How strangers touching strangers transformed the moment of death

A homeless man told a nurse at Providence Alaska Medical Center that he had grown up an orphan and all his life had rarely been touched. He said no one would come to his bedside as he died.

But a hospital volunteer did. Her hands were on him as he passed away.

I reached out to volunteers of the No One Dies Alone program to learn about this work. They simply sit with patients who otherwise would have no one with them as they pass away.

I wasn't sure if I would meet busybodies or saints. The volunteers turned out to be regular people unafraid of being near life's deepest mysteries.

Their stories reminded me that living fully requires us to pay attention to moments of meaning and intensity, not avoid them. That's how you discover what life is worth.

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Karen Maskarinec's beeper goes off when a nurse or social worker at Providence believes a patient nearing death will be alone. Some patients are far from home, with family and friends unable to attend, while others have family standing a vigil but in need of a respite.

Some patients are all alone in the world.

The volunteers visit in two-hour shifts. Forty-one are active in the program. They had 68 cases last year.

They're like midwives of passing spirits.

Maskarinec joined after learning of the need from her daughter, anesthesiologist Gwenyth Crabtree, who was on her second day training as a resident in a New Jersey hospital. A doctor on rounds pointed out a patient likely to die within two hours.

Maskarinec said her daughter asked, "If this person is going to die, shouldn't someone stay with him?"

The supervising doctor replied, "Dr. Crabtree, this is a hospital. People die every day."

Maskarinec said her daughter called home that night distraught, unsure if she had chosen the right profession. To help her stay on her path, Maskarinec volunteered for the program in Anchorage. At least her daughter would know that here, dying patients would have companionship.

Most of the time, the patients are unconscious and volunteers don't know if they can hear the conversation, music, or reading aloud they provide, or if they can feel their soft touch. But Maskarinec has also been with dying patients who wanted to talk. She has had profound conversations with people about to die.

"They've never met me, but that doesn't mean that I can't stand in for someone they miss or who can't be there. Because we're all sharing life," she said.

As a stand-in, she has helped patients complete the unfinished business of their lives.

"Is there anyone you would like to forgive, if they could be here?" she recalled asking. "Is there someone from whom you want forgiveness? Just picture them and hold them in your heart."

She became a committed Catholic — after a lifetime away from the church — after sitting at the death of her father, at 89, and feeling the mystery of that moment and the power of his faith. But in the hospital, volunteers avoid being explicitly religious unless a patient has stated a preference in advance.

An elderly man was brought to the hospital from a remote cabin where he had lived alone and, she supposed, fished, heated with wood, and worked with his hands.

"All those things involving shoulders," Maskarinec said.

She stood behind him and touched his shoulders, saying softly into his ear, "This shoulder has chopped so much wood, this shoulder doesn't have to chop wood anymore, this shoulder can relax now."

She repeated that litany for each of the physical tasks of living remotely — fishing, building, carrying water.

"I felt his shoulders relax, and a few minutes later he drew his last breath," she said. "I think I was giving him permission."

Do some patients want to be left alone as they die? Maskarinec said a nurse told her no one ever does.

"I think it's possible," said volunteer Mary Ripp, in another conversation. "I guess you never really know."

Ripp said nurses help with that. They get acquainted with patients and can learn their wishes while still conscious — including the homeless man I mentioned, whom Ripp touched as he died.

"I put my hands on them. I tell them I'm here to keep them company. And if I happen to know what kind of music they like, I play Pandora," she said. "I remember a guy I was with really liked rock 'n' roll, and when he passed away he happened to be listening to AC/DC."

Ripp began volunteering last fall and has been present for the death of several patients. Helping a neighbor who died of ALS inspired her to do the work.

Readers may remember Ripp from a column in which I described her rescuing a homeless, mentally ill woman at Christmas. But she pushes aside credit for her community work.

"Everyone is able to do things in different ways, and this is something that I'm able to do," she said.

[How strangers rescued an elderly homeless woman and sent her home]

She recalled the first time she was alone with a patient who died.

"It was kind of amazing. It's not a good thing, but I strongly believe that they're not disappearing forever, and I guess that's what helps me," she said.

Ripp is a spiritual person, but not a member of a religion. She deals with death in her own way.

"I don't want the moment of that person passing away to go unnoticed. I need to talk about it," she said. "I need it to be known that I witnessed him. It's important. It's really important to me. I can't really put it into words."

Maskarinec expressed a similar sense of wonder.

"It's made me a lot more comfortable with life and death in general," she said. "People ask, 'Isn't that depressing?' My response — my inner response as well — is that when I leave a patient's room, I am awash with gratitude.

"It makes me much more aware of the gift of life," she said.

The views expressed here are the writer's and are not necessarily endorsed by the Anchorage Daily News, which welcomes a broad range of viewpoints. To submit a piece for consideration, email commentary(at)adn.com. Send submissions shorter than 200 words to letters@adn.com or click here to submit via any web browser.