THE IN-BETWEEN

A hospice nurse writes of the difficult—but sometimes sublime—moments surrounding the end of life.

As Vlahos tells it, she wasn’t cowed at the thought of tending to patients whose recoveries were off the table. With family in the funeral business, she writes, “I grew up with an understanding that death was natural, and it felt normal to me, not scary or mysterious.” One normal part of the deal, she notes, is that most of her time as a hospice nurse is spent simply on the way from one home to another, the places where most of her patients have chosen to end their days. That’s usually not fraught, though in one memorable account she tells the story of a man she tended to in a homeless camp who worried that she was in danger of being hurt in an auto accident—a prophecy that very nearly came true. Some of her patients are proud and aloof, others a touch disconnected. From all of them, the author gleans interesting lessons. One concerns “the surge,” a temporary revival of life force that signals not the restoration of health but instead the body’s last hurrah. Another is her conviction, after years on the job, that “we seem to have some control over when we die,” some choosing to wait until their loved ones have left the room, others until a loved one arrives from out of town. Particularly moving is Vlahos’ depiction of the stillness that comes when a person has died: Where it may have been two people in the room before, after the patient dies, it’s just her to document “the tangible shift in the air in that moment when a person leaves their body.” Although some of the author’s anecdotes run a touch too long and there’s a little repetitiveness to the book, one gets the sense early on that a person could do worse than die under her empathetic—not sympathetic, she takes pains to explain—care.

Gentle encouragement for all those who live under life’s running clock and for those who love them.