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by Cindy A. Abole, Public Relations

Like apple pie and amber waves of grain, the volunteer is deeply embedded in the American culture. At times this centuries-old tradition of caring and doing something about it, seems even to define and sustain the national character.

Americans will volunteer for anything.

With open pockets and the sweat of their brow, they charge into any charity that touches their hearts. And they are easy touches. They will join walkathons, telethons, bikeathons and even kissathons—and then take deep satisfaction from having done so. They will donate their food, their clothes, their homes and even their blood and see who can give the most.

When their community or their nation seems imperiled, volunteers will get in line even as the tocsin rings.

And nowhere is the volunteer more vital than when life is threatened.

That spirit is most visible in crisis, such as the imminent death of a friend or neighbor.

Hospice provides specialized care for terminally ill people living at home, in nursing facilities, clinics, hospitals and healthcare programs. It is an ethical option, usually offered during the last months and weeks of a patient's life.

“Hospice workers and volunteers are not hired, they’re called.” said Phyllis Robinson, a hospice social worker and volunteer coordinator at Hospice Health Services. “It’s incredible how people are generous of their time.”

Studies indicate that a majority of Americans prefer the opportunity to spend their final days of life at home. In truth, only one in four actually does.

In South Carolina, about 60 percent of the dying population will die in hospitals. It is among the highest rates in the nation.

Aida Lacson and Matt Stolick embody the spirit of American service with their roles as volunteers at Hospice Health Services in West Ashley.

“Patients come to hospice to find a sense of peace,” said Robinson. “They want to concentrate on making the most of every day.” Before that, patients spend a stressful time taking care of business and making decisions, as well as dealing with their illness.

Central to the patient and family are the hospice team members. This group might include physicians, chaplains, nurses, home health aides, other health professionals and volunteers. Hospice services are available 24 hours a day, seven days a week.

Stolick’s interests extend beyond just volunteerism. An interdisciplinary fellow with the Institute of HumanValues with the Department of Surgery, Stolick wrote his graduate dissertation on compassion in healthcare. He is genuinely interested in advocating for patient’s rights as it relates to the end-of-life experience.

“There are no set rules in what I can do for my patients,” said Stolick. He is a person who wants to help his patient find a position in life for themselves. “Each patient is unique in their needs.”

Often, Stolick sets no specific agenda for his visits. “I usually allow my patients to help guide me.”

Lacson, 25, fits the mold of a typical hospice volunteer. The youngest of four children, this slender and petite young lady has the heart of a giant.

Even at a young age, Lacson’s life was influenced by personal grief. At the age of 13, she was shocked by the death of her sister following an auto accident. The tragedy was personal for Lacson and her family.

In her first year at MUSC, Lacson found some extra time to devote to volunteer work. After attending September’s MUSC Gives Back Volunteer Rally on campus, she met Phyllis Robinson, a social worker with Hospice Health Services. Robinson recognized something special about this occupational therapy student.

“I learned how hospice is a great support service that is very crucial for others,” said Lacson. “It is especially helpful to those people who are losing a loved one.”

Lacson was paired with Ms. S, a retired nurse in her late 60s who has been diagnosed with end-stage renal failure. The pair hit it off immediately.

“I really love to put a smile on her face,” said Lacson, her own face beaming with delight. Since October, Lacson has visited Ms. S weekly and has contributed more than 35 volunteer hours.

The pair spends most of their time talking and they are totally happy in their deep discussions about current events, politics and sometimes even the subject of death.

Like the blossoming of a Lowcountry azalea in spring, Lacson has come to admire the many qualities and virtues of her patient. “Ms. S has a strong, positive attitude,” said Lacson, referring to her patient’s strong religious beliefs and good family support.

“Aida’s presence brightens a room,” said Robinson. “She always brings a warm, bright smile to her patient, the family and staff.”

Working with terminally ill patients can be emotionally challenging.

“Perhaps the hardest part of the program is coming to terms that one day, my patient can go away,” said Lacson. “I just don’t know when.”

Instead, Lacson places all of her energy and attention on Ms. S’s care and comfort. “I wish I had learned about hospice earlier in my life,” she said referring to her own grieving process.

Stolick is a rare breed when it comes to hospice volunteers. Males are a minority in an organization that traditionally attracts healers. Stolick has been matched with three male patients since January.

Although two have passed on, he feels particularly close to Mr. T, a 34 year-old terminal brain cancer patient who has been with Hospice since 1996.

Twice a week, Stolick makes the drive between Charleston and Ladson to visit his patient. Stolick enjoys his drives. It's usually the best time to spend reflecting and putting things into perspective prior to visits, he said.

Asked about his volunteer efforts, Stolick remains humble. “At the same time I’m providing for them (patients), they’re providing something for me.” he said. “It’s hard for a person in their condition to give up control, stop the struggle and find peace.”

Stolick’s beliefs were tested recently in a gathering between other fellowship participants and MUSC president James B. Edwards, DMD.

Edwards asked if he could change or influence one thing at the university, what would that be? Stolick was quick to reply. He hoped that all caregivers could initiate the hospice philosophy in the early care and treatment of pain suffering and terminally ill patients.

The university currently sponsors several end of life care programs for students, residents and practicing physicians.

Although Stolick and Lacson will move on with other life plans in the coming months, they will not forget the experiences and influences these relationships have made to their lives. “There’s no substitute for what you can get as a volunteer,” said Stolick.

Campus programs focus on death, dying issues

America has been called a death-denying society.

Current data indicates that physicians often have difficulty knowing when cure is no longer possible and when patient care efforts should instead focus on quality comfort care for the dying patient.

There is an urgent need to train health care professionals in palliative and end-of-life care.

“An interdisciplinary approach to end-of-life care is vital to the success of individual programs and to achieving the overall goal of improving care for dying patients and their families,” said Jerry Kurent, M.D., associate professor of medicine, neurology and psychiatry and acting director, Center for the Study of Aging.

Since 1979, the College of Medicine has sponsored the course, “Death and the Human Experience,” for medical students. Originally offered to seniors as a full-time elective, the course explored the different stages of the dying process. Taught by Bert Keller, associate professor of family medicine and more recently by Kurent and Frank Brescia, M.D., Department of Hemocology and Oncology, the course focus includes the humanities perspective as well as clinical dimensions of palliative and end-of-life care. In 1988, a hospice elective was also offered to students desiring an educational experience in this important area of end-of-life patient care.

Kurent is involved with the program, Education for Physicians in End-of-Life Care. This “teach the teacher” initiative is sponsored by the American Medical Association and the Robert Wood Johnson Foundation, and consists of an end-of-life curriculum developed by a panel of national experts.

A key challenge with the program is to use all available means to disseminate educational information to physicians across the state. Efforts are underway to acquire continuing medical education accreditation for the program.

The South Carolina Collaborative on End-of-Life Care is developing a grant proposal to be submitted this spring to the Johnson Foundation's program which will fund, “Community-State Partnerships in End-of-Life Care.”

Interdisciplinary approaches to enhance end-of-life care policy at the state level are being discussed, as well as the means to educating the public and health care professionals. The collaborative includes the South Carolina Health Care Alliance, Hospice for the Carolinas, MUSC, USC and other institutions of higher education in South Carolina.

The Ralph H. Johnson Veterans Administration Medical Center is one of 30 VA sites across the country selected to develop an end-of-life curriculum for internal medicine residents. Once developed, the curriculum would also be made available to other similar sites across the country.

The College of Medicine is currently involved in curriculum revision. Keller, Kurent and other MUSC faculty are involved in developing a palliative and end-of-life care focus within the curriculum.

Few medical schools across the country presently have a specific focus on these key areas. MUSC is in a unique position to develop a model curriculum in this regard.