was always easy. After I saw a client who was physically abused in her marriage, I realized that I did not want to work with those kinds of problems. But I did have significant success with people who had suffered early childhood trauma, abuse, or neglect. I also did marital counseling, which would occasionally evolve into family counseling. I taught classes at a university while maintaining my private practice. It was a great time for me professionally.
In 2000, I began to have some health issues. I slowed my private practice way down. I always continued to have at least a few private clients, just to keep the door open and my skills sharp, but I discontinued agency work. My natural ease as a successful psychotherapist was wonderful, and it might have turned into an early retirement—except it was not to be.
Although I had expected to spend my fifties playing golf and quilting, the stock market took a big fall and my husband, who still works in the financial industry, was increasingly stressed and exhausted. It was clear that I needed to go back to work, but where? While I still had a few private clients, restarting a private practice from scratch is a lot of work in and of itself, and it takes a lot of time. Getting a job might be smarter.
As I was glancing through the newspaper one Sunday afternoon, I saw a want ad that would change my life forever. It seemed pretty straightforward:
Hospice social worker. Provide counseling and social work services to patients with terminal illnesses, provide individuals and families with the psychosocial support needed to cope with death and dying services, including providing patient education and counseling support services for caregivers and families and making referrals for adjunct services.
I had never really considered working in a hospice agency before, but I thought, I bet I could do that. After all, I knew how to talk to people of all ages, with all kinds of problems. The position was for a counselor on a home-care team. I was going to give this a try. It never occurred to me that this might be a very difficult job, with many days of loss. I just forged ahead.
When I walked in for my first job interview, about twenty people were waiting for me in a conference room. It was quite intimidating. They were looking for somebody with experience in death and dying. I had done work with an older population, but none of my patients had died.
Not surprisingly, I was not their first choice. They were able to find somebody else with actual hospice experience. Still, the staff reassured me that they really liked me and thought I would work well on their team. Social worker positions are really hard to come by; so “luckily,” I was still out of a job by the time the next position opened about two months later.
When I finally got that callback, I was ready to work—and more than ready to learn. I knew I had a lot to learn. But when I showed up for my first day, I was amazed that there was virtually no training.
There was a manual and a video, but that was basically it.
As it happened, I received the same cursory introduction to hospice care that the facility would provide to its unpaid lay volunteers. On day two, I was simply sent out with another social worker to observe for a couple of hours. Even as this “training” continued for the next few days, I was given my own caseload. There was not a lot of preparation, other than shadowing people and simultaneously learning on my feet for about a week.
Registered nurses with medical backgrounds, not clinical social workers, would be my supervisors as I trailed my coworkers into a maze of the turmoil, depression, and regret that often surround the end of life. What followed in the coming months was a nonstop roller coaster of emotion and personal and professional challenge. I have always been a very emotionally sensitive person, willingly to listen to the client’s stories with great empathy and compassion. But this was different; this work was “live,” not history. As the drama unfolded before my eyes, I found the need to push my own feelings aside in order to be there for the clients and their families.
I learned that I was very ready to talk to people—but I was not ready for death.
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