The Caring Approach of Death

By DUDDING, Adam

Mary Death’s job is to ease the pain and brighten the days of patients at Marlborough Hospice. She talks to Adam Dudding about the lessons of a life full of death. ——————–

REACTIONS TO her name? Mary Death’s favourite was the guy she met in a lift in a San Diego cancer ward, who did a double take after seeing the nurse’s name badge.

“He said, ‘Oh Gawd – is that your name? If I had a name like that I would change it.’

“‘What would you change it to?’ I said.

“‘Susan. I’ve never liked Mary.”‘

These days the jokes are usually made by Death’s patients – the men and women, young and old, who have come to the Marlborough Community Hospice in Blenheim in the end stages of cancer or renal failure or heart failure or emphysema.

“They’ll say, ‘Oh, I don’t think I’ll have you look after me today; can you wait a couple of months?’ kind of thing. There’s always a bit of humour.”

Death is the clinical nurse manager at the hospice, leader of a 26-strong nursing team that provides end-of-life care for around 60 outpatients and four inpatients in a cosy, art-filled building that feels more like a motel than an institution. Two days a week she shuffles managerial paper; three days she is just another one of the nurses.

A warm, no-nonsense 57-year-old, she is talking to the Sunday Star- Times because of the Hospice Appeal, which starts tomorrow. Government funding covers only 55% of the $60 million cost of running the 32 hospices in New Zealand, so they rely heavily on about 6000 volunteers and regular fundraising to deliver free services in hospices and in the community to 11,000 people a year.

Hospice patients receive the clinical attention they might in a hospital, especially pain relief, but it is in her creative attempts to put some life into the last days of her patients that Death has made her mark in Blenheim since she arrived in 2006.

One woman told Death her husband played her the piano accordion every night before they went to bed.

“I rang him,” says Death, “and said ‘So, you play the piano accordion . . .’ “

The musician was persuaded to bring his instrument in. “He went from room to room and played it. When he got to her she was in the bath, and we’ve got this beautiful photo of his wife in the bath, with him playing the piano accordion.”

Another time, Death arranged for a local chef to cook a meal for a young mother of three whose family were under strain as she got sicker and sicker. “People went home and got candles and lace tablecloths and candelabra. The husband walked her down the hall and we had a little sideroom set up with lanterns outside. (The chef) served the husband a full meal and he served her little tastes on little spoons.”

After she died, the woman was left in her room, and the children came the next day.

“They touched her, and we got some perfume and put some perfume on her; they got some handcream and put handcream on her. We packed her stuff up and the little girl put one of her cardies on and the two boys were fighting over who was having the iPod. It’s so fabulous to be able to do that; in the hospital they don’t have the room or the time.”

Sometimes making a difference is simpler. “I asked one patient, if I could get you just one thing what would it be? And he said a lemonade iceblock. His whole life had reduced down to a lemonade iceblock.”

A LOT HAS been written on what makes a hospice nurse, says Death, “and the literature will say that 90% of them have had some sort of significant loss in their life”. Certainly, there has been loss in hers.

Born Mary Hunt in Tawa in 1950, Death always knew she wanted to be a nurse, but life got in the way. She married the man she had first met at 16 (“half of the attraction was, imagine going out with someone called Don Death”) and they had three sons (she also had a daughter from another relationship).

In 1978 the family moved to Australia. Four days after they arrived the middle boy, Myles, nearly three, chased a ball in front of a car and was killed.

When the family moved to the US four years later, Death volunteered at a San Diego hospice – and loved it. She also did some basic nurse training. She didn’t realise it then, but knows now it was a response to Myles’ death.

There was more grief to come. In 1986 her youngest son was left in a coma after a similar accident. “Byron grew up knowing how his brother had died. But he was a typical nine-year- old boy on the way to the video shop. Saw a green light, thought it was his and just ran out . . .

“A few people did say, well, could it be something to do with your name? Well, hello! I just wished that I’d taught them their road safety better. Two of them.”

Byron was in a coma for nine months and, though left with permanent brain damage, he recovered significantly (now 30, he lives with a carer). Mary and Don’s marriage, however, didn’t survive the strain. Divorced, Mary returned to New Zealand. Her trials were not quite over.

“I came back with these two kids, and my mother and my brother and my father all died within six months. I was starting to think hell, how much more can happen?”

In Wellington, she finally began at 40 the nurse training she had been wanting to do all her life. A student placement at the Mary Potter hospice confirmed her desire to work with the dying and, two years after qualifying, she joined the staff there and stayed nine years.

Not all hospice nurses have experienced tragedy, says Death, but it is common. “You probably go there originally to sort your own grief out, if you’re totally honest.”

Mary Potter was open to creating experiences for patients beyond their clinical needs and Death brought that approach to Blenheim. “Most hospices have someone who’s like that – the person who will push it outside the square a little.”

But surely a place for the dying isn’t all aromatherapy and gourmet meals and beautiful memories?

Sure, it can be grim at times, says Death. “To see a mother gradually pulling away from her kids because she knows she’s going to be going – that’s gut-wrenching.” There are the patients who say, “I’ve had enough, just give me something”. That can be hard too, says Death, but if you can relieve their stress, life often doesn’t seem quite so bad. She would hate to see euthanasia legalised.

And yet, “we can’t always get on top of someone’s pain, no matter how we try. Sometimes people die in anguish, be it spiritual anguish or emotional anguish, and we can’t always fix that. Death can be smelly and ugly and horrible, too. The destruction of human tissue and rotting things – it can be disgusting. Disgusting for them and disgusting for nurses as well.

“But the balance is that if you can do one thing to make that person smell better, feel better, look better.”

Hospice work is “sad, but it’s not depressing”, says Death. Still, all that grief can take a toll. She took two years away from it before going to Blenheim, nannying for a wealthy Auckland family. “I think to be a healthy palliative care nurse you need to get out every once in a while.”

She takes advantage of the monthly counselling session offered to staff, but she also has her own way of “moving on”: she writes poems about interactions with patients, often showing the result to them, or to relatives later.

Working with the dying helps you grab every moment in your own life, says Death. “We have people in who’ve saved every penny and are going on this huge trip and they’re in the hospice and they don’t spend a damn penny of it. I will die broke, but I will have done all the things I want to do.”

And she will keep looking for ways to help others achieve the things they want to do. One of her poems (above) is about electrical engineer Frederick Langdale, who died of lung cancer in February, aged 88.

Langdale’s wife Gwenyth told the Star-Times about the treat Mary Death arranged for Fred in his last days: “She said, if you could have your last meal, what would it be? And she said he never hesitated. He said straight off it would be Chatham Island blue cod; we always used to get that when we were younger. And he said Bluff oysters and New Caledonian crab.

“They gave him this blue cod and they poached it, and he was allowed to chew and chew and chew till he got the flavour all in his mouth, and then he had to spit it out, because he couldn’t swallow.”

When Fred told Gwenyth about it later that day she didn’t believe him at first. “He said you’ll never guess what I had for lunch – I had blue cod. Chatham Island blue cod.”

* For details of Hospice Appeal Week see www.hospice.org.nz.

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(c) 2008 Sunday Star – Times; Wellington, New Zealand. Provided by ProQuest Information and Learning. All rights Reserved.