The Rev. William Wendt remembers visiting Jenny Moore 12 years ago, when she was dying of cancer.
"I can still hear her say, 'Bill, don't pray for me, just rub my feet,' " Wendt recalls. "And I learned how to rub feet in a beautiful, wonderful way. She also wanted to be buried in a plain pine coffin, and we couldn't find any, so we built her one.
"And that was the start of the St. Francis Center -- rubbing feet and putting people in pine coffins."
For 10 years, the St. Francis Center, near Dupont Circle, has ministered to the needs of people facing death, grief or loss.
Last week, the center sponsored a conference on care of the terminally ill, which founder and executive director Wendt dedicated to "the Washington community" and the memory of Jenny Moore.
They came to talk of life and the part of it called death. Patients, families, clergy, nurses, doctors, social workers and friends all met to wrestle with questions that have no satisfying answers, sometimes turning those questions on themselves.
What kind of counsel, for example, would counselors wish when facing their own death?
"I would look for a person who doesn't have a lot of tricks in a bag to use on me to make things better for me when I know they couldn't possibly be better," said the Rev. John Golenski, medical ethicist at the University of California Medical Center in San Francisco.
"I think we must remember," said Mila Tecala, director of the Center for Loss and Grief in the District, "that sometimes our presence is sufficient -- if we listen with our hearts."
The Rev. Vienna Cobb Anderson, chaplain of the Washington Home Hospice, said she would seek someone who is caring, respectful and honest.
And willing to cry.
"When someone cries with me, I feel that I matter," Anderson said. "They have given me the value of mattering to them, and that's a gift."
And willing to let go.
"A lot of clergy come busting into the room with a high level of energy," she said. "Can they let go of that -- their own agenda, their own energy, their own emotional level, and meet yours?"
And willing to listen.
"I want someone who's willing to share with me my experience, my life, my dying," she said, "not someone who will tell me what it ought to be like. The openness to hear whatever it is I need to say, even if I need to curse God. Even if I need to say, 'God damn it! Why is this happening to me?' Or that I feel abandoned by God and I don't believe in God.
"I don't want a priest telling me 'I should,' at that time. I'd like someone to hear my pain, my sense of abandonment, my loneliness, my fear. And not have an answer to give me."
Perhaps the most difficult challenge for counselors of the dying is to balance intimacy and distance.
"We have a tendency in approaching the imminent death of a patient," Golenski said, "to distance ourselves as much as we possibly can from that event and that person's humanity and to forget, deny, contain and separate the mortality which we share with that person."
Medical technology is a marvelous tool, said Dr. G. Peter Pushkas, a Washington area cancer specialist, but it also gives "an easy outlet for physicians to distance themselves from patients."
"Nobody would like to treat pneumonia with handholding nowadays, when antibiotics are available," Pushkas said. "One writes an order for intravenous antibiotics and gets the respiratory therapist to get some oxygen and walks away from the situation."
That is fine for a case of pneumonia, he said, but what about an incurable cancer? It's too easy for a doctor still to "walk away from the situation and get another respirator going, another i.v. going, or pass another tube, and somehow transform the patient into just 60 or 100 pounds of living tissue, with no other psychological involvement."
The doctor's obligation, he said, is to let patient and family know that he or she is there -- available to listen -- whether the patient wants to talk about medical matters or anything but.
"There are days," Pushkas said, "when you the patient don't want to think about it, when you want to daydream, when you want to think that 20 years from now you'll still be around to see the Redskins game. That's fine. We'll talk about that."
The problem of emotional distance is even tougher when a child dies suddenly, with no warning or time for the family to prepare, said Golenski, who directs a children's hospice in San Francisco. "It has been my experience almost universally," he said, "that the clergy who come in with them from their community are dreadful.
"I think it's because all of us who have been trained to be members of the clergy . . . are trained to be epiphanies, if you will, of the presence of a loving God. We fundamentally believe that . . . We try to banish from our minds anything which may be negative, mysterious, challenging, sorrowful and even horrific.
"The death of a child, particularly the traumatic death of a child, is a horrible event. It is something which calls into question all of the suppositions we have about the universe, about God, about the meaning of life and what we're doing here."
Clergy who are thrust into such a situation, Golenski said, often "find themselves sputtering words about a loving God in the face of parents who have experienced quite the opposite, talking about things like 'flowers in God's garden,' 'only the best are taken young' -- all of the things that somehow are like a bean thrown into the ocean."
"Too many of us who are priests are terrified of death," Anderson said. "Like everyone else, we are afraid. And too often it's convenient for us to hide behind our rituals and our prayer books.
"It is the people who die who have taught me the most about how to live, how to minister in a time of death, how to have a strong and unshakeable faith in God."
Anderson recalls a patient named Irving, a dying man who asked her to pray with him. It was Holy Week, Good Friday night, and they sat up late and talked -- a Jewish patient and a Christian priest -- of fear and deliverance and death.
The next day, Easter eve, she visited him again.
"Irving took my hand and kissed it and said, 'I'll always remember you.'
"What struck me is, those are the words the living often say to the dying: 'I'll always remember you.' But a dying man with not too many hours left said them to me.
"That gift was overwhelming."