SITTING at her bedside, balancing appropriate medical care and the emotional well-being of his patient, Dr Tony O’Brien asks “what are you hoping for now, Lynn? What do you want for yourself?”
“What do I want for myself?” she says. “Just a peaceful, nice end to my life.”
St Patrick’s Hospital and Marymount Hospice opened in 1870, when the Sisters of Charity founded St Patrick’s Hospital for Incurables on the north side of Cork City. While lauded for its work with the elderly, offering respite or long-stay care, it is the hospice that is venerated, particularly by those who have been touched by the care afforded to a dying friend, relative or loved one.
St Patrick’s has moved to a beautifully designed state-of the art facility on the far side of the city, in Curraheen, but the ‘soul’ of Marymount remains unchanged. A remarkable and beautifully judged two-part documentary, Marymount Hospice, produced by M3TV Productions for TV3, the first episode of which was screened last Tuesday night, spans the move from the old premises to the new.
“When M3TV first approached us,” says Kevin O’Dwyer, Marymount CEO, “we viewed it as an opportunity. We wanted to use it as an educational tool, to dispel the fear and myths people have about palliative care. And we were reassured by colleagues in the CUH, who confirmed M3TV (who also made the documentary series From Here To Maternity) would handle the programme with sensitivity.”
O’Dwyer is referring to people for whom the word ‘Marymount’ evokes dread, because of its association with death. “I suppose the general perception of hospice care is that it’s focused on care of the dying. And I think that’s a very reasonable and understandable attitude. The reality, I like to think, is entirely different. And in hospice work we focus more particularly on enabling people to live,” says Dr O’Brien, who is consultant physician in palliative care and medical director at Marymount Hospice.
Following her cancer diagnosis two years ago, Chris Doyle’s specialist suggested she attend daycare in Marymount. “In those days,” says Doyle, in the first episode, “Marymount struck chill into all our hearts. But I went up and, do you know, I think it was really the beginning of my recovery. I found a lovely, truly warm, genuine atmosphere from when you walk in that door. It’s not like a hospital, where people look at tests and don’t look at the person, at the whole being behind the tests.
“The first day I went in there, I felt so ill but a lovely nurse just put a blanket around me and a pillow. It’s almost like the sense you have of when you were a child — you were being tucked in at night and everything was safe.”
O’Brien is a respected authority in palliative care. Along with clinical expertise, there is an emphasis on the therapeutic value of emotional support. Repeatedly in the film, as O’Brien sits softly conversing with seriously ill, sometimes terminal patients, he does something unusual — he asks the patient what they would like to happen, which must be empowering even in the final stages of life. That holistic philosophy of support is also offered to loved ones. “Particularly when somebody is imminently dying,” says O’Brien, “family members want to know, ‘how long has he got?’ It seems to be the case that there are questions within the question. It may be that there are things that they wish to say to the person who’s dying. And they want to get some sense of what time frame they have to do that. Because some of these discussions may not be easy, and they may, in fact, be working up a little courage to sit down and have the difficult conversation. There are three things people generally want to say to somebody who is dying. One of those is, ‘I love you’. The second is, ‘I’m sorry’. And the third is, ‘thank you’.”
If ever evidence was needed for the regard with which Marymount is held in Cork, look no further than the staggering €24m raised locally over the last ten years to offset the €60m required for the new building. “Fundraising is crucial in terms of the capital projects and in terms of the ongoing day-to-day revenue costs, and never more important than in the current climate,” says O’Dwyer, “and despite the challenges people are facing, their commitment and support for Marymount has remained as strong as ever — that support is more critical now because of the cutbacks in the HSE funding.”
In the documentary, patients, some in the terminal stages, open up for the cameras yet never lose their dignity. “Director Peter Carr did a brilliant job in persuading people to appear and speak as they did on camera,” says executive producer Aidan Mulcahy, “it was all about building confidence, rapport, trust.”
“I am an extremely elder gentleman. I was 70 last Sunday,” says BBC-trained Carr wryly, “and I do find myself contemplating mortality but I consider myself very privileged to have done this project.
“I found it very uplifting, it wasn’t hard, everything I experienced made me feel better about the world, it made me feel better about dying.”
The second, and final, part of Marymount Hospice is on TV3 on Tuesday, Feb 7 at 10pm