LOS ANGELES (AP) -- Jay Westbrook's cowboy boot is planted firmly on the gas pedal of his shiny black pickup. Everywhere he turns, a memory flashes.
In Van Nuys, it is the lifeless little girl he held at Valley Presbyterian Hospital after she was found in the bottom of a hot tub. Near Beverly Hills, outside a Wilshire Boulevard high-rise, it is the old woman in a seven-figure condo whose misery he tried to soothe. On Skid Row, it is the 29-year-old crack addict he brought morphine to numb the pain of cancer, as she died in a box on the street.
There have been thousands of them, thousands of souls he journeyed with to the intersection of living and dying, who helped establish him as one of the foremost experts on care in a patient's final days. Thousands of moments, tender and haunting and sweet, that rush back to him. Thousands of deaths that collectively formed his life.
It might have gone on this way forever, the never-ending string of deathbed confessions and last breaths and tear-soaked eulogies. Then came one death too many.
The first time was a cluster of machines and tubes, and breaths shallow and panting. Westbrook was a student nurse, the patient a big man, maybe 6-foot-4, so swollen from cirrhosis it looked as if he was pregnant with triplets. His mustache was trimmed, his flattop prematurely white. Westbrook had cared for the man for several weeks and when the time finally came, a profound sadness drove him to tears.
He felt powerless and mortal; and for the first time, this product of atheist parents felt something more.
"I had that experience of the place where life and death meet being filled with God," he said.
In the two decades that followed, Westbrook experienced more deaths than he could count -- as a cancer nurse, in pain management and, most of all, in hospice. He'd put 50,000 miles on his truck some years, driving from one dying person's house to another. Some nights, he'd balance three deaths.
One man had spent 30 years in prison and believed if he endured the pain of death without the relief of a morphine drip, he might reduce the time he'd spend in hell. The towels and blankets nurses used to pad his door couldn't muffle his screams, nor keep them from haunting Westbrook's memory.
He heard a little boy confess to his dying mother he once stole from her wallet, and a married Orthodox Jew acknowledge he had a long affair with a man. One patient's daughter doused herself in gasoline and set herself ablaze as her mother lay dying; another's final days brought him face to face with the daughter the dying man had raped for years. He saw athletes and movie stars and singers, deaths surrounded by dozens and deaths all alone.
Each one was both singular and similar. Those who survived a brush with death -- by electrocution or shooting or drowning, perhaps -- reported traveling down a tunnel toward a bright light. Those whose age or disease brought a more gradual exit often experienced visions of a loved one who went before, as well as a day of seemingly stunning turnaround, where lucidity returned and pain subsided and all, for a short time, seemed well. It could be a cruel tease to those praying for a miracle, as it was generally followed by clues the end was near: mottled skin, cold extremities, rolled-back eyes and breathing that sounds like a locomotive leaving the station.
Through it all, he was sustained by love.
They met on June 7, 1968, at a party bidding Westbrook farewell before he was to leave California to teach reading in Appalachia. Two young women arrived dragging an unenthusiastic third to whom he was soon introduced.
"Nancy, this is Jay," the host said. "Jay, this is Nancy."
She wanted to take a walk on the beach, and Westbrook accompanied her. They took the footbridge over the Pacific Coast Highway, walking and talking for hours and coming to rest on the sand.
"Six hours later, the sun came up and we were in love," Westbrook said.
He never went to Appalachia. He was smitten with her sensitivity, her humility, her long, golden hair. Before long, Nancy Morgan was Nancy Westbrook. They lived modestly but joyfully.
"The only fight that we had on an ongoing basis," he said, "was who married up."
They couldn't have come from more different upbringings. She grew up in an Ozzie-and-Harriet family, surrounded by love and support, kindness and stability, living in the same Wichita, Kansas, home throughout her childhood.