Hospice Girl Friday | Why I Became a Hospice Volunteer


Devra Lee Fishman’s dear friend and college roommate, Leslie, died from breast cancer one month shy of her 46th birthday after a four-year battle with the disease. Being with Leslie and her family at the end of her life inspired Devra to help care for others who are terminally ill. Each week, she documents her experiences volunteering at her local hospice.

Hospice volunteer caring for a female patient lying in bed
Photo courtesy Shutterstock. © Dragon Images

“You’re so brave.”

“I could never do what you do.”

“I don’t know how you do it. You’re my hero.”

These are just some of the comments I hear when I tell my friends that I am a hospice volunteer.

I don’t feel brave or like I am doing something—anything—extraordinary. I’m embarrassed to admit that my stomach flip-flops every time I walk through the hospice doors to start my weekly shift because I am convinced that I will be found out as an imposter, unqualified to be around people who are ill and know that they are at the end of their lives. I am afraid that I will say or do the wrong thing and make patients or their family members uncomfortable, which is the direct opposite of my intentions. I doubt true heroes feel those emotions. But, greater than my fear of failure is a sense of being compelled—the same way I am compelled to breathe or write—to try to make a difference in the lives of people who are aware of their impending death, and are often afraid or unwilling to accept it.

I was inspired to become a hospice volunteer by my friend Leslie. She was diagnosed with stage 4 breast cancer in 2001, just after she moved back east from Los Angeles and had settled into a charming, quiet village on the Hudson River with her husband and 10-year-old daughter.

Knowing that the odds were not in her favor did not stop Leslie from fighting. She believed that if she could just stay alive long enough, some smart person would break the code and put an end to breast cancer once and for all.

“This is the best time to have cancer,” Leslie would say, “because researchers are this close to a cure.” So for four years Leslie pursued surgeries and treatments to hold back the cancer as it spread into her chest wall, brain and, eventually, throughout her body. Leslie succumbed to the disease a few weeks before her 46th birthday.

About a month before that, I drove up from my home in Virginia to stay with Leslie for several days while her husband attended graduate school classes. I was surprised to see how much she had deteriorated since my previous visit and for the first time I wondered if she was going to stay alive long enough to benefit from that elusive cure. Her skin was waxy and had a yellow cast. The left side of her body stopped working (the cancer in her brain came back after bouts of radiation) and her vision was diminished.

On my first day there I took Leslie to a doctor’s appointment that was meant to be a routine pre-chemo check-up. Instead, the doctor told Leslie that her cancer was no longer responding to the chemotherapy and that there were no more treatments available to try. Leslie was always stronger than me; the one who took on any challenge with a bright-side attitude and sense of humor, but the ride home was quiet with each of us in our own thoughts. I remember thinking that I was not qualified to handle the situation and considered going home, but then quickly decided I would not let my fear get in the way of being with Leslie at such a critical time.

I don’t know if her doctor recommended hospice care but when we got home that day I did, even though I wasn’t entirely sure what hospice was or how it worked. I only knew that hospice was for people who were sick and dying … people for whom there are no medical cures.

Leslie told me she was not interested. She argued that she was not dying and a few days later found another doctor to give her more chemo. The side effects made her sicker and it didn’t take long before her symptoms were out of control. Finally Leslie’s husband made the decision to put her into hospice.

Leslie spent the last five days of her life being cared for by a team of compassionate doctors, nurses, social workers and grief counselors who managed her symptoms and kept her comfortable as her body transitioned. They were patient, kind, and caring to Leslie and took time to answer questions and explain the dying process to those of us who were sitting vigil. Once Leslie was gone they generously shared hugs and sweet words of comfort. I am convinced they were all hiding angel wings underneath their scrubs.

Leslie and I shared all of our major life experiences since the day we met as freshman roommates at Syracuse University and it was an honor to be with her—and her family—as she died. Leslie gave me an opportunity to provide unconditional, loving strength and support when she needed it most and the hospice professionals inspired me to continue to at least try to provide some sort of comfort to others.

I became a hospice volunteer the year after Leslie died.

Next post: These Four Walls

Bonus: For more on end of life care from a physician’s perspective, see How Doctors Die from our March/April 2013 issue.

A Walk To Remember

Devra and Leslie
Devra (left) and Leslie were paired as college roommates more than 30 years ago. Today, Devra participates in the Avon Walk, not only to raise money for a cure, but to stay connected to her lifelong friend.

Nearly 2,000 of us gathered at the foot of the Washington Monument on an early May morning waiting for the opening ceremony of the 2012 Avon Walk for Breast Cancer to begin. Clouds of coffee and sunblock hung in the warm, humid air and a song about being strong against all odds thumped out from the loudspeakers like a hopped-up heartbeat.

A group of women wearing pink tulle skirts and black T-shirts embroidered ‘Tutus for Tatas’ across the chest moved toward me as I bent over to tie my sneaker. The fronts of their hats were inscribed in black sharpie: “For Mom”; “In loving memory of Susie”; “For Cathy, Barb and Allison.”

One of them greeted me when I stood up. “Hi, I’m Mary. Who are you walking for?” she asked, smiling and scanning my unadorned T-shirt for clues.

“My friend Leslie,” I said, who was diagnosed with breast cancer 10 years earlier.

The music faded as a man called our attention to the stage. “Good morning,” the speaker’s deep voice boomed. “My name is Mark and I’m walking for my three sisters who were all diagnosed with breast cancer at the same time and died within two years of each other.”

Some walkers stopped warming up their hamstrings to applaud. I reached into my fanny pack for a tissue and before anyone had a chance to recover a woman wearing a bright pink Nicki Minaj wig stepped up to the microphone. “Hello. My name is Margaret and I am 38 years old. This is my second Avon Walk. Four years ago I walked for my aunt Joanie, who is a 26-year survivor. Now, after being diagnosed with breast cancer in 2010, I am proud to say I am a survivor too.”

A woman from the Avon Foundation was the last to speak. She told us that every three minutes someone is diagnosed with breast cancer and every 13 minutes a life is lost to the disease, numbers many of us already knew by heart. I swallowed down the fear that I could become one of her statistics and applauded with the other potential victims around me as she officially opened the event.

As I started to walk, I thought about how lucky I was that Leslie and I were paired as college roommates more than 30 years ago. One evening, a month or two into our freshman year, Leslie and I walked back to our room after dinner to play backgammon, which had become a nightly ritual. We got to know each other over those games, taking turns asking questions about our families, our friends back home, and our likes and dislikes. We always sat on Leslie’s bed, made up with dark green flannel sheets and a red and black plaid wool blanket, all from L.L. Bean, a store based in Maine where her family had a vacation home. On the shelf next to her bed, she lined up three family photographs in matching black frames and a clock radio tuned to the local “Music of Your Life” station. Across the room, I had a rainbow striped quilt on my unmade bed and a poster of Tom Selleck in Magnum, P.I. taped to the wall above it.

About 15 minutes into our first game, the fire alarm went off, and as we rushed out of the room, I caught my finger in the door when I tried to slam it shut. The pain was instant and excrutiating.

Once outside, I began to panic. “I need a doctor, but I think the student health center closed at 6,” I sobbed to Leslie, holding up my swollen finger. My parents had always handled situations like this, and I wasn’t sure what to do.

“Come on,” Leslie said, taking charge. “There’s a hospital three blocks down the street that I pass every day on my way to class. We can walk.”

Five minutes later we were standing in front of the emergency room of the local Veterans Hospital. It was dark and looked closed except for the lighted sign indicating an ambulance entrance. We knocked on the locked door, and a nurse slid open a peek-a-boo panel. All we could see was her face, tilted upward as though she were standing on tippy toes.

“How can I help you?” she asked.

Leslie stepped in front of me and said, “My roommate slammed her finger in a door, and we think it’s broken. Is there a doctor we can see?”

“Is your roommate a veteran?” The nurse’s lips were thin and creased. She smiled, but only with the bottom half of her face.

“Should she be?” Leslie asked.

“If she wants to be treated here, either she or someone in her immediate family needs to be a veteran.”

Leslie looked at me. “Know any veterans, Devra?”

I shook my head, then asked, “What if I split my head open and was standing here with blood running down my face? Would I have to be a veteran to see a doctor?”

Leslie looked at her shoes and stifled a laugh while we waited for a reply. Her right leg started to shake, her tell when she was uncomfortable.

“There is a public hospital half a mile east of here. They take anybody,” the nurse said sharply. Then she lowered herself and snapped the panel shut, so hard it made my finger throb even more.

To distract me from the pain as we walked, Leslie started playing a game to see who could come up with the most gruesome injuries that the veterans-only hospital would turn away.

“What if I were carrying your severed leg while you hopped on one foot. Do you think they’d let us in?”

I knew it was my turn. “Or how about if I just swallowed a pencil and was experiencing stabbing pain in my stomach. Would she open the entire door?”

“Good one. Or what if your eyeball fell out and you showed it to the nurse through the peep hole. Would you get to see a veteran’s doctor? Get it? Peep hole? See a doctor?” Leslie’s words rode out on waves of laughter. We had to stop walking for a moment to give in to our giggles.

I was treated right away at the public hospital, and Leslie and I continued to make each other laugh throughout our friendship. In the late ’80s, we were in each other’s weddings, and when my marriage failed, Leslie offered the wisdom that helped me move on: “Dev, I’m sorry you’re hurting, but everything in life is a crapshoot, so quit your crying and live your life.”

And when she found out a long-term boyfriend dumped me around the same time she was diagnosed, she called and said, “In a lot of ways cancer is easier to deal with than a broken heart because there are treatments for cancer. You’re going to be fine. So am I.”

I participated in my first Avon Walk in 2004 to help Leslie in some way, as she helped me so many times since the night I slammed my finger in the door. Even though Leslie said she didn’t need anyone’s help, I wanted to raise money for the cure she felt we were “this close” to finding. At the opening ceremony I listened to the stories of loss and survival but didn’t relate, because even though Leslie had been fighting recurring cancer for two years, she had everyone convinced that she was going to be fine. I felt the same at the 2005 Walk, probably because Leslie was still alive.

Leslie died in 2006, a few weeks before my third Avon Walk and just shy of her 46th birthday. While leafing through an issue of Oprah magazine during my post-walk pedicure, a J. Crew ad caught my eye. The male model was our dorm manager from freshman year, a closeted, flirtatious blond artist who had a steady stream of boyfriends he didn’t think we noticed. I started to tear out the page to send to Leslie, who I knew would get a kick out of seeing it, but froze when I remembered that she was gone.

The more time passes, the more trouble I have recalling the smell of Leslie’s Clinique Happy perfume, or her quick laugh when I said something she thought was funny, or the way she made me feel safe and loved with her caring wisdom. I miss all of that. As long as she lived, she never lost her sense of humor; around her I always felt as bright and sparkly as she was to me. Gosh, I miss that, too. When she died, our story, our inside jokes, our friendship died with her, and I struggle to keep the image of us—of who I was with her and who we were together—clear in my mind. It’s as though a photograph of her is fading, which makes me feel like I am disappearing too.

I continue to participate in the Avon Walk every year, despite the unwelcome bond I now have with the other walkers who have lost someone they loved to the disease, because when I walk I replay my favorite moments with Leslie. Somehow my grief gives way to the joy I used to feel in her presence, and, for a brief time, I am whole again. Yes, I am committed to raise money to help find the cure that Leslie believed was just steps away. I fundraise and walk with the determination that breast cancer will become something that used to be, like eight-track tapes and rotary dial phones. But mostly I walk to stay connected to Leslie—my lifelong friend—and to keep the part of me that was a part of us alive.


This year, Devra is participating in her 10th Avon Walk in memory of her dear friend and college roommate, Leslie Klein.