“It is a gift from God to be with a person who is dying

I have been living in a hospice for exactly two weeks now.

And this is not a figure of speech, I just live, I don’t live, I don’t worry, or anything else. I live and breathe full breasts, even despite my asthma and slowly recovering bronchitis.

I am grateful to God for what New Year I found myself in this space of love called the First Moscow Hospice.

I am grateful to Vera Vasilievna Millionshchikova, who is undoubtedly a holy woman, because only a holy person with God’s help could create such a thing.

I am grateful to Nyuta and Diana Vladimirovna for the fact that they are outwardly modest, but in fact very large-scale, serious, thoughtful, and constantly do their work, giving themselves to other people. I am grateful to my wonderful Zoya Vladimirovna (doctor), who does her job sensitively and thoughtfully.

I am grateful to Father Christopher, Mother Silouana, Milena. Little did I know that I would receive communion at the Throne like this! I am grateful to the magical Frederica (it is a blessing to know such a person and be able to communicate).

I am grateful to the nurses (Dima, you are wonderful!), who not only do their work smoothly, clearly and quickly, but also fulfill small stupid requests like “can I have a satin ribbon” or “I want a picture with cats”, make surprises , joke, help take care of yourself (“here’s some coconut oil for your face and hands”).

I am grateful to the volunteers, thanks to whom I met Katyushka Borodulkina, made friends with my much-loved therapy dog ​​Masya, thanks to whom I and my loved ones even had more than one gift and Santa Claus, thanks to whom we listened to poetry and music, thanks to which I have well-groomed nails and neat haircut...

You can continue endlessly, because love knows no boundaries. I am grateful to my friends. It’s amazingly simple how each person from my loved ones, friends, acquaintances was able to open up in this space of love and give me a piece of understanding, sympathy, tenderness, creativity, care. Thank you my dears! I'm just happy that I have you all.

When I entered hospice, it was very difficult. For us - the limit. I had intense pain that could not be relieved even with a combination of very serious medications. I was out of breath because my weakened body got sick acute bronchitis and they gave me medicine asthmatic attacks, which came one after another, I began to have cramps from pain and fever, my legs and arms gave out.

First Moscow hospice

It seemed to me that I had come to the edge of an abyss. I was extremely scared for myself, but even more so for my loved ones. I saw how I frighten those who love me with my terrible deteriorating health. It's very scary when close person you are out of breath, in great pain, and don’t know what to do.

Zakharka was over the horror, we tried, but I understood that the New Year could become scary for our family.

In 2-3 such days, Andrey’s hair ends seemed to be covered with frost... Only 3 days. I am very grateful to my doctor, to the fact that my good, prudent Zoya Vladimirovna, knowing my well-being, anticipated our decision and said that if anything happened, they would wait for me at the hospice.

But, I must say, I resisted to the last (“how come, I wanted to make Czech duck for Christmas”). The decisive factor was this terrible day with asthma and the understanding that I do not have the right to condemn my loved ones to this horror.

The first day at the hospice was difficult for me. True, I slept for almost a day, since it was the first day when the pain went away completely. First day in many, many weeks. But I woke up in anxiety, the feeling that I was completely, completely alone, like a grain of sand in Space, that New Year and Christmas were ahead, and I was in a hospice. It all burned.

But I just didn't know. I didn’t know then that hospice is about life. I have never had such a fabulous New Year, such a wonderful Christmas. I have never had so much love before... I have a feeling that God is now even closer. And the hospice is a small piece of heaven here on earth.

I am so grateful to God that he gave my loved ones and me such an experience and the opportunity to rest our soul and body after many, many works.

What follows after all this? You should live!
Sew sundresses and light dresses from chintz...
Do you think all this will be worn?
I suppose all of this should be sewn!

I will live. Stage 4 is a time, sometimes short, sometimes long. The important thing in all this is the absence of pain. It shouldn't exist at all.

I have a lot of ideas and plans (I even have a business idea, and I will approach some of you with it in the near future, hehe), and I will do everything to the best of my ability and capabilities... As God willing. And I will be glad, friends, for your support, your communication, ideas, words, deeds, creativity. Let's create, rejoice and love. This is important and very wonderful.

Well, in general... Czech duck must be cooked, in the end, because it is a culinary masterpiece :))) And I really invite everyone who makes it to it :)

And one more thing... For a considerable number of my friends, the year suddenly started very difficult, I wrote about some of my friends, I didn’t write about some, but they are there. I ask you to pray with me. I read Psalm 90 for all those who suffer. I ask you to join too.

And no matter what misfortune touches you, please know that it is at this moment of pain, despair and fear that the Lord is very, very close, and most likely, he is carrying you in his arms. You can feel it. It’s worth stopping for a while, being silent and listening.

This article is devoted to such a structure as a hospice. What it is, many people know only approximately: most ordinary people- Having accidentally read or heard something somewhere, doctors - from the experience of American or European colleagues, and journalists - from various sources.

This situation is not accidental and is caused by an incorrect understanding of the tasks solved by hospice institutions. When and how did the first hospices emerge? What goals and objectives do they solve? What is children's hospice? We will try to answer all these questions in detail.

What are they needed for?

Quite often, the concept of “hospice” is associated with isolation and a place where seriously ill and dying people live their last days away from the whole world. However, this is not true. The symbol of the hospice is the dying light human hands candle. It is this symbol that helps to reveal the essence of the care provided to seriously ill patients and to explain clearly: hospice - what it is. In such clinics, they treat sick and dying people with care and reverence, show compassion and, empathizing, provide them with decent care and pain relief, help them overcome spiritual, physiological and psychological problems caused by illness.

What does this word mean?

Initially, the word “hospice” arose in Latin from the merger of two roots - hospitium and hospes - “hospitality”. Subsequently, the word passed into Old French as hospice and retained the same meaning as it had in Latin. In the Middle Ages, this was the name given to houses where travelers stopped to rest during a pilgrimage to Jerusalem. During long journeys, the pilgrims got sick, and in such hospices they were provided with all possible medical care. Together with the pilgrims, the word “hospice” came to the British Isles and into the English language, from where it passed into other European languages ​​in the 19th century.

History of appearance

Hippocrates, considered the “father of medicine,” believed that doctors should help only those who have a chance of recovery, and hopeless patients should live out their lives without care or attention. A similar approach to the dying was practiced in Europe until the widespread spread of Christianity.

In the French city of Lyon in 1842, the first hospice was organized by Jeanne Garnier, a young woman who had lost her entire family. What was it like at that time? The Golgotha ​​Hospice, as it was called, for the first time provided the opportunity for terminally ill patients to live and die with dignity. Irish nuns supported Jeanne Garnier's idea and opened the Mother of God Hospice in Dublin in 1879. In 1948, Cecilia Sanders came to work at St. Thomas' Hospital in London, thanks to whose work the hospice movement spread throughout the world. Moscow hospices that operate today were also opened.

Modern history

Enough long time neither doctors, nor nursing staff, nor volunteers knew what it should be like proper care for hospice patients, and there was nowhere to get such information. Only in 1935 was it published, which later became a classic of palliative medicine, written by family doctor Alfred Worchester pamphlet "Care for the Sick and Dying." Targeted training of nurses in working with incurable and dying patients began to be carried out by the Marie Curie Foundation only in 1952.

In 1967, St. Christopher's Hospice, founded by Cecilia Sanders, opened its inpatient hospital in England, and since 1969 began providing outreach services. In the same year, the book “On Death and Dying” by Elisabeth Kübler-Ross was published, which managed to revolutionize the ideas of doctors of that time about the conditions of a dying person.

Among socialist countries Only in Polish Krakow in 1972 did the first hospice appear.

Hospices in pre-revolutionary Russia

The first such medical institution was opened in Moscow in 1903. Its creation was initiated by Moscow State University professor and practicing oncologist L.L. Levshin, who organized the collection of funds for its construction. The greatest financial contribution to its organization was made by the famous Russian philanthropists Morozovs. That is why this establishment bore their name for many years. This oncology hospice accepted only cancer patients at the last, terminal stage of development of this disease. However, over time, it lost its functions and was reborn into a research institute dealing with oncology problems.

What about today?

Until 1990, Soviet people did not know about hospice, what it was and why it was needed. Seriously ill people died at home, in the arms of relatives who did not know how to alleviate their suffering, or in hospital beds, almost forgotten medical personnel. The first hospice in modern Russia was opened in the village of Lakhty near St. Petersburg in 1990 on the initiative of the English journalist V. Zorza, who thus fulfilled the dying wish of his daughter Jane, who died at the age of 25. Psychiatrist A.V. Gnezdilov took a great part in this, so that the hospice opened and began its work in the city of St. Petersburg.

In the early 90s of the 20th century, a special Board of Trustees for the creation of hospices was created in the Soviet Union, the chairman of which was Academician D. S. Likhachev. In October 1993 in Moscow, on the initiative of E.I. Moiseenko, who worked at the Institute of Children's Oncology and Hematology, created the first home-based children's hospice for children with cancer.

In 1994, thanks to the efforts of V. Zorza, the First Moscow Hospice, now headed by V.V. Millionshchikova, was created.

How many are there?

Today we have approximately one hundred hospices, which is very small for such a big country like Russia. According to WHO calculations, there should be one hospice for every 400,000 people in the population. That is, if you count, our country lacks at least 250 of these medical institutions. Those that exist do not always meet the requirements and standards. The hospices in Moscow and St. Petersburg are the best equipped, and their number in these cities practically corresponds to WHO calculations. For villagers and those living in the provinces, it is difficult, almost impossible, to get into such an institution.

A terminally ill child... This tragedy can happen in the life of each of us, and then main question: where to look for support when there is no more hope. The motto of the children's hospice "House with a lighthouse" is "It's not about death, it's about life". The hospice cares for children with incurable diseases, and it was their stories that formed the basis of a special project “ It's time to live " on "D o mashnym". Premiere: April 8.

Mothers are often told by friends and doctors that they can’t cope alone when their dads leave them. Children are not accepted into kindergartens and schools, offering to “give birth to a second child.” And the worst thing is that young patients are not provided with qualified medical care, doctors give up on them and do nothing while the child suffers from pain. “ Home” will talk about hospice patients and their mothers, about doctors and people who devote themselves to helping children, and will also try to destroy myths about incurable diseases and how you can live with them.

Myth number one: “You can’t do it alone”

According to statistics, a third of fathers leave families with a disabled child and no longer participate in their lives. Young mother Daria Guseva has been raising Sashenka for three years. The child suffocated during childbirth and now lives with the diagnosis ischemic lesion CNS. The girl does not see, does not hear, does not move, but lives and breathes with the help of a tracheostomy and an oxygen concentrator. The father abandoned the family as soon as he learned about his daughter’s diagnosis and Daria’s decision not to send the child to a boarding school. But the mother says she is happy to be able to give her child the best.

Myth two "Incurable children do not need to be taught"

Of the 198 preschoolers cared for by the Children's Hospice "House with a Lighthouse", kindergarten Now only 24 children are attending. Only 50 out of 155 schoolchildren are studying. One young man out of several dozen managed to enter the university. In our country they don’t understand why a terminally ill child needs to study, but hospice children dream of going to school. Artem Komarov is nine years old, but he is in second grade. He has a congenital muscular dystrophy- the boy can’t even sit on his own, his arms are very weak. But in an electric wheelchair purchased by the hospice, he goes to an ordinary school in the city of Dubna in the Moscow region, whose director wanted to take the boy, despite a lot of problems with installing lifts and ramps. The hospice workers helped Artem make his dream come true and were able to negotiate with the school, which accepted Artem, despite his diagnosis.

Myth three “If you can’t cure it, it means you can’t help”

Little Fedya Raspopov died quietly in an orphanage. His medical history included a huge number of diagnoses and the staff did not understand how to care for him. One day, a hospice field service was invited to an orphanage to train nannies. So it began amazing story. Successful businesswoman Tatyana Konova responded to a hospice ad on Facebook to bring Fedya a toy. She fell in love and took him in and became a foster mother. Unfortunately, the boy cannot be cured. But how striking is the contrast between his life in an orphanage without special care - and at home, with his mother, with the support of a hospice.

Myth four “Hospice is when nothing can be done”

Thirteen-year-old, smiling, tall and handsome Maxim Bezugly was playing football with his friends. A jump, another, hung on the gate - they swayed under the weight and fell. The top bar struck the head, breaking the bones of the skull. Doctors said that the injury was not compatible with life, that he would always be on a ventilator. The tragedy divided everything into “ before " And " after ". There was a lot, but now Maxim is home. Breathes and eats on its own. Every day his parents do something that makes Max feel better.

The chief doctor of the hospice, Natalya Savva, talks about how quality care prolongs the lives of children and brings joy back to them.

Myth fifth "If death is inevitable, nothing can be done"

In December 2016, mother Elena buried her daughter Pelageya, who was under the care of a hospice. She had a congenital genetic disease, she lived for nine months in hospitals and intensive care units. The girl's heart stopped. Now Elena admits that during these 9 months only hospice workers were with her. They helped her accept the inevitable.

Life is always stronger than death, even if the smallest and most defenseless ones stand at the line. “ Homemade” I am sure: even if there is almost no strength and faith left - “Time to live”!

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“Just please be careful. We can never know for sure what is going on in the souls of our patients. Even if they look quite cheerful, you understand why they come to us,” Dilnoza Muydinova, assistance coordinator at the First Moscow Hospice of the Vera Foundation, tells me. We walk along the corridors of the hospice, and I catch myself thinking that I’m not scared.

While I was riding here on the subway, I was going through scenarios in my head: here I am entering a building, around a bed with patients who are moaning and calling for help, and I am hiding my eyes and wiping away my tears. In reality, everything turned out to be different: the most cheerful patients walk along the corridors on their own, others walk in the garden arm in arm with volunteers, the rest lie on comfortable wide beds in spacious rooms filled with sun. Everyone I meet smiles at me warmly, and I don’t want to look away.

Why do we need hospice?

Dilnoza takes me to meet Ramilya. She is only 56 - she is practically the youngest in this hospice. Ramily has stage 4 with metastases and is holding up well. Ramilya is dressed in a bright pink sweater, neatly lined eyes framed by glasses fashionable frame. She smiles too.

I got sick in 2015. At that time, I didn’t really understand what cancer was at all - I thought that now everything would be cut out, and I would live my old life.

“But everything turned out wrong: two operations, several courses of “chemistry” and radiation therapy... Nevertheless, the cancer progressed. I consulted with the government and private clinic in Russia, went to Israel. In May of this year, I had to put an end to treatment - all the doctors came to the conclusion that medicine was powerless here,” says Ramilya.

At first, my doctor simply said: “Go to the dacha, live there, breathe.” fresh air“. I took his advice, and in June my husband and I went out of town. Unfortunately, I was getting worse. I crawled along the walls in pain, barely making it to the toilet to relieve myself.

No, of course, upon discharge the doctor prescribed me painkillers. It wasn't easy to get them, but it wasn't as difficult as they say. My husband went to the pharmacy with a prescription, asked for confirmation from the hospital that they really had such a patient, and they gave him the medicine. It took maybe half a day.

The trouble is that these drugs did not work. I injected it, which was given at the pharmacy, but it only relieved the pain a little. I took an anticonvulsant once - I had never had withdrawal symptoms in my life, but then similar sensations appeared: I was pounding, my arms and legs were shaking. In the end, we decided to go to hospice. Our district doesn’t have one, so I registered with the First Moscow Hospice.”

A hospice is a place where a patient who can no longer be cured is provided with palliative care: pain relief, nausea relief, care provided if he can no longer care for himself. Also, hospices try to create a homely atmosphere and surround with attention.

Anyone can get into the city hospice for free - for this you need a referral from the district. There are eight hospices and a Palliative Care Center in Moscow, and four hospices and several more palliative care departments at city hospitals in St. Petersburg. In others major cities They also have their own hospices and palliative care departments. Many locations also offer outreach services to support patients at home.

How to get to the hospice

“We have 35 beds in the hospice, and the outreach service helps about 400 patients at a time. We bring medicines, various care supplies, nurses or volunteers can wash and feed the patient. The patient is admitted to the hospital when it is no longer possible to cope with the symptoms of the disease at home,” explains Dilnoza Muydinova.

Ramilya says that employees of the First Moscow Hospice came to her as soon as she registered: “Even then it became easier - my family and I received support, they brought me good medicine, dressings. I didn’t wait long to be hospitalized, less than a week. When I got to the hospital, the doctors quickly managed to find a therapy.

Now I’m not in pain, I feel good: I read books, walk in the garden, receive guests.

I worked as a teacher in English at the gymnasium, therefore, in addition to my relatives, colleagues and former students come to see me. Everyone is tense before coming here. I understand them: before, I also thought that a hospice was a place where they put barely alive people who lie and groan under IVs. In fact, we have practically a sanatorium here: meals six times a day (the food is delicious!), concerts, a library. As soon as I talk to you, I’ll go for a massage.”

Illustration: Oksana Kashirskaya |

You can spend approximately 21 days in a hospice; if necessary, you can go to the hospital again. This is my second week here. The doctor wants to discharge me early - he says I’m already normal - but I would like to stay here for another week. My husband and sons are trying to take care of me, but it’s all very difficult for them. In the meantime, I’m here - and I feel good, and my family takes a break from me.

It is a common misconception that people come to hospice to die. In fact, they come there to live out the end of their lives with dignity. Some people live with a terminal diagnosis for months or even years, so they become “regular clients” of hospice.

“It’s nice to see a familiar face when a patient returns to the hospice. In general, contact is very important for me: I came, walked with the patient, helped him eat, and I looked - he took my hand. I looked into his eyes and he didn't look away. At such moments, I feel the importance of what I do,” says Pavel, a volunteer at the Vera Foundation.

Pavel has been helping hospices for 10 years. Volunteers like him can give patients what health workers and family members do not have the time or mental strength to provide - attention, communication, care. For a person who is no longer allowed, this is one of the main joys in life.

When patients leave, I am always sad. But I want to believe that this is not the end. In any case, the joy of human contact, the feeling that you helped the patient in his last weeks and days - this all outweighs the pain of loss.

Volunteer

“In a hospice they don’t say “died” about a person, they say “gone.” No, we are not trying to escape reality or mislead patients about their prospects. There’s just something too... final about the word “death.” I prefer to think that the patient “left us” - as if he went on vacation or for permanent residence in a distant country,” adds Dilnoza.

Without thinking about the inevitable

Ramilya does not think about death. She lives, lives for today, without regard to empty worries, vanity and plans.

“I try to tell everyone about this, but it can’t be put into words. It’s as if everything superfluous and superfluous flies away, and you live here and now. Although some people who came to visit the hospice were impressed - they stopped worrying about material things, about all sorts of trifles. Some even cried.

My sons are now depressed because of my illness. I tell them - live, live now and rejoice! Don't think about me! But, of course, they don’t succeed. I hope that at least my stay in the hospice will give them a break to recover a little. I don’t know how it is in other hospices, but here we live, not live,” says Ramilya.

The nurse brings lunch to Ramili's room. She jumps up from the sofa in the hallway where we are sitting and runs to open the door for the nurse.

This door is so hard to open!
- I see you feel completely at home here?
- Yes! I tell my guests: “Here is my library, here is my garden.” Let’s go to the hall, I’ll pour you coffee or tea.” My husband is even indignant and tells me not to forget - I also have a real home!”

Ramilya is already looking forward to how, having returned home, she will finally get up at the stove and cook dinner for her family - due to terrible pain in Lately before the hospice, she couldn't afford it. Her husband also dreams of taking her to Israel - not for treatment, but just for the soul.

Hospice employees say: sometimes patients with terminal stage cancer seem even more positive than healthy people. But there is no need to be deceived - due to the awareness of imminent death, sooner or later it overtakes almost everyone. However good care In hospice, the right medications help relieve patients' pain and anxiety, improve their mood and give them strength - until the very end.

If you need any information about palliative care, please contact hotline Hospice Fund "Vera": 8-800-700-84-36.

During the preparation of this material, Ramilya passed away.

- Vera Vasilyevna, is your hospice the first in Russia?

No, the first Russian hospice was founded in 1990 in Lakhta, a district of St. Petersburg.

- Did the first hospice appear in the world?..

In England. Baroness Cecilia Sanders, already in adulthood, came to work at the hospital, where she came face to face with the problem of cancer patients. The suffering of one of the patients touched her so deeply that she took up this problem seriously and organized a hospice in 1967. (Today Baroness Sanders is 88 or 89 years old, she still teaches and brings the idea of ​​hospices to the world). Then hospices appeared in America and other countries. And when perestroika began, the Englishman Victor Zorza came to Russia with the idea of ​​hospices.

I think in 1989, the magazine “October” published his and his wife Rosemary’s story “I’m Dying Happy” with a foreword by Dmitry Sergeevich Likhachev?

Yes, this was an excerpt from a book that came out a little later. Victor was a native of Russia, a Ukrainian Jew. In 1971, his daughter Jane fell ill with melanoma and died a year later, at 26, in a hospice. Having learned before his death that her father was from our country (he hid this all his life), she bequeathed to him the construction of hospices in India and Russia. When the opportunity arose, he carried out her will.

- How did you come to the hospice? After all, if I’m not mistaken, your specialty is not an oncologist, but a gynecologist?

I really started my medical practice in obstetrics - first as a gynecologist, then as an anesthesiologist, but in 1983 she came to oncology.

- While working on birth, did you become interested in the problem of death?

Everything was much more prosaic. I switched to oncology so I could retire early. But the person assumes...

Faced with hopeless cancer patients, I realized that I couldn’t leave them. After all, the state abandoned them to their fate. If the diagnosis was hopeless, the patient was discharged with the wording “to be treated at the place of residence,” that is, not to be treated at all. In principle, these patients are of no interest to doctors. Doctors are determined to win. In their opinion, it is worth treating a person only for the sake of recovery. It is indecent to even think about death.

- The fruits of an atheistic upbringing?

Certainly. Death has always been hushed up. According to statistics, even in oncology clinics our mortality rate is 0.2%. Absurd! For the sake of these false statistics, hopeless patients were “thrown out” home. Only hospices can help these people.

But still not knowing anything about hospices, I myself went to see my former patients and tried to help them until my last breath. Naturally, I did this in my free time from my main job, and I was very tired. In 1991, she got ready to retire, but providentially met Victor. I still work this way and I’m unlikely to ever leave.

Field service - in May 1994, inpatient service - in 1997.

- Did the state help?

Only the state. The hospice was built with money from the Moscow Government with the participation of the Moscow City Health Department.

- For several years your hospice was the only one in Moscow?

Yes, for 8 years we were the only ones. But today there are already four of them, and one of these days we will open a fifth one - in the Southern District. In the near future, there will be hospices in every administrative district of the capital. We serve the Central District.

- Probably, new hospices today need sponsors more?

Of course, but they still need to develop a reputation. The first 4 years were also very difficult for us.

- How many people live in your hospice?

We still have an outreach service that currently serves 130 patients. There are 30 people living in the hospital.

- But can you take more?

No we can not. We have 30 beds. The hospice environment should be close to home, and this cannot be done with a larger number of inpatient beds.

- Then, apparently, no more than five people live in your wards?

We have single and four-bed rooms. This best option. Some people prefer to live their illness alone (usually children and young people), and, naturally, we place them in a separate ward. Older people, on the contrary, are more likely to seek communication. To avoid psychological incompatibility or, on the contrary, the excessive attachment of neighbors to each other (when the death of one can traumatize the other so much that it will shorten his life) requires not two - and not three -, but four-bed wards.

- Do you help dying people live active, meaningful lives to the end?

You exaggerate the capabilities of a dying person. These people are mainly focused on internal experiences. We have a good library, one artist teaches people to draw for free, and the hospice regularly hosts concerts. We try to give patients positive emotions, but only at their request. Nothing can be imposed on a person, especially a hopelessly ill person.

- In such a state, moments of despair are inevitable. Were there cases when patients demanded euthanasia?

It was not and could not be. Euthanasia does not fit into Russian thinking.

Does not fit, however last years many publicists talk about the humanity of euthanasia. They cannot help but know that euthanasia was used in Hitler's Germany, and still, without blushing, they stand up for it.

Facilities mass media can do anything. They can zombify people so that they become supporters of euthanasia. But only theoretically. When this problem affects someone personally, no one will want to be “helped” to die. This is contrary to human nature. The thirst for life is the strongest human instinct. I'm not even talking about the ethical side. A person is not the master of his life.

- Vera Vasilyevna, does the Church participate in the work of the hospice?

We have a home chapel Life-Giving Trinity. On Tuesdays and Thursdays, Father Christopher Hill from St. Andrew's Monastery serves there.

- How often do you remember non-believers coming to God during illness?

There were such cases, but not often.

- Maybe we need to be more active in missionary work?

It’s impossible, we are not a religious institution. Upon admission, we inform all patients that there is a chapel and on such and such days a priest comes. But Father Christopher will not talk to the patient against his will.

- How many people work at the hospice?

82 people, including accounting, kitchen and laundry.

- You once said in one program that you have a lot of young people in unskilled jobs.

We mainly employ young people. This is due to my interest in young people, with the desire to teach them goodness.

- Do they come for religious reasons?

In different ways. But when hiring, I never ask people if they are believers.

But you're probably asking why they want to work in a hospice, and some say it's because they want to serve God?

Happens. Then I set a condition: not to preach, but to help. Serve the pain, serve the grief.

- But this is serving God.

Certainly. But some believers who came to us sought to read prayers over the sick, not even asking whether they were baptized, and this often frightened non-believers. Father Christopher doesn’t force anything on anyone, but it happened more than once that he came to talk with one patient, and by the end of the conversation, another patient from the same ward, who half an hour earlier had not even thought about communicating with a priest, expressed a desire to talk with him. It is impossible to impose faith, especially on a dependent person. And our patients are always dependent on those who help them.

- Vera Vasilievna, over the years of working as a doctor, has your attitude towards death changed?

Drastically. Before, I didn’t think about death at all; either because of youth, or because of vanity. And now... First of all, my attitude towards life has changed. When you are constantly faced with death at work, life becomes more contemplative. In the morning you wake up - thank God, the day has passed, you go to bed, thank God too.

- Why did hospices appear only inXX century? Has the number of cancer diseases increased significantly?

It's not about the increase in diseases, but about the development of medicine. Doctors have learned to diagnose diseases more early stage. In general, hospices are a product of civilization. Civilization leads to a breakdown in relations between people, including between close relatives. Hospices are a result of this gap. Of course, in poor countries this is compounded by the non-intervention of the state in helping the suffering.

In the West, a hospice is a house of death. In England, for example, a patient is placed in a hospice 6 days before death. They put them to die because people don’t want to see death at home. They have a man-made attitude towards death. A relative dies - quickly go to a hospice, then rather be cremated and “continue to live.”

It's different with us. Many people come to us at an early stage, then are discharged; after an indefinite period of time, some come to us again. The first commandment of our hospice (there are 16 in total) says: “A hospice is not a house of death. It's a life worth living to the end. We work with living people. Only they die before us.”

- That is, hospices, although they came to us from the West, in Russia acquired a completely different meaning?

Of course, these are Russian hospices. You cannot graft a foreign model anywhere. The British suggested that we go to them to study, but I said: “No, dears, come to us, study with us. We have different soil, different people, different medicines.” Subsequently, they were grateful to us, although they had to go back 50-60 years ago - they knew about the green stuff only from the stories of their parents.

True, in such megacities as Moscow and St. Petersburg, one can also find a Western attitude of people towards a hospice as a house of death. Our commandments include working with relatives, and we make every effort to improve and change their relationships when necessary. It happens that dad dies, and my daughter has no time to visit him - she has courses. We don’t tell the girl directly, but the meaning is: “What courses? Do you have one dad? So sit with him, look after him, take his hand and say: “Dad, I love you!” (when was the last time I spoke?).” There is a lot more warmth in our hospices. Human warmth. This is the specificity of Russian hospices.

- Should a hospice transform the patient’s relatives?

I think I should. After all, no one knows who is being tested by a serious illness - the patient himself or his relatives? It often happens that the suffering of one person changes better side another. For example, fatal disease The mother not only forced her son to visit her more often, but also opened his eyes to his dissolute life. Therefore, we work with relatives not only to help them overcome grief, but often also to return them to their parents, to remind them that they, young people, will not last forever.

- Do young hospice employees change their value system in the process of work?

Very fast.

- Do you often have to part with people because they can’t cope with their work?

Often. For the first 60 hours, newcomers work for us for free (we only feed them lunch and give them money for travel), so we don’t hire random people. But working in a hospice is hard, exhausting work. It often turns out to be beyond the capabilities of very good young men and women who, in my opinion, can work wonderfully in any other institution. So we part with them not because of their human qualities, but because this cross is beyond their strength. But even those who are capable of it last no more than two years with us. And we have no right either to hold people back or to be offended by them - human strength is limited. I am grateful to everyone who worked for us over these years. And I am very glad that 12 weddings took place between the hospice employees.

- But do doctors work longer?

We have very few doctors: 2 oncologists, a therapist and a gerontologist.

- Is four doctors really enough for a hospice?

Not enough at all. Doctors do not want to work in a hospice; they are not interested here. I told you that the doctors are only determined to win.

- Is this the right attitude?

No. But how do you tell a modern medical student that he will not cure people, but only treat symptoms? This requires a special state of mind. Among our doctors one is very old man, the rest were brought here by their life's ups and downs, they found themselves in a hospice. This is an individual path. Nowadays in medical institutes A bioethics course has emerged that addresses these issues.

Do you think that a bioethics course can change the psychology of students, or will a deeper understanding of life come only with age?

Probably nothing can replace life experience. But without a course in bioethics, this experience can last for long years and be more tragic.

- In the sense of spirituality, our medical education leaves much to be desired?

It is completely unspiritual. Bioethics courses - the first shoots. If they get stronger, something will change. In the meantime, young doctors often have no ideals.

But a doctor is not a profession, but a vocation; his work is not work, but service. Serving God. And the future of Russia depends not least on the spirituality of doctors?

I won’t dare to prophesy about the future of Russia, but the future of our medicine seems gloomy to me. I'd like to be wrong.

- Vera Vasilievna, how many hospices are open in Russia today?

About fifty.

- In cities?

Mostly. But there are also in villages. One near Yaroslavl (and in Yaroslavl itself there are two more hospices) and one in Bashkiria.

- How satisfied is Russia’s need for hospices?

I think I'm not even 10% satisfied. There are 150 million people living in Russia, and about two hundred and twenty thousand are diagnosed with stage 4 cancer every year. So calculate how many hospices are needed. Of course, we must take into account the cancer situation in a particular area. And for this we need honest medical statistics.

- Surely many readers will want to help the hospice in some way. What is the biggest need for hospice?

The hospice needs everything you need at home: books, audio and video tapes, and hygiene items. Our people live a normal life.

- Would you like to organize concerts for patients?

We constantly have concerts. But the staff needs them more. Sick people too, but less. As a rule, out of 30 patients, 8-12 people are present at the concert. We always welcome the arrival of artists and musicians.

- Vera Vasilyevna, the majority of Internet readers are young people. What would you like to wish to young people?

I always ask Irina Vasilyevna Siluyanova’s students, when was the last time they kissed their mother or hugged their grandmother? Everyone needs this. When leaving home, kiss and hug all your relatives; “and every time say goodbye forever...” Don't pass on evil. You were pushed into the subway - don’t be angry, forgive this person, he’s apparently in big trouble. Treat people the way you want them to treat you. You can work in a hospice, in a children's institution, in a bank, but please remain human.

- Thank you.

Interviewed by Leonid Vinogradov