"The In-Between" (Hadley Vlahos R.N.)

TITLE: The In-Between: Unforgettable Encounters During Life's Final Moments
AUTHOR: Hadley Vlahos R.N.
PUBLISHER: New York, NY: Ballantine Books, 2023, (288 pages).
 

Among the many kinds of phobia in the world today, the fear of dying remains at the top of the list. News of terminal illness can not only bring about depression to the sick, but it also stresses our family and loved ones in unimaginable ways. Whether it is cancer or some form of debilitating disease, as long as there is some hope of recovery, the fear of dying can be kept at bay. However, when it comes to incurable illnesses that involve entering into hospice care, the mood takes a traumatic turn. Imagine being a full-time staff working in such an environment. This is exactly what author and registered hospice nurse, Hadley Vlahos has experienced. She takes care of and walks with many people living their final days on Earth. Each patient can live up to six months. Sharing many powerful stories of courage, despair, hope, powerlessness, and many emotional moments, Vlahos takes us through the ups and downs of hospice ministry. She shares how she first became interested in end-of-life matters after the death of a personal friend. Through various twists and turns in her life, after some time in nursing school, she ends up working in hospice care. This book is about her learning, experiences, and journeys with individuals in hospice care. There was Glenda, an 86-year-old female whose metastatic melanoma had spread to other regions. She was the first person the author had to practice the checklist on "patient death." Carl who struggled with congestive heart failure seemed to have a sudden ad mysterious surge of energy toward the end. He had become like a grandfather to Vlahos. Then there is Sue who suffers from chronic obstructive pulmonary disease (COPD) and didn't want to speak to anyone at first but eventually opens up to Vlahos. Sandra, a 50-year-old breast cancer patient whose cancer had advanced to such a state that her doctor had to recommend hospice care. Sandra was able to maintain a smile despite her illness. Vlahos marvels at how simple things could make such a big difference. There are others with all other kinds of sicknesses like Edith's Alzheimer's; Reggie's end-stage liver disease; and Lily, a dying travel patient, etc. 

My Thoughts

In each of these stories, the author shares her initial encounters with them, moments of interaction with them, and eventually experiencing personally their passing. For some of us, this can be too squeamish for comfort. Yet, these are part and parcel of living, struggling, and dying. These interactions are heartwarming and meaningful. It brings to mind something that comes from the popular writer, Mitch Albom, whose work "Tuesdays with Morrie" was a bestseller. Albom once said: "The truth is, once you learn how to die, you learn how to live." Each chapter does exactly that. I am amazed at the level of detail the author has to describe the conversations and observations. For some of us, just seeing the physical ailments might render us speechless. Here we learn about the value of silence and persistence. As Vlahos faithfully carries out her nursing duties, her regular attentiveness to her patients' needs opens them up. By becoming friends, there is much joy in sharing stories and also much sadness in saying goodbye. In our world, many people tend to be more comfortable in solving problems and finding ways to overcome barriers. In a hospice world, what can be more distressing than an incurable disease? What can make us more helpless than to know we cannot do anything to help a person get better? Perhaps, it is such levels of helplessness that prompt us to cherish life as we have. Appreciate our loved ones when we can. Do all the good when we are able to. Do not miss out on the simple things in life. 

Helen Keller once said, "The best and most beautiful things in this world cannot be seen or even heard but must be felt with the heart." These are things that money cannot buy. All of us are mortal beings. It is only a matter of time before we all say goodbye to this world. Why not make our lives count by doing all the good we can, when we can. Vlahos has been called to serve in the Ministry of hospice care. I know of people who shun such places mainly because they fear death or the thought of dying. My take is this. The sooner we learn to embrace the reality of death and dying, the less the fear. The more we learn to accept that life can be short and utterly temporal, the less uncomfortable we will feel when we meet dying people. Life in the In-Between is not easy. As Vlahos has shown us, neither is it impossible. 

Hadley Vlahos, RN, is a hospice registered nurse, mother, and wife. Her husband also works in the medical field as a doctor of physical therapy. Vlahos started her career as a registered nurse at twenty-two. As a hospice nurse, she now visits people at their home while also educating and sharing stories about hospice care on social media, where she has more than a million followers.

Rating: 4 stars out of 5.

conrade

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This book has been provided courtesy of Ballantine Books (an imprint of Random House) via NetGalley without requiring a positive review. All opinions offered above are mine unless otherwise stated or implied.