WORK
Offering Comfort At Both Ends of The Life Cycle
By Laura C. Girardi
Photographed by Brett C Vermilyea
Susan Tapley’s doctor delivered the disturbing diagnosis in November 2003: He told the divorced 53-year-old grandmother that he had spotted pre-cancerous cells during a routine gynecological exam. The doctor removed them on a subsequent visit, but five months later, Tapley had to have a full hysterectomy to remove fibroids. The worst part was the required four weeks of bed rest.
Tapley leads a busy life. By choice, she had three jobs—which she still holds today. In addition to working full-time as an office manager at a Manhattan translation firm where she has been employed for 14 years, she works part-time as a “doula,” a companion for women in childbirth. (“Doula” is a Greek word for “servant”.) Tapley became a doula when she was 48. To date, she has helped 64 women deliver 65 babies, including one set of twins. Tapley is also a part-time Lamaze®-certified childbirth educator. Since she was 51, she has been teaching couples about pregnancy, labor and delivery, and the early postpartum period. Extensive bed rest also meant that Tapley would have to put the brakes on her volunteer work: providing companionship for dying patients who have limited family support.
Tapley is a trained volunteer in the “Doula to Accompany and Comfort,” a non-denominational and nonsectarian program of the Shira Ruskay Center of the Jewish Board of Family and Children’s Services (JBFCS). The volunteers, who are also called “doulas,” help seriously ill clients who live in a variety of dwellings, including private homes, hospitals, and nursing homes.
When Tapley fully recovered from her own health crisis, she happily returned to her active lifestyle. Eager to resume the work she had started with the Shira Ruskay Center, she was soon paired up with Rachel, a single 69-year-old retired schoolteacher who, like Tapley, also had a hysterectomy. There was one major difference: Last year Rachel was diagnosed with ovarian cancer and currently receives chemotherapy treatments every 10 days. (Tapley never had cancer and is in good health.) A social worker at Cancer Care, a national social service agency that provides free emotional support, information, and practical assistance to people with cancer, their loved ones, and caregivers, sensed that Tapley and Rachel would be a good match.
“We met and immediately clicked—like soulmates,” says Tapley of Rachel, with whom she speaks once a week. Three times a month, Tapley travels an hour and a half each way on the subway from her Astoria, Queens apartment to Rachel’s home in Washington Heights. Tapley takes Rachel for walks, accompanies her to the movies and restaurants, checks Rachel’s mail, and helps her with other small chores. Recently, when Rachel spent six weeks in the hospital due to surgical complications, Tapley visited her every other day.
“Basically my role is just to be a companion,” says Tapley. “I listen to her, let her talk about what’s going on with her treatment, and let her process it. My job as a doula also involves guiding people through an examination of their life experiences.” This way, Tapley explains, clients become more likely to see what was great about their lives, and therefore become more likely to die without a sense of regret. This adjustment in perception can transform death from a somber occasion into a more celebratory one.
Tapley also keeps the Cancer Care social worker abreast of Rachel’s needs. Tapley and Rachel often discuss end-of-life arrangements, like a living will and the crucial “Do Not Resuscitate” order. These are among the topics that Tapley learned about during eight weeks of training, which currently takes place at the Shira Ruskay Center and at partnering agencies in the metropolitan area.
She and the other volunteers were also taught how to deal with death and dying, and how to relate to the patients. One poignant exercise for Tapley involved writing down a list everything she loves on separate pieces of paper, and then watching as the instructor removed one beloved item at a time. Tapley says the activity helped her understand how patients feel when “little bits of their lives are taken away from them – their dignity, their self reliance, their ability to dress and feed themselves. It showed us how we would feel, so we could empathize.” During the training, the doulas were also instructed to keep a journal of their interactions with patients.
Rachel is Tapley’s second client. She hasn’t yet experienced the loss of a client. Even so, she admits that working with the dying has been “intense.” It has forced Tapley to think about her own mortality and to start making end-of-life arrangements. She has already discussed the topic with her three adult children. One source of comfort for Tapley has been the monthly meeting with other program volunteers, whom Tapley describes as a diverse group of people, including teachers, office workers, lawyers, and doctors, many of whom are middle-aged. At the monthly meeting, the doulas discuss their experiences with clients and how they as caregivers are coping. Such work, after all, can stir up painful memories. “It brings up your own issues,” says Tapley. “Sometimes it reminds you of the loss of your own parent or sibling, so we process our stuff there.”
The program has also had a positive impact on Tapley’s life. “It makes me very grateful to have friends and family close, because most of these patients don’t,” says Tapley, who learned about the program when she read a newspaper article about it in April 2001. The article especially caught her attention because it mentioned Phyllis Farley, who started the program after she heard Sherwin Nuland speak at a conference sponsored by the SRC. Farley is chairperson on the board of the Maternity Center Association (MCA), a not-for-profit organization dedicated to improving maternity care in the United States, with which Tapley, a birth doula, was already familiar. The article inspired Tapley to get involved in Farley’s program, which she feels complements her own work as a birth doula and a childbirth educator. “I wanted to help babies come into the world, and then help people go out,” says Tapley. “Death and birth are both miracles, but people need help with those miracles.”
To learn more about the Doula to Accompany and Comfort program, visit www.shiraruskay.org, or contact Maxine Skurka, the program’s coordinator, at (212) 399-2685 ext. 214. To find out more about doula services and childbirth education, contact Susan Tapley at: susan_your_doula@yahoo.com.
Laura C. Girardi’s work has been published in TIME FOR KIDS magazine and THE WORLD ALMANAC FOR KIDS. She, too, has a second career as a first grade teacher in Brooklyn.
