Talking about death and dying is never easy. But for nurses, navigating through the issues surrounding end-of-life care can be all in a day’s work.
On Feb. 28, students and faculty of the University of Virginia School of Nursing, employees and volunteers from Hospice of the Piedmont, and members of the Charlottesville community packed the McLeod Hall Auditorium to experience a drama about dying.
A one-woman play, “Waltzing the Reaper,” tells the story of an elderly woman facing the end of her life as she moves through the dying process and struggles to mend broken family relationships.
Sponsored by Hospice of the Piedmont and the School of Nursing’s Compassionate Care & Empathic Leadership Initiative, “Waltzing the Reaper” refuses to hide from the realities and complexities of death in today’s society. The play asks a hard question: How can compassion and dignity be given to the dying?
In a remarkable performance, actress Judith Gantly – whose resume includes extensive national television, film, broadcast and theatrical work – met the challenge of playing two characters. In the play’s first half, she played Vera, a cancer-ridden dying older woman; in the second half, she portrayed Vera’s daughter-in-law, troubled and confused by her role as a caregiver.
Gantly’s non-stop, one-woman performance mesmerized the audience, who lingered on the actress’ every word as if they, too, were at her dying bedside. In the McLeod Auditorium that evening, Gantly’s movements and speech created a sacred space onstage for every member of the audience to share.
With laughter, tears, song, dance and silence, Gantly brilliantly conveyed the emotional struggles of one woman’s dilemma after being hooked up to “six gurgling, buzzing, flashing technical wonders” – even though being resuscitated is against her living will.
“Why do my offspring want to keep me here like this, preserved but not alive?” Vera asks. “How long must I endure this?”
“Using performance arts, like ‘Waltzing the Reaper,’ is an inviting and nonthreatening way to explore complex, very real and emotionally difficult issues related to the end of life,” said Susan Bauer-Wu, Tussi and John Kluge Endowed Professor in Contemplative End-of-Life Care at the School of Nursing.
“Judith Gantly’s performance is one of the many ways that the U.Va. School of Nursing’s Compassionate Care & Empathic Leadership Initiative is bringing attention to the human-side of living with illness and facing the end of life,” she said.
The initiative helps to prepare nurses who regularly deal with people in life-changing situations, from one-time illness to death itself. Nursing faculty involved in this initiative offer retreats and workshops dealing with death and the dying across the spectrum.
The ultimate vision of the initiative is to reduce human suffering and promote health and well-being by fostering compassionate people and systems.
In “Waltzing the Reaper,” Vera does a kind of dance with death, passionately expressing her joys and sorrows about her life as if to establish her personal narrative one last time before her last gasp. As she moves through the last moments of her life, Vera begins to view heaven as a new way of being – “like dancing the waltz.”
In an email interview, award-winning playwright and filmmaker P. Paullette MacDougal said that she originally wrote “Waltzing the Reaper” with Gantly in mind for the part.
“Having a play written expressly for you is a magnificent gift,” Gantly said after the performance. “Then to have the privilege of taking this lovely play to audiences at hospitals, universities, conferences, seminars and workshops is a complete joy.”
When MacDougal wrote the play in the 1990s, her neighbor was living quite contentedly in her own house at the age of 107. But that was then. Such a lifestyle is not often the case for the elderly anymore.
“It has been a great privilege for me to have had close friendships with many older people and to learn from them how it is in their last days,” MacDougal said. “But in most institutional settings, it is not so good.”
MacDougal used to sing in a musical group that entertained in what were once called “nursing homes.” In many of these places, residents were tied to their wheelchairs all day in the hallway and were desperate for human contact.
“My own grandmother said her stay in this kind of facility was like ‘being in Hell,’” MacDougal said.
MacDougal’s primary purpose in writing “Waltzing the Reaper” was to let more people know about the services of hospice. On Jan. 28, MacDougal’s own mother passed away at the age of 100. She died under hospice care.
Ordinary language often does not seem to work when the conversation is about death and dying. Through artistic creation and dramatic performance, words and images can take shape to offer healing and hope to those facing death as well as to their families.
“Our work goes beyond end-of-life care and encompasses the larger context of health care,” Bauer-Wu said. “It’s about changing the experience of health care for individuals and changing health care systems through infusing compassionate and empathic presence and action on all levels – at the bedside and in management and administration.”
As Nursing School Dean Dorrie Fontaine succinctly puts it: “Compassion is not a choice, but a necessary ingredient in caring for patients and families. Organizations need to choose compassion.”