At Harborview Medical Center, volunteers sit with the dying — and it changes lives.

A patient is dying. In her hospital room, doctors and nurses come and go. Still, she’s mostly alone — no family and no friends to fill the room with their presence, or to bring flowers and cards. But then a visitor arrives, pulling a chair up to the bed and introducing herself.

This close to the end — it’s a matter of days now, perhaps hours — the patient is past words, but the comfort of touch endures. So the visitor takes her hand, and offers some quiet, reassuring words.

“As the body shuts down, the material world starts to fade away, and what’s precious to the person is human companionship,” says Ann Patnaude, a volunteer with No One Dies Alone (NODA), a program offered by the Department of Spiritual Care at Harborview Medical Center.

Patnaude began volunteering at Harborview by visiting Catholic patients, offering them Holy Communion and prayer. But being a volunteer for NODA, she says, offers a unique opportunity for human connection.

“Holding hands or looking into each other’s eyes — just being present is what brings a patient comfort,” says Patnaude.

Sitting with the dying

Part of Harborview’s mission is providing healthcare for King County’s most vulnerable residents, so NODA patients may have had difficult lives. They may have been homeless, or in jail. They may have been hungry; they may have used drugs. It’s possible they suffered from racism, or a mental illness, or lack of access to consistent health care. They may simply have outlived the rest of their family.

“At Harborview, these patients are safe and being cared for by our nurses, and volunteers are visiting,” says Cindy Thelen. She’s the operations manager of Harborview’s Department of Spiritual Care.

Although NODA is a spiritual care program, Thelen is quick to point out that the program isn’t linked to a specific belief system. Volunteers of all religions — and some with no religious beliefs — register for the program. There’s no judgment, only kindness — and an awareness of the patient’s spiritual preferences, if they have any.

Why would someone choose to sit at the bedside of a dying stranger? Some of NODA’s 30-plus volunteers are Harborview nurses who stay after work to spend more time with patients on other floors. Then there are volunteers who have varied reasons for participating, such as having their own near-death experience, or having been a patient at Harborview.

In Patnaude’s case, someone she loved was dying, and she hadn’t been able to visit. Patnaude recalls with gratitude that other people had visited the dying woman, providing a great deal of comfort.

“It offered her dignity in her time of need,” says Patnaude. “I’m so grateful for all the people who cared for her at the end.”

A powerful moment

The volunteer group also includes medical students like Christine Wang, who was drawn to NODA as a way to connect with patients and increase their comfort level with dying and death.

“Connecting with people is what initially drove me into medicine,” Wang says. ”As students, there are countless items on our to-do lists, but I’m lucky to be a part of No One Dies Alone. I can spend some extra time at the end of the day peacefully sitting with a patient before going home, just appreciating the powerful human connection.”

It was uncomfortable at first. Wang still wonders, sometimes, if she belongs in a dying patient’s room. If she’s worthy of the moment. “You’re sharing a deep and sacred part of their life,” she says.

One of Wang’s first NODA patients was an older woman who could open her eyes, but had lost the ability to speak. To protect her from infection, visitors had to wear gowns and masks — a frustrating barrier to the physical comfort Wang could offer.

But she held the patient’s hand in her gloved one as she dozed, and each time the patient woke up, she would meet Wang’s eyes and smile.

“There is such strong meaning in just being in the presence of someone else,” says Wang. “It’s an intangible, powerful thing.”

A loving presence in the room

Patients can become part of NODA if they’ve received a terminal diagnosis, generally with a prognosis of living two weeks or less. Nurses might notice that a patient hasn’t had any visitors and refer them to the program. If the dying person can’t confirm their desire for company, a spiritual care provider will consult a family member or friend to learn if companionship would be appropriate.

Patnaude remembers sitting with a patient when his family, who lived out of state and were unable to travel, called and spoke to the patient’s nurse. The relatives were comforted to hear that Patnaude was with him, and she, in turn, could tell the patient that his family sent their love.

The program’s name, No One Dies Alone, isn’t meant to be taken too literally. Some patients do die alone, and that’s not necessarily a bad thing; they may prefer privacy in their final moments. The goal of the program is to offer comfort where comfort is wanted.

“We want to bring peace, loving presence and calmness into the room,” Thelen says.

Sitting with the dying is a profound experience that can be hard to put into words, says Patnaude. For her, it refreshes her perspective on what’s important in life — and what doesn’t matter as much.

“It takes you out of that everyday rhythm into something bigger and broader, more expansive,” she says. “To be present for such a great mystery — you can’t help but be changed by that.”

By Stephanie Perry
Illustrations: © 2018 Kary Lee