Archive: Keeping the Balance at Hospice

By Cynthia Trenshaw
March 1, 2006

This post has been moved from its original location at and archived here, so you can continue to access it.

This month's circle tale comes from Cynthia Trenshaw, author of the The Circle Way booklet, The Circle Way for Proactive Aging: A Harvest of Years. Cynthia traveled in New Zealand this past fall, practicing circle and introducing her concepts of conscious aging.

To attend a death is a powerful experience.  Every death at a residential hospice leaves its mark, and some deaths affect the staff and volunteers more profoundly than others.  Sometimes this has to do with how intentionally the guest approaches his or her death and how s/he feels about the relationship of consciousness to pain (the inevitable formula is: the more pain relief, the less consciousness; hospice continually strives to find the patient's ideal balance between the two).

Recently we had a hospice guest, G, who had "done everything right" with her life. She was young, in great physical shape, a vegetarian, a meditator, a marathon runner, an intensive care unit nurse.  And she had a rare and virulent cancer that allowed her only two months from diagnosis to death. In her work she had seen many people die, and she chose to come to our hospice to spend her limited last days dying very consciously.  G's was one of those deaths that marked each of us profoundly.

A few days after G died, I was talking with one of the staff, telling him how deeply grateful I was to have attended G in her dying.  When he said, "You have no idea how difficult that was for me," I asked, "You mean her dying?"  He replied, "No. Caring for her."  We decided to meet with two other volunteers, to talk about how this death was for each of us.

I assumed that the four of us knew the basics of speaking in circle.  I was wrong.  We used no talking piece, which turned out to be a mistake.  Holding onto a talking piece gives a speaker more time to choose words, more time to see if there is anything else that is wanting to rise up and be spoken.  Without a talking piece it is too easy for another person to "rescue" a speaker from the difficult emotions that want to surface but are all too willing to go back into hiding if there is any hint of rejection – and "rescuing" is a very subtle form of rejecting.  Like immediately handing a Kleenex to someone who has begun to cry – it says "Don't."  So, while the four of us did get to speak about how G's death was for us, the one for whom it was "so difficult" got cut off before he arrived at the core of his experience.  He had just recounted all the things that G had "done right," and was in the process of wondering "why bother?" when his discomfort was cut short by another who took the conversation off onto a different philosophical tack.  He never got to express the full consciousness of his existential pain of "why bother" before his pain (and that of his rescuer?) was anesthetized by safer ideas.

Next time, I will introduce the use of a talking piece at our hospice debriefings, so we can honor the balance between consciousness and pain – the best of the hospice tradition – in the experience of our staff as well as our guests.

Cynthia’s booklet is available here.