With a bonfire blazing in late afternoon sunlight behind them, eight women gathered to celebrate the summer solstice. These women have special reason to celebrate the passing of spring into summer and the new cycle of life it brings — they run Hospice of Martha’s Vineyard.
On Tuesday afternoon, the women gathered at the Edgartown home and farmstead of Linda DeWitt, who works as a nurse at Hospice. Led by executive director Terre Young, the gathering was intended not only to mark the longest day of the year, but to recognize quietly among themselves the work they do each day.
An additional cause for celebration is the 30th anniversary of Hospice of Martha’s Vineyard this year. Hospice will mark the event with a June Jubilee for Art event this weekend at Featherstone Center for the Arts, which is also observing its 15th anniversary.
Hospice currently has 44 patients, 36 of them bereavement patients. The organization which is completely free to its patients and unfettered by insurance regulations, employs a staff of 10 (nurses, administrators, bereavement counselors, and a doctor) on a budget of around $350,000.
Most of the budget comes directly from fund-raising:; the rest comes from small grants and income on an endowment started 12 years ago.
On Tuesday afternoon each of the women spoke of their unique understanding of the end of life and their ability and desire to pass that along to their patients and families. Throughout the seasonal celebration, they spoke of the varied life experiences that enable them to speak sensitively and sensibly about death. While this willingness to confront the idea might seem exceptionally courageous to some, for these women it is simply about being in touch with the wisdom of the ages.
“Part of that wisdom is that we are comfortable with the cycle of life, which is not typical in this culture. We help people get comfortable with the idea that life is finite, and all of that is influenced by your life experience,” said Judy Hickey, a Hospice nurse.
“Hospice is still one of the areas of medicine that tries to understand the patient as a person. Medicine is so specialized now that the patient just gets parceled down into those specialties,” said Trudy Carter, a bereavement counselor.
Most often, Hospice gives people the opportunity to be at home, to spend time with their families and to choose how to live their remaining days. “We see the patients in the context of family and place, and we’re able to tailor-make the treatment to the needs of the family. We don’t have to see 27 patients a day for five minutes at a time,” said Colleen Seadale, a clinical social worker and bereavement counselor. “We’re there to help, but they’re in charge, they’re creating their plan — we advocate for them with their doctors, and we work with them to create the best plan,” she said.
Because it operates free from the constraints of insurance regulations, the Vineyard Hospice has no six-month prognosis requirement, no specific diagnosis necessary for admittance. Hospice of Martha’s Vineyard can take care of anyone the minute they begin to show signs of a life-limiting condition.
A second organization, Island Hospice, which does take insurance, began operating here through the Vineyard Nursing Association two years ago. While there has been some confusion between the two organizations, the women said this week they are optimistic that things will sort themselves out. “It takes a generation to really understand — it takes awhile to sift and sort how you work together within the medical profession,” said Ms. Carter.
The backbone of the Vineyard Hospice organization is its volunteers — angels, they are called. They schedule weekly visits with their patients, doing everything from taking them shopping to replying to their mail.
Hospice currently has 32 patient-care volunteers, and one volunteer bereavement counselor. “They establish a relationship with the whole family, and they understand what’s happening,” said Mrs. Young. “It’s nice that the volunteers can already have built a rapport by the time of the six-month prognosis,” added Carolyn Stoeber, an administrative assistant.
“I can offer bereavement counseling to anyone on the Island for free. You can say your father died 10 years ago off-Island, but I can still talk to them,” said Mrs. Seadale.
Hospice also offers psychological care and spiritual guidance. Chaplain Vicky Hanjian provides nondenominational spiritual care to those who ask for it. “She sits over there like a Buddha,” Ms. Carter said, quietly helping patients to reconcile this world with the next. Like many volunteers and employees of Hospice, Ms. Hanjian became involved after a direct personal experience with the institution. “Bereavement care was my introduction to hospice. Twelve years ago, they were very active in giving me the healing care that I needed. Then I turned around to give that back to the community,” she said.
Dianne Smith, who spent time as a nurse in rural Kenya, returned to the Vineyard looking for a way to replicate that meaningful experience at home and turned to Hospice. “What in the world else was I going to do? Where can I find meaning, selfishly, but also to give back? It has been lovely to work within this team that has such a strong commitment to community and to individuals,” she said.
A few minutes before the solstice struck, Mrs. DeWitt brought out a photograph of one of her patients, taken 15 minutes before he died. In the picture he sat in a chair with his dog at his feet, cane in hand, looking away from the camera. He looked comfortable, not like a man minutes from the end of his life. Mrs. DeWitt confirmed that the picture was a true likeness: “He was still a gentleman. He sat back in the chair, without any drugs, and just went to sleep. He was 96. He was a wonderful person and it was a pleasure to take care of him.”
Despite the deep commitment and passion that the women bring to their work, they are by no means a somber bunch. Mrs. DeWitt burned an effigy of winter’s gravestone in the bonfire and plied her guests with drinks, joking about her days as a bartender at the Hot Tin Roof. They laughed too as they talked about how old they were, and how whoever published their ages in an article would surely end up in a hospice themselves in a few days.
When the solstice had passed, Mrs. Dewitt told the women she had a few things she wanted them to see. The first was a flight of newly-hatched barn swallows; the second was a mother hen turkey sitting on her eggs. Mrs. DeWitt said she had tried to help the turkey during a rainstorm by putting an umbrella over her head, but almost killed her. “That just goes to show that humans need to stay away from nature! Don’t interfere — leave nature alone,” Mrs. Dewitt said.
In their approach to life and to death, these women show an immense respect for nature, for the natural cycles of life. And in their community, where there are few people whose lives are untouched by their work, their wisdom too deserves a similar level of respect.
Hospice of Martha’s Vineyard will hold its 30th anniversary celebration at Featherstone Center for the Arts from 4 to 6 p.m. on June 25. The June Jubilee for Arts is held in concert with Featherstone’s 15th anniversary. Works of art will be for sale for $100 each; the event is free.