Looking back on my motivation to enter into training to become a Conscious Dying Coach, it’s clear that my experience as a Threshold Choir* singer was “instrumental”. And now that I am working as a coach, so far for healthy people whose deaths feel far away, I realize how important it is for me to stay connected to those whose departure from this world is imminent. Being in their presence keeps me grounded in the reality of death – both the unpleasant and sublime parts – which keeps my coaching real and authentic. Let me explain a bit about how it has impacted me to be mere feet away from hundreds of people who are actively dying by sharing some of my journal entries.

(names removed, with one exception, to maintain privacy and sanctity)


June 2017 – true words

Sang for L today at HG Hospice. As we ended, she said “I am almost finished”. Chills – the good kind.

August 2017 – alone

At CC, we sang for an actively dying woman. She was on a mattress on the floor and the room was strangely and uncomfortably empty of anything comforting. One week later I see her obituary. I am so glad we were with her in that sad, lonely place.

November 2019 – the high of being validated

Went to HG Hospice and sang for six people. One person was so scrunched under the covers that we had no idea who was under there, only that their body was quite small. Another person seemed to be very close to letting go and so we sang as tenderly and quietly as we possibly could. But what I will remember most about today was meeting Mr. Lewis. We rarely know the names of the people we sing for, but he introduced himself with a strong voice and wanted to look at each of our nametags and greet us individually by name. He explained that an operation he had hoped would cure him could not be performed and so he had come here to receive comfort care. He was a large man, with big, expressive hands that he used a lot as he continued to speak to us. Or, better said, preach to us. With a bible in his lap, he quoted verses and told us about his deep faith. As he talked, we gently began to hum, almost as an accompaniment. His attention shifted to the music and he asked us to please sing to him. We sang “You are So Loved” both for its beautiful message and for its alignment with his words of love and gratitude. To say that he responded positively would be an understatement. He loved it and told us so! After several more songs, we got up to leave and he asked us to please come back next time we visited. Of course we will for however much time he has remaining.

November 2022 – staying present can be difficult

Four of us sang at OL Hospice today and I came away feeling raw. One man was deeply agitated, moaning loudly and calling for help. We knew that he had been tended to by the nurses, but hearing his cries was unnerving. We chose simple, soothing songs to distract and comfort him, which seemed effective as long as we were singing. As soon as we stopped, the moaning started up again. It was both difficult and a relief to leave his room. Next, we went into a room with a woman whose skin was so jaundiced, it was disturbing to look at her. But she was awake and aware and so of course we adapted quickly and began to sing. It was tough to stay focused on music. Questions about her condition were flitting through my head and I had to tell myself to recenter and concentrate on singing. We needed a little more time than usual to share our reactions/observations in our debrief time before we all departed. Heavy stuff.

August 2023 – witness

I’ve seen many people who were very close to death, but today someone died while we were singing. 5 of us were at HG. After a moment of quiet in the hallway to prepare ourselves, we entered to find a woman breathing quite erratically. It was clear that she was very near the end. We put our stools around her bed and sat silently for a bit before beginning to sing. Instinctively, we all used our gentlest lullaby voices and paid close attention to the long gaps between breaths. It was only the 5 of us and her in the room. I have no memory of what we sang, but I will never forget the experience of being her witnesses as she left this life. When the moment came that she did not draw another breath, we continued to quietly sing (I think we were humming) for another 5 minutes or so. When we stopped, we silently sat for another few minutes, reaching to hold each other’s hands as we continued to gaze at this perfect stranger whose gentle departure became a gift to us individually and collectively. Eventually, I got up and went to the nurses’ station to let them know. The nurse smiled and said, “Well, she must have been waiting for you to sing her home”. Wow.


In our debrief, we acknowledged the irony of how very profound and ordinary the experience was. People die every day, after all. It’s ordinary and natural. But to be with someone as they leave is something most people experience rarely, if ever. I found it deeply centering. My mind was quiet and intensely focused and the air felt charged with…something. I don’t know what it was, but it was different and special. We knew literally nothing about this woman except what we could observe in the few minutes we spent with her. Not her name, not her age, not her story. But we will forever be intimately connected to her.

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*Threshold Choirs sing for people on the thresholds of life, particularly focusing on people who are dying. To learn more about this special work, visit www.thresholdchoir.org.

Susan Patterson owns Gifts From the End, a conscious dying coaching practice in Atlanta, Georgia and is a 2023 graduate of the Conscious Dying Coaching training program. You can check out her work at www.giftsfromtheend.net.