After graduating from high school, Mary Landberg, MPH, RN, CHPN, thought she wanted to be a doctor.
But as she was finishing her premed major at the University of Hawaii, she took opportunities to volunteer in hospitals and learned quickly she wasn't prepared to handle the emotional suffering that accompanies loss.
"I changed my major to health education in my senior year. It wasn't clear to me then, but I needed to work through some of my own suffering before I could get anywhere near anybody else's suffering," she said.
Landberg went on to earn a master's degree in public health and worked as a health educator in a variety of settings from community, corporate to collegiate for about 20 years.
"They say we teach what we need to learn most," she remarked.
At the age of 43, Landberg was inspired to go back to school to earn her BSN. She believes it was the best move she ever made. Her plan was to work as a cardiac nurse/educator because cardiovascular disease prevention and control had been her teaching focus for the past 20 years.
Then, one rotation in oncology Landberg said she "just knew" she was destined to work in end-of-life care and chose to spend an entire term shadowing a hospice RN.
"I felt absolutely at home working with the dying," she revealed. "It took me 20 years to get there, but I was finally ready."
Landberg worked a year in cardiac care to gain acute care skills before she transferred to hospice care. She currently holds the position of RN case manager at Asante Hospice, Rogue Regional Medical Center in Medford, OR.
An Untraditional Service
As a hospice nurse, Landberg is part of a comprehensive team of trained professionals to implement a holistic plan of care for not only the dying patient, but for the family as well.
She and her team work closely with the primary care physician, medical social workers, chaplains, pharmacists, home health aides, bereavement counselors and volunteer coordinators.
"We are liaisons and advocates for patients and families in every possible way. Our goal is to minimize the physical, social, emotional and spiritual suffering of the patient and family and to allow the patient to live fully while they are alive and to die peacefully with dignity and grace," she noted.
Several years ago, Landberg had the urge to offer an untraditional service to her patients.
"I was sitting with a patient who was ready to pass. His grandson, his only living relative, called from across the country to check on him - as he did daily. I answered the phone and offered to hold the phone to his grandfather's ear so he could say his hellos and his last goodbye," she recalled. "After their (one-sided) conversation, we chatted for a bit more on the phone and he expressed his wish to hold his grandfather's hand one more time."
Landberg, whose background includes photography classes and self-portraiture for a book she wrote, called Fear Means Go, offered to snap a shot of her hand holding his grandfather's hand. She sent it to him instantly via text and the grandson was thrilled. Soon after, she began offering hand portraits as a service to families.
These days, Landberg offers hand portraits free of charge to her patients' families. (She'll shoot a traditional portrait if the family desires.) A far cry from her initial text message, today she gifts family members with high-resolution images on a CD and a print or two.
"I do accept donations, which don't quite cover my costs of printing, framing, CDs, mailing supplies and postage. It's a way I give back to my community. It feels good," she said.
A Loving Touch
In her work as a hospice nurse, Landberg was struck by the way people lovingly touch each other.
"Love is what survives any prognosis to the last breath; love is all that is left in the end," she said.
This is what she strives to photograph. Her mission is to capture the unwavering expression of love that endures between people while living with terminal illness. Hand portraiture preserves this important expression of love.
"Hands reveal honest emotion. We hold hands to express love, comfort, safety and connection. We held our parents hands as we crossed the street; we take a hand in marriage.
"Our hands give and receive, wave hello and goodbye. Our hands tell stories, are placed over our hearts in joy and in surprise. They give pats on the back and offer approval with a thumbs up. They express who we are. Hands are for holding," she explained.
Landberg believes the meaning of her hand photography to magnify after the loved one has passed away.
"When a patient's wife tearfully told me that her hand portrait with her husband on the last day of his life was her most cherished object, I knew I had to keep doing this," she said.
Not long ago, a woman told Landberg that the photographs have kept her connected to her mom, a constant visual presence of a mother who is physically gone. On a weekly basis people express their regret for not having thought of this simple meaningful gesture for their own family members who have passed on. That's why she encourages everyone to do this.
'Simple But Potent'
Recently, one of Landberg's photos won first place in the National Hospice and Palliative Care Organization's creative arts contest. The NHPCO featured her work in an article in the August NewsBrief and after an article ran in her local paper, the American Nurses Association offered her story in their SmartBrief.
Since then, she has received many emails of support and gratitude for what she calls a "simple but potent" idea. "It only takes a few seconds to snap a photo and its value is priceless and lasts a lifetime," she said.
Landberg hopes that someday these portraits travel as an exhibit. She'd like to raise money to provide hospice nurses with point-and-shoot cameras so they could provide the same service.
"I want to start a movement." she noted.
Landberg's upcoming book titled, Capturing the Spirit of Enduring Love, will feature about 200 hospice portraits and stories she has gathered from families over the past few years.
It will also include her adventures in hospice and some wisdom and insight she has gathered along with way.
You can view Landberg's photos at http://www.hospiceportraits.com/.
Beth Puliti is a frequent contributor to ADVANCE.