When I first learned about hospice, I focused on death and dying. That’s certainly one focus of hospice—but it’s not the only one.
Although the modern hospice movement began with the work of Dr. Cicely Saunders in the 1960s, the concept of “hospice” is much older and wider. It derives from the Latin hospes, which refers to both “guest” and “host.” In medieval Christendom, hospices were hubs of hospitality for the sick and dying as well as for travelers and pilgrims. These early European hospices were common throughout the Middle Ages, phasing out only with the decline of religious orders.
When I first became involved with a hospice in college, I didn’t expect to learn about hospitality. I began volunteering because I’d lost loved ones and wanted to learn about death, that cloaked thing that isn’t supposed to sting but usually does anyway. In my four years of involvement in the world of hospice, I’ve learned a little about death and a lot about hospitality. The former is mysterious and maybe inaccessible to my twenty-something brain; the latter is abundant in my life and, I’d argue, hard to avoid once you start looking.
Hospitality in Hospice
In my most meaningful hospice experiences, the patient-provider relationship has been marked by a distinct depth. The dying person is treated not as an unsolvable medical problem but rather as a guest in the home. To sit with a dying patient is to sit with a living person, to peer through the glass and into some of the strangeness of that last chapter. This perspective colors the relationship and can shift the dynamic from one of living-and-dying to one of host-and-guest.
This host-and-guest relationship may be a marker of quality hospice care. While interning with a palliative care organization in New Delhi, I had the opportunity to shadow teams of Indian providers as they visited terminally-ill patients in their homes. In ideal cases, the family and team treated the dying person like a guest of honor; the person’s needs were prioritized, and extra efforts were made to ensure their comfort. Even in America, where most of the people I’ve visited have died in care centers, effective hospices have treated their patients as guests, not as medical consumers. Hospice creates space for comfort and rest.
Similarly, my current vocation as a traveling hospice songwriter has not only invited hospitality but depended upon it. I wrote this post while on a month-long tour, a road trip that would be nonsensical if not for the generosity of my hosts. In many cases, these hosts are “strangers”—we’ve never met, several of them are unfamiliar with my work, and yet somehow they remain open to disruption in the form of a wandering musician.
These tokens of freedom are hot coals on pessimism, and they're contagious.J Lind
My recent encounters with hospitality could fill a book. Two nights ago, one “stranger” refused to let me sleep on their couch; instead, they gave me their bedroom and private bathroom, fresh towels and linens, and the key to their house. Last night, another “stranger,” who is not in any financial position to give, invited me over, let me raid their fridge, and then invited me over again. Others have sent me on my way with bags of food, gallons of antifreeze, and even money to fix my broken windshield. I’ve stayed with more than sixty such hospitable “strangers” coast-to-coast, and I’ve been consistently moved by the absurd grace in it all.
Hospitality As Creation
Henri Nouwen offers a refreshing take on hospitality:
Hospitality means primarily the creation of free space where the stranger can enter and become a friend instead of an enemy. Hospitality is not to change people, but to offer them space where change can take place.—Nouwen, Reaching Out
An open fridge; keys to the house; windshield money. These tokens of freedom are hot coals on pessimism, and they’re contagious; I want to spread the coals and burn the fields, but only to create more free space. I have received a gift, and now I want to pay it forward. The beauty of hospice, I would argue, lies at least in part in its coincidence with this virtue of hospitality, which involves the creation of free space for restoration.
To be a caregiver is to be hospitable. To be hospitable is to be creative. And to be creative is to participate in a wider story.