Petra HILLINGER, the author of this series of articles on hospices in Austria, was born in 1968. She works as an editor in the arts section of the well-known daily newspaper "KURIER" in Vienna/Austria, where she lives with her family. For several years now in her spare time she has been doing voluntary work in the Caritas Socialis Hospice in Vienna. She explained the reasons for her choice in a recent interview:

"I've been very lucky in life. I am in good health, have a good job, a wonderful family, great friends and lots of fun. Why not share some of it with less fortunate people?" Six years ago at the Hospice of the Caritas Socialis she came into contact with cancer patients in their terminal stage, and she instantly knew: "This is where I belong." Since that day she has worked there as a volunteer. She assists the regular staff in washing the patients, changing their diapers, etc. and also talks with them about books, the aquarium, or the world in general: "Those are very special encounters", she says, "no one is showing off or hiding behind a mask." Hillinger wants to prove to the terminally ill "that they are still of value, even when they can't work or talk anymore." In order to be with them for up to 15 hours a week, she asked her chief editor to grant her part-time employment. In the world of journalism such a step is rather unusual and results in a substantial loss of earnings. "He accepted my request without making any problems. I have to give him full credit for that."

It goes without saying that the idea of hospice was created out of love and is still supported by the spirit of love. It even began with a true love story in a London hospital in 1947. Cicely Saunders, a nurse and social worker and then in her late twenties, and David Tasma, terminally ill with cancer, realized - as his death was fast approaching - that they would have made a perfect couple for life. They talked. They knew they had not much time left, so they tried to spend it in the best possible way by giving meaning to their lives. Breathing space was closing in on them, but until the end they tried to keep a perspective.

The idea developed that it is much easier for a dying person to find a meaning for his life and thus maybe an exit into another world. But it took all of 20 years until this idea could be put into practice: David Tasma had left his modest fortune to Cicely. "I will be the window in your house", he told her in his will. And thus St. Christopher's Hospice in a suburb of London became the mother-house of the modern Hospice movement.

There is plenty of time in that house. There is also plenty of space. One would have thought that the idea of hospices would have been fully appreciated everywhere. Not at all: In Austria, for instance, 30 years after the opening of St. Christopher's the idea is only slowly catching on. There are still some defenders of orthodox medical thinking, whose ultimate goal is to cure a patient and who are opposed to the idea of releasing a terminally ill person from the clutches of the system. And still for many people accompanying someone on his last way equals practicing euthanasia. Ignorance and suspicion are still rife.

What happens in a hospice? An individual who in all probability is terminally ill is taken care of as a human being in his entirety. So-called palliative medicine is geared towards pain relief and control of the symptoms. Special skin patches and subcutaneous depot release pumps are used for pain control, and side effects such as fatigue and nausea are dealt with. The aim is not to stretch out the lifespan left, but to fill the time left with quality.

If, for instance, a patient refuses to eat, that decision is accepted. Up to the very last moment the patient's autonomy is preserved. The body may fail, but the thoughts are still free. And dignity remains intact. The human being in its entirety is taken care of - and that encompasses body, spirit and soul as well as family and friends. In hospices loved ones may visit round the clock, and their cares are also addressed, as far as possible. Family members are supported in their pain when their loved one dies, as well as later during the period of mourning.

Letting go, leaving everything behind, giving up. Sometimes this may represent a struggle going on for weeks, sometimes it is seen as an event awaited almost with joy.

By Petra Hillinger

Staying in a hospice means living until the very last minute. Without the usual sophisticated medical machinery and without any time pressure. It means crying together, but also laughing together. It means learning from each other, growing together and supporting each other. A voluntary hospice helper tells the story.

I first saw Mrs. Markovics last autumn. A great looking small lady with a soft, almost raw little voice. She was modest and very courageous. She had brought up two sons, and she had had to bury two sons. Mrs. Markovics had never wanted her cancer treated. She had lived with it as if she considered it an uninvited visitor. Maybe she didn't want to know for sure what exactly it was that had taken possession of her body. In any case, she never wanted to talk about her illness. Not even when the symptoms were there plain to see. Her legs failed her - so she clung on to life with her arms. All that was left to her were her crossword puzzles, her tremendous willpower and a husband who proved helpless when confronted with her disease. And who displayed rather strange reactions: "Pull yourself together", he admonished his paraplegic wife, when once more she fell out of her bed during the weeks when he nursed her at home. He gave her little to eat and drink to avoid having to change her diapers too often.

She smiled - sometimes behind a veil of tears. She encouraged herself and him: "In spring everything will change for the better." Mrs. Markovics passed away one week before the beginning of spring. After lying in agony for ages. She was nothing but skin and bone, weak, and her body was covered with sores. Until the end her arms had flailed about as if in panic. She was thrashing about, clenching her fists.

During his rare visits, her husband tugged and pulled at her nervously. If someone tried to calm him down, his reaction was a reproachful wail: "She's partly dead anyway."

But how alive she was! She instantly quieted down when someone sat at her bedside. Nevertheless, everyday I wished that her suffering would finally be over. When I was with her I never knew for sure whom I wanted to inspire more with my murmured litanies of poems. Often for hours I recited Hermann Hesse's "Steps". One night, Nurse Barbara had watched over Mrs. Markovics. Nurse Barbara had told her in no uncertain terms that it would be perfectly all right if she set out for her journey. Someone would assist her husband. The very next morning she fell asleep for good.

Mrs. Prammer has been with us only for a few days. Due to her gall bladder cancer she was like a yolk-yellow granny straight out of a book of fairy tales. She was over 80 and very lovely. All through her life she had cared for other people. Now the only thing she wanted to do was to sleep. Huddled up like a baby. "Oh, I'm still alive", she stated in amazement one morning. She used to take a keen interest in the weather forecast. Her last days were sunny and warm. That is what kept her in this world. Once it got rainy, the deeply religious woman went into her "better world". Just like she had pictured herself doing.

A friendship that was to last only two weeks

By Petra Hillinger

Staying in a hospice means living until the very last minute. Without the usual sophisticated medical machinery and without any time pressure. It means crying together, but also laughing together. It means learning from each other, growing together and supporting each other. A voluntary hospice helper tells the story.

I am having a conversation on the phone with my sister: "Hallo dear, so you're still alive!" My answer: "Yes, I'm still alive but everyone else has died." I take much from the hospice back into my own home - sad things and beautiful things, small details and things of greatness. I learn to live for the here and now, to plan for the next hours and days, but not further ahead.

Will I have a cup of coffee with Mr. Knopfler next Tuesday? I would be delighted. Nevertheless, perhaps to be on the safe side, I looked him straight in the eyes when I left him yesterday. Mr. Knopfler is 80 years old, he is a worldly-wise and warmhearted man who always tries to conceal how bad his condition is. We have much to say to each other. And then we sit together silently, in tacit understanding. It was like that from the beginning. He has bright blue eyes. I don't know if I will have the opportunity once more to look into these sparkling blue eyes. But this gaze, even if this time it's the last one, nobody can take it away from us. Not from him and not from me.

"You will receive a big present", Mrs. Zwingenberger had told me. And how right she was. "How is the weary warrior?" I asked Mr. Knopfler. He tried to manage a smile. "The Sioux wants to go to the happy hunting grounds." The question of how long it would still take him was hanging over our heads constantly.

I suggest to Mr. Knopfler that he should try to rely on his instincts, to listen to his inner voice. And I tell him how happy it has made me to have known him. He tells me he feels the same: "A friendship like ours is very rare in life." Mr. Knopfler started to paint at the age of 75; he took a course at evening school and learned to copy the Impressionists. An unfinished summer garden done after Monet stands propped against the wall above his headboard. The red field poppy is still missing in the painting. And Mr. Knopfler has a hard time resigning himself to the fact that his work will remain unfinished.

Two days before his death he told me what he saw in his dream: "My daughter guided my hand and I could finish the Monet." That evening I went to the Danube Channel, picked a bunch of field poppies and put them on Mr. Knopfler's bedside table.

We communicated a lot with our eyes. His blue in my green, my green in his blue. Our friendship lasted only two weeks, but it ranks among my most precious possessions. We were open for each other, each made an effort to please the other. Not only me but also him. He recounted stories from his life, and through all of them shone his gift to track down happiness in ordinary everyday occurrences: "It was all so beautiful!" Mr. Knopfler was a rich man.

On my last day attending to Mr. Knopfler we talk only very little. He wants to sit up in bed and let his legs hang out of the bed. He has great difficulty sitting up straight. I sit down on the other side of the bed and lean my back against his. We are sitting there like lovers in midsummer somewhere in a meadow. We don't talk. We feel each other's breathing. We have backed each other up. When I say good-bye to him in the afternoon, he calls after me: "Thank you, thank you for everything." I had told him I would return the day after tomorrow. "I will wait for you." We missed our last rendezvous by a mere two hours.

Some have opened up just a little, others have really shared their lives with us

By Petra Hillinger

Staying in a hospice means living until the very last minute. Without the usual sophisticated medical machinery and without any time pressure. It means crying together, but also laughing together. It means learning from each other, growing together and supporting each other. A voluntary hospice helper tells the story.

Within one year 126 people have died in the CS Hospice. Many of them we didn't manage to really get to know, the stage of their illness was too advanced, the life span left to them too short. Some of them opened up only a little bit and permitted us just the slightest glance into their souls. But a few of them really entered into our lives. They were luminous figures that stood out in the crowd. Luminous figures that will always be remembered and whose sayings will be quoted again and again.

We miss Anna exclaiming, "You're the greatest", a pronouncement she repeated several times a day. Those giant marguerites on Anna's dressing gown - we're missing them. But above all we miss Anna. She was the youngest patient I was permitted to accompany part of her way. "Tell me, what exactly are you to me?" she asked me once. Well, how did I compare with her? I was certainly someone of Anna's age, but someone who could do everything she pleased. Someone who could go dancing and travel to the seaside and paint her nails blue and someone who could fall in love. By contrast, Anna just managed a few laborious steps and even then needed a lot of assistance. She spent her days in her wheel-chair, smoking and eating, sometimes both at the same time. How much pleasure one can derive from eating a plum - Anna has demonstrated it to us. In the same way she made it quite clear to us when something didn't meet with her approval. For instance, I never managed to get her the right amount of jam on her breakfast roll. Anna frowned but made allowances instantly. "But those toe nails - what a mess you have made of them!" - "OK, Anna, I'll remove the polish before tomorrow". She smiles, visibly contented.

I ask Anna if she wants to take a bath. She needs half an hour to make up her mind. But first, her mother quickly wants to show me a photo album: Anna on her 30th birthday, Anna with her new-born son, Anna at an outing with her colleagues. Anna, a beautiful woman.

Now, Anna is finally lying in the bathtub, listening to "Private Dancer" and smoking. Her mother is scurrying around, always intent on pleasing Anna. "Is the water too hot, too cold, too wet?" "Maybe we should have a look at the photos once more?"

Mother can be persuaded to leave Anna alone for a while. A quarter of an hour later we return. Anna is radiant. She tries to sit up, but this proves to be beyond her strength. I ask her what she wants to do, if I can help her. "Oh, it really doesn't matter any more", she says. And then: "I want to give you a kiss."

It is now eight days since we buried Anna. A mother behind the coffin of her daughter, a sister behind the coffin of her sister, nieces behind the coffin of their aunt. And we from the Hospice behind the coffin of a young woman, whose four-month-long stay has been a revelation to us all. We follow the coffin of a young woman who had to put everything behind her when she still had everything before her.

After the funeral, I look upwards into a cloudless sky, like a child. "Hello, Mister God, what's Anna saying?"