When people thumb through the playbill while waiting to see Vesta, they think they have come to see a play examining one family’s struggle with end-of-life issues.
They need to think again.
They will come to know Vesta, a fiercely independent 75-year-old matriarch confronting a debilitating stroke and then terminal cancer; her middle-age daughter Carol, who is her mother’s primary caregiver; and Carol’s husband and teenage daughter Kelly, each struggling with the family’s upheaval.
But it’s who the audience doesn’t expect to see in this tender and often humorous portrait of an ordinary family that surprises them most: themselves.
“Vesta is everyone’s story,” explains Jeanne Twohig, deputy director of the Duke Institute on Care at the End of Life (ICEOL).
“When you see the characters step on stage and get engrossed in their story, you can’t help but take those same issues and apply them to your own life.”
Last January, Twohig traveled to Seattle, Wash., for the first professional production of Vesta. Following the performances, she led talk-back sessions attended by more than 100 people, including hospice nurses and social workers.
“Emotions ranged from sadness to joy to anger to regret,” Twohig recalls. “Like so many pieces of art, the play is a call to action about what we as a society can do differently about these issues.”
Life’s End Institute in Missoula, Mont., a national organization devoted to exploring concepts of death and dying, first acquired the rights to license Vesta in clinical settings from playwright Bryan Harnetiaux of Spokane, Wash., in 2002. It assigned these licensing rights in 2005 to ICEOL, which was founded in 2000. The mission of the Duke institute is to create and promote knowledge—and its use—in caring for the whole person at life’s end.
The play’s main character is aptly named Vesta after the Greek goddess of home and hearth, which is what the play exudes—the sense of coming home to the end of life. “We love this play because it’s a gentle and non-threatening way to introduce deeply personal, and sometimes sensitive and frightening, issues,” says Twohig.
For actress Megan Cole, who headed the critically acclaimed Seattle cast, the play resonated with her previous role in the Pulitzer Prize-winning WIT, whose main character also faces the end of life. Vesta is different, she adds, in examining aspects of end of life such as advanced directives, Medicare and pain management.
“The practical parts are just as important as the emotional parts because they are the daily things that people have to trudge through on their way to finding the peace that can happen at the end of life,” says Cole, who is also active in the national end-of-life movement.
Many hospice and end-of-life organizations have embraced the 90-minute play, which ICEOL makes available as a teaching tool for a modest licensing fee to community groups, health-care institutions, medical and nursing schools, hospice and end-of-life organizations, churches and others.
Harnetiaux was commissioned to write a short play that would ultimately become Vesta for a 1991 health conference on aging, primarily sponsored by Washington State University. During the process, the play helped him resolve issues from his father’s death in 1987. “I lagged behind the rest of my family in accepting my father’s dying and took issue with his wishes to forgo nutrition and hydration in the final days of his life,” he says, “so I brought to the play my own experiences and shortcomings. There was an element of therapy in writing Vesta that greatly helped my own grieving process.”
To research the topic, he went with a medical social worker on home visits to patients in various stages of dying. “It was such a sacred experience,” says Harnetiaux, who is also an attorney. “So many of them helped me try to capture the emotional and interior landscape of the dying process.”
Theater gives people permission to discuss death and dying, which is taboo in the American culture, Harnetiaux says. “With the critical distance the play provides, you can see yourself, your values, questions and struggles in sharper relief. In that sense, theater is a ministry.”
Twohig agrees. “People are better able to think about their own issues by observing the lives of others, whether watching a movie, seeing a play, or reading a book. Vesta is another resource to raise consciousness about end-of-life issues.”
The play’s embodiment of the intersection of spirituality and health at the end of life supports the mission of ICEOL, which is among a handful of such institutions at the nation’s elite academic centers and the only one housed in a divinity school rather than a medical school.
“This allows us to go deeply into the spiritual side of things,” says Dr. Richard Payne, professor of medicine and divinity and director of the institute. “At the heart of end-of-life care, there is the belief that we are whole people with biological, spiritual, emotional and psychological parts. What happens in our medicalized society is that the biological aspect takes on more importance. We become the diseased kidney or the failing heart. True end-of-life care gives attention to the whole person.”
Congregations are rich places for end-of-life discussions because both pastors and parishioners seek support at the end of life and want relief, not only from biological but from spiritual suffering, he adds.
Despite progress made during the past decade due to work in the end-of-life field and increased visibility as baby boomers start to age, much work remains to be done to raise awareness, says Payne.
That’s where Vesta comes in. A dramatic reading of the play proved to be the most effective teaching tool Gaston Hospice in Gastonia, N.C., has used, says Lee Bucci, executive director and a registered nurse.
“Vesta covers all the dynamics that families face when dealing with the experiences of aging, relationships, chronic illness and dying. We cannot begin to describe the impact this play has had on everyone who has the pleasure to listen to the words of Vesta,” she says.
Leif Bergerud, a first-year divinity student with a theater background, directed two local performances of the play spring semester—one for a regional health ministries conference held in Chapel Hill, N.C., and another on Duke’s campus.
“It’s very exciting to be a part of this,” says Bergerud. “I believe art has a healing power that can change us and affect society. Theology has that same power.
“We’re all going to have to die, so the question is, ‘How are we going to deal with it?’ Vesta is an ideal way to start that conversation.”