitting by her son's bedside almost around the clock, reading stories to him, administering medications, making him as comfortable as possible. What more could she possibly do?
"How long have you felt this way, that you're not doing enough?" I asked—a neutral question, meant to allow her to communicate but not to talk her out of what she was feeling or dismiss it by suggesting it wasn't really true.
She told me more about her son and his diagnosis, his weakness and decline, about the fact that he might die at any moment while she was right there watching, and how helpless she felt to prevent it.
As she spoke, Donna's eyes welled and her face contorted with grief. I was surprised to see Izzy appear out of nowhere, put his head on her knee, and stare up into her eyes.
Suddenly, I saw what he, perhaps, saw. I understood that Donna was no longer playing a role; she had lived this. She wasn't simply a volunteer portraying a stricken mother. We had moved into the realm of real loss.
I don't know what dogs can see or sense, but I know they can discern things that I can't. Rose sees things invisible to me when she is working with sheep. Izzy had some sort of insight about people.
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