By Maryellen Apelquist
RANDOLPH, Vt.—In 2015, a native Vermonter who had lived a solitary life moved into Gifford’s Garden Room, a suite for those who are dying and their loved ones. Previously this lone figure had made his home in a rundown camper in the woods and had no close family members, save for his dog, a dachshund/bloodhound mix named Crankshaft Buckshot, “Cranky” for short. For privacy reasons, from here forward we’ll call this patient RL.
Gifford staff and providers remember RL as gruff but bighearted. They remember how Cranky and RL loved each other, and how the two shared a fondness for bun-less cheeseburgers and “Double Stuf” Oreos, which RL persuaded staff members to buy during their off-hours. They also remember how, in addition to encouraging them to smuggle in burgers, he asked staff to take whatever pocket money he had to buy stuffed animals for the new babies across the hospital in the Birthing Center, and donate to the Bethel Food Shelf.
Cranky spent his days with RL at Gifford and his nights sleeping in the houses of Gifford employees, who took turns taking the friendly, short-legged canine home. Cranky and RL became part of the Gifford family.
Physician Assistant (PA) Sue Burgos grew especially close to the duo.
“Everyone was endeared to [RL], but he was hard to get to know, a tough Vermonter, a kind of woodsy character,” said Burgos, a Bethel resident who has worked at Gifford for 31 years, first as a nurse and as a PA since 1999. “He loved the dog—that was clear—and the dog loved him. Everyone catered to the dog. Our facilities guys even set up a tent for them outside,” so they could sit together on their favorite bench, protected from the elements.
However tough, RL “was very kindhearted,” she said.
He lived for several months in the Garden Room, deteriorating in health but being made as comfortable as possible. As he drew closer to death, RL made plans for Cranky.
“About a week before he died, as he was declining, he said to me, ‘I trust you to take care of Crankshaft,’” said Burgos. “I promised to take care of him. Originally I was going to rehome him, but I fell in love. I adopted him.”
A Good Death
As a PA, Burgos works with dying patients and their families, helping them to understand that it is the end of life. Everyone’s situation is unique and some patients, like RL, don’t have close family nearby, or family members have become estranged, or there is other conflict.
“After I give the facts and the prognosis, we discuss goals of care,” she said. “Not having pain, not having shortness of breath, not having anxiety—those are the big three. We are alleviating symptoms.”
In addition to the clinical care provided, she said, “we try to make whatever happen for them that is important to them, whether it’s getting family members here or planning and hosting a special event such as a wedding.”
To make those end-of-life wishes come true, Burgos and other members of the end-of-life care team enlist the help of the Last Mile Ride (LMR), Gifford’s annual fundraising event that grants unique requests—one patient asked for a hairless cat to keep as a pet, and a cat shower to welcome the cat (she received both)—but also helps to cover more practical costs, such as travel and funeral and burial expenses, when called upon.
The LMR covered the costs of a graveside service and headstone for RL, who held a variety of jobs over the years, including logging in the Bethel area and working at a cemetery in Windsor County, where he was buried after his death.
“The day he died, I still have a visceral feeling of this,” said Karen Bonoyer, RN, a Gifford charge nurse who also liaises between patients and their families and the nursing team. “Patient care went on, but time seemed to stop. We were all there, with the common goal of making him comfortable. It was such an honor to help this man. I have never been more proud of our nurses and aides. There was no judgment, only compassion. It was such a blessing to be part of this with him. It renewed my faith in humanity.”
“Gifford does a lot really well, but we do end-of-life care really, really well,” said Bonoyer, who often advocates for LMR funds for things like food, massage sessions, music therapy, gas cards and more. “I help to make sure that we are doing everything we can to give patient comfort. It’s also about what the family takes away as their last memories of their loved one. I check on patients throughout the day, and their families. And I support the nurses, some of whom may be experiencing death for the first time.”
There are many on the Gifford team, from medical to nutrition and food services staff, who work to provide comfort to end-of-life patients and their families. They include Janice Giles, RN, who provides wound care and believes “there isn’t any more important work than being with people as they are dying”; pharmacist Jane McConnell and her team, who work in collaboration with providers to treat each patient uniquely to alleviate pain and anxiety; and Becky Olmstead, RN, who serves as Gifford’s lead care manager and also runs in the Last Mile Ride because “I know the need for this wonderful campaign exists, and I have the privilege through my work to see some of the very special ways that these funds have made an impact.”
The Rev. Timothy Eberhardt and volunteer chaplains visit patients and families daily, and help to celebrate a life.
“Our philosophy is that everyone has a unique story and a person’s life story is holy ground,” said Eberhardt. “It’s a journey that’s wonderful, full of hardship and grace, ups and downs.”
“I think the Last Mile Ride demonstrates clearly Gifford’s all-out effort to help families and patients have ‘a good death,’” he said. “It’s a tough term to say, because you have to think about a good death, and you really begin to think about your own death. You start to think about the Garden Room, family accommodations, catered food, the security of the staff being on deck with palliative care and nursing, the LMR filling the extra needs like weddings, transportation, et cetera.”
The team’s work to contribute to a good death is marked by meaningful gestures, large and small.
“It is a gift and an honor to be able to hold people’s hands, be with someone at their death, just be with them,” said Lisa Locke, a menu host who serves food and provides a “comfort cart” with sandwiches, fresh fruit, coffee and other refreshments for patients and families staying in the Garden Room. “I always try to go into people’s rooms and think about how my mother, my grandmother, my nephew would like to be treated. We do whatever we can to make it a little easier. We take one small thing off their plate to make it easier.”
“It’s so gratifying for patients to have people visit,” said Locke. “As menu hosts we like to say we’re the bright spot of the day. Sometimes it’s the simple things, like bringing a vanilla milkshake.”
Locke remembers Cranky and RL well.
“Even if I was out, offsite for lunch with my daughter, I would stop and pick up a burger for them,” she said. “I swear he willed himself to live until he found a home for his dog. He loved that dog so much. He kept pulling.”
Today, Cranky, 6 years old, no longer eats burgers and Oreos, but he’s healthy and happy. He enjoys dog food and vacations in Maine, where he paddleboards with Burgos and the rest of his adopted family. He stopped by Gifford for a photoshoot and belly rubs before this story went to press, and spent a few moments on the bench he once shared with RL, his first family. A plaque on the back of the bench notes that RL “and his dog, Crankshaft, sat here, and grace abides.”
2019 Last Mile Ride
Gifford continues a central Vermont tradition Aug. 16 and 17 with the 14th annual Last Mile Ride to support end-of-life care for patients and their families. The two-day, family-friendly event features a motorcycle ride, 5K run, and 1- and 2-mile walks to raise funds for palliative and end-of-life care, as well as special services. Since 2006, the Last Mile Ride has raised more than $760,000, with all proceeds used to help ease the end-of-life experience and support grieving families.
The walks and 5K run begin at 6 p.m. Friday, Aug. 16, with registration starting at 4:30 p.m., at Gifford Medical Center. The registration fee is $25 per person. Participants are encouraged to create teams with friends and family.
Registration for the motorcycle ride begins at 8:30 a.m. Saturday, Aug. 17, at Gifford. The entrance fee is $50 per driver; $75 per driver and passenger. The ride, which starts at 10 a.m., takes participants on an 80-mile journey through central Vermont.
In addition to the scheduled Last Mile Ride events, funds are raised through raffles for a motorcycle from Wilkins Harley-Davidson in South Barre and a quilt made by Dawn Decoff, a Gifford nurse. For more information about the Last Mile Ride, including routes and registration, visit lastmileride.com, follow on Facebook, or call Gifford Director of Development Ashley Lincoln at 802-728-2380.