Holding Death at the Small of Its Back: A Day in the Life of a Death Doula

I remember being about six years old finding out that people die. My body still tenses up thinking about how I was told one day, people just stop breathing. I never thought I would live on a planet without my parents, grandparents, or myself. I remember lying in my bed, terrified, yet the magnitude of fear from the lack of information didn’t stop me from wanting to know more. As I grew into young adulthood, and the moments presented themselves, I ran towards death. As friends and partners’ family members passed away, I was always volunteering to go; my mom jokingly called me ‘the funeral dater’ as she couldn’t understand me wanting to attend these drab ceremonies in front of dead bodies. Yet for me, they were fascinating—the churches, the traditions, the way that people wailed, moaned, laughed, and even ate, yes–– in front of dead bodies. I found that in my own expression of grief, I could still help when others didn’t have the emotional capacity. I handed out tissues to those who needed them, lent an extra ear to hear a story (or a complaint) wrapped in pain, and even took photos of the ceremony, and yes, the body.

I am a death doula—a grief counselor by another name. For me, my work is as much about creating a space to hold silence in the presence of loss as it is about using precise clinical skills to help people move through it. As birth doulas help usher life into the world, death doulas walk alongside those at the end of life, serving as steady guides through the final stretch of the journey. Death doulas bring different skills and sensibilities to the work, each offering their own way of easing the passage. Some sit quietly at bedside, attending to comfort and presence as someone moves toward the unknown. Others help with burial plans, or bear witness to the loved ones, joys, and pains that make up a life coming to its close. I once knew someone who worked in hospice and would gently decorate the rooms where people were preparing to die, personalizing the space and softening for what was to come.

Me? My superpower is slowing time—expanding the space for silence, and making room for whatever emotions need to surface in mourning. Silence is where, after death has done its work, we finally regain a measure of control. Though some death doulas feel they are guides for the dead, I trust that the ones I lead already know where they are going. Instead, when Death is present, I slow its influence by holding its hand—or placing mine on its back—as if to say, just a moment, sit awhile, and let us feel.

I wasn’t introduced to death work until graduate school, through a mentor who was working at a local grief and loss center in Washington, D.C. He worked part-time at The Wendt Center for Loss and Healing, where one of his jobs was to help people identify bodies in the morgue. In social work school, the roles presented to us in the field rarely included anything like working in a morgue—it was never framed as an option. When my mentor mentioned it casually in class, I was already sold on the idea by the time the session ended. I couldn’t believe there was an established role for what I had been instinctively drawn to all along. For the first time, I felt validated in my so-called weirdness, and I found a small, kind group of people who understood how to sit in stillness—something most others were unwilling to approach.

Though I brought my death curiosity with me, my clinical skills as a social worker at the morgue strengthened my practice. My role at the morgue contained two parts: being present for the morning briefs, and then helping next of kin identify bodies. The morning meetings weren’t for me to participate in so much as to witness. They offered a reference for setting the boundaries of grief, and for learning how to create the pause of silence that those spaces require. We were invited to witness the difficult work of officers, medics, investigators, and doctors as they reviewed images from the scenes, explained the cause of death, and guided us through the details. For example, dying on the toilet might appear straightforward to the naked eye, but it can mean many different things—particularly if drugs are present or there’s a history of untreated medical issues.

The Chief Medical Examiner, drawing on his medical expertise, taught us how to look for clues within the often gruesome photographs. More than that, he offered a humbling reminder of the privilege it is to be present for the final moments of so many people in Washington, D.C. He led with dignity and grace, especially when the cases involved children. In those moments, we did not linger, nor did we study the photographs closely. Once the necessary information was gathered, we collectively chose restraint—out of respect, we let the babies rest, leaving the final moments of mourning to those who loved them.

As I grew in experience, I learned the importance of protecting my energy in a practice I call mundane consistency. Having a work routine allowed me to stay clear-minded, structured, and unwavering throughout the process, taking ownership of the chaos that might arise in the space. From my apartment, I took the train into the city and set my phone on silent. I wanted to consciously feel the air in the mornings undisturbed as I walked to the metro, so I could observe as many living things as I could before I got to the office. After greeting everyone at the front desk, I settled into my small office with the grief materials and funeral information. As with all magic, doulas have their tools. Mine was sage spray. I have a belief in my grief practice that people should not have to grieve in the residual energy of those before them. There is nothing wrong with shared grief, but its accumulated weight can overwhelm the silence of a room. The tears of a loved one left behind by murder are different from the wails of a mother who lost a child. For me, control means a cleared room—space enough for each person’s grief. I straighten the chairs, make sure the tissues are stocked, and then I wait.

Identification is typically done by photograph, not by viewing the body, unless a religious exemption applies. Under the guidance of grief visionaries like Stephanie Handel, I learned to look at the photographs first, allowing us to describe what they contained before families saw them. If the body was in good condition, the photographs were taken in color, with the person’s head facing forward. In other cases, the images were in black and white. All were taken from the shoulders up, with the face positioned upward—or turned to the side if there was damage to the face. I would give myself a second to prepare for what I was going to see, granting myself a second to observe the possible space I needed to create for the next of kin. Once identification is confirmed, the next of kin sign the photograph, complete the paperwork, and the funeral home arranges transport to the final resting place.

One case I can clearly remember was a dad coming to identify his son. The deceased had completed suicide while the family was away on a camping trip and waiting for him to join them. He died from an overdose. His ex-partner–– who had ended the relationship the night before––made a frantic call to his parents. That morning, I was there to see the scene before the father arrived. The photos looked as still as death could be. The room was scattered with clothes, books, and a guitar flung aside. A body rested among them. With my clipboard, pen, and photo face-down, I walked into the room and made eye contact with a white man who, even seated, was visibly taller and broader than I was. He wore a red plaid shirt, khaki cargo pants, and black, muddy boots that rose to his shins, as if he had  just come down from the mountain and driven straight to the office. His face was deeply flushed, a red that looked settled, as though it had been there for a while––if not from grief, then from anger and inconvenience.

“Why didn’t he just come with us when I told him to?” he said, huffing as he signed the documents at the front desk. “This trip was for him. He always wanted to ruin everything.”

I introduced myself as the grief counselor and said what I always say: I’m sorry for your loss. I explained the process, and why we needed him there—to make a positive identification so the funeral home could move forth with arrangements.

He stared at me as if my words were jumbled, as if his mind had been left behind at the cabin. Distraction is a common response to grief; the brain is in overdrive, working hard to fill the space where future memories should have been. My words echoed uselessly as he struggled to stay present.

He shook his head and reiterated, “If he had just come to the mountain like we told him to, this wouldn’t have happened,” he said, scribbling the paperwork. “He was always so hardheaded.”

It would be easy to intervene here—to de-escalate, to soften his anger. But we hadn’t even arrived to the hardest part. Maybe the father was right; maybe his son had been difficult. His voice still carried the force of their last argument.

My role is not to change his narrative. It’s to meet him where he’s at in silence, and to walk beside him toward the other side of his emotions, should he choose to go there.

“I hear you, sir, and I’m sorry again for your loss. I know this is frustrating,” I said, reflecting his words without platitude. This was my magic—keeping him present with me.

“I am about to present the picture to you,” I said. “It’s a black and white photo of his shoulders up, head on, with his eyes closed. Once we get a confirmed positive ID, you can sign your name on the back, then I can answer any questions that you may have.”

He shrugged, still irritated, but I felt the energy in the room tighten. This is where my superpower comes in. I was seated beside him, the clipboard resting on my lap. I set the pen down to keep one hand free—because as still as silence can be, it can also knock you over.

I turned over the photo.

He gasped, inhaled, and held it in.

The red drained from his face, slowly leaving his forehead, then his cheeks, until he was sheet-white, his mouth hanging open. We locked eyes—his filled with shock, mine steady as he met this new reality. Then he collapsed forward, straight into my lap.

This is where death doulaship, for me, takes precedence over clinical training. Talk therapy could not reach him; his pain had moved beyond language. What remained was silence, and the grounding power of touch when words are no longer available.

“Breathe,” I said firmly, placing my hand lightly on his back—offering grounding pressure and making space for the mourning within him to surface. He gasped for air and sobbed from somewhere deep in his body. I moved the clipboard aside and let him lean closer. When he finally sat up, his face was wet, the frustration that had marked him earlier dissolving into a sadness shaped by regret and devastating love.

“That’s my baby boy,” he sobbed.

He sat up, still close enough that we remained in contact, and began walking me through the life of his child—not the grown man we had found among clothes and pills. Not the chronic depressive they had argued with for years about mental health and substance use. But his baby.

The soccer star. The baby brother. The fishing partner. The love of his life.

He spoke of a boy who loved the woods, which was why the family had planned the cabin trip—hoping it might pull him out of another downward spiral. This was supposed to bring his son back. This was supposed to fix it.

Yes, I agreed. How unbearably frustrating.

We sat together for nearly an hour. He showed me photographs on his phone and told me stories. At one point, we were holding hands, and when he noticed, he blushed, his face flushing a different shade of red. I waved it off. “Being close seemed like what you needed in the moment.”

In grief work, I stick to the facts. He nodded then, understanding what I meant. The gaps in his experience of his son had begun to fill in; the story of the loss had fewer holes. What had satisfied the brain was now opening the chambers of the heart.

There were plans to make—to call his wife, to tell his other children. The room felt different now, carrying a bit of color and substance, as if the silence itself was ready to move on. I shared resources to help him talk with his family about suicide and offered therapeutic support, should any of them need it, including him. Before he left, I encouraged him to keep looking at the photos on his phone—to return to his son’s smile, so that this would not be the last image he carried with him.

I repeated the Wendt Center’s guiding words, spoken by its founder, Reverand Bill Wendt: No one should have to grieve alone. I smiled gently. “I was honored to be here with you.”

And as we had begun, I ended the same way: “Again, I am sorry for your loss.”

He nodded, paperwork in hand, and left to continue his journey.

***

In the spirit of mundane consistency, I ended my day the way it began. I cleared the room of trash and made sure the tissue box was filled for the next day. I returned the chairs to their places.

I took out my sage spray and misted the room generously. No one should have to grieve in energy left behind by someone else. I sprayed above my head and let it fall to my feet, too—I shouldn’t have to carry that energy home with me.

I packed my bag, put my phone away, and headed for the train. I made a point to greet people, to look them in the eye, to hold space for those still living their lives.

Because inside a glass building in downtown D.C., there are people who aren’t.