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LINDA WERTHEIMER: Medicare paid for Dixie's help. Medicare pays for six months of hospice care once a doctor certifies that a patient has a terminal illness. Social workers and counselors, home care aides and other kinds of help are also available from the more than 2,000 hospices around the country.
SOUND OF VELCRO SEPARATING
Dixie Orrison called on Helen frequently, eventually growing close to the family.
DIXIE ORRISON: How's that appetite?
HELEN PAYNE: Good.
DIXIE ORRISON: OK.
HELEN PAYNE: Just got through eating a big salad.
DIXIE ORRISON: Yeah, well.
HELEN PAYNE: Kids help me.
DIXIE ORRISON: You been up moving around a lot?
HELEN PAYNE: Oh, yeah.
I did a whole lot of moving around over the weekend.
DIXIE ORRISON: Well, you know they say they can't keep a good woman down. So...
LINDA WERTHEIMER: Hospice workers like to say they treat the patient, not the disease. They're not trying to cure their very ill patients, but to keep them comfortable, and to help them and their families find ways to deal with their last illness.
In Helen Payne's case, her family is large and close. Her older daughters live too far for daily visits, but would come weekends. Her two sons were not able to help at all. One has Down's Syndrome and lives at a group home. The other is in prison.
But in addition to Glenda and Dee Dee, the middle daughters, Jenna and Missy, were available evenings, as was daughter-in-law Mary Lee. At this point, at the beginning of the summer, the pattern was set, responsibilities were assigned, and Helen and her family all understood her time was short.
But in the early summer, Helen Payne's leukemia unexpectedly got better and she had a period of relatively good health. It was during a visit in that period that she told us about herself. She grew up in the country. Her father farmed land in Virginia, where Dulles Airport now is, and led a small congregation of Primitive Baptists.
A rebellious school girl, the child of strict parents, she got pregnant at 17 and had to get married.
HELEN PAYNE: I was young then and really didn't want no marriage. But I was caught up in it and I had six children by the first husband. And then he become so abusive, so my daddy come got me, but took me back home. So I stayed with my mom and dad 'til I got married again.
LINDA WERTHEIMER: You and all your children?
HELEN PAYNE: Yeah -- all my children. She more or less took care of the children, and I worked.
LINDA WERTHEIMER: And how did you meet Mr. Payne?
HELEN PAYNE: Oh, at a dance, and my brother, he decided he was going to find a friend for me. And this guy was in the Army with him -- my brother. That's how I met him, on the dance floor. So we courted around and finally I turned up with a baby for him. So we went on and got married. That was another marriage.
LINDA WERTHEIMER: Did...
HELEN PAYNE: So that's where we stayed for 47 years.
LINDA WERTHEIMER: Forty-seven years.
HELEN PAYNE: Until he passed; he passed.
LINDA WERTHEIMER: Well now, was he a good dancer?
HELEN PAYNE: Oh, my Lord yes. He could dance, but I couldn't 'cause I hadn't been used to no dancing. My daddy was a preacher, and we wasn't allowed to do nothing like that. So -- but he was a dancer.
LINDA WERTHEIMER: Was he good to your children?
HELEN PAYNE: Oh Lord, yes. He was good to all of us -- all of his children and all of mine, and we just live happy.
WERTHEIMER: Tell me what it was like to be a preacher's daughter that also is the origin of your faith, right?
HELEN PAYNE: Right.
LINDA WERTHEIMER: I mean, and your...
HELEN PAYNE: He was an old school Baptist. I joined the new school. I joined this church first 'cause my husband was in that church...
LINDA WERTHEIMER: Mm-hmm.
HELEN PAYNE: ... and I always said I want to be in the same, you know, same faith that he would be in. And they did a lot of stuff that I wouldn't think a Christian would do -- seeing 'em at dances; seeing 'em drinking, and my husband was doing the same thing. I says now wait a minute -- something's wrong here.
We went to the beach one Fourth of July, just him and I. And nothing I went in -- I didn't enjoy. I used to like play bingo. It wasn't right. I went in the dance hall. It wasn't right. So I told my husband on back up the road, I said, well, I won't be coming to these places anymore. Well, that's where I was shown that I wasn't getting no joy out of it.
So the Saturday, on a Saturday, my daddy then was staying with my brother. So we went on down that Saturday morning, he was sitting out in the yard reading his Bible. And I sit down there beside him. So he said, "Daughter, look like you come tell me something." I say, yeah. I think I'm ready to come in. You want to talk to me now? You want to go before church? I said I'll go before church Sunday. And that's when I went in. And I've been there ever since.
LINDA WERTHEIMER: Helen Payne became a pillar of that small congregation, where her father preached and now her nephew does. The church now meets every other Sunday in a little cinder block building by the side of a country road. We went to church with her on a special morning, which began with a baptism.
SOUND OF ATTENDEES AT BAPTISM
The baptism was in Bull Run, a creek in Virginia -- the Civil War battle of the same name was fought nearby. Ignoring her daughter's pleas, Helen wore the red high-heeled shoes which matched her red and blue dress, and one of her many fancy hats. With help from Dee Dee and me, she slowly walked down the hill to the creek.
DEE DEE PAYNE: Ooh, I tell you the water's real good.
HELEN PAYNE: Well, it's warm.
DEE DEE PAYNE: They said they had snakes in the water when I got baptized. Thank God I didn't know anything about it.
HELEN PAYNE: Ill duck a little bit.
DEE DEE PAYNE: Just put your head down.
LINDA WERTHEIMER: In Helen Payne's church, only adults who are sure of their commitment are baptized and come into the congregation. Often, people attend church for years before they take that step. At a place where the creek widens and the banks are low enough to walk down, the minister, Elder Carol Newman, waded in with two people.
SOUND OF SINGERS: Take me to the water / to be baptized.
While children played at the edge of the water, Sister Odelle Carter led the singing, the minister lowered each of the new members into the water. Helen sat on a lawn chair her daughters brought and watched, tapping her hand on her knee, smiling her little smile.
SOUND OF BAPTIMS BY IMMERSION
The rebirth of baptism, to go into the water a sinner and be raised up cleansed, was part of Helen Payne's faith. She was confident of heaven and her place in it, and when we asked her, she repeatedly told us she had no problem with dying, no fear of it, and expected to be taken up by the Lord.
The days that were coming strained the faith of almost everyone else in the family, and there were hard and painful days for Helen herself. But her church and her faith continued to be the lens through which she saw her own death. And as far as we could tell, that was true to the end.
SOUND OF SINGING: Oh lead me to the water / to be baptized
ELDER CAROL NEWMAN: Again, we've got another candidate -- as the Lord God says, Go ye into all of Earth, as ye go before us, baptizing in the name of the Father and of the Son and of the Holy Spirit. Amen.
SOUND OF BAPTISM BY IMMERSION
UNKNOWN: All right. Thank you Jesus.
SINGERS: I have been to the water
LINDA WERTHEIMER: The Second Shiloh Primitive Baptist Church was also a social place, of course, and a place where Helen Payne, a very dignified and powerful woman in her own world, was afforded considerable respect.
She sat in the pew immediately to the preacher's left with other older members -- the "amen corner" her daughters irreverently said. And after church, she had a place of honor at the substantial lunch served next door -- ham, fried chicken, green beans, succotash, cherry pie, and many more good things.
SOUND OF A CROWD AT SOCIAL EVENT FOLLOWING CHURCH SERVICES
WERTHEIMER: Late in the summer, something happened. Helen woke up one morning in great pain, unable to sit or stand or even lie down in comfort. The hospice nurses were called. The doctor was called. And the decision was made to go to the hospital to see what was wrong.
SOUND OF STRETCHER BEING MOVED
But Glenda and her sisters were afraid to try getting their mother into a car, so the doctor ordered an ambulance.
AMBULANCE RADIO: ... has the (Unintelligible) been secured?
SOUND OF STRETCHER
AMBULANCE ATTENDANT: It's in.
SOUND OF A CAR IGNITION
LINDA WERTHEIMER: Dee Dee, Missy and Glenda followed the ambulance to the hospital. Glenda Crabbe questioned doctors and nurses at every phase of her mother's illness. She insisted always on knowing why various tests and procedures were being done; what the information might lead to.
GLENDA CRABBE: We just -- we just need to clarify it so that she don't get you know, 'cause she requested not -- and but this is not an emergency anyway...
LINDA WERTHEIMER: She saw to it that everyone who treated her mother understood: no invasive procedures; no resuscitation; nothing beyond what's needed to make her comfortable. All that information was in Helen Payne's medical record, but whenever she was treated at the hospital, Glenda checked to see if it was on her hospital chart as well, and sometimes it wasn't. This time, no one could tell Glenda what was wrong. The leukemia was no worse, but her mother was suffering.
HELEN PAYNE: This is the first time I've had -- been sick.
LINDA WERTHEIMER: What do you think about it?
HELEN PAYNE: Well, I just think it's something that I've -- I've got to go through this. I know we all got a trial, sickness, we got to go through this before we go at the end. So, I just feel like this is my time.
LINDA WERTHEIMER: Do you think you feel resigned? I mean, you're just going to ride it out.
HELEN PAYNE: I'll ride it out. I will not resign.
You let that devil knock me down, I'm just going to ride it out. I know the Lord knows all about me, so He said he wasn't going to put no more on us than we were able to bear, so I might as well bear it on out.
GLENDA CRABBE: I don't know why Mama does that, though -- that kind of angers me.
WERTHEIMER: What do you...
GLENDA CRABBE: Like she thinks she's supposed to, you know, put up with it. And I tell her: mom, you got to tell 'em you're in pain -- you know, constant pain; hurtin' pain. I don't even know how she do it. I really don't. I think I'd be the one that's cuttin' my throat.
HELEN PAYNE: I just feel like this is my time to have this pain.
LINDA WERTHEIMER: Helen's mysterious problem was a kind of warning for the family. They'd begun to relax, enjoying the summer, planning ways to spend more time with Helen. Now, they began to be concerned that if something else happened, they would not be able to honor their promise to their mother -- to keep her comfortable and at home until she died.
SOUND OF PIANO PLAYING
ROBERT SIEGEL: Our story of Helen Payne and her family continues tomorrow. If you'd like to do more reading about the issues of terminal illness and the care of the dying, visit our website at npr.org. There you'll also find transcripts for this week's series.
This is NPR, National Public Radio.
Dateline: Linda Wertheimer,
Washington, DC; Robert Siegel, Washington, DC Copyright © 1997 National Public
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Copyright © 1997 National Public Radio, Inc. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to National Public Radio, Inc. This transcript may not be reproduced in whole or in part, including any electronic download or any other form of copying or distribution without prior written permission. For further information please contact NPR's Office of the General Counsel at (202) 414-2040.