When my mother first moved to an assisted living facility, they placed her under hospice care.  Being the stubborn and contrary person that she was, she fought them every step of the way until they disenrolled her (she lived for five more years).  We weren’t sure why she was put on that plan, but I ended up feeling it was a very good program that was more holistic than most medical treatment today.

So my interest was piqued when I saw The In-Between:  Unforgettable Encounters During Life’s Final Moments, a memoir written by a hospice nurse, about her experiences with twelve patients over the course of a few years.  Most interesting to me was the medical reality of patients receiving visits from their loved ones as they neared death.

The author, Hadley Vlohos, R.N., was a teenage unwed mother when she enrolled in nursing school and later landed in hospice care.  She felt at home with the more patient-centered, comfort-driven mandate of hospice.  Hadley shares what she learned from her patients, who were usually open and candid at the end of their lives.  We follow her on her journey as she acclimates herself to the challenges of her job, gets married, goes through the death of her mother-in-law from brain cancer and learns to confront medical authorities when necessary.  Her patients range from wealthy to homeless, elderly with dementia to a young parent, slow and expected weakening to quick passages, and all offered insights and wisdom.

But it’s the unusual relationships that develop, as well as the metaphysical experiences described that were the most compelling.  Patients invariably felt calm and peaceful near the end, and many looked forward to rejoining long departed family members who had recently visited them.  Hadley herself had struggled with her religious upbringing, and she found that beliefs didn’t affect her patients’ experiences in dying.  (Even a life-time atheist was also visited by family from the other side.)

While the topic may be off-putting to many, Hadley Vlahos tells her patients’ stories with great feeling and empathy, and the book becomes a celebration of life in all its many facets.  Hadley learned that she couldn’t control everything and often had to trust both her patients and the universe and let go.  (Saturn is often invoked in the subject of death, but may also be appropriate in its sense of timing and the idea of release, too.)  All of the patients’ stories resonated with me.  In an age of AI and continual promotions, it’s nice to find a work that honors uniquely human experiences.

See The In-Between on Amazon.com.

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