As a student nurse, Gea Arentsen discovered that hardly any attention was paid to the dying. Thus began her lifelong calling to accompany the end of life. “The last period can be extremely valuable.”
“In my family, animals are treated better on the farm than the dying are treated in this hospital.” That thought came to Gea Arentsen in the late 1970s, when, as a young nurse, she had her first experiences with dying people in an Amsterdam hospital.
Her childhood in Aalten in the Achterhoek was ‘very protected’. Both her parents come from farming families. With her younger sister they form a harmonious family that has the Protestant church as its Sunday hub. Holidays are celebrated in their own country, with a trip to Belgium as an exotic exception. Gea is a ‘serious and well-behaved’ child.
After eighteen years in the Achterhoek, she moves to Amsterdam to study English. She doesn’t feel at home in student life: ‘Everyone was so focused on themselves.’ She falls in love with a medical student, later a general practitioner, with whom she would have three children. A friend of his tells about nursing: ‘Helping others appealed to me, so I signed up for the course. Only I hadn’t realized that people also die in the hospital.’
To her dismay, doctors and nurses seem to pay almost no attention to the dying. As a student nurse she does receive lessons in the practical ‘laying down’, but otherwise the ekaze is not to talk to the dying: ‘I kept doing it anyway, even though the head nurse gave me my thunder. My nickname became ‘the cuddly sister’.’
It is the very beginning of what will become a lifelong calling. Decades later, the progress in dealing with dying is undeniable, she notes. ‘Since the 1990s, palliative care has become established and many hospices have sprung up.’ Since 2004, the now 65-year-old Arentsen has been working as a staff member in Hospice Rozenheuvel, near Arnhem, where she comes into contact with people from all walks of life.
Despite TV programs and awareness campaigns, death remains a difficult subject for many: ‘Most people prefer not to talk about it. My biggest job is to get the family to dare to be part of the dying process. I wish people that.’ Because in her eyes approaching death offers an opportunity for life lessons: ‘I learn a lot from it for my own life.’
Why did you choose this job?
“It’s related to the very first time I witnessed someone’s death. That was in the seventies in a small hospital, near the Jordaan. The patients were local residents, homeless people and sailors. The dying were placed in a windowless room at the end of the corridor. A colleague who didn’t like me as a starting nurse told me that I had to watch over an elderly homeless man there.
‘I thought he was terrifying, he had frightened eyes and was bewildered. I went knitting away from him to focus on something else. Gradually, a kind of calm emerged. I moved my chair closer and closer. We got in touch without exchanging a word. First with our eyes, later that night I dared to touch his arm and hand. He relaxed, stopped moving, and his breathing settled. I sat with him from eleven in the evening until four in the morning. Eventually, his breathing became shallower and he died. At that moment the room became light, while it was dark outside and only a small table lamp was on. I find it difficult to interpret, at the time I thought: now he is with God. In any case, that event made me feel no fear of death anymore. That helped me further on this path. Gradually I became more and more convinced that the dying should be treated more humanely.’
Then what bothered you?
‘There was absolutely no awareness that these people are in their most vulnerable phase of life and therefore need support. The concern was minimal. The wounds were treated and people were washed, but otherwise there was hardly any attention. Doctors seemed to view dying as failure – they were there to make people better. They had no knowledge of what to do when healing was no longer possible. “There’s nothing more we can do for you,” was their regular turn of phrase. Later, as a nursing teacher, I explained that you should never say that. You can mean a lot, especially in the dying phase.’
What do you learn about how to deal with dying on a daily basis?
‘The last period can be extremely valuable. You go back to the essence of what life means. I don’t want to overstate it, it is also usually accompanied by pain and can be terrible. Everything is magnified on the deathbed. For example in relation to the family: what is beautiful, the attention and love that someone receives from his loved ones increases. Unfortunately, that also often applies to misery and irritations. The walls of protection you have built around yourself are crumbling. The masks fall off. This also has a physical explanation: you no longer have the strength to keep them upright. People become more honest, purer towards their neighbors. Often that is preferable and softer, sometimes harder.’
What will you learn from it?
“One of the life lessons for me is the importance of surrender. That’s how I get it. Recently, two women in their 40s were in hospice with the same type of cancer. They both had a hard time with it. But one did not want to receive visitors at all and remained angry. If someone came by, she let it pass. The other woman welcomed people: she played beautiful music, there were flowers, there was room for sadness, but also for love and humour, anything could happen. She accepted her death. When I went from one room to another, my eyes closed. It was instructive, I know how I would like it myself.’
Is that acceptance tantamount to “resigning yourself to death”?
‘No, that’s too passive. People who accept it think: it is no different. But those who can accept it surrender to it. That is active: they entrust themselves to the unknown. That’s a big difference. If you accept it, you will remain a victim in a sense. For me that is also a form of suffering, not of living.’
Is that a contradiction, suffering and life?
‘For me, life is open and full, accepting what is. While suffering is a form of resistance and being stuck. There is much suffering in everyone’s life. You can become freer from that when you live through it. Then you end up with trust and love – I think the meaning of life is above all love. That may sound soft, but in the end that’s what it’s about. Love comes through surrender. For me that is a lesson that applies not only to the last phase, but to life as a whole.’
What else do you learn from the dying process?
“What I’ve learned is the importance of forgiveness—or at least speaking up. Even when it comes to terrible things. Then you don’t have to carry that backpack of pain for the rest of your life or less. I have seen daughters no longer able to talk about incest with their fathers and I saw how much bitterness remains.
‘I have also experienced the opposite. Recently we had a very charming man in hospice, but he turned out to have been abusing his wife for years. She was afraid of him, had never said a word about it and asked my advice: how should she go on with her life, what should she do now that he was dying? We practiced how she could talk about it: not accusingly, but by telling it from her experience. She made it clear to him in twenty minutes how she suffered and how she did her best. He heard it.
“When she came out, she was a different woman. “I just wanted him to listen to me,” she said. She also thanked him for their children and for his financial support. He didn’t apologize, but he didn’t have to. By telling it, she had, in her words, “returned it to him.” Venting your heart in that way, in real contact with the other, that is a great life lesson for me.’
Have you also applied it?
“The pure and honest that the dying can show has been an example to me – it taught me to be closer to myself. Gradually I learned that besides being sweet and kind, I can also be a shrew. That is an enormous power. During my divorce I got really angry with my husband and his new girlfriend.
‘I divorced my husband in 2011, after 32 years. I always wanted to be liked and liked and adapted for a long time, without saying what was bothering me. I wasn’t honest about that—not to my husband, but not to myself either. It made me complain and whine and see myself as a victim.’
Were you able to forgive him too?
‘I quickly resolved that, because I didn’t want to be bitter for the rest of my life. That took years. I was going through an existential crisis. Sometimes I thought I wanted to die, sometimes I thought I was going crazy. It was a dark night for my soul. I also got jealous of people in hospice who had a partner die. That seemed like pure mourning to me, better than what I felt. Because of that jealousy I stopped for half a year. I sat on the bottom and then I asked for help. I showed myself in all rottenness, that took a lot of courage.
“The divorce initially felt like a betrayal of our marriage – I had been convinced we would never do that. But in the end it wasn’t a betrayal and I just became true to myself. In retrospect, it is very good that I lived through that crisis. It made room for the last seven years, the happiest period of my life. This is the time when I was most myself. I was afraid to be alone. That turned out to be unnecessary – there is a lot of love in my life, like from my children, grandchildren and friends.
‘A new love seems very nice to me, that is a desire. But if it doesn’t happen, that’s fine too. When death comes, I suspect that I can let go, yes, my children and grandchildren too. But I’ll keep my eye on it, you never know for sure. In any case I will be happy, because I think I have lived a fulfilled life.’