For most of his 63 years, Bruce Sladen had been the heart and soul of his Capitol Hill neighborhood. It was with sincere affection, not the rancor usually reserved for politicians, that he was known as "the mayor of 11th Street."
"He was a missionary to the neighborhood," his brother Milton said. "He was always available to do work. He picked up the trash and put the trash cans back when others wouldn't. He'd sweep out the gutters and cut the grass for people and around the trees in the street. When somebody wasn't home to get a package, he'd take it for them. He'd even clean the sidewalks."
When it became clear that myeloma, a particularly virulent form of cancer that attacks blood plasma and lymph nodes, was going to claim Bruce before his time, his constituents gave him the ultimate gift. They helped him die.
Neighbors and fellow parishioners at St. Mark's Episcopal Church formed a hospice so that Sladen, a retired Defense Department employe, could spend the last weeks of his life in the house at 120 11th St. SE -- the house in which he had lived all his life.
Led by Betty Lawrenz, a social worker at the Georgetown Cancer Home Care Program and a St. Mark's worshiper for 17 years, and Irene Pearlman, a nurse in the community services department at Greater Southeast Community Hospital, Sladen's friends found a way to repay him for the friendship he had given them.
"This was a very unusual occurrence," Lawrenz explained, "because in most hospice situations -- which we define as one that allows a patient to die at home with dignity and emotional and physical support -- the family takes care of the patient."
In this case the family couldn't.
The closest relative was Milton, a spry 81-year-old also born in the house that he and Bruce had shared since 1962. But he was unable to cope with the demands of the disease.
Friends had visited him at Greater Southeast Community Hospital, where he was undergoing chemotherapy, but the treatment was too little and far too late. Talk began at St. Mark's about bringing Sladen home.
"He very definitely wanted to come home," Milton Sladen said. "Every time I went to visit him he'd say, 'Get me out of here.' "
Meanwhile, Lawrenz and her friends were wondering why he couldn't come home.
"A lot of people were asking me, 'Why can't we bring him home and make a plan to take care of him?' " she said. "I knew it could be done."
After determining Sladen was ready to go home and convincing Milton it would involve minimal care on his part, Pearlman and Lawrenz organized a meeting at St. Mark's to explain the caretaking functions and set up a schedule.
"You couldn't say 'no' to Bruce," said the Rev. James Adams, rector of St. Mark's. "He was an unbelievably helpful person. He held every important office in the church and was always doing something for somebody, whether it was sweeping old ladies' walks, taking care of the church when we were on vacation or gardening the little park in the alley next to his house. (A proposal to call it Sladen Park and the alley Sladen Walk is now before the City Council.) He always did it cheerfully and never gave you the feeling he was being put out."
Twenty-five volunteers returned the cheerfulness and signed Lawrenz's list. Three different people a day went to the house, from 8 a.m. to 8:30 p.m., when a licensed practical nurse took over.
Milton cooked Bruce's meals, cleaned, and cast a critical but loving eye over the proceedings. The volunteers took care of everything else. By the time Bruce died on April 2, the waiting list was only slightly shorter than that for Redskins tickets.
"It became a status thing to be involved," Lawrenz said. "But everyone understood there were three basics: pain, emotion and elimination. It was very difficult for everybody, including Bruce. He had to completely surrender his privacy to let his friends clean up after him, but he was very gracious about it. And in exchange for the physical labor, they had the emotional satisfaction of being close to him."
But that didn't help ease the pain of his death.
"This was the first test of whether the church can practice what it preaches about helping others," Adams said. "The response didn't surprise me. It was very gratifying."
The hospice formed for Sladen is not unique in the Washington area, although it is families who normally take on the responsibility. Hospice Care of the District of Columbia offers round-the-clock support for families or friends who want a loved one to die at home.
The nonprofit agency, funded by private donations, will train families in the care of a terminally ill person at home, counsel family members, visit the home anytime during the day or night if a doctor or nurse is needed and provide volunteers to do anything from grocery shopping to taking children out for an evening. There are about 100 volunteers who have completed 20 hours of training.
"Hospice is not something new," said Lucia Roberts, nurse coordinator for the agency. "People have been doing it for years." But an organized group to help people do it has only existed in the District since 1978, when Hospice Care was formed. Since then, it has helped 110 patients die with loved ones.
Roberts said patients considered for hospice care are terminally ill and receiving no curative treatment, with a life expectancy of up to six months. Families who are unsure whether they could handle hospice care may contact the agency for an evaluation of their situation.
The agency also offers bereavement counseling after the person receiving hospice care dies. "We help them with their loss and see them get their lives on track again," Roberts said.
Fees for visits by Hospice Care staff members are based on ability to pay, Roberts said. The agency's telephone number is 347-1700.
Another hospice care facility in the District accepts patients whose families are unable to care for them at home, but want to have them die in a home-like setting. Located in The Washington Home, 3720 Upton St. NW, it is a seven-bed facility and accepts only cancer patients with a prognosis of three months or less, and who have problems that make it impossible for families to care for them, according to Kristin Spector, hospice administrator.
Hospice services are offered in Virginia by the Hospice of Northern Virginia and in Montgomery County, where the Montgomery County Hospice Society will begin operations by the end of the summer, according to organizers.
Said Lawrenz about her group's hospice care of Sladen: "I know this can be done elsewhere. . . . I tried to transmit the idea that it isn't that heroic. And I wanted to give the community a chance to be what it says it is -- a caring place."
It surely was for Bruce Sladen. And it can be for others like him.