GrabDuck

Other People’s Houses: What I Saw While Working in Hospice

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Here is how the interaction proceeds: I get a case assignment. I read through the demographics. I look up the intersection on Google Maps, although I don’t necessarily need to. I drive to the patient and family’s home. I can nearly always tell where the patient lives: on a street of manicured homes, the patient’s home is generally the one that stands out as “unkempt.”

In social work, we often talk about choices — specifically, the choices patients have made that have led them to this juncture. Social workers meet people at a moment, for a moment. We listen to their stories, and we help find a direct path through the miasma.

After a while, I start to notice that all the homes I am going to are in the Sunset and the Excelsior. Familiar homes — layouts that I recognize. The smells too: a little musty, cooked rice, faint bleach. I point this geography out to my coworker. “Think about it,” she says. “Who’s dying?” The answer is everyone: rich and poor patients, people alone and together. They have lived here for years and moments, in every building on every street corner.

Here is my secret to this work: I am a selfish detective. I want to know the innermost workings of what makes every person tick. I want to know what has left people ashamed and touched. I have always been someone who has asked one too many prying questions, only now I get paid to do it.

It strikes me that I am cataloguing the city of the dying. After hundreds of cases and deaths, story lines start to emerge—familiar characters, narrative arcs, big reveals. I am grateful to be able to distance myself from the brutal reality of death by believing that I know how the ending will play out.

When I was a little girl, I used to say to my parents, “Take me to someone else’s house and leave me there.” I remember saying these words. I didn’t mean them because I didn’t love my home; I meant them because I wanted to know how other people lived. “You got what you asked for,” my mother says.

Regular people. These are the words I keep finding myself using. So many of my patients are just regular people who found San Francisco or who sought San Francisco, because where else could they go? First-generation immigrants who landed here by chance, gay men who found nirvana and then were ushered into pure darkness as the AIDS crisis swept through, and, yes, natives who never wanted to leave.

Regular people in their regular houses. Cups of instant coffee with creamer from unbreakable CorningWare mugs. Unremarkable T-shirts with slogans that hint at hobbies from earlier in life. Clean wooden staircases that bend at the landing, the same as in the house I grew up in. Dirty carpets stained with years of habits. Very ill people sleeping on beloved, well-worn sheets from children’s twin beds. Sofas with slumps from long nights of sitting, talking, watching television — things that everyone does.

Here is my secret to this work: I am a selfish detective. I want to know the innermost workings of what makes every person tick. I want to know what has left people ashamed and touched. I have always been someone who has asked one too many prying questions, only now I get paid to do it.

Is hospice work sad work? Is it any more sad than any other line of employment? I start to notice some of the newer narratives emerging from my patient’s mouths. They talk about how much their apartments will be rented for after they are gone, longtime tenants with decades of rent control. At first, I feel angry on their behalf. How cruel to be turned into a dollar sign, all your years of possessions discarded by a hired cleaning crew. The fullness of these homes and lives, cluttered with decades of stuff: shopping bags, cake tins, photographs, half-filled notebooks, strings of beads, holiday decorations, glassware, fake flowers, real flowers — a whole life thrown into a dumpster. Someone else’s problem.

I am a normal person with a passport to the world of the dying. There is no application process for this passport.

Dying people fall into two categories: the prepared and unprepared. The prepared greet me, their documents ready for me to look at, as proud as if they were showing off a family album. Look how ready I am. I am grateful to these people, as there is a certain timbre to our conversations. We both know the basic inevitables. It is sad to die, but it is one of only two universal truths in life: we are born, and we die. We are here, and then we aren’t.

I believe that this planet is split into two worlds: the living and the dying. This means that in every city, there are two worlds, too. The world of the living is the traffic outside the patient’s front doors. The world of the dying is inside the home. I am a normal person with a passport to the world of the dying. There is no application process for this passport.

I open the door to leave a patient’s apartment, walk to my car and return to my home of the living. Outside, a tenant is waiting to get in. She looks at me. I am her age; we dress the same. I am sure we know people in common. She thinks we live in the same world. I don’t correct her.