Annalouiza (00:08.087)
Marci grew up in a town of 200 people in rural Wyoming as the youngest of six children and was raised by a single mother. She is a world traveler, a wife, and a mother to a 14-year-old son, and she currently resides in Gresham, Oregon. She discovered her passion in end-of-life care as a hospice volunteer and returned to college at the age of 32 to acquire her bachelor's of science in nursing from Johns Hopkins University. Marci focused her career in the nonprofit sector and has served 25 years as a nurse, educator, end of life doula, mentee and mentor, board member, administrator, and program innovator.

Wakil David Matthews (00:54.652)
Marcy is a generator at heart, and her career has been inspired by significant gaps in care that exist at end of life, especially or particularly around addressing existential suffering, a need for presence, and the lack of in-home support.

She's writing her first book to address the gaps in education, preparation and support for hospice workers new to the field. So needed. Marcy owns and operates End of Life Advocacy and Care, LLC, liaison referral and support service assisting those out of state to pursue medical aid in dying in Oregon. And we will put links to all of this in the podcast notes. So glad to have you. Welcome.

Annalouiza (01:48.684)
Welcome. Yes.

Marci Donaldson (01:51.214)
Yeah, thanks for the invitation. It's beautiful to be here. This is my first podcast interview, so it's kind of exciting.

Annalouiza (01:57.293)
Yay!

Wakil David Matthews (01:57.438)
Oh excellent. Yeah, good. I'm glad you could be with us today. We always like to begin to try to get a feel for the place our people come from, our guests come from. So we'd like to start by asking when you first became aware of death.

Marci Donaldson (02:15.5)
Yeah, know, growing up, I've heard from many of your guests, growing up in the country, the connection to animal death was certainly the first taste of that. It's been really interesting to sort of go back through my lifetime and think about think about where things came from and how things progressed through my life. 

But we always had horses from the time I was born until current times. And, you know, coming home from school and then there's not a horse there. And you know, thinking about death, there were times I remember a very significant experience with a cat that had died and my mom, you know, raising kids as a single mom working three jobs. She wasn't always around. So I do remember calling her at her job and, and saying the cat, I think she's dead, you know, and, and she's laying on the couch and my mom just trying to, you know, as gently as possible, well, put a blanket over her and I'll be home around 11, you know, this thing, and then sort of tiptoeing around the house, kind of staring at the blanket and then looking under the blanket, touching her, then putting the blanket back. 

And, you know, thinking back on as an adult and how horses have died throughout our lifetime and what that burial really looks like, you know, there's this balance between a parent trying to protect your child from a very ugly process, right? You know, you're digging a hole with a large machine and a, you know, 2000 pound animal is being, you know, pushed into the hole. And sometimes there are broken bones that happen in the process of that. And it's a very big to bury an animal that large, it's a very, it's a very big and can be a traumatic visual, right? 

Annalouiza (04:24.226)
That sounds brutal.

Marci Donaldson (04:50.768)
And so there was such a difference between like digging this little hole for Alice the cat and just gently laying her in it and wrapping her in a thing and then putting some flowers in there and then gently putting the dirt over her so it doesn't get into her eyes and those things that you'd want to gently hold this animal but coming home from school and realizing that we now don't have a horse was like, well, where did it, where did it go? Like what happened? 

And thinking back on how that affects you as a child thinking like, well, what if I go to school and then I come home and there's like a different parent there or something, you know? 

Annalouiza (05:09.976)
Mmm.

Marci Donaldson (05:20.512)
Like, is my parent just gonna disappear? So it's a, it's a hard thing for a parent, I think, you know, to, to delicately balance that and navigate world of death and children and love and protection and openness all those things. Yeah, it's a curious thing.

Annalouiza (05:34.654)
It is a curious process. And you know, I have buried many little toads and fish and cats and sparrows that we found. I buried a hawk last year that we had found and I've never considered the amount of effort to bury a horse. Like, wow, that is an image. 

Marci Donaldson (05:58.17)
Yeah. Yeah. It is an image and it's not a pretty one. I think a lot of times now, in our older lives, we often will put a horse down at a vet for extensive disease or suffering, et cetera. 

Annalouiza (06:05.934)
Yeah.

Wakil David Matthews (06:24.414)
Yeah.

Marci Donaldson (06:30.836)
And that again is a sort of a closed space. It's like, okay, we say our goodbyes, here we are. They put the horse maybe in a sling and inject them so that they have a peaceful, you know, quick go, but still there's this huge body to work with, right? And so it's now once again sort of hidden, like the vet kind of takes care of that piece for us. But back in the day, you know, in the 70s in a town of 200 people, that's not how that happened.

Annalouiza (06:55.693)
Yes.

Wakil David Matthews (06:56.178)
Right. Yeah. I was thinking that the part of the trauma around it is that you have to go put it down yourself sometimes, or often back in the day. That was the job of the farmer or the rancher. And they just had to go be with an animal that maybe they've been come very close to and, you know, take it out, take it out with a rifle or whatever they did, you know, so, and that could be very traumatic in and of itself.

Marci Donaldson (07:18.798)
Yeah, and that was the behind the scenes job of my mom, right? You know, she owned a pistol and that's how she took care of that with the help of a neighbor or a friend or, you know, she didn't have heavy equipment. 

Wakil David Matthews (07:25.152)
wow.

Annalouiza (07:33.752)
Yeah.

Marci Donaldson (07:47.598)
So there was the farmer down the street that would help dig a hole and on our property, that kind of thing. So there was some support, but she was...my mom was a badass. mean, she really, she really was. 

Annalouiza (07:47.662)
I think so too. I love her.

Marci Donaldson (07:47.798)
She could do it all. She could waitress and wait, you know, raise kids and put animals down and love animals and take them all in and all the things.

Annalouiza (08:02.062)
What was her name?

Wakil David Matthews (08:02.206)
Well...

Marci Donaldson (08:03.47)
Her name was Jan.

Annalouiza (08:05.048)
Okay, well thank you Jan for these stories that you have imparted to Marcy and to me now. So just kind of settling into this awareness of death from an early age and what I hear you saying is you're not only aware of the passing of critters, but you're aware of the heavy lifting that your mother had to do around death and dying in your little family. So how has those stories impacted
your life story. Where has that led you?

Marci Donaldson (08:40.624)
Well, it first led me into, I think, a space of fearfulness of death because of the way I look at those subsequent deaths. So I had a very close friend named Lakin was my best friend and her mother, when we were in high school, developed cancer and looking back on my, you know, I was, I was unavailable to her during that time. I was really like scared to go to the house and you know, I did go to the house a couple of times and she didn't have hair and what do you say, you all the things, you know, that, that people in our culture generally are, are, you know, tacking onto. But so I, I think about that time and then Laken also was very instrumental with another experience. She was caregiving a woman who was bedbound, emaciated. 

This was in my first year of college. And I went to visit her with, I don't know what her disease process was at the time, but she was fully alert and oriented. And, and Lakin was hired to go to this house to turn her every couple of hours, but she was by herself during the interim because know, kids are working and you know, all the things trying to keep food on the table. 

And that experience of coming into that space and seeing this very vulnerable person isolated, you know, I didn't, I wasn't curious enough at the time to ask questions about that. 

Annalouiza (10:34.349)
Right.

Marci Donaldson (10:38.448)
There could have been a request to be alone and have quiet and not have kids around and just have someone come in. you know, I can't make any assumptions about what that was. But what I took away from that was just the lack of presence for her. 
And so I think those two, my friendship with Laken and those two experiences were pivotal in transitioning me from a place of fear to a place of wow, this is a thing. This happens in our world every day and it's going to happen to me at some point and how do I want that to look? And I think that shaped me in so many ways. And then I spent years and years living in San Francisco and playing hard and going to college and then traveling and doing all these things and then ended up in Hawaii with 18 years of restaurant work on board and thinking, you know, I just want to do something that feels a little more meaningful. 

And I looked up in the phone book. Do you remember phone books? Looked up in the phone book, the hospital, and I called and called to become a volunteer there just to kind of be in the community, get involved. I didn't get any return calls. so the next, you know, right there was hospice. And I thought,

Wakil David Matthews (12:00.062)
Mm.

Marci Donaldson (12:03.194)
I have no idea what hospice is. This is before the age of technology. So wasn't looking it up online. So I called up hospice and I said, I don't know what you do, but do you take volunteers? And they did. And that was like, you know, I became a volunteer and it was in this rural area of Hawaii. And just thought to myself, know, I wanna be more available and more in this world in big in ways and and professionally like this is this is this is what I'm going to do. 

And so went back to college and did another round of college for four years, which was interesting and then became a hospice nurse and and that that experience was very different than what I thought it might be once I got into it, you know, looking at the wonderful work that hospice does and there are so many gaps in what people need in their homes. You know, the 99 % of what people need is someone to be present. The caregiving gaps are huge. You know, we'd go into people's houses and they're just doing the best they can with what they have.

Annalouiza (13:19.086)
Right. Right.

Marci Donaldson (13:29.296)
And, you know, you, you have less than $2,000 and you can't, you know, you can get Medicaid and then you have, even as much money as my dad had, who was very good with money, still struggle with how long is the caregiver at $800 a day gonna last? I've got $185,000 in my savings account, but how long am I gonna live? And then once that's out, what happens to my life? And all of these crazy situations in the house where you just come in and there's nobody there and somebody's wrapped up in their oxygen cord… 

Annalouiza (13:47.886)
Mm-hmm.

Wakil David Matthews (13:48.242)
Yeah.

Marci Donaldson (13:57.572)
And the husband who's paralyzed is watching this happen to his wife from across the room and calling 911. And I'm thinking, my gosh, these folks are just in such distress around just the lack of support. That piece of support is so key. And then it would spin them out of control and they'd end up in, you know, their symptoms are out of control. They'd end up in general inpatient situation for a few days to get under control. 

Wakil David Matthews (14:04.798)
Yeah.

Marci Donaldson (14:26.244)
And then once again, Medicare stops paying for that. And so puts them back in that unstable situation and they spin out of control again. You know, it's just this wave of we can do better. We can do better. That was a very long-winded answer to your question.

Annalouiza (14:26.498)
Yes. Yep.

Wakil David Matthews (14:37.776)
We can, yes, yeah, we sure can. Right, very, very, well, no, very, very right on, very profound, actually, thoughtful about, you I think I worked in hospice as well. And of course, Annalouiza has been working in this world for a long time. And we've seen that. We've also have noted at times about how hard it is to be a hospice nurse or a hospice social worker or a hospice chaplain because of the commercialization of hospice and how it's more about making money anymore than it is about the care and compassion, which most people who sign up for that work are motivated by care and compassion. But then they have to fill out the forms, and they spend half of their time filling out forms and making sure they get to enough places to make enough money for the corporation, which is just totally anathema to what's in their hearts. It's been my experience.

Annalouiza (15:33.55)
Mm-hmm. Mm-hmm.

Wakil David Matthews (15:35.326)
We often, or we actually talked about maybe the one of the main people we can help with this podcast and or with our spiritual direction, spiritual support, spiritual companionship would be people who are in hospice. We're not in hospice, but people working as hospice. Yeah, yeah. 

Marci Donaldson (15:50.774)
Mm-hmm. Mm-hmm. Well, I did want to create systems to also help those that are working in hospice because as a nurse case manager,

Wakil David Matthews (16:02.226)
Yeah.

Marci Donaldson (16:04.56)
I had a ticket to the bedside. They had to have me in order to have hospice services. 

Annalouiza (16:16.717)
right.

Wakil David Matthews (16:19.39)
Right. Yeah.

Marci Donaldson (16:31.78)
But then folks would say, well, I don't want all these people coming in my house or, you know, I'm not spiritual. don't want somebody coming in and Bible thumping me, you know, this notion of what a chaplain is, right? That's a misconception of that piece. 

But so then the nurses then are kind of forced into all of these because the needs are there they need presence, they need to listen to that story of what happened in their childhood and reflective life review and all those things still need to happen. And they don't necessarily recognize that. So then the nurse is in the position of filling those roles and really, I felt thrown into the fire a little bit like, I've got to learn all these things because I try and try and couldn't actually get the additional services into the house oftentimes.

Wakil David Matthews (17:03.816)
Yeah, yeah, wow. Why don't you tell us a little more about what you're currently working on and creating? Sounds like some really cool stuff.

Marci Donaldson (17:14.352)
Yeah, you know, I'm kind of I'm, I'm finding over the last, you know, 15 years of my profession that I love to create things and innovate things. And, and so I've got a few irons in the fire. 

Wakil David Matthews (17:29.778)
Mm-hmm.

Marci Donaldson (17:42.84)
But I just finished, not finished, I'm still supporting hopeful house, but it's a 12 bed facility in Southwest Portland that that was originally opened in the in that early 80s by a woman named Joan Strong Buell. that house was owned by a large health system and they announced that they were going to close it down. Joan was in her 90s and she was a volunteer there and a donor, but she didn't have a lot of direct oversight of the house. 

And when the health system announced they were going to close it, she, she had been mentoring me for about, I guess, six or seven weeks at that point to open my own home on the East side of Portland. And she kind of railed me in and said, hey, let's do this thing and save Hopeful House. 

Wakil David Matthews (18:22.11)
Hehehe.

Marci Donaldson (18:36.826)
So the last five years since 2019 have been really learning a lot about construction and if fundraising and messaging to the community and modeling, creating a model that can be sustainable. This was the fourth version of Hopewell House ownership. And so how can we create something that's completely different that does fill a gap and that was, and doesn't compete with other services. 

And that was really what I could offer to Hopewell House was eight years of my own research, wanting to create services that I saw Missing as a hospice nurse and I wanted to get actual beds open on the east side of Portland and I could bring that to the group and Joan was a force to be reckoned with. 

Wakil David Matthews (19:33.736)
Ha

Marci Donaldson (19:36.204)
She died a year and a half ago but she gathered, she was on next door and gathered 70 people on a porch of someone she didn't know across the street from Hopewell House the next morning at 11 a.m. and we ended up moving that like a freight train, you know, we got it open, raised six million dollars, 

Wakil David Matthews (19:45.096)
Wow.

Marci Donaldson (20:06.128)
Got, you know, it like, it was crazy fast in that experience. And I still support them by filling in for administration and filling in for, for nursing. So I was still involved there. 

But in that development of that house, what I intended to do on the East side, serving those in the rural and mountain communities on the East side of Portland feels like a little bit of a drop in the bucket. feel very well prepared to create something. And it's going to be very, very simple. mean, 

Wakil David Matthews (20:09.886)
Yeah.

Annalouiza (20:18.528)
Mm-hmm. Mm-hmm.

Wakil David Matthews (20:27.774)
Yeah.

Marci Donaldson (20:30.286)
It's not a medical event, as we know, dying. And we've been doing it for thousands of years. And it takes a village. And so working from...that I don't know if you've heard of the Compassionate Community Model of Care developed originally in Australia and there's an Omega Home Network that creates homes around the country that are what they call social model homes. They are social benefit to the community and there's a network of assistance to help you help others expand that model and so the combination of those two is really the drive of what I wanna do is, I mean, the big dream is to have four walls and four beds available on the East side within an intentional community of folks, small community of folks that have a path to, death is their path to service and would love to age in place, care for each other in that space as well. And as I'm aging, I'm thinking, you know, where do I want to die and how do I want to die and do I want to be institutionalized and what will happen based on how much I have financially, etc. 

Wakil David Matthews (21:26.824)
Yeah.

Annalouiza (21:27.864)
Yeah.

Marci Donaldson (21:52.908)
So that's kind of the big dream right now and that's in motion. You know, looking for funding, looking for property, those kinds of things are on the docket currently but in the interim, I created an LLC end of life advocacy and care because what I'm seeing at Hopewell House is now that Oregon has immediate residency for folks coming from out of state to participate in medical aid and dying, there is, you know, a pickup of folks coming, you know, I wouldn't say it's necessarily a wave. 

Annalouiza (22:13.922)
Mm-hmm. Mm-hmm.

Marci Donaldson (22:22.682)
I think Vermont a year and a half ago also changed their law for that residency and they for sure are seeing a wave. But what we're seeing is people calling and saying, hey, do you have a place for two nights? You know, I've already seen my, had my first doc visit. I'm in Florida. I'd like to fly back, see my second doc, you know, have my second doc visit and just have a planned death in a location. Trying to find an Airbnb can take months.

Annalouiza (22:32.654)
Yeah. Mm-hmm. Mm-hmm. Hmm.

Marci Donaldson (22:48.996)
To call each individual one, or anybody that's renting a space, motels. I people are doing all kinds of things that are unsupported, unsupported from the organization. They're renting motel rooms and not saying anything to the motel owner, or, they feel backed into a corner. 

And so really this service is intended to help those folks get, find a place, you know, they're sick and they're overwhelmed and they're now suddenly in this new environment that they're not familiar with at all and getting a car and getting transportation and finding that Airbnb or finding any kind of rental space that will allow a death to happen. Complimentary services, I mean, when I think about this service, I think about when all of our needs are met, we now have space for beauty to emerge in the death process. 

Wakil David Matthews (24:01.95)
Yeah.

Annalouiza (24:08.942)
Mm-hmm.

Marci Donaldson (24:19.322)
And when you're in a flurry and a tornado of emotions, grief, et cetera, there's no space for that to happen. And a lot of folks are going to spaces and places that aren't in agreement of this thing. And then how does that add on to your loved ones grief when the aftermath of after they want to help support your wish in the in best ways possible. And then they're also dealing in their grief with the anger of a, you know, an owner of an Airbnb or, you know, I'm not saying that this is happening all the time, but I'm, I'm saying that there's only 12 beds at Hopewell House and there's a lot of folks coming from out of state that just need some assistance. So that's what I'm doing now.

Wakil David Matthews (24:25.459)
Right.

Annalouiza (24:35.299)
Mm-hmm.

Wakil David Matthews (24:46.748)
Yeah, beautiful.

Annalouiza (24:47.426)
Wow. Yeah, it sounds like you're doing the really big lifting of awareness and opening spaces for folks at the end of life. But there's a lot of challenges that I hear, too. The financing, the finding, the supporting. takes like it's the village people. 

Marci Donaldson (25:06.672)
The village people.

Annalouiza (25:15.768)
It's a village community, right? The village people to come in and and and help hold, you know, all of us carry this along. So are there just like a few more challenges that you feel like you have met with.

Marci Donaldson (25:21.218)
I think the biggest challenge to this logistic support model is really finding the spaces for people to do this. That's the biggest challenge. And I have reached out one at a time to Airbnb, VRBO owners. There's also a group here in Portland that has sort of separated from that large conglomerate of Airbnb and they're creating their own hosting network here in Portland, which is awesome. 

Annalouiza (25:53.688)
Beautiful. Love it.

Wakil David Matthews (25:56.584)
Yeah.

Marci Donaldson (26:18.98)
And then of course, you know, all of the connections that I have through Hopeful House, the net really starts to be thrown wide. And there are folks who say, hey, you know what? I have an ADU. You know, I've had three people just this week say, I've got an ADU that's in my backyard that my mom, you know, worked in. I would love to just provide that for someone, you know, I don't need to be on a network, just word of mouth. If you find someone that needs a space, it's there. 

And so I think there's gonna be a lot of that happening. And then I do hope, you know, and the universe always throws you in the right direction, right? Those paths open up and the four walls and the four beds on this East side will come eventually. But right now, I think there's plenty of places and spaces and nooks and crannies to support people.

So that is definitely one of the biggest challenges currently. And I do love when people say, oh, you can't do that. That just fuels my fire. I'm like, but we can. We can. There's always a way to figure that out. 

Annalouiza (27:01.067)
Mm-hmm.

Wakil David Matthews (27:06.524)
Hahaha!

Annalouiza (27:14.303)
Mm-hmm. Mm-hmm.

Marci Donaldson (27:17.946)
And we're so versed in like, no, no, but the state, that doesn't mark the boxes for the state. doesn't, it's like, there are there are endless possibilities of meeting the needs for the state and simplifying it to the point that we can do a thing and hold love and support in a very, very minimalized loving manner, right? 

Annalouiza (27:34.53)
Right. Alternative.

Wakil David Matthews (27:34.75)
Beautiful, yeah.

Marci Donaldson (27:47.184)
Doesn't take, we want to, we have to move. So many people are so stuck in death has to happen at a healthcare facility or death has to be, you know, regulated in some way. It's like,
That's it.

Wakil David Matthews (27:49.502)
Right, yeah. right. So what helps you feel supported? What kind of things help you carry on and do this work?

Marci Donaldson (28:02.724)
Well, it's been a, it's been a diff, there's a different answer to that question having helped both of my parents die this year. That's, that's a really interesting and it's a different experience, reflecting on what it was like for me during that, their, their dying process and what was and wasn't available to me as their support person. 

That was really just a thorn in my side, being in other places where something like Hopeful House didn't exist and thinking, wow, I just spent five years building this beautiful thing. And then it couldn't be there for me. And I thought, this is just, this is crazy that, that people aren't held, you know, I mean, six weeks of going through hospice in another state with my dad and not once did someone offer to hug me. And I thought, this is bizarre. Like I'm not being like,held as a person very well. 

Annalouiza (28:38.221)
Mm-hmm.

Wakil David Matthews (28:38.269)
Yeah.

Marci Donaldson (29:00.432)
And so, you know, the support, what supports me is really finding and being around those who, in my own grief process personally, is being around those who are grounded and centered enough to be present with me.

Annalouiza (29:01.858)
Mm-hmm.

Wakil David Matthews (29:03.299)
Right, right.

Marci Donaldson (29:28.516)
Who understand the difference between pity and compassion and what that looks like physically on someone's face, know, the frowny face or the, you know, and I'm really finding like that's really a big deal to me this year is really realizing how few people in the world can hold presence with me in a way that feels like we're on the same level, you know, that there's not this sort of imbalance of, I'm so sorry for you. And here I am being the sort of like giver. I'm your rock, you know? 

Wakil David Matthews (30:07.228)
Can help you.

Annalouiza (30:08.952)
Mm-hmm. Mm-hmm.

Marci Donaldson (30:28.312)
Yeah. And that's been really powerful for me this year is realizing, not only realizing my trajectory of how I have supported people in grief, from my very beginning baby steps as a volunteer to now, is kind of a wild thing to think about. Like I have been that person that I don't really that I struggle with right now. We all have, we all grow.

Wakil David Matthews (30:28.882)
Yeah.

Annalouiza (30:30.446)
Yeah. Well, well, and the more we are in these spaces and learning and talking to each other, we hear these things and we start kind of instilling them in our presence as well. And just meeting the needs of people going through grief, definitely I am no longer like surprised or, you know, I would give you a hug. Like, I'd be like, come here. Yeah. Yeah. I'd be like, do you want a hug? Do you need a hug?

Marci Donaldson (30:55.82)
I know you would. Yeah, you know, that's, that's super interesting as well as is is to reflect on, you know, how how did I present to those folks in that moment? You know, did someone hear from my stepmom that I was a hospice nurse, so therefore they stepped back from me like, she's got it right. 

Annalouiza (31:15.51)
Yes, they assumed, right.

Marci Donaldson (31:24.304)
Like, so you have to think about how how I presented Did I present like, hey, you know, I got it. And then therefore that message is to them a certain thing, right? And so there's a lot of reflection of like, I didn't, I came away not feeling like my needs were met, but what was my role also in that, in that relationship, those relationships. 

Annalouiza (31:27.746)
Yeah.

Wakil David Matthews (31:44.104)
Yeah.

Annalouiza (31:44.846)
Yeah.

Marci Donaldson (31:53.752)
And so that's, you know, that's always a learning process too. But I do think that, you know, going back to your question about feeling supported, it's really interesting having a 14 year old son as well. And so a lot of death in our lives, my friend of 36 years, both of my parents this year. And so he's really getting a lot of mom, you know, like, wow, mom, this is mom's grief process. 

Annalouiza (32:10.328)
Mm-hmm. Mm-hmm.

Marci Donaldson (32:22.04)
This is how that looks, you know, and this is kind of a big wave this year. And, sort of as a 14 year old teen, you know, he's like stepping back, like observing more than he is jumping in, you know, and, and I realized that the way I feel very supported by him is through his music. He plays piano and he may not be able to articulate love in the same way that I might have expected. But man, when he sits down on that piano and I just feel that music swirling around me, it just makes me realize like we share and love and support each other in such different ways. And I'm like, there it is, you know, there's that love and support. And that's the way it's expressed through him. And I was like, it's just wrapped up in that music blanket, you know.

Annalouiza (32:53.972)
Mm-hmm. Mm-hmm.

Wakil David Matthews (32:56.594)
Beautiful.

Annalouiza (33:07.266)
Well, and my next question was about how do you resource yourself? But I think you just really gave us one way that you resource is like listening to music and letting it envelop you and wash over you and be with you. And that's a as a like a signifier of love and support for you. So do you have any practices to keep yourself resourced?

Marci Donaldson (33:29.75)
So many. Gosh, you you learn, you learn, I think back on my first 10 years in hospice work and think, man, how did I even survive? Because I didn't have a lot of things in place, right? I learned, I learned along the way out of waves of, of just overwhelm and then coming out of that. 

And, and it started in my nursing career by writing a letter, sometimes it would be two sentences, sometimes it would be two pages of what a person taught me while they were dying. sometimes it, there were very few times that I actually shared that with a family member, but it was just for me. And it was very real. was, mean, sometimes it was like, yeah, everything you did, I do not want to do that. 

Annalouiza (34:18.894)
hmm

Wakil David Matthews (34:19.07)
Yeah.

Marci Donaldson (34:27.962)
Right. And then sometimes it was like, you, you know, I felt you go through my body when I was
hugging you to adjust your shirt and you died in my arms. Like there were some profound moments that happened, right? So those letters were pivotal for me at the beginning, but as time goes on, those rituals change. I mean, at Hopewell House, I moved from a place of, you know, in case management, I'd see maybe one or two deaths in a month. 

And I knew it would be very different seeing maybe two or three every week. Sometimes we have 30 in a month at Hopewell House because they stay for days, sometimes hours. And so I knew that there would have to be some new tools. I'd have to step up my game, right? 

Annalouiza (35:06.328)
Mm-hmm.

Wakil David Matthews (35:07.772)
Mm-hmm. Yeah.

Marci Donaldson (35:26.882)
So I often will go into a room after they've died, I'll come in, know, half hour early for work and I'll go into that space and we let those spaces clear and we don't fill them right away. We leave everything untouched and and allow the window to be open and have those have those moments. 

So I spend time in those rooms, talking and instead of writing those letters, I now just talk out loud and tell them everything that I loved about them and things that were difficult and what they taught me and and that's a very, powerful ritual for me. Yeah, there's there's so many I mean, we all have all those little pieces and little nuggets, right?

Wakil David Matthews (35:41.118)
Mm.

Annalouiza (35:51.404)
Lovely. Yeah. Well, right. But that's a really great and a good reminder for so many of us to like resource by speaking resource by writing. that's like, thank you so much for that, that’s a really good reminder.

Wakil David Matthews (36:05.084)
Yeah.

Marci Donaldson (36:08.014)
Yeah, speaking out loud, know, my mom died seven weeks before my dad in two different states. And so it was really interesting that I had my mom's ashes sitting on the front seat of my car, driving to my dad who's declining. And I just said, you know what, mom? I think we're gonna spend this time together. And she sat there with her little seatbelt on for seven weeks. And we talked out loud every time I got in the car to go to the store. I was like, all right, mom.

Annalouiza (36:36.406)
Let's go. It's good.

Marci Donaldson (36:37.146)
You gotta help me with this part. Talking, speaking out loud is powerful too.

Wakil David Matthews (36:43.492)
Yeah, beautiful, beautiful. Thank you for that. Well, is there anything that you fear about your end of life or your... As you said, we're all going there, right?

Marci Donaldson (36:51.312)
We are going there. Yeah, you know, outside of of somebody putting elevator jazz on the radio while I'm dying. 

Wakil David Matthews (37:03.375)
Yeah. Hahaha.

Marci Donaldson (37:19.906)
That's that is definitely a fear of mine. Like, please don't put the elevator jazz on the radio. Yeah, you know, we've I've done a lot of. A lot of my own death ritual work too, you know, imagining what that's like, imagining we did it, my husband and I did a really interesting practice where we both wrote down what we wanted to happen like on the day of our death. And then we exchanged stories. So now all my expectations are now his story. And that's what's really happening to me. It's like his whole story that wasn't my plan.

Wakil David Matthews (37:44.04)
Mm-hmm. Yeah.

Marci Donaldson (37:46.36)
And the anxiety that came up and that was like, my gosh, I could have all these ideas and then none of them happen, you know? And so that letting go of those expectations is a huge one. And in this last year, I think really reflecting on how my son would handle it, would he be able to be with me? 

Wakil David Matthews (38:13.798)
Yeah, yeah.

Marci Donaldson (38:17.102)
This is pretty raw, you know, being with my parents recently. But would he be able to be present? Not fear being around me, you know, ask the questions you needed to ask. Be okay being tearful. I do. I think that that relationship and how that would play out would probably be the scariest part and where I would have most of my attachments and those attachments, you know, are always troublemakers. Yeah, yeah. So I think that's probably our the biggest one.

Wakil David Matthews (38:41.95)
So true, yeah.

Annalouiza (38:45.506)
Marci, I'm totally watching your tears flow. And that's a very profound mama fear, right? And just as an aside, and then I have to actually head out to pick up my child. But do you talk to your kiddo about this stuff on the regs?

Wakil David Matthews (39:06.323)
Ha

Marci Donaldson (39:11.04)
Gosh, his whole life. You know, it's so funny because when he was in, I think grade school, I remember one of his teachers coming to me and saying, you know, he was talking about this thing. She was very concerned. And I said, yeah, and it's the family business.

Annalouiza (39:28.96)
It's a family business. Yeah, that's right. Yep. Yeah.

Wakil David Matthews (39:38.212)
Hahaha.

Marci Donaldson (39:40.312)
You know, that's, that's what we talk about at home. She's like, he's talking about death a lot. And, know, was talking about the neighbors cat dying and wanting to see it. you know, these
kinds of things. And it's, it's a very open conversation. It always has been, you'll be fine. And he has a great dad.

Annalouiza (39:41.218)
So he's gonna be fine. Yeah. I think he'll show up for you. Yeah.

Wakil David Matthews (39:45.63)
Yeah, I think he'll be fine. Yeah. Thank you. Yeah. Thanks for those tears. We consider tears sacred. Sacred honor. So thank you.

Annalouiza (39:52.68)
Yeah, we do. And Marcy, need to just, I need to go pick up a kid. blessings on your journey. 

Wakil David Matthews (40:01.66)
I'll keep will keep going. We'll be done pretty quick here. 

So yeah, Marci, we can kind of finish up. Just a couple of things we want to, basically we just want to see if there's anything you wish we had asked you.

Marci Donaldson (40:30.992)
Yeah, know, psilocybin, I'd love to talk about that for a moment. So my first introduction to the use of psilocybin for fear and anxiety at end of life was introduced to me during my nursing school, 2005 to 2007, the work that they were doing at Johns Hopkins. that has always been a curiosity for me.

And in my adult years, in the last four years have, you know, now that it's legal in Oregon, that changes a lot of things. But that therapy has been profound for me in my own trauma work. And I would love to have that be part of an offering you know, when we have the four walls and four beds, I'm hoping that I know people are working hard to get psilocybin legalized for hospice folks in their own setting and not have to go to a service center for those therapies. So very much immersed in that world. And I think that's how I got introduced to you all is through Intertrec Service Center in Portland.

Wakil David Matthews (41:49.822)
Yeah, yeah, actually, my friend, our friend, she's Phyllis, trained and is now working down there. I think she's the one who sent me or suggested we call and talk to you. yeah, I think that's we're hearing more and more about that. we're hearing about it. 

And Phyllis talks about how important it's been, how wonderful it's worked for people. you know, trauma, trauma work or just end of life and how she again, she's one of the people working to find a way to be able to do it in the hospice as part of a hospice service and not have to have people be transported to the service centers, so you guys are at least well ahead of the curve for most, most of us, you know, but, but, there's a long way to go with that, but I still think you're right that that kind of, is a wonderful service that we could provide. So thanks for offering that. We'll see if we can find any links about that and put it in the podcast notes too, or if you have any.

Marci Donaldson (42:47.0)
I certainly could give you a few links of organizations that work with folks at end of life specifically around, I'm throwing the net out. So I'm learning and meeting all kinds of places and spaces that I didn't know existed. There's just people everywhere doing all kinds of really, really interesting things. So I do hope that we can open the four beds and four walls somewhere in a location where that could be an offering for folks in their last days of their life or last months.

Wakil David Matthews (43:18.216)
Mm-hmm. Mm-hmm. Wow. Well, may it be so. We will, yeah. Well, so we like to end with a quote or a prayer or a poem. And you sent us a quote from the Bhagavad Gita. Do you want to read that?

Marci Donaldson (43:38.928)
I did actually let me pull it up here. Joan Strong Buell, who was a mentor for me through Hopewell that I mentioned earlier, used to read this portion of the Bhagavad Gita before for our grounding, you know, when we would meet or, or when we would leave a session, it was very, it was very moving for all of us and became became part of the flow of our lives every day. So I can read that.

Wakil David Matthews (44:04.552)
Yeah.

Marci Donaldson (44:09.762)
Never the spirit was born, the spirit shall cease to be never. Never was time, it was not. End and beginning are dreams. Birthless and deathless and changeless, remaineth the spirit forever. Death hath not touched it at all.

Marci Donaldson (44:35.792)
But since I had a couple slip-ups, maybe you could reread it when you post the podcast.

Wakil David Matthews (44:36.997)
I will read it again. Yeah just seems like that is always a good idea anyway. So thank you. will. So from the Bhagavad Gita, 
Never the spirit was born. The spirit shall cease to be never. Never was time it was not. End and beginning are dreams, birthless and deathless and changeless remaineth the spirit forever. Death hath not touched it at all.

Birthless and deathless and changeless remaineth the spirit. Yeah, that's such a profound thought. Thank you for sharing that with us.