AT THE HOSPICE, we used to have a cat that predicted death. It was a tabby that never had a name other than Cat, as far as I know, but she lived in the building and there was a line item in the budget for her food. We had two therapy dogs that came in to see patients, but the cat was quintessentially standoffish and wouldn’t suffer being petted. Her only use, as far as I could see, was to let us know when someone had less than twenty-four hours to live.

Without fail, if I went into a room and found the cat curled up at the bottom of someone’s bed, they died shortly after. I don’t know if it was a sixth sense, or some kind of olfactory cue—I know dogs have been trained to sniff out some cancers—but that damn cat had a hundred percent success rate.

After I became a hospice social worker, it was nearly a full year before someone died in front of me. (Even now, many of my clients die when everyone leaves the room, as if they have been hanging on by sheer force of will to the people who will miss them.) One morning, I walked into Judith’s room at the hospice facility and Cat was staring at me, flicking her tail.

Without alarming her daughter, Alanna, who was the primary caregiver, I did a quick survey of Judith. She was unresponsive, her breathing thick. I looked at the cat, nodded, and she jumped off the bed and slunk from the room.

“Alanna,” I said, “if there’s anything else you need to say to your mother, I’d say it soon.”

Immediately tears sprang to the woman’s eyes. “It’s already her time?”

If there is one thing I’ve learned while doing the business of death, it’s that it comes as a surprise, even in hospice.

I pulled up a chair beside her. Alanna leaned forward, unconsciously holding her breath every time her mother inhaled. Cheyne-Stokes breathing—which sometimes happens when a person is dying—is a cycle, slowed inhalations followed by faster pants, and then no respiration at all, before it starts up all over again. The pattern repeats every few minutes. Even though it is a normal occurrence as the respiratory system shuts down, it sounds agonizing, and it is hard to listen to, especially for family members who know that this is the beginning of the end.

My job is to support not just my patients but also their caregivers. So I tried to distract Alanna, asking how the night had been, and when her mother had last opened her eyes. Finally, when I realized that Alanna was coiling tighter and tighter, I asked her how her parents got engaged.

I once read that every story is a love story. Love of a person, a country, a way of life. Which means, of course, that all tragedies are about losing what you love.

When someone with a terminal disease can’t stop fearing the future, it’s comforting to look to the past. We tend to forget that we were all young, once. And that there was a time when we had beginnings, instead of endings.

Alanna looked up at me. “My mom and dad came from really different backgrounds. Dad had family money, but my mom had next to nothing. They decided to take a trip to the national parks, and my mom showed up with a cooler full of sandwiches, because every time she’d gone somewhere as a girl her mom packed all their meals. It was like she never even considered restaurants as a possibility.”

I imagined Judith, wherever she was at that moment, listening to her own history and smiling on the inside. We know that of all the senses, hearing is the last to go.

“They went to Old Faithful,” Alanna said. “My dad had been planning to propose. But there was some random guy who kept asking questions, and my mom—who had read everything she could about the geyser before the trip—kept answering him. How often does it erupt? About twenty-two times a day. How high does it reach? Around 130 feet. How hot is the water? Over 200 degrees Fahrenheit.” She smiled faintly. “My dad was losing it. So finally he tapped my mom on the arm and said, ‘I have a question.’ He got down on one knee, and asked, ‘Where does all the water go?’?”

I laughed. “What’s the answer?”

“I have no idea. She never gave it to him. She just said yes.”

We looked down at Judith, who let out a puddled sigh, and stopped breathing altogether.

Alanna went still. “Is that…is she…?”

I didn’t respond, because I needed to make sure it was a cessation of breathing, not just a moment of apnea. But after five minutes had passed without another breath sound, I told Alanna that Judith was gone.

She pressed her forehead to her mother’s hand, still clutched in her own. She was sobbing hard, and I did what I always did—rubbed her back, soothed, gave her a moment for her grief. I slipped out of the room to the front desk. “We need a nurse to come in and declare a death,” I said, and then went back to comfort Alanna.

After a little while, she sat up, wiping her eyes. “I have to call Peter.” Her husband. And probably a dozen other relatives. Her eyes were swollen and slightly wild.

“It can wait a minute,” I said. I wanted to give Alanna something to take away with her. “Judith told me many times how much it meant to her to have you here.”

Alanna touched her mother’s wrist. “Where do you think she is now?”

There are all kinds of answers to that question, and no one is more right or wrong than another. So I told her what I knew for certain. “I don’t know,” I said, and I gestured toward the body. “But she’s not in there.”

Just then, Judith’s jaw moved, and she drew in a deep, viscous breath.

Alanna’s gaze flew to mine. “I thought she was…”

“So did I.”

The nurse appeared, looked at the breathing patient, and raised a brow. “False alarm?”

I tell this story a lot at conferences and workshops: that the first person who died in front of me did it twice. It always gets a laugh, but it’s not funny, not at all. Imagine Alanna having to grieve her mother a second time. Imagine if the worst thing in the world happened to you, and then you had to experience it all over again.

* * *

—

MY POTENTIAL NEW client has the same birthday as me. Not just the month and date, but the year, too. I have been the death doula to clients who are younger than I am, and in a few terribly sad cases, to children. In the past I have been philosophical about it: it’s not my time, it is theirs. But today, I look down at my intake form and it feels like a metaphor.

Winifred Morse lives in Newtonville, in a small duplex that backs up to the green run of the Boston College Law School campus. She is dying of Stage 4 ovarian cancer, and unlike most of my clients, she called me herself. Usually I get inquiries from concerned family members, who want me to come in to support a loved one without telling the client what I do, as if naming a death doula is what will trigger mortality itself. I don’t take those jobs, because it feels dishonest to me, which means that I often have to tell a caregiver to wait until the client herself is facing down the barrel of death and accepts that she needs support.

I drive to her home and stand outside for a moment, closing my eyes and taking a few deep breaths to release the tension in my shoulders and spine, pushing Brian to the far corners of my mind. Right now, the only problems I will let myself have are Winifred Morse’s problems. I can worry about myself on my own time.

Her husband, Felix, answers the door. He is at least six foot five, all hooks and angles, like a praying mantis. When I introduce myself, he smiles, but the joy stops short of the fill line. “Come in, come in,” he says, and I find myself in a foyer whose walls are covered with modern art. There are canvases where soft pink blots look like the curves of a woman, from a certain angle. There are some with angry black slash marks, like the claws of a beast trying to rip its way free from the frame behind. There is one that has the most painstaking gradients of blue from top to bottom, like all the moods of the sea. It makes me think of my mother.

I do not know much about modern art, except that it is supposed to evoke feeling, and I can’t drag my eyes away from that painted ocean. “I like that one, too,” Felix says, coming to stand beside me, his hands in his pockets and his elbows sharp. “Win painted it when she was pregnant with Arlo.”

I file that information away, wondering where her son is, and how he is processing her illness. “She’s an artist, then,” I say.

Felix’s mouth twists. “She was. She hasn’t painted, really, since she got sick.”

I touch his arm. “And how about you?”

“I’m no artist. I can’t even draw a stick figure. I teach driver’s ed.” He looks at me, sheepish. “I wanted to be a doctor, but my grades weren’t good enough. So I figured out another way I could save lives.”

I try to imagine Felix cramming his frame into the passenger seat of a car, patiently instructing someone to turn on their signal before pulling away from the curb. “I wasn’t talking about work,” I say. “I meant…how are you feeling? Are you eating? Sleeping?”