DENVER—I was lost, searching for Helen Simon, walking through a maze of corridors in a skilled nursing community—the current term for the dreaded words, “nursing home.” I passed a dining area with no one eating. A grand piano with no one playing. Seeing an attendant, I asked, “Where can I find suite M-2—Helen Simon?” *

“She’s not in her room,” the attendant said, pointing to an alcove with a large TV and a woman in a wheelchair parked in front. “That’s her,” she said.

I dropped to my knees beside the wheelchair. “Hello, I’m Sara, I’m a doula, and your son asked me to visit you.” Her son had told me Helen has advancing Alzheimer’s and communicates mostly through facial expressions. “I heard that you love books, and your favorite author is Willa Cather?” Helen looked me in the eye, but did not respond.

Cather on Time cover, 1931

“She’s one of my favorite authors too,” I said. “Would you like me to read you one of her books?” She kept looking in my eyes, so I pulled up a chair and started reading Death Comes for the Archbishop. As I pronounced the title, I wondered if I’d picked the wrong book.

This was my first experience as an end-of-life doula, something I’d never in my wildest imagination thought I’d be.

Doula, a Greek word, is the professional title for a woman who supports a new mother through childbirth and learning to care for her baby. More recently, it’s become a title for a person who supports someone going through the dying process.

I’ve never been caregiver. My lifelong calling has been writing—stories that inform, inspire, or amuse—and I’ve had to safeguard the time and energy needed to do that. I never understood the pull people felt to what seemed more altruistic professions—nursing, counseling, social work. Last winter, though, after losing a friend, someone whose absence left a hollow in my life, I found myself in a state of angst. Darkness was visible. Omens were everywhere: the end was increasingly nigh.

During this time, I received an email from Tarron Estes, founder of the Conscious Dying Institute, inviting me to take a three-month training to become a certified end-of-life doula.

Kurt Vonnegut wrote, “Peculiar travel suggestions are dancing lessons from God.” I thought the same might apply to peculiar email invitations. I had no interest in a career as a doula, but I sensed that this was an opportunity to face my fears, to immerse myself in the practical reality of dying.

The course began with a three-day seminar, then a three-month break, during which we were told to imagine this was our last three months to live. We were to make it the “best three months,” and prepare for the way we wanted to die.

Most people, when surveyed, say they want to die at home, not in a hospital, but only a small percentage actually do. It takes foresight and effort. Working with a partner, we did research on issues like how to rent a hospital bed and how to find affordable home care. We made lists of music we wanted played and poems, literature and sacred texts we wanted read to us. We also made lists of what was important to do in our last three months, then set dates to do those things and held each other accountable. (We did most of them)

The course ended with a four-day intensive, during which, to my surprise, the fear I’d been nursing was transformed into a knowing that love doesn’t die, love goes on. I could actually envision a peaceful ending, surrounded by love, in a state of acceptance.

I knew that in years ahead, friends and relatives would be dying, and I wanted to be a companion, walk with them, not for pay but from love. I put out the word that I was available, and a friend of a friend in Boston called and asked if I would help his mother, Helen, who was in a care home in Denver. The man had a demanding job and teenage kids, so he could only make short visits to be with his mother. I said I would visit Helen soon.

As I sat beside her wheelchair, I related the prologue to Cather’s novel, which I’d read in advance to make sure it was compelling. I acted out the prologue, using a dramatic voice and big gestures, to hold her attention.

“It’s 1851,” I said, “and a young priest, Jean Latour, is lost in the New Mexico territory. He’s riding a horse and has a pack mule…” I mimed riding a horse. “…and he’s about to die of thirst.

Opening scene from Cather’s book

There’s nothing around him but scrubby red hills and juniper trees.” I made the shape of a tree with my arms. “All the red hills look the same. He can’t see a trail, can’t tell what direction he’s heading, and thinks he may be riding in circles.” Helen gave a snort. Was she drifting off?

“They’ve had nothing to eat or drink for two days. The animals are about to collapse…” I imitated a horse collapsing. “When suddenly, the priest feels the horse come alive beneath him, raising its neck and sniffing the air.”

Helen’s eyes opened. I wondered how much she was hearing, let alone understanding.

“The priest gives rein to the horse, hoping he smells water and can find it,” I said. “After an hour, they come to a rise in the desert and below them, there’s a big river…” With my arm I traced the course of a flowing stream. Her eyes followed my arm. “There’re trees and grass, and an adobe house. A young girl runs out to welcome the priest, who can’t believe his eyes,” I said. “The people living there bring him water and lead the animals to drink. They serve the priest a fine dinner and give him a feather bed to sleep in. Lying in that bed, after preparing himself to die, he wonders at the miracle that’s happened. He knows, now, that he’s meant to do his work in the new world.” I stretched my arms. “Is that interesting?”

Helen made some sounds I couldn’t understand. Then slowly, she said, “In life…. anything you try…. you take a risk.”

I was startled at her comprehension. “I bet you took risks in your life?”

She stared in my eyes. “I sure did.” She sighed. “I want to go… bed. I’m tired… Are you?” She repeated the word “tired” several times. I went looking for someone to help her back to bed.

In a separate room, I saw a staff member, Joan,* working with a group of women and one man circled in their wheelchairs. I told Joan what just happened with Helen, and that she wants to go to bed. “Not only did she grasp the core of the story, she commented on it.”

“Sounds like a great book,” Joan said. “But… that’s not Helen.”

What?

“That’s Ruth. Helen is in her room.”

I’d just spent an hour reading to the wrong woman?

Joan led me to a room at the end of a different corridor. “This is Helen.” She looked more like what I’d expected, with a crown of loose white hair, lying in bed on her back with her eyes closed. Her arms rested on top of the sheet, and one was waving about slowly. “You can talk to her,” Joan said.

I pulled up a chair next to the bed and told her I was a doula. One blue eye opened, the other stayed shut. I put my hand on her arm, stroked it gently, and took her hand. She gripped it with her own, squeezing tight.

Just sitting there, the minutes passed in a comfortable, companionable silence. Her hand relaxed, but kept holding mine. When I rose to go, I had to unfasten the two. I said goodbye, promising to come again, and walked off, feeling peaceful and, interestingly, fulfilled.

Later, I remembered what Bebe Moore Campbell, the gifted, best-selling African-American writer, had told me when I interviewed her while I was writing Leap!  She had a family member who was mentally ill, and, finding there were no mental health facilities in the black neighborhood where she lived, was working to raise awareness, eliminate the stigma of mental illness, and bring help to the community.

“We’ve been stars,” Bebe said. “Now it’s our turn to serve.”

At the time, that didn’t seem to apply to me. Now… it resonates.

* name changed for privacy

Please leave a comment. Have you thought about where and how you’d like your ending to be?