• Kasia Borowczak

Conversation with Mariana García -end of life doula from Colombia who lives and works in the UK

Kasia - You work as a psychologist and end-of-life doula. What is an end-of-life doula and what do you do?


Mariana - The word doula is of Greek origin and means ‘woman at the service of others’, but I prefer to say person at the service of others, since not all doulas are women. End-of-life doulas are best known for the integral care, support, guidance and companionship they provide to the individual and their loved ones before, during and after death. However, it is important to emphasise that doulas support people at any stage of life, not just at the end, and an example of this is the work we do with healthy people and their advance health directives. Another important aspect that is not known about end-of-life doulas is the work we do at the community level, and this is the area that I am most involved in at the moment

because the community has a very important role for us from the moment of our birth to the moment of our death.


Kasia - And why did you decide to work as an end-of-life doula?


Mariana - Well, let's say that my father's death showed me that we were doing many things wrong as individuals and as a society in the context of death, dying and grief support, and then I thought that there should be better ways of feeling, thinking and acting in the face of

death. That is how my path as a death doula began. Death is the only 100% certain thing we have in life and the only thing, after birth, that we all have in common, but we have moved so far away from it that the knowledge and skills required to receive it have been lost. That is why, in addition to the individual and family support that I mentioned initially, I am involved in

the movement of compassionate communities, the training of doulas and in the carrying out community activities such as workshops, festivals, conferences and Death Cafés. I think it is important to offer spaces where people can approach the subject of death and dying and, at the same time, life and living as I always say.


Kasia - How can the support and service of a death doula help during death?


Mariana – A death doula can provide support on a physical, emotional, social and/or spiritual level, according to what the person who is approaching death wants or needs; cultivating their autonomy and empowerment, collaborating in the maintenance of their quality of life, and advocating for their wishes/decisions if necessary, among many other things. However, death doulas are not only there for the person who is in the process of dying but also for their loved ones, to help them to understand the natural processes of death and dying, support them with practical day-to-day things, give them space to rest, and support them

with their emotions and grieving processes, among other things. Nevertheless, it is important to highlight that everything we do we do by invitation. We never impose or force anything, but rather work jointly with people. At this level then, we work with the dying person, family members, healthcare professionals and all other people or institutions involved in the final stage of the individual’s life. That is why many times we act as mediators between the parties, too.


Kasia - Although you live in England, you are originally from Colombia. What is the approach towards death, dying and grieving within the Colombian community? Do people in Colombia talk about death?


Mariana - I don't like to generalise because death as well as grief are very individual

processes, but I will try to do so to answer your question. In Colombia people don’t often talk about death and dying and, being a country where the Christian religion predominates, most people have a Christian approach to death with a belief in the final judgment, heaven and hell (with some differences). However, in my lifetime, I have seen an enormous transformation in terms of what we do in the face of death. In my opinion it used to be more familiar, slow-paced and with community support, while now it is something more external, fast and commercial. For example, in 1990 my grandmother died. She died at home, surrounded by her family and her body was prepared by her children. There was also a 3 day wake at home and the townspeople accompanied us even several days after her burial. In contrast to this experience, the last death of a person close to me in Colombia occurred last year. She died in hospital and a prepaid funeral company prepared the body, the

religious service and the cremation, all on the same day as her death. Obviously, I must emphasise that the family and their wishes play a huge role in the way this is done (and there are things that are out of our control, like when we were in the pandemic), but I think there has also been a social change at this level, anyway.


In terms of grief, as I said before, it is a very individual process, but I think that the collective support has also decreased a lot, and this has generated more difficulties. However, this isolation does not only happen in Colombia but in many other parts of the world.


Something that I would like to investigate one day in Colombia are the beliefs and customs around death in indigenous groups, since I believe that we have a lot to learn from them. I did some work on this with the Misak, and although colonisation and evangelisation obviously caused many original beliefs and customs to be lost or transformed, there are still some characteristics and ideologies that show a different view.


Kasia -Although in Colombia death and dying are not topics which occur often in

conversations, you told me when we met for the first time that in your family house these issues were openly discussed.


Mariana - Yes, I was fortunate to grow up in a family in which death was part of life and it was not a taboo subject but rather a subject to be scrutinised. From a very young age I was

taken to funerals and my father was always very open with me about it. So, since I was a child, he talked to me about it and when I was a teenager he started giving me books about it. Also, he later confessed to me that one of the reasons I always had pets was to get me familiar with death!


My father was to some extent in love with death. In 1972 he had a near-death experience and since then he had always view death with hope and prepared himself for it, even reciting and writing the words of Teresa of Jesus “I die because I don't die”.

Spiritual growth and death, as well as the analysis of various books and people that spoke about it, were sacred topics in our conversations. We loved exchanging ideas and

philosophising while eating a cheese board with wine or stargazing while lying on the lawn. Many times the dawn surprised us in these conversations and we went to sleep after enjoying the sunrise.


One thing my father did all his life was to write (documents, poems and books) and record audios in which he not only exposed his vision of death but also the possibility of his own

death. So, if you’ll allow me, I will share with you some excerpts from a poem he wrote for my 26th birthday:


My time is getting short on this earth

...I'll leave and you’ll stay...

As a country man I tell you

that you have been, Daughter, my best sowing.

[…]

Just like the chick in the egg,

Now the shell is too tight for me…

Our paths will part... for now

but we’ll still be together, beyond time.

[…]

For twenty-six years, I showed you the way

I didn't want to carry you but I had my hand ready!

Today that you know how to walk, I’ll depart,

Happy for not having lived in vain!

(Manuel Darío García Ramón, 2006)


Kasia - Beautiful. Thank you for sharing it with me.


Mariana – My pleasure. As you can see, we always had open conversations about death and he was willing to receive it when it came. Therefore, when we found out about his cancer in stage 4, he decided not to have any treatment to prolong his life but instead he returned to his farm to continue writing, sharing his time with others and dying in his own environment.


Kasia - His attitude was very extraordinary but your relationship shows me that there are ways to talk about death and approach it in a calm and beautiful way. And with your mother did you talk about death?


Mariana – With my mum I talk more about it now than before; and when we do so, we do it in a very open manner. We both know (and have in writing) each other's wishes for before, during and after our deaths, because we don't know which one of us will die first.


Kasia - The topic of death is very present in your life because of your work and your own

experience of losing your beloved father. How has all this changed your attitude towards death and grieving?


Mariana –It was a change that began with the illness and death of my dad, because that made me realise how unprepared we are to receive death, to support those who are in the process of dying and to accompany those who grieve. So, when I came back to England, I took some time to experience my grief and to study more about death. Then I started volunteering with the elderly and in hospices, and facilitating bereavement support groups, until I finally decided to become certified end-of-life doula. So all this has contributed to who I am, what I do, what I think and what I feel now.


Regarding my attitude towards death, I have to say that death has become my best life teacher, and that thanks to it I now live more fully and I try to “not to leave for tomorrow what I can do today”. I think my closeness to death and my role as a doula have also helped me become a more compassionate, humble, spiritual and loving person. Becoming friends with impermanence has allowed me to be more aware of the here and now, encouraging me to enjoy more of the simple things in life. In terms of grieving, I believe that although we tend to standardise it and set times for it, the truth is that it is something extremely individual, so in my opinion there is not a single way to grief and even less a correct way to do it, but there

are as many possibilities and nuances as there are people and situations.


Kasia - And how was it for you when your father died?


Mariana - I felt my grief deeply when I returned to England. I think that the loneliness in addition to the cold and dark days contributed to me submerging in a feeling that I had never felt before and that at times turned into uncontrollable tears. For me, grief was not (and is not) a linear process. I felt like I was taking one step forward and two steps backwards. I found myself oscillating between emotions and, as Margaret Stroebe and Henk Schut say, fluctuating between loss-oriented and restoration-oriented coping processes. However, as Lois Tonkin proposes, I also felt that my grief was not going away, but that my life was growing around it. It was as if I learned to grow around my pain and, as William Worden says, I finally found a different but strong and lasting connection with my dad.


Then little by little I went from crying when I saw something that my dad liked to enjoying it twice as much because he liked it. That was how I began to feel my dad inside my heart and not just outside; and that is how I now feel more love and gratitude than sadness when I think about him. This doesn't mean that I don't miss him. No. I still miss his physical presence and in fact there are times when I still burst into tears because I would love to have a more palpable contact with him but that feeling doesn't stop me. It rather drives me to keep moving forward, because love doesn't die when the body dies.



Fortunately, I could and still can rely on my husband, who is quite empathetic and helped me a lot. But our lack of tools and the absence of external support made me realise how poorly prepared we are as a society in the face of grief. In my opinion this may be related to the disconnection we have with death in general, because if we don't even talk about it, how are we going to know what we can do when other people or ourselves have a direct or indirect encounter with it?


Translated from Spanish by Kasia Borowczak

Proofreading by Aggie Rice and Robert Dascenzo

 

Mariana García is a psychologist whose father's death inspired her to become an end-of-life doula. Although she is Colombian by birth, she currently lives in the UK. She is a member of End of Life Doula UK, Living Well Dying Well Training UK, Doulagivers USA and Colegio Colombiano de Psicólogos.


To learn more about Mariana and her work, visit her website and her Instagram and Facebook accounts:

www.doulamarianagarcia.com

@doula.mariana.garcia

www.facebook.com/doula.mariana.garcia/