Anne Johnstone has been a member of the TS since 1982 and is a trained nurse. With an interest in group work and science, she left her homeland of New Zealand in 2001 to help at the Krotona School of Theosophy for three months. By a stroke of luck, she received a green card through a lottery system to reside in the US. Twelve years later, she is still living in the Krotona Institute community and is part of the school staff. Her nursing knowledge, as well as her increasing familiarity with the US health system and her respect for complementary health approaches has been useful. Anne tries to help out with the gardening at Krotona and walks many miles each day. She recently started learning to sing with more emphasis on diction! Here she reflects on insights she has gained over the years as an end-of-life midwife.

Over the years, some of my most life changing experiences have been when working with others as a helper in a professional capacity.  It will easily be seen that they are in essence ones that anyone can have anywhere, at any time – in the grocery store, at a neighbour’s place, or during a TS branch or study group meeting. We could call it being a midwife to a situation.

I was a nurse in a mental health facility and during the holiday time, a female patient in her sixties was suffering agitation and generally unable to look after herself. She seemed so disturbed that it was unlikely her daughter would be able to take her on leave for a few hours over the holiday period.

One afternoon as I was working, the woman came up to me distressed about her washing or how to do her washing. While I don’t remember exactly what I said, I remember it was a straightforward reply. Within seconds the woman suddenly changed. She somehow began to understand what was happening to her and seemed to function much better for the rest of the evening. The next day she was able to be out with her family and her condition improved so much she was eventually discharged from the facility and able to go back to work. Weeks later, I met her in the store where she worked and she commented to me that she would never forget how that brief conversation had changed her. Now, some thirty years later, I have not forgotten either. With complete respect for her as a rational, normal human being and with the confidence that she would be able to understand and cope, I focused my full attention on her. This intention gave her the confidence she needed to believe in her own abilities.

Another time, when I was working in an acute medical unit during the night shift, I met a young woman with, I was told, a life-threatening lung infection. Intensive Care was prepared to admit her when needed as there was the chance that the infection would take her life. On the first night of meeting her, there was an unusual brightness to her voice. I walked out of the room convinced that she would be fine during the night.  Over the next few nights, many conversations ensued about our interests and the books we had read. One book we discussed was The Road Less Traveled by M. Scott Peck and how helpful we both found it.

The next evening, as I was giving her intravenous medications, she shared that just before her hospitalisation she had seen an image of what she perceived as a Christ-like figure. She soon realised that she was quite sick and summoned medical help. At the hospital, while she was being X-rayed, she felt herself move into another realm. She stated that it was a nice, comfortable and warm feeling, but she knew she still had work to do.  I was somewhat struck by how this woman was testing me to see if I could handle what she was sharing. This was before Near Death Experiences were widely known or spoken about. After the disclosure, the relationship felt different. She had shared something very private so there seemed to be a deeper understanding between us. This ‘differentness’ in a relationship after disclosure is apparently quite common. It seemed that through a common exchange such as talking about books we had both read, she felt safe to disclose information affirming that her encounter was part of a transformative process. She seemed to realise that her illness wasn’t just a physical experience, but something more.

Working with folks who are dying also provides an opportunity to be a 'midwife' to a life changing experience. In fact end-of-life midwifery, or Death Midwifery as it is referred to nowadays, is becoming a more widely known skill amongst those working in the healthcare field. The role of the midwife can vary from providing resources to family members who may not be aware of them, to listening to concerns of the patient or the family members about the dying process. Giving respite to caregivers is also a major role. It is important to be aware of the cultural concerns the dying might have as well as making sure the environment is conducive to their wishes.  All this may include tying up loose ends so the person transitioning can focus on the process of letting go. The main goal is to meet the expressed needs and desires of the dying.

This may be about helping them move from a hospital to their last few days in their home or to move to be with relatives. On one occasion I recall, some members of my local theosophical branch were caring for an elder who had no relatives and was in need of a place in a home to live.  The family, who had not known him for long, offered him a comfortable room in the midst of family life in their home. We were able to ask the local nurses to attend to his personal care needs while the family provided physical and spiritual support, thus facilitating a smoother passing for the dying man.

Another time, amongst the bustle of a busy hospital unit, a relative of mine shared that she was scared to die.  She kept saying, “It was a dreadful place and you get a hard time over there.” I was consistent in my approach, saying that what she was seeing now was what she would get.  I shared my conviction that she would encounter whatever she envisioned habitually and that by thinking differently she could achieve an entirely different experience.  Sometime later, she told me that she had let “them” know she was ready to go.

After she passed, I wondered how many times I had missed out on such gems amidst the cacophony of a place where many folks are coming to grips with dying or an adjustment to a change in their way of being. It made me realise how important being a midwife can be.

Sometimes just being fully present, in a calm focused way, can prove useful to move people through an issue whether it is a mental illness, a life-threatening illness, or death itself.