Alex Doering ’14 got involved with hospice somewhat by chance. Two years ago in late spring, he was helping out at Bowdoin by shepherding around successful alumnae who were on campus for a career panel. As he led oncologist and palliative care specialist Suzana Makowski ’90 to Moulton Union, he struck up a conversation with her. When she heard Doering had no summer plans, she suggested he volunteer with hospice.
Doering quickly warmed to the idea and signed up to begin a volunteer training program with a Brunswick-based organization, CHANS Home Health Care. “I want to be a doctor,” he explained, “and I had had no experience [prior to hospice] working with patients.”
After a year of working with hospice clients, Doering says he’s become better conditioned to handle some of the challenges that come with working in medicine. “With hospice, you are helping patients and grieving family members,” he said. “Dealing with hospice patients should help students deal with the pain and suffering that other kinds of patients experience.”
Now Doering, who is from Windham, Maine, is partnering with CHANS to recruit more Bowdoin students to its volunteer program. At the moment, he is the organization’s youngest active volunteer, but other students are eager to participate. At an informational meeting Doering organized on campus in November, 20 to 25 students showed up. Earlier this semester, four students — Roy Tsao ’16, Rachel Gladstone ’15, Tobias Nicholson ’14 and Julia Gomez ’15 — completed the fall training program and will start volunteering next semester.
Gomez said she’s excited to start volunteering. “Before CHANS (and Bowdoin), I had volunteered at a local hospice in New Jersey where I helped develop the curriculum for a teen bereavement program,” she said. “Since then, I’ve become more interested in medicine and wanted the experience of working directly with people.”
Doering says he wants to attract more students into the hospice system because he feels the lessons it imparts are important, particularly to young people and to those who aspire to go into medicine or public health. “When I went into this, I realized there were some big problems in the medical field that I hadn’t thought of before. Problems related to end of life care,” he said. “I would like other people to know about them. Doing hospice is a good way to spread the word.”
“Hospice is very hard and some of it is very sad, but there are also some beautiful moments.”
—Alex Doering ’14
One problem with the medical system, he points out, is that, armed with our advanced medicine and knowledge, we tend to view death as the enemy, as the worst possible outcome for a patient. But in some cases, staying alive is more terrible than death. “For a terminally ill patient, unnecessary suffering — physical, spiritual, emotional or existential — is the worst outcome. Death is inevitable, but we can help the patient die with as little pain as possible,” he said.
Margaret Zillioux, director of CHANS, agrees that the recruitment of young people to hospice is a “big plus for our community, for our society.” She continued, “If and when these students embark on health professional careers, they’ll already have an understanding of and belief in the benefits of hospice and palliative care.”
At the same time, because some of the students might be relatively inexperienced with illness and death, Zillioux anticipates providing additional support and monitoring for the students. She might encourage some to shadow experienced volunteers. And she’ll ask her hospice clients whether they prefer an older or younger volunteer. Some clients, she knows, prefer to work with people closer to their age. Others, though, are happy to be able to offer something back, and to have the opportunity to act as a mentor to young people beginning their adult lives.
On a personal level, Doering says his hospice work has clarified for him what he wants to focus his career on: oncology, but oncology combined with palliative care. Cancer treatment, be said, is an area filled with healthcare providers who become so fixated on curing the disease that they overlook a patient’s needs. “I would like to reform it from the inside,” he noted.
All the students who sign up to volunteer must commit to a 30-hour, 10-week training, which introduces them to hospice and its philosophy, and prepares them to help many different types of people during their last days of life. Each client has unique needs and circumstances. Veterans, for instance, might be struggling with wartime memories. LGBT clients might be feeling ostracized or neglected by nursing staff or families.
The training program also prepares volunteers to handle some of the pain they might witness and feel, and the hard conversations they could have with their clients about faith, fear, guilt or regret. “Hospice is very hard and some of it is very sad,” Doering said, “but there are also some beautiful moments.”
Doering so far has worked with three clients. When he was assigned his first patient, she was experiencing “large amounts of spiritual distress,” he said. Doering and other volunteers were enlisted to sit by her side and hold her hand so she was rarely alone. “We tried to have a volunteer [or family member] with her holding her hand as continually as possible,” he said. Doering was told that when she finally died, she looked as if she were in peace.
His other two clients were easier in some sense. And he’s still in touch with one. “A wonderful guy,” Doering commented. With this elderly man, he would spend time at the client’s home to give his wife time to shop or visit with family. After she would leave, Doering said, “we ate snacks, drank Kool-Aid and watched old Westerns and zombie movies.”
At one point, his client confessed to Doering that his visits were one of his favorite parts of the week. Doering replied to him, “It’s one of my favorite parts of my week, too.”