Death Doula Initiation

My initiation into the realm of end-of-life care presented itself unexpectedly when my grandfather was dying. I showed up largely unprepared for what I was entering into, which is the case for all doula work, truly. We don’t know exactly what will be asked of us or how we’ll support ahead of time. My grandmother was exhausted and happily handed over his care to me so she could sleep. This would be my first time sitting vigil through someone’s death. I stepped in and stepped up, having had no real preparation—no studies, no training, and barely any frame of reference. Heart in hand, I began my work.

My grandfather, curled in a fetal position, was already in his deep final sleep. He was verbally uncommunicative. His feeble state and arrhythmic inhalations begged the questions: How are you still alive? And: For what reason(s)?

I sat by his side in that quiet house, reading a book that was coincidentally perfect for calming my nerves. It happened to contain his favorite prayer, “Make Me an Instrument of your Peace,” which spoke volumes to me about what it means to be “of service.” I communicated with my grandfather on a spiritual level with comforting words. He slept, didn’t move, and rarely breathed. I was sure he was working, though. It seemed like hard work. Mysterious work. He was working through something… working on something… working toward something. I encouraged his efforts and held him in peace and love.

For his wife and three children (one of whom hadn’t been able to visit for the previous week or so because it was too upsetting, and the others who waited until the final breaths to enter the room), it was excruciating to get through this period as it continued on, much the same, the next morning. I took notice of their discomfort, but didn’t share their sentiment. Because of my birth work, I felt comfortable with the unknown, intrigued by it, an eager student of it. This is what death asks of doulas: Can we settle into this liminal space?

We seem to afford birth more ups and downs than death while still calling it “beautiful.” Yet, birth is really hard work (“labor”). It beckons all of a woman’s strength and resolve. We puke, have diarrhea, experience flashbacks of abuse and trauma, scream, beg for it to end, moan like animals, bite on things, and cry. Not always, not all of it, not for everyone every time, but these responses are normal aspects of the process, and yet birth is still “beautiful.” And it is.

Can death be beautiful, too? Can we hold steady through the twists and turns? Can we support with compassion? Can we doula? I think we can. Not without apprehension or doubt. That isn’t reasonable. We can with trust—trust in one another, trust in our inner wisdom and benevolent intentions, and trust in death itself. We can, with the unwavering, prevailing courage of the doula heart.

(Adapted from: Cultivating the Doula Heart: Essentials of Compassionate Care)

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