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 Media Kit
From Sun to Sun
A Hospice Nurse Reflects on the Art of Dying
A Memoir
by
Nina Angela McKissock, RN
She Writes Press
August 2015
ISBN 978-163152808
FOR IMMEDIATE RELEASE
Publication Month: August 2015
Media Inquiries | Interview and Excerpt Requests
Contact: Kaye McKinzie, Publicist
[email protected] | (415) 927-7365
From Sun to Sun, A Hospice Nurse Reflects on the Art of Dying
A hospice nurse brings readers the profound lessons learned in this open-minded
reflection about the mysteries of life and death.
Twenty-one people of different ages have one
thing in common; they’re within six months of their
deaths. They’ve endured the battle of the medical
system as they sought cures for their illnesses, and are
now settling in to die. Some reconcile, some don’t.
Some are gracious, some not.
As Nina Angela McKissock, a highly
experienced hospice nurse goes from home to home and
within the residential hospice, she shares her journey of
deep joy, humorous events, precious stories, and
heartbreaking love.
Free of religiosity, dogma, or fear, From Sun to
Sun brings readers into McKissock’s world in this
engaging memoir that explores the tender mercies of hospice care.
“This work is so important, honest, unflinching and well written…really a gift for anyone
who has or will experience the process of dying. (I guess that covers a lot of people!),”
says Dr. Dan Gottlieb, PhD, author and host of NPR Radio Program, “Voices in the
Family.”
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From Sun to Sun (She Writes Press / 978-1631528088 /August 4, 2015 / $16.95)
releases this summer with book tour readings by author Nina Angela McKissock, RN, at
bookstores and libraries in Philadelphia, New York City, Boston, Washington DC, Los
Angeles and San Francisco.
Find and follow Nina Angela McKissock Online:
Website | http://www.ninaangelamckissock.com/
Goodreads |https://www.goodreads.com/book/show/25079820-from-sun-to-sun
Facebook | https://www.facebook.com/ninaangelamckissock?fref=ts
Twitter | https://twitter.com/NinaMcKissock
Advance Praise for From Sun to Sun
“This work is so important, honest, unflinching and well written…a gift for anyone about
the process of dying. (I guess that covers a lot of people!)
—Dr. Dan Gottlieb, PhD, author and host of NPR’s “Voices in the Family”
"From Sun to Sun is a beautiful memoir by a dedicated hospice nurse who listens, speaks
and acts from the heart."
—Frank Ostaseski, founder Metta Institute, founding director, Zen Hospice Project
“The revelation that dying in hospice care can be an emotionally uplifting last chapter of
life is one of many in the book. This tenderly rendered addition to the literature on
hospice care deserves the widest possible audience. “
—Kirkus Reviews
It is an art to understand unfinished business and to lead others on the path to die gentler
and more compassionately. Nina has that art and conveys it so well that caregivers and
loved ones everywhere can read these stories, and relate and use these stories to help
others.
—Cass Forkin, Founder of Twilight Wish Foundation
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About the Author
Nina Angela McKissock has been a registered
nurse for thirty-nine years. She was featured on
the Spirituality Channel’s three-part television
series From Hospice to Heaven, has created
hospital-based programs on Death and Dying
and Bereavement, and was the Executive
Director and Founder of Serenity House and
Hospice Support in Doylestown, Pennsylvania.
Before that, she worked as a nurse in top-rated
hospitals including The National Cancer
Institute in Frederick, Maryland, and
Hahnemann University Hospital in
Philadelphia. McKissock lives in Philadelphia
and has three grown children.
Q&A with Nina Angela McKissock, RN, author of From Sun to Sun
1.
Tell us a bit about From Sun to Sun, and what inspired you to write this book?
NAM: One afternoon I was in my hospice office complaining and whining about how
the public perceives dying in a fearful, misinformed, and unrealistic way. When my
fellow nurses told me that I was the one to write something about this, I resisted. Weeks
later, I conferred with my financial advisor and—being the fellow dreamer that he is—
told me that it would be alright if I took some time off to write.
Little did I know that writing is an exacting, complex art form, and that it would be a
torturous, giddying, loving, and vulnerable experience learning the craft. The discipline
required while attempting to perfect basic skills, and the constant “checking-in” of my
voice and content, were skills and habits I wish I’d learned decades ago.
So I can honestly say that this is a tribute to these wonderful people I served and to those
who cared for them. Their stories simply had to be heard.
2.
You were born in New York, a first generation American. How did your parents’
culture influence your childhood and were they in agreement about religion and some of
the mysteries of life and death that you write about?
NAM: My daily communicant Puerto Rican mother and Italian father, were prisoners of
many of the incapacitating beliefs professed in organized religion. Their guilt, constant
shame, fear of judgment and retribution thwarted all their dreams of independence and
any questioning. As a child who witnessed the tail-chasing madness of those beliefs, I
adopted the gentler, more tender characteristics and teachings of the man they perceived
as Jesus. Now that my mother is ninety-two years old, she has mellowed to allowing the
Mystery of life to simply be.
3.
You are one of three children, and your older sister had developmental disabilities
and you were her fierce protector, a lioness. You write about the trauma of her early
death. Did that set you on a path of nursing and did it inform your book in any way?
NAM: Yes. Even though I was eight years younger than my sister, I took on the role of
protector and caregiver early in my life. Her gift to me was to learn to see people for who
they really are, and that the smoke and mirrors of clothing, makeup, social status and
belongings mean nothing in the end. Another gift was that she made me courageous to
defend someone who is unable to defend him or herself. And…the biggest gift she gave
me was the intolerance of injustice.
4.
You began this memoir as a private book to be left to your children. Why did you
want them to learn about it after your death, and what brought you to publish the book
now?
NAM: They were affected by my hospice career for at least ten years. They understood
that when I was overcome with sadness, or was overly jubilant about something most
people would not even care about, that these reactions came from the deep connection I’d
made with those who are at the end of their lives. Those of us who serve the dying have a
very different perspective on how to live life. I guess at times I am perceived as reckless,
when in reality I simply didn’t want to miss a beat. When you serve this population you
have a choice to choose to be content and curious about life, or slip into sadness, fear and
dread.
I published this now because, truthfully, I am tired. Tired of people running from death,
tired of other people telling us what to fear, tired of being considered odd because I find
funny moments within the end of life experience, and tired that no one is speaking up to
the reality that Love has a constellation of faces. I think starting an open conversation
gives everyone an opportunity to lighten up, keep death close at hand, and enjoy being
here on this planet. Stop missing the beauty of being present even if it isn’t pretty! Don’t
wait!
5.
You are not religious, but quite open-minded about the death process, and
adamant about the need for respecting the moment of death and the time immediately
after as sacred, as in childbirth. How did you come to this viewpoint? Is it inspired by
other traditions?
NAM: I’ve seen religiosity work both ways. You cannot convince me that we are being
judged by some big man in the sky. My goodness, they’ve updated The Joy of Cooking
cookbook many times to adapt to evolving tastes, why don’t we do this with the religious
texts?!. I ask, why don’t the major religions sit down and do this with their great books?
The bible is extremely violent; let’s update it.
After we teenagers and parents had Catholic mass in my home—with a beloved priest
Fred Crugnale, presiding—Monsignor McDonough asked me to leave the Catholic
Church. That was when I was 16 years old. Again, my sister taught me to dislike
injustice, so I left willingly. I suppose my beliefs are a little bit of this and a little bit of
that. But one thing is for sure…the constellation of styles in which love exhibits itself is
grand and mysterious and to be celebrated. I suppose my religion is: Don’t Cause Harm
to Yourself or Others. It’s tricky and I’m not really good at it, but I feel this is my core
belief.
6.
Your marriage and breakup were difficult, you write about traveling to Italy, and
a reconnection with yourself, a return to living deeply and fully. Did that rite of passage
inform your work in hospice, or did your work in hospice inspire you to want to live
more passionately, or some might say, authentically?
NAM: My work in hospice inspired me to live more passionately. My husband, though a
very good man, was always worried and concerned about what people thought of us. We
lived in a community that had impossible standards. I could no longer compete because I
realized their standards meant nothing in the end. Having “cut” biceps, expensive cars
and gorgeous Ivy League children means nothing in the end. I’ve made many promises to
my hospice patients, and I have yet to fulfill probably ten of them! But I believe what
matters is the quality of your heart, your intentions.
7.
From Sun to Sun represents decades of your experience and learning about the
deepest human transitions—love, loss, grief and ultimately, the journey we must all take
toward death. There are many mysteries and profound discoveries in the twenty-one
individual stories. Did your reflection during the writing of the book provide new insights
for you?
NAM: Whew, I was surprised that I cried so much as I recollected the patients and
experiences that comprise From Sun to Sun. Two insights were that I didn’t have to be so
fearful learning to write, and that being isolated for two years was really awful for my
personality. I’m writing a work of fiction now, and I happily write in the middle of a
crowded café!
The mysteries and discoveries I’ve made while writing the book are the same one’s I’ve
had all along. They reflect the Five Precepts created by Frank Ostasescki, founder Metta
Institute, founding director, Zen Hospice Project.
They are:
• Welcome everything, Push away nothing.
• Bring your whole self into the experience.
• Don’t wait.
• Find a place of rest in the middle of things.
• Cultivate Don’t-know Mind.
8. Many people today are not religious, yet religion often has a role for them at the time
of marriage or birth and other life passages. What role does faith or spirituality have
in the way we die?
NAM: As many people know, many of the world religions advocate a judging god, who
judges you 24/7 and is one that should be feared, and has the ultimate hand to punish you.
What I know and believe about love IS in the First Corinthians. “Love is patient, love is
kind.“ As I see from being with the dying, love matters most. Longing for forgiveness,
and to be forgiven, is often foremost for them, and their loved ones. It’s from a place of
wanting to know that their life held meaning because there was care and love, even
though there was sorrow, huge mistakes, and pain in relationships.
These are matters of living, not religious matters of after life, but this life, that gives ease
and comfort to the dying. So while religion is a comfort of a sort for some about an
unknown afterlife, I see more often that it is the business of closing a life and speaking
about love that has seemed to ease dying. There is always something good that someone
has done in his or her life. They can be reminded of it as they are dying. Personally, I
don’t believe for a moment that a person must beg for forgiveness, for approval, or for
anything from god, if He—and why NOT a she—loves you. If God is love, as we read,
and many religions espouse, then I think he should be the entity that laughs with us as we
mess up. It’s fear of what others think of you, and failing to love oneself that seems to be
a challenge at the end of life.
So perhaps you can have those important conversations—apologize to yourself and
others—and if you find the inner strength, say you love and forgive. That’s what I have
witnessed matters most.
9. What advice would you give someone who has a loved one needing hospice care?
NAM: Call your local hospital and ask to speak to a social worker. Get all the legal
forms in order: the Will, the Advanced Directives. I strongly advise that someone other
than a family member be the health care advocate.
Many times a family member will usurp what the patient wants and cause great suffering
for the patient with more tests, more treatments. Have the discussion with the loved one
about the reason why they will go on hospice and that it is not about giving up. It’s about
specialists managing their symptoms and taking a break from constant doctor office visits
and the poking and prodding of treatments. Make sure they know that people can
GRADUATE AND BE DISCHARGED from hospice care if their quality of life is good
after getting their symptoms under control. We are like birthing nurses on the other side
of life. We want it to go well, and have highly specialized training. Your doctor will still
be in the loop of decision-making and you’ll have an extra set of hands and eyes a few
hours a week to help you with your loved one’s care. We can also supply names of
people/agencies that can provide 24-hour care, too.
10. You have a lot of poetry and literary references in the book—philosophy, mythology
and poetry— have you always been a reader and writer? What writers are your
favorites and which informed From Sun to Sun?
NAM: I am such a lover of biographies. I devour them. Many of the biographies I read
pertain ancient wisdom-keepers, religious idols, and historians. I enjoy the research and
perspective that Sam Harris shares with us. I respect how he challenges us to question.
I’ve written reams of poems, but they aren’t good enough for the public yet!
11. You took a year off to write From Sun to Sun, and have taken many writing
workshops prior to starting the book. Do you have plans to write more books?
NAM: Yes, the book I’m writing now is fiction. It began as an autobiography of a 91year-old First Division Marine who I met two years ago. It has evolved into the stories of
three people I’ve known who were in WWll in the South Pacific.
Fiction is challenging; keeping it all together is such a discipline. I think I’ll have it
complete in a year. When you read From Sun to Sun, the last chapter of a patient named
Everitt Banks, and he is the inspiration for a supporting character in my book. People just
love his story.
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From Sun to Sun, A Hospice Nurse Reflects on the Art of Dying
A Memoir by Nina Angela McKissock, RN
Excerpt
Introduction and 1356 Word Excerpt of Chapter 3
(With permission from She Writes Press. Copyright 2015)
Prologue
And so, in the end . . .
The last five minutes are often the same: the chest expands from the shoulders as
if with each breath they are attempting to shrug. It’s a posture of submission. Those with
angst and fear—who have fought with every cell in their being to remain alive—are
finally submitting to the process.
It’s quiet now.
I breathe with them.
The breath is shallow, like the end of a moan after making love.
If I’ve managed their symptoms well, they no longer have the sounds and scents
that terrify their loved ones—the gasping, gurgling, and sighing at the end of exhalation
and the oily, lappable scent of separating cells and closing synapses. The breaths are
staccato as they diminish. The mouth opens as jaws relax, and one or more eyes may
gently, slowly, close.
The heart quiets; less work to do now. My hands remain under and over their
heart, the hand on their back—between the shoulder blades—absorbing the beating, the
slowing, the quieting.
I close my eyes and imagine strength and peace. I place my mouth next to their
ear and whisper, “Good work. Go with love. Thank you.” And sometimes I add, “Say hi
to my sister MaryJane.”
CHAPTER THREE
Rick Gallen
I kept reminding myself to breathe the way my yoga instructor had demonstrated
in the introductory class; it was crucial in this situation. I’d learned long ago
breathing was the only way to step into someone’s fear without becoming undone. Rick
had been a platoon sergeant for two tours of duty in Vietnam. Even though he had been in
a coma for the last two days, he suddenly did that standing-up-and-running thing that
some dying soldiers do when they get close to death. I shouldn’t have panicked, but it
was unsettling. It’s so eerily odd, as if the deathbed were a foxhole, and when the enemy
finally discovers them, they run forward, as though saying, “Come and try to get me,
motherfucker; I’m not going down without a fight.” It unnerved me, and I wanted to turn
away at that moment, but my responsibility to the family and dedication to the journey of
dying stopped me.
I told myself, “Dammit, Nina, you’ve been in this situation many times before.
Get your act together.”
Rick was slumped down on the floor next to the window. “Look at me, Rick.” I
placed my slightly trembling hands on the sides of his familiar, handsome face and gently
lifted his chin off his chest. I kept nodding as I softened my voice.
“I’m gonna give you a big hug and we’re gonna get back up together. Then I’m
gonna tuck you into bed. Stay with me sweetheart, stay with me. Your beautiful family’s
here, see them over there? Your bed is right here. You’re safe, no worries. Stay with me.”
I kept my belly soft as I guided this six foot one Marine onto the hospice bed he
had occupied for the last two months. A soft belly enabled me to be strong, flexible,
and balanced if either of us began falling. His family stood sniffling in the doorway,
suppressing their grief and sobs. They were frightened and heartbroken. They needed
some relief.
Rick had been admitted to our residential hospice against his family’s wishes, and
he let me know his displeasure after his son, daughter, and wife introduced themselves.
I perfected the half nod, half smile that communicated, “I get it. Don’t worry. I’ve seen
this before. I can tell you’re not happy. We’ll talk alone later. Trust me on this one.”
His son, wife, and daughter wanted him to die at home, and they started the
conversation with him by having a family meeting. Knowing that Rick was a selfproclaimed “results” and “logic” guy, they used data, reasoning, and statistics to convince
him that dying at home surrounded by family and friends would be more comfortable for
him.
“Dad is obviously not happy. He fought to be here, and it wasn’t too popular at
home. He may give you a hard time because he knows how he wants this to play out.
Mom is heartbroken that he refuses to be taken care of at home, and my sister is pretty
numb at this point,” Rick’s son explained to me.
Rick believed their idea to have him home to die was a purely romantic notion
corrupted by “Hollywood and pathetic romantics.” He was sixty-two years old and
had founded a successful advertising firm in New York City after returning from
Vietnam. His medical charts were extensive. We received them in chronological form,
and the story of his life was one of accomplishments and overcoming obstacles many of
us could never comprehend. During his admission, he chose to sit in the chair located
farthest from the bed. I sensed he was evaluating a territory he didn’t trust quite yet. He
watched my body language, mannerisms, and tone of voice as I read his history. I could
feel that every one of his senses was assessing me. I spoke first.
“Thank you, Mr. Gallen. I want to begin by honoring and admiring you for
coming face-to-face with the possible end of your life. It takes a lot of courage and
love.”
He looked surprised that I said this so openly. “Call me Rick.” He cleared his
throat. “Well, I don’t know about the courage part, but I think I’ve exhausted all my
possibilities.”
He looked at his family. “And I don’t want them being bothered by me anymore.”
In this country, we think of dying primarily as a medical event. It’s much more
than that. It’s about relationships: to ourselves, those we may be caring for, or those
caring for us. Caring for the dying can be an intense, intimate, and deeply enlivening
experience. Death can be an extraordinary mirror through which we see ourselves.
I continued, “I’m impressed with how thoroughly you’ve faced your disease.
You’ve been through the mill, and I see you’ve done plenty of traveling for treatments. I
read that it’s been two years since you were diagnosed?” I flicked through his chart.
“No big deal, I just did what the big team of docs thought I needed. I just had to
do what needed to be done,” Rick replied, his voice strong and direct.
I waited, put his chart down. “So . . . what’s next? I need to know your
understanding of where your disease is now, so we can all be on the same page.”
Admitting a new patient is often challenging. Sometimes a family member will
stand behind the patient and wave me away when I get near their forbidden words
like death, hospice, cancer, and terminal. For instance, they haven’t told their loved one
they have cancer, and the verbal gymnastics that support their omission make for a
very stunted relationship with the patient. When I have a family like this, I look forward
to the private, one-on-one conversation I’ll have with the actual patient. I make sure
these conversations are light and factual, and that I’m without prejudice or judgment
when I meet with them.
They almost always know the truth.
Nurses, volunteers, and visitors each have their own ideas of how one should die.
I remind my staff that we are to meet everyone exactly where they are in their beliefs
about their lives, without trying to impose our personal beliefs on them unless they are in
danger of harming themselves.
Rick was one of those patients who made me think outside routine medical
consciousness, and I respected and appreciated it. Wherever a nurse works, the facility
breaks him or her into its own style and consciousness. I could always tell a nurse
who trained at a certain hospital or school by the way she or he approached a problem,
and the structure of her or his communication skills. These differences made for
some challenging conversations during team meetings, to say the least.
The interior decorator of the hospice wanted to achieve what he thought
resembled the look of his favorite five-star hotel in London. Large bright pink and green
floral patterns covered the formal swags and valances on the windows and the dust ruffles
on the beds. The chiseled Marine made the décor look even more ridiculous and
staged. Rick’s family kept a twenty-four-hour vigil in the little seating area next to the
nurses’ station. We always saw them as we worked, and they grew to know each nurse’s
idiosyncrasies, speech patterns, humor, and style. Rick’s daughter would walk to the
medicine room when we were laughing, and I knew this added levity to her life of
waiting. I’d try to repeat a joke or share the story of a harmless mistake our staff made,
and she would join in the laughter. She knew all the patients’ families by now, and she
would add her own amusing stories that only those surrounded by the dying found funny.
One day she shared with us which music we would have to play to confirm her death. “If
I don’t start dancing when you crank that up, then you can pronounce me dead.”
I hope her family realized that sometimes we had to laugh when all we wanted to
do was cry. Maintaining a calm, peaceful environment in the hospice is more difficult
than it seems.
* * *
From Sun to Sun, A Hospice Nurse Reflects on the Art of Dying
A Memoir, by
Nina Angela McKissock, RN
She Writes Press | August 4, 2015 | 270 pages | $16.95 | Trade paper
ISBN 978-1631528088 She Writes Press (SWP) was founded in 2012 as a response to increasing barriers
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