Osal Doula Services
Offering support and care as you navigate serious illness and transition
Aren’t Doulas for childbirth? Yes!
But there is also a growing movement of Doulas who are trained to accompany people through serious illness, crisis, and end-of-life care.
Think of it as an extra layer of support and advocacy as you navigate any serious physical/mental illness, or as you transition into the end-of-life. As a doula I am here to support you in whatever you are experiencing. I am here to advocate for your wishes within your care team and within the often bewildering healthcare system— to accompany you in your joy and in your suffering, to help bring whatever it is that is life-giving and soul-nourishing closer to you.
I am here to encourage exploration of the love, the grief, and the robust broken-heartedness that is our magnificent birthright and death-right.
In just a matter of decades, we’ve lost touch with dying in many areas of the world. Dying has been so medicalized that we have no longer been exposed to it in our own homes, or developed a healthy and grounded relationship with death that our ancestors passed along to one another for centuries before us. I believe we all still have that wisdom deep in our cells, deep in our collective consciousness, but we just need more help right now to remember it.
How I arrived here:
There were three key events that called me to this work as a doula. First, I accompanied my grandmother through the end of her life in 2005 and she showed me what dying can be. She approached her death with curiosity, mystery, and even excitement, as though it were a birth. Her death was the greatest teaching I have ever received. She had an amazing hospice team around her that made it all possible.
Second, I faced a life-threatening illness in my late twenties and developed a very close relationship with my own suffering, and with the challenges of managing an ongoing illness.
Third, I met Harvard Buddhist Chaplain Khenpo Lama Migmar Tseten in 2009, and have studied and practiced under his guidance at the Sakya Institute for Buddhist Studies in the thirteen years since, including assisting Lama Migmar in the editing and release of 9 books on Buddhist practice and philosophy.
Those three experiences led me to return to school at Boston University School of Theology in 2015 to complete a Master of Divinity degree in interfaith clinical chaplaincy.
After graduating in 2018 I completed a year of clinical residency at Brigham and Women’s Hospital (4 CPE Units) in a diverse 793 bed Level 1 trauma hospital in downtown Boston. During that time I was the chaplain on a Neuro ICU, a Hem/Onc/BMT floor, and Cardiovascular/Heart Failure units respectively. My chaplaincy training included:
Providing interfaith spiritual /emotional care and assessment for patients, families, and staff
Covering overnight on-call shifts, responding to all trauma and cardiopulmonary codes
Providing end-of-life care across all units of the hospital including NICU
Collaborating with multidisciplinary teams including ethics, and psych/oncology rounds
Facilitating weekly guided meditation groups
Designing and leading interfaith chapel services
Articulating complex family dynamics in critical and end-of-life care
Collaborating with interdisciplinary teams to optimize patient comfort and family support
In early 2020, just weeks before the Covid pandemic arrived here in Boston, I accepted a position as a palliative care chaplain at Beth Israel Deaconess Medical Center. I was an inaugural team member of a new palliative care oncology program. I was embedded on an advanced cancer unit, working closely with a very skilled palliative care team of MDs, NPs, Social Workers, and Chaplains. It was an extremely challenging time for everyone in healthcare at every level, especially for our patients as they faced such difficult decisions while also experiencing the fear, loneliness, and isolation caused by the pandemic. We got to know our patients very well over the course of years and numerous long hospitalizations, and were able to accompany them and their loved ones through complex medical decision-making and difficult goals-of-care conversations.
When staffing changes significantly impacted our program, I decided to transition into working in home hospice where I had always imagined I would settle into a long career. I accepted a position as a spiritual counselor with Care Dimensions in 2022, supporting patients and families in the Greater Boston area.
The work of people like BJ Miller and Stephen Jenkinson spoke deeply to me, and led me to understand that serving as a doula was another one of the ways that I could accompany people and participate in the cultural changes that need to happen. I also knew I wanted to remain engaged in a highly esteemed and well-established non-profit hospice and to continue learning from mentors and colleagues.
It’s been seventeen years now since I sat with my grandmother in those final days of her life. Seventeen years in which I have felt my life working on me in beautiful ways— leading me to chaplaincy, and to starting this independent doula practice.
Suffering comes in many forms—
When we are navigating a serious illness we may experience existential, spiritual, emotional, logistical, physical, intellectual & social distress at various times, in various combinations, and sometimes in ways that feel completely overwhelming.
Here are some possible points of inquiry in our time together:
Existential
What are you thinking about? Worrying about? Is there something on your mind when you wake up in the middle of the night that you don’t have words for yet? It’s healthy and normal when facing a life threatening crisis to have so many feelings and experiences you don’t even have language for yet. I am here to accompany you, to ask you questions, to encourage you to inquire into those fears, to befriend the existential dread. Or to rage against it! Whatever feels life-giving for you.
Logistical
Do you need help creating your Advanced Directive or choosing a healthcare proxy? Do you want support with all the medical terms and forms as you get your affairs in order? I can help you talk about what medical interventions you would want and to make sure that is written out clearly for your medical team and loved ones. Do you want someone to take notes at a doctor’s visit or at a family meeting? Do you need help planning your memorial service/celebration of life? Do you have specific instructions related to your spiritual beliefs for how you are buried or cremated that you want people to know? Putting some of these logistical things down on paper really helps calm the mind and free up your energy for things you would rather focus on.
Social
The great palliative care physician Ira Byock said there are four things he’s observed that seem to matter the most to people at end of life regarding their relationships:
“Do you forgive me? I forgive you. Thank you. I love you.”
Is there anyone you are longing to have that conversation with? If you are unable to for some reason, would you like help writing a letter or creating a ritual for that connection even if someone has passed away before you could speak those words? Who are your allies on your family/friend team? (this is not necessarily the same as your healthcare proxy.) Maybe you want one person making healthcare decisions on your behalf but a different family member or friend in charge of who can visit you, how your room is arranged, how your faith community is involved, when your clergy visits and other things that are very important to you.
Spiritual
What does spirituality mean for you? Is there a word you prefer? For some people, their vegetable garden is their spiritual practice. For some people their church, synagogue, mosque, temple is a deep place of spiritual belonging. For others, the faith tradition you were born into has been a place of deep pain and there is a mixture of grief and longing for that spiritual home. For some people the sense of awe and wonder is inspired by string theory or quantum physics. What is it for you? Is there anything unresolved that you wish to resolve in your own spiritual experience? Do you want members of your faith community involved at end-of-life and would you like support talking about those wishes with them?
Physical
What makes your body feel safe? Would you prefer to be more alert but have less pain medication? Would you prefer to have very strong pain medication even it if means you lose consciousness? How would you like your room to be during your final days? Are there songs you would like played that we could prepare? Are there prayers or poems or stories you would like loved ones to read to you if you can no longer speak? How would you like your body to be treated in those days? Do you want to be touched or held by loved ones? Would you like a guided meditation even if you appear to be unresponsive? Do you prefer physical space and quiet instead? As your doula I can help ask you the questions and create the plan that will meet your physical needs and help you feel safe and supported.
Emotional
Illness and death bring up every single possible emotion and then some! Sometimes they also bring a numbness. There is space and there is love for all of those emotions and for the emotions you’re feeling for the first time as a result of this illness. My role as doula is not to diagnose, treat, fix, answer, or solve anything. It is to hold space for your feelings, to listen deeply, to ask clarifying questions, to witness and to respect you. Sadness, grief, anxiety, and depression are not synonymous but they are often confused during illness because they are all experienced at one time or another. Sometimes these very normal emotions that accompany end-of-life or crisis are medicated away instead of cared for or listened to in the modern healthcare system. At other times, depression goes unmedicated when it should actually be treated. As your doula I can help you discern what your needs are so you can express them to your medical team.
Intellectual
What are you curious about? What would you like to learn or leave in your dying? Would you like help with legacy projects? For example: writing memoirs, writing letters to family, making photo albums or scrapbooks, recording stories, creating a video journal, blogging, writing a song or poem? What has always excited you intellectually in your life? Some people like having the New Yorker read aloud to them. Some people want to hear a beloved children’s story. Some people like to explore memoirs about end of life. Often people want a little help slowing the brain down and becoming more mindful of their experience. Guided meditation and simple breathing yoga exercises are a wonderful way to slow the mind, reconnect with the body, and become more familiar with the anxiety. Anything that is unfamiliar can be frightening. Death can feel very unfamiliar to us at first. This is because we have forgotten how to die and how to talk about dying in our current culture. Mindfulness can be a method for staring right at those unfamiliar things until they become familiar again.
Whatever you are going through — may you find what you need in this moment in your life. May you feel the wisdom of your ancestors around you, may you lean in to the bigger love wherever you find it, and may you feel and know that you are seen, you are valued, you are beautiful, you are loved, and you belong.
To learn more e-mail osaldoula@gmail.com
A quick note regarding referrals. My doula practice is completely independent. I cannot accept any referrals to my private practice that arise as a result of any aspect of my work with Care Dimensions or with Active Minds. However, you will find helpful resources and a directory of other doulas at inelda.org an organization I am not affiliated with. If you are referring someone who is seeking spiritual and emotional support in navigating mental health concerns, I will consider the referral as long as someone is also in the care of a qualified therapist/psychiatrist and is comfortable with care providers working in collaboration as a team. In the interest of best ethical practice I am committed to avoiding conflicts of interest that might interfere in any way with the exercise of my role as doula. Such conflicts of interest may involve direct family, loved ones, friends, social or work relationships, or direct supporters of my music or other advocacy work.
Thank you for reading this far!
New website coming soon
osaldoula.com
The Tibetan word འོད་གསལ་, ‘od gsal is translated as clear light, inner radiance, clarity, lucidity, and luminosity. It is taught that one of the greatest opportunities to experience this inner radiance of the clear-light mind is at the time of death. This light is often part of the dying experience for people from many different spiritual traditions and has so many names, often the name of God.
As Leonard Cohen sings …
Ring the bells that still can ring
Forget your perfect offering
There is a crack, a crack in everything
That’s how the light gets in.