Sandra Clarke was working the night shift as a nurse in a West Coast hospital, checking in on a half-dozen patients as she made her initial rounds.
She noted that one man had a "do not resuscitate" order on his charts. "His breathing was shallow, and I knew he was close to the end," said Clarke, who now lives in Eden Prairie.
The dying man asked if the busy nurse could stay with him for a little while.
"I told him, 'As soon as I was done checking on the other patients, I'll come back to see you,' " Clarke recalls. "It was a simple, human request."
Clarke returned to the room, only to find the man dead.
"His arms were stretched out, as though he were reaching out for someone," said Clarke.
He had died alone.
The image stuck with Clarke, even as she moved from the Los Angeles area to Sacred Heart Medical Center in Eugene, Ore. So did the impulse to do something about the growing number of people who die in the hospital without family or friends.
"We come into this world with somebody, it just seemed like we should go out with somebody," Clarke said. "No one should die without a loving face with them."
In 2001, Clarke mentioned her idea at a retreat, and a hospital administrator asked her to write up a proposal. Clarke came up with the idea of a volunteer organization, No One Dies Alone (NODA), in which patients in their last days are assured bedside company as they die.
The idea has spread across the country and as far as Singapore. Tuesday, Clarke met with the approximately 150 volunteers at Mayo Clinic/Methodist Hospital in Rochester to share stories of how the idea has comforted the dying while enriching the lives of those who witness death.
Barbara Kermisch, coordinator of the program in Rochester, said she and others heard Clarke speak and knew she touched on "the frustrations all nurses have when they have dying patients but can't stay in the room."
Kermisch said volunteers come from the hospital staff, area residents and churches who adopt the program. When Mayo started the program, they predicted volunteers would sit vigil for maybe a dozen "lone travelers" a year. But in two years they have had vigils, ranging from a few hours to 72 hours, for 52 individuals.
Some of the patients are alone because their families don't live nearby. The majority, however, are what Clarke calls "elder orphans," who have simply outlived the rest of their family.
The program is little more than a phone and message tree. When a patient is near death and has no visitors, word goes out and volunteers sign up for shifts that usually last for between four and eight hours.
Usually, they've never met the patient. Sometimes they talk, other times they read, play music or just hold the dying person's hand, said Kermisch. "Being a companion is a way to honor that person's life and death," Kermisch said.
Mary McCabe of Rochester completed her first companion vigil a few weeks ago. She had some initial trepidation about sharing this most personal moment with a dying stranger but soon embraced the experience.
McCabe has experience in massage, so she massaged the hand of the patient, who was unable to speak.
"You can really communicate through touch," said McCabe. "It was really meaningful for me to be there and be a representative for a family who couldn't."
Even though she was with the patient a couple of hours, she connected enough to "make sure the next volunteer was going to treat her well."
The patient died shortly after McCabe left.
"Volunteers tell me over and over how the experience has helped them become a resource for their own families," said Clarke. "Some are able to expunge guilt if they weren't able to be at a family member's death."
Clarke has received numerous awards around the country, was featured in Oprah Winfrey's magazine and confesses to an "impostors complex."
In fact, as her husband's health waned several months ago, the joke in the family was that Clarke would be too busy speaking or working on the issue to be around for his death.
But when he died earlier this year, she was beside him. "I kept my promise," she said.