I hear that or a similar question at least once a week, because I am not a healthcare professional. I am, instead, a hospice volunteer. And whether the question comes from a neighbor who has seen me coming from a patient's home, or from an acquaintance visiting the Mountain Hospice office, or from a homehealth professional during a medical ethics consult, I can't wait to provide an answer.

It was when my father was dying that the need for a hospice in our area became clear. The local hospital was handy and offered excellent care, but he wanted to be at home. He wanted his family around him. He did not want extensive or extraordinary treatment. In short, we needed a hospice. Several individuals in the community, including the minister of my church, had been talking along that line during the mid-1980s, but the enormity of the task had virtually smothered that spark of interest.

Dad died in 1989, and I could think of no more fitting tribute than the establishment of a hospice. Half a dozen of us met, we enlisted half a dozen others, and we called the offices of People's Hospice in nearby Harrison County. Their administrator responded with many hours of free consultation, with participation in our meetings and with copies of documentation ranging from job descriptions to protocols to lists of possible contacts. People's Hospice even included a dozen of us in its volunteer training program. We were only slightly disheartened by the administrator's suggestion that it would probably take us 5 years to secure a license.

We did it in just more than 2 years-thanks in large part to People's Hospice and some intense work on our part. In 1992, with a license hanging conspicuously on our temporary donated quarters, Mountain Hospice, Inc., changed its volunteer director position to part-time, hired several other staff members, and admitted its first patients.

Our 10th anniversary was celebrated in 2002. By then, the situation had changed, and it continues to change dramatically. The hospice is currently serving 6 counties and has a staff of some 35 individuals. Patient census now hovers around 50. During these 11 years we have cared for almost a thousand patients plus their families and their friends.

My role as a volunteer through all of this was to write all of the initial licensing materials and to serve as the first president of the Board of Directors. Within a few months of my involvement, I also joined the West Virginia Network of Ethics Committees and was trained as a medical ethicist. I became active in the Initiative to Improve End of Life Care in West Virginia and have served as a community dialogue leader, a seminar panelist, and a reading group leader. As a member of 2 of the initiative task forces, I have judged writing contests for high school students, have served as a consultant on the development of a videotape for elementary school students, and became a bibliographer of children's literature related to death and dying. I have taught scores of Elderhostel courses on medical ethics, which is also one of my topics as a member of the speakers' bureau of the West Virginia Humanities Council. I have also been serving as chair of the Barbour County Medical Ethics Committee and write case studies for that committee and for the Network. This interest in the ethics end of hospicing has been a result of my educational background and professional assignments as a college professor of literature and writing and as the chair of a college humanities faculty.

A colleague and I also compiled a chapbook of bereavement poetry, which we have sold as a modest fundraiser for Mountain Hospice.

Retired from full-time teaching, I am again president of the Board of Directors and am a member of not only the Executive Committee, the Ethics Committee, and the Finance Committee but also the Building Committee. We have outgrown our rented office space, which was a major move up from the original donated spaces, and are building a much larger structure, which we will own. During all of this time, I have been visiting patients in their homes, the most rewarding part of my hospice involvement. There are no words to describe the privilege of being allowed to share in the final stages of a human life. There are also no words to express my admiration of and respect for the healthcare professionals who have chosen hospice as their lifework. They are, without exception, special people.

The basis for my ongoing interest in hospice is my Christian faith and my intent to respond to Christ's directive to serve others. However, regardless of whether one is religious, the moments and hours spent by a patient's bedside or in the company of an ambulatory patient or simply running errands for a hospice family are immeasurably meaningful. Volunteers, as well as professionals, know that we are involved in and committed to "the bottom line," and we realize on a daily basis what life is all about.

In short, I will try to answer any question anyone poses concerning the concept and practice of hospice. I will visit patients. I will solicit donations. I will enthusiastically recruit volunteers. I will encourage families and individuals to consider the hospice approach to end-of-life and palliative care.

I am not just a volunteer-I am a hospice fanatic.