Journal of a Death Doula - January 2025

Susan

January 14, 2025

“This is Carey.  Your hospice care team asked me to contact you.  I’m an end-of-life doula.”

Silence.  Aching silence.

“I’m sure this is a difficult call to receive, but if you requested a doula, I would love to help.”

An introductory call from a death doula is not a call any of us wants to receive.  It signifies heartache and grief and (sometimes) comes at a time of great chaos as families gather around their beloved to pay final respects and sit vigil as they watch them slip away. It’s too painful to think about tomorrow, let alone the details that need to be tied up when a loved one dies.  No one knows how to die.  It’s not something we practice, thankfully.

On Friday, I received a call that a young woman in her early 30s (we’ll call her Susan to protect her identity) was actively dying and that her family requested a doula.  The initial call was with Susan’s sister, and she had a list of questions to ask me, prefacing with, “I had to write everything down because I don’t know what to do.”  Her voice was sad and desperate, even curious. She learned about me, an end-of-life doula, from her hospice care team.

“I’ve never done this before,” she said.  “How can you help?”  As I gave an overview of how I could help, we made an appointment for the next morning, Saturday. I would drive to Susan’s home and sit with her and the family to offer support and to ensure that Susan was comfortable and transitioning according to her wishes.  I grabbed my doula kit: sugar-free Jolly Ranchers, cotton swabs, a prayer book, a blank journal, a couple of bottles of water, mints, hand cream, and my Barbara Karnes RN book, Gone From My Sight - The Dying Experience.   These are the essentials.

At approximately 9:30 PM on Friday, my phone rang. “Please, can you come now?  I think my sister is dying right now.” Hearing this through sobs and tears, I could also hear significant background noise.  “Have you called the hospice nurse?” I asked.  “No, I called 911.  The ambulance is here, and they are taking her away.  I don’t know what to do.” As a doula, I am on call to assist the family when their beloved is transitioning. In this instance, the patient died and was no longer at home.  “If your sister has gone to the hospital, there’s not a lot I can do for her now, but there’s a lot I can do for you and your family.  I will still come in the morning.”  Affirmative.

Arriving on Saturday morning, the house was full of silence, silence so loud it hurt my ears.  Some were just waking up after a long night of sorrow and disbelief, and some were wide awake, forfeiting sleep for grief, alone in their thoughts and reflections on Susan. I introduced myself to the rest of the family, including Susan’s mother, who had only just days ago arrived from her home country, thousands of miles away.  She looked completely defeated, and I was immediately drawn to her. “May I hold your hand?” I asked her.  Not my usual greeting, but out it came involuntarily.  She nodded, stretched her warm hand out to mine, and squeezed it with strength only a mother can muster for her child. “I am so very sorry about your daughter,” I said.  “But I’m so glad you made it in time to be with her and for her to know you were here.”  She did not let go of my hand.

The young woman I’d spoken to on the phone the night before came over and introduced herself, as did the rest of the family, one by one.  They spoke to one another comfortably in a language I did not know, sizing me up, smiling, crying, and looking to me for guidance on what was to be done next.  The mother continued to grip my hand firmly.  I felt the warmth of her hand in mine and was reminded how comforting the human touch can be. She didn’t know it, but she was comforting me every bit as much as I was comforting her.  After many minutes, the room grew quiet, and we began talking about this wonderful young woman whose life had ended too soon.  Heartwarming stories were shared in a tapestry of language and emotions. There were moments of riotous laughter and many smiles as they regaled stories of Susan. She was amazing in her kindness, generosity, and ambition. 

Without fanfare, friends began streaming silently through the front door, removing their shoes and pulling, as if by a magnet, to Susan’s mother with respect and compassion. There was so much love in the room I thought I’d burst. 

I visited with the family for several hours, mostly listening and learning. I made notes on what I learned about Susan. After a while, her sister and I pared off to a quiet corner of the kitchen, and we began writing a list of all the details needing attention—notify Susan’s employer, contact a funeral home, write the obituary, contact her credit card companies and banks…the list is long and growing, so many details in need of attention. With Susan’s religious background, some special considerations and accommodations needed to be made. 

I was able to write a draft obituary that night, which the family accepted without edits, something I was so happy to contribute.  On Monday morning, I contacted Susan’s employer and got the wheels in motion on Susan’s life insurance and other benefits and administrative matters that needed attention.  The family was scheduled to meet with the funeral home on Tuesday morning, at which time I jumped back in to work with them (at their request) on Susan’s celebration of life. 

Being an end-of-life doula, no two situations are alike.  My role is to be flexible, accommodating, organized, respectful, and open – open to listening, open to grief, and open to the unique and loving ways families choose to celebrate their departed.  People frequently ask me if what I do is depressing or “a downer.”  No. It’s not.  It’s heavy, yes. My work as an end-of-life doula is a ministry of presence.  It’s an incredible honor to be in the presence of families who share and express infinite love. Being an end-of-life doula is an ongoing, heartwarming, and profound education about humanity.

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