Laura Horn has found what she calls her end-of-life career, “a vocation to last the rest of my life”. In her 60s she decided to train as a registered nurse, specialising in hospice care. “I’m a brand new nurse but that’s not what’s important,” she says. “I’ve had life experience.” After Margaret, her wife of 20 years, died “suddenly and unexpectedly”, Horn understood she had to make a change. She had been thinking about volunteering in a hospice, after her mother and both parents-in-law were given palliative care. Following Margaret’s death in January 2017, Horn applied to the Zen Hospice Project in San Francisco, which trained volunteers to sit with the dying. They told her: “Wait a year. You can’t do it right away.”
Looking back, she says, they were right. “You can’t jump into something new until you have grieved appropriately.” She had “good therapy” and did what she calls “walking grief – I mean, I walked everywhere”. A year later, she reapplied. “They said, ‘Why do you want to do this?’ and my first sentence was, ‘I know loss.’”
As well as Margaret, she had outlived her parents, her parents-in-law and her brothers. They both “died of substance abuse, one of a heroin overdose, and the other of long-term substance abuse. That, I’m sure, was part of my motivation,” she says. “That kind of pain can also lead to openness and joy, and that’s what I’ve discovered.”
Volunteering was “a truly transformative” experience for her and Horn realised she wanted more. “I thought, I want to do the nursing part too.” As an undergraduate, she had studied biology, and her early work was in public health before she switched to education research. Most of her career was spent “trying to determine what helped students succeed in college and beyond. But I always had the sense that I would circle back to the world of health,” she says.
At 63, she enrolled at one of the very community colleges whose impact she had been researching, to take the prerequisite courses – anatomy, physiology, microbiology, pharmacology. From there, she applied to nursing school at 65, on an accelerated one-year programme for graduates.
The intensity was staggering. “I was devoting every waking hour to studying and my clinical work,” she says. The friends who had supported her after Margaret’s death, and lived nearby in Berkeley, California, cooked for her three nights a week. Horn would visit for an hour, then leave to study. “We called it ‘catch and release’,” she says. Her two children with Margaret had left home but were supportive. When she graduated, one of her friends made a little sign out of brightly coloured paper – “It’s never too late” – and stuck it to the back of her mortarboard.
In some measure, Horn has put herself back at the heart of the storm, in a place of death and loss, which she occupies for three shifts a week at the hospice where she works in Oakland. How emotionally taxing is her new career?
“We are not part of the family so there is that distance,” she says. “We are here with you at this important time. We are here to normalise the experience and we teach family members what to look for, and not to be scared. It’s emotionally taxing but not overwhelming.”
Now 68, Horn has noticed her own attitude to death evolving. “I think I have relaxed around it,” she says. “After seeing all I have about death I’m not so scared of dying. I have a limited amount of time left on this Earth and I will try to make the most of it. And not be too terrified.”
Most of all, she has realised that palliative nursing care is “a reciprocal relationship with patients and families”. She hopes “to find real balance in that, to learn from them as they learn from me. If I’ve learned nothing else, we can’t live a full and meaningful life without deep relationships. And that’s what I’m hoping for.”
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