Staff members regularly make miracles happen
The bell chimed three times at Hock Family Pavilion, and everyone knew what it meant. Duke HomeCare & Hospice nurses and workers stepped into the hallway of Duke's 12-person inpatient hospice facility, solemnly waiting in silence.
Anthony Wilkie, a Duke Clinical Nurse, had been bracing himself for the moment with a mixture of sorrow and humility.
When a bell rings three times at Hock Family Pavilion , a patient has just died and a ritual is about to begin. On Jan. 26, 2024, Erik Sundelöf took his last breaths in Room 12 after his 47-year-old body succumbed to colon cancer. Sundelöf had spent nearly two months having his pain eased by and forming bonds with Duke staff at the hospice center that cares for nearly 650 a year.
Wilkie held a piece of paper as he stepped into the hallway to pay his final respects as Sundelöf was wheeled through the staff-lined corridor toward the funeral home hearse. Wilkie had a special bond with the thoughtful and caring patient, and while he was honored to read aloud a letter Sundelöf wrote to the care team, he knew this goodbye would be one of the hardest.
"In December, I came to you in pain, in a leap of faith, hoping for a reprieve," Wilkie read. "I did not come with great expectations, but it is in the hands of strangers that I found kindness. It is here that I found comfort and peace during the most challenging days of my life."
In the letter, Sundelöf, a visionary in the tech world, thanked the staff who brought festive lights and decorations for his "Charlie Brown Christmas tree," tolerated his "rowdy crowd" of visitors during afternoon dominoes and supplied him with seeds for feeding birds and squirrels from his patient room porch.
They were just a few of the small and profound ways that Duke's hospice workers, honored each November during National Hospice and Palliative Care Month, regularly make miracles happen and fulfill last wishes for the terminally ill patients in their care.
"None of us is really there by chance," Wilkie said. "Whether it's the nurses, the physicians, the secretaries, the chef, the nursing assistants - everyone is there for a reason. It feels like we're part of a team that's going to do whatever we can for our patients in their final moments."
'Grief is love that has nowhere to go'
Debra Harper-Crespo, Assistant Nurse Manager at Duke HomeCare & Hospice, discovered hospice work suits her personality - "very holistic, very hands-on," she said.
When Imer "Paul" Ramadanovic came to Hock as a chef after a career in restaurants, he had one demand: He would only accept the position if he could cook the final meals each patient requested.
Deb Davis went into hospice care 10 years ago as a second career. During a clinical rotation performing postmortem care, she felt a sense of calmness and peace, humbled to give families "one last gift."
Wilkie, the Clinical Nurse, simply felt as if he could make the greatest impact in hospice.
Kara Andrade began volunteering at Duke HomeCare & Hospice a few months after her husband, Sundelöf, died in Room 12. Andrade, a writer and communication professor, now spends their former "date nights" volunteering however the hospice center needs her and has become an end-of-life doula.
"It's a community there and they're all there because they want to be there," Andrade said of the staff. "You don't just get placed in palliative care; you choose to go into palliative care. Most of them have gone through some very meaningful deep loss that they've somehow come out of with some insight that they want to give to others.
"Grief is love that has nowhere to go, and I think a lot of people who are there have a lot of love."
Making miracles happen every day
As a Clinical Nurse in admissions, Deb Davis is the first person many patients and their family members meet when they arrive at Duke HomeCare & Hospice at Hock Family Pavilion. Every time, she asks some variation of, "What is most meaningful to you? If we can give you anything, what would it be?"
"The fact that you can make the absolute worst time in someone's life a little bit bearable, that means a lot," Davis said.
They've transformed patient rooms into beach scenes and holiday tableaus to recreate favorite memories. They've arranged for terminally ill patients to wed their true loves, and hosted weddings for the children of patients who would not live long enough to see the planned ceremony.
Treasured pets have been brought in to spend precious moments with their humans, and they've brought patients into the facility's vibrant flower garden for one last glimpse at a rare red moon.
They've held the hands of patients who do not have friends or family with them as they take their last breaths.
Now Duke HomeCare & Hospice Health Unit Coordinator for Hock, Ramadanovic, served as the facility's chef for 10 years. He learned to prepare more final meals than he can count - from chicken and dumplings to vegan creations, ice cream sundaes and blood sausage.
"When we get patients here, they have very few smiles left," Ramadanovic said. "But when I showed up with a plate, I got one. That satisfaction of making them the last meal, even if they only take one bite, it gave me great pleasure."
Andrade and her husband, Sundelöf, saw the miracles daily at Hock. Once, after hearing the bells chime three times, Andrade suggested they find a way to thank everyone who had helped to ease their pain when the chimes would finally ring for Sundelöf.
"Your death wouldn't be just another death," Andrade remembers telling him. "It wouldn't just sadden them. You could express your love and gratitude to them for the journey we all took with you - one of abundance and love."
With the letter, they would also present bonsai trees to the hospice staff as a way to symbolize "harmony, inner peace, balance and positivity."
As Wilkie read Sundelöf's letter to the hospice workers who gathered in early 2024, his voice began to quiver.
"Please know that you have made a significant and positive difference in our lives," Wilkie read aloud. "Your work is not just a job; it is a calling and you answer it with compassion and professionalism. None of this goes unnoticed."
Wilkie, sniffling, couldn't help but add his own final line.
"Thank you, Erik," he said.
Read the full letter from Erik Sundelöf to the Duke HomeCare & Hospice staff at Hock Family Pavilion here .
To learn more about the impact of Duke HomeCare & Hospice, see the annual report .
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