A Lesson About Dying Successfully
By Pauline T. Nguyen, Staff Writer

Summer of 2002:
Intern at Houston Hospice.
Camp Counselor for children with HIV/AIDS.
Uncle died.

To many, it would seem that I had a rather morbid summer. In each line, it seems that death is the underwriter in each event - but I promise you, this story is not about death (well, not literally).

I was an intern for Houston Hospice, a non-profit organization that strives to provide all individuals, regardless of means to pay, with hospice and palliative care. Since I did not seek a job in the hospice industry, I started the position with the belief that hospice is a place where people die. Instead, hospice is about the affirmation of life. It is a program that provides palliative care, relieving or controlling the symptoms of a disease or disorder. The team of nurses, home health aids, doctors, chaplains, and social workers of hospice works with the patient's physician to care for the patient's physical and spiritual needs. They are dedicated to helping people who are far past the "there's nothing we can do" diagnosis: the last stage of life.

The second link. Each year, I am a counselor with a camp for kids with HIV/AIDS. For the first time in seven years, a camper died. The beautiful part of this story is that his health had dramatically deteriorated before the camp began, but he held on for camp. He fished, he swam, he rode horses - he refused to allow his body to interfere with his week of fun. On the bus ride back home, he simply had no more energy left and, subsequently, died two weeks thereafter.

The last link. My uncle had been ill to the degree that he was placed in twenty-four hour care. He was not terminally ill, but it seemed as though he was tired of being sick; his mind saw death before his body surrendered to it. He left behind children still shocked and grieving, who probably will never understand how their father lost the will to live.

Over the summer, I became aware of how I, as an Asian American, view death. I feel that I have been raised in a contradictory culture: fear death but honor the dead. I have been taught so many superstitions about death, that I only saw death as something to avoid by doing random acts: never giving white flowers, never wearing white or black to weddings, never taking a picture with four people (the Cantonese word for "four" sounds like their word for death). So, I spent a life of avoiding death, and then this summer happened where death seemed to be the main subject. Honestly, I think that Asians have a love-hate relationship with death. We love to talk about it when we talk about superstitions or an anniversary of our ancestor's death; we are silent when it comes to dealing with death in our own families. We can elaborately celebrate the death of our ancestors, but we are silent and fearful of our own. Perhaps that is why death causes so much silence - we simply do not know what to say after "I'm sorry."

For the first time, I was exposed to how "Americans" dealt with death through my hospice experience. Hospice is simply amazing when it comes to how they care for their end-of-life patients. Their main goal is to attack silence: get the patient, their families, the doctors, and the hospice team to all communicate so that the remaining time in the patients' lives is optimized. By opening the lines of communication, the goal is to have the patient and their families make decisions so that when the time does come, the family can concentrate on grieving, not shopping around for deals. It is about keeping the patient and their families in control.

I think the largest contrast between the "American" way and the "Asian" way is how we distance the physical and the spiritual part of death. For my uncle, I think that we were all trying to tend to his physical needs and we never even addressed his spiritual needs. We just seemed to separate the two. We knew that he was unhappy, but we thought that once his health improved, so would his disposition. In contrast, our camper was put on hospice right after camp. He was only 12 years old, but through years of counseling and understanding his medical condition, he was in control of his life. He was the one that said no to more medications. He was the one who decided when to draw the last breath. Everything had been planned. When he passed, he passed in an environment of love, surrounded by his family and comfort; whereas, my uncle slipped away in his sleep in a nursing home bed. I think that was the hardest part for my family. The fact that he was alone was the factor that hurt my family the most. When my cousin arrived at his bedside, she later said absently to me, that his face was just so cold.

Afterwards, I kept on thinking, why didn't I push hospice more? I was not even supposed to get this internship. There are times in your lives when some correlations are too real for you to dismiss. Was it written somewhere in my fate that I was supposed to be the link between hospice and my family? Had I failed? Was I responsible for the pain, frustration, and confusion on my cousin's faces?

This article is not only about hospice, but also about how our tradition of being silent and fearful can hurt us when we need comfort the most. Talking about death is another one of those crass and taboo topics that never seems appropriate, even when someone in your family is dying. So, if the right time is not then, then when? Will it turn out to be too late, like my uncle's death? When Americans find out that they are dying, they live life to their fullest. They do everything on that "things to do before I die" list. That is what I learned from my hospice of summer. You may have a few months to live, but that is still a few months to leave. Think about all the people that die suddenly. These individuals were never given a grace period to do solve their life and leave comfortably.

For my family, we never knew what my uncle's last thoughts and words were, or how he would have wanted his funeral. It is ironic to ask a person about their own funeral, but what happens when we believe in the afterlife? Since my family is Buddhist, his funeral was a preparation of his afterlife. Shouldn't he be involved in that?

The conclusion of my reflection is that we will never know. But what I have learned from my summer of hospice is that life is life- whether you have fifty years or ten days. When we are silent about death, don't we kill a part of ourselves? We can't grieve; we can't get resolution - we can't live ourselves. Are we really so fearful of our words that we would sacrifice peace of mind for silence?