The Death Doula

The Monthly (Australia) - - CONTENTS - by Sarah Kras­nos­tein

The cof­fin is smaller than a sand­wich. An­nie Whit­locke, a Mel­bourne-based death doula in her 60s, plucks it out of the “Good­bye-box” she or­dered from a play ther­a­pist in the Nether­lands. Other con­tents in­clude hu­man fig­urines of var­i­ous sizes, miniature flow­ers, hearts, stars, a can­dle holder, an emo­tion dice with a dif­fer­ent fa­cial ex­pres­sion on each side and a mu­sic box. Ev­ery­thing is made from blond wood and hand­painted, spar­ingly, in gen­tle colours. The medium is the mes­sage; the toys’ frank util­ity re­flects a mind­set pro­foundly dif­fer­ent from the mod­ern An­glo-Aus­tralian psy­che. “I thought this was just per­fect,” Whit­locke ex­plains, turn­ing the crank on the mu­sic box to re­lease a sweet, but not sad, song into her cosily colour­ful liv­ing room alive with fruit and flow­ers, pets and art­work. “It’s for chil­dren to play. Mummy’s go­ing to stand here, dad or a friend is go­ing to stand here. We’re go­ing to put the flow­ers over there.” She kneads the emo­tion dice in her palm, con­sid­ers its dif­fer­ent sides. “So maybe they’re feel­ing sad right now, maybe they’re feel­ing a bit an­gry or, you know, maybe there’s some hap­pi­ness. In the cof­fin, we can put flow­ers, notes, it’s just beau­ti­ful.” Death doulas ful­fil a non-med­i­cal role, pro­vid­ing a range of be­spoke prac­ti­cal and emo­tional sup­port ser­vices to the dy­ing and those around them. In ad­di­tion to her pri­vate prac­tice, Whit­locke is a spir­i­tual/pas­toral carer at Monash Med­i­cal Cen­tre and the Peter MacCal­lum Can­cer Cen­tre in Moorab­bin. Her work in­volves train­ing other spir­i­tual care work­ers, and be­ing on call for Bud­dhist sup­port at end-of-life for sev­eral Mel­bourne hospi­tals. As well as pro­fes­sional train­ing, Whit­locke brings life ex­pe­ri­ence: childhood aban­don­ment; ill­ness and iso­la­tion; sin­gle mother­hood; mis­car­riage; di­vorce; a decade spent in sear­ing pain from un­di­ag­nosed en­dometrio­sis; deaths pro­longed and late; deaths too quick and early (a hus­band, a new­born grand­child and a new­born nephew). “I got into Ti­betan Bud­dhism be­cause it’s so con­fronting and chal­leng­ing and I love that,” she says. “Be­tween the ages of 20 and 28, I had to have sev­eral op­er­a­tions. I wanted to un­der­stand how I could come to terms with this pain, and I started putting it to Bud­dhism. They said, ‘Move closer to the pain.’ So I would prac­tise get­ting closer to the things that scare me so that they don’t re­main un­known and a threat but they be­come known and maybe a not-so-close friend. “There was this ar­ti­cle that I read about an Aus­tralian surfer. She said when you’re out deep and can feel the might­i­ness of the wa­ter and that wave be­gin­ning to form, your nat­u­ral in­cli­na­tion is to move away – but in surf­ing you lean into it. I could so re­late to that. And then I was read­ing this book; this young man was with a more

When faced with our mor­tal­ity, the sim­plest things be­come the most sig­nif­i­cant. Kind­ness. Pa­tience. Grate­ful­ness.

ex­pe­ri­enced worker, set­ting up tele­phone poles. The young guy said, ‘If that starts to lean, I’m run­ning so fast.’ And the old guy said, ‘No, you move in close to it be­cause then you know where it’s go­ing be­cause you’ve got your hands on it. When you’re run­ning away, you’ve got no idea where it’s go­ing to fall.’ “So I learnt to deal with dis­ap­point­ment, loss of ex­pec­ta­tions. I learnt to deal with men: doc­tors, sur­geons, spe­cial­ists triv­i­al­is­ing what I was say­ing, not lis­ten­ing to me. I had to learn hu­mil­ity and per­se­ver­ance. I had to learn not to mince my words.” This is part of the ser­vice she pro­vides to her clients. (“I try not to use the word ‘pa­tient’ be­cause it sort of sep­a­rates me from that per­son.”) “There was a woman with a neu­ro­log­i­cal dis­ease,” she re­calls, her res­cue dogs snooz­ing nearby. “I was with that fam­ily for months, got to know her hus­band and the chil­dren and grand­chil­dren. “The hos­pi­tal hadn’t said any­thing about an ad­vanced care di­rec­tive, so I ex­plained the sig­nif­i­cance of it. First, I said, ‘What are your val­ues? What are the things that are im­por­tant for you?’ She was quite ad­vanced in her dis­ease, and she said, ‘My fam­ily.’ She didn’t have a lot of needs, just wanted her fam­ily around for that con­nec­tion. “I said, ‘Do you have any idea of where you’d like to die?’ She said, ‘I want to die at home.’ “Her hus­band and chil­dren were there, and I said, ‘Does ev­ery­one un­der­stand that? Have you spo­ken to them?’ She said no. So I said, ‘Well then, this is the first thing we start work­ing on.’ “I would go with her to spe­cial­ist ap­point­ments. This woman was a peo­ple pleaser, al­ways wanted to say things that she thought the spe­cial­ist wanted to hear … [So] when the spe­cial­ist asked if she had any ques­tions, she said no. “I said, ‘Well, I do. I want to let you know that she wants to die at home.’ Straight away the neu­rol­o­gist says, ‘Well, that’s re­ally dif­fi­cult.’ “And I could feel my frus­tra­tion com­ing up, leaning to­wards a bit of anger,” Whit­locke says, pars­ing her feel­ings like in­gre­di­ents in a sauce. “This poor woman. So my role was com­ing up with op­tions and sug­ges­tions.” Even­tu­ally, with the woman’s GP, they im­ple­mented a plan for her to die at home. Rad­i­cal ac­cep­tance of un­cer­tainty and im­per­ma­nence is what one may ex­pect of a per­son who shares her home with a se­nior Ti­betan monk, who is cur­rently eat­ing his lunch out the back, and an enor­mous gold-painted Bud­dha. But Whit­locke’s focus is less on let­ting go and more on let­ting in – find­ing lan­guage for ev­ery­thing hid­den in the dark si­lence that so­ci­ety in­sists on drap­ing over the dy­ing and those left be­hind. Whit­locke fon­dles a lux­u­ri­antly thick wash­cloth. “You can wash the body, or just the face or hands, the feet,” she ex­plains. “As you’re wash­ing, talk about things. What did th­ese hands do when that per­son was alive? Th­ese feet? And the sto­ries start com­ing up and laugh­ter and tears.” The wash­ing does not have to be an act of re­mem­brance, but can be about at­ten­tive­ness and con­nec­tion: “Th­ese are things that can be done when your baby has died. Some ritual, some lit­tle cer­e­mony.” She holds up a wool bun­dle cinched with pink rib­bon: a pro­to­type of a baby car­rier she is try­ing to present to hospi­tals to help griev­ing par­ents con­nect with their dead ba­bies. “It’s soft. You can squeeze a bit. When a lit­tle baby has died and it’s just in that blan­ket, it’s so frag­ile, you don’t want to hug it.” Cradling the bun­dle, she con­tin­ues. “That child can then come home, and the other chil­dren can hold it, or the ex­tended fam­ily, be­cause ev­ery­one is touched by that.” Af­ter the death of Whit­locke’s new­born grand­child, her son found that peo­ple sim­ply did not know what to say. The si­lence ex­ac­er­bated the grief. “We’re not told about how to re­spond to a sit­u­a­tion like that,” she ex­plains. And we don’t nec­es­sar­ily do it any bet­ter at the other end of the age spec­trum. Whit­locke cared for an aunty in her 70s. Stage IV pan­cre­atic can­cer. “Mum said, ‘Don’t talk about all your death stuff with Betsy, we don’t want to up­set her.’ So I went in and Betsy’s in a lot of pain. I said, ‘How you go­ing?’ and she said, ‘Good, I’m fine.’ “I said, ‘So what do you know about your sit­u­a­tion?’ She said, ‘I know that I’m dy­ing.’ I said, ‘Do you want to talk about it?’ And she said, ‘I do want to talk about it but peo­ple won’t let me. They keep say­ing, ‘You’ll get bet­ter.’” Like all so­cialised si­lences, the one around death breeds dis­con­nec­tion. But chat with death doulas long enough and di­vid­ing lines dis­ap­pear. So if dy­ing well is just part of liv­ing well, then what, re­ally, is our fear of death ac­tu­ally about? “I asked Betsy, ‘What do you want to tell ev­ery­one?’ And she just said, ‘I want ev­ery­one to be kind to each other.’ This is one of the things I’ve learnt: When faced with our mor­tal­ity, the sim­plest things be­come the most sig­nif­i­cant. Kind­ness. Pa­tience. Grate­ful­ness. And that doozy of all things: for­give­ness. I never use the word ‘love’ be­cause there are bet­ter words to de­scribe what that per­son is try­ing to say. “Betsy felt as a mother that she was a fail­ure, that in her life she’d been a fail­ure. That she could have done things bet­ter. Her chil­dren had got to­gether this box of her mem­o­ra­bilia, and I started pulling out things that she to­tally for­got about: the vic­to­ries that she’d had in her life that she had to­tally triv­i­alised, be­cause the neg­a­tive things were just tak­ing over her at­ten­tion. Which is quite com­mon, isn’t it?”

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