Home Flowers We are not talking about death,” Archpriest Alexander Tkachenko, director of the children’s hospice. Volitional threshold

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We are not talking about death,” Archpriest Alexander Tkachenko, director of the children’s hospice. Volitional threshold

The President presented State Awards for outstanding achievements in the field of charitable and human rights activities. The State Prize in the field of charitable activities was awarded to Archpriest Alexander Evgenievich Tkachenko, Founder and General Director of the first Children's Hospice in Russia.

Dear Vladimir Vladimirovich, I am deeply touched by this high state award.

A decade and a half ago, starting a charity project to create children's hospice, we sought to fill the lives of those children whose lives are limited by the severity of the disease with joy. Even when it is impossible to cure a disease, this does not mean that nothing can be done. There is a lot that can be done. It is important to preserve the quality and dignity of life, to relieve physical and spiritual pain.

The first children's hospice in the country was built in St. Petersburg thanks to the efforts of many philanthropists. The highest credit for this belongs to Valentina Ivanovna Matvienko. In subsequent years of work, teams of doctors, psychologists, specialists various professions allowed the formation of a new direction in medicine - pediatric palliative care.

The high quality standards of child care applied at the St. Petersburg Children's Hospice are included in regulations Ministry of Health. According to them, hospitals are now being built and field services are opening in all regions of the country. People come to us to study from federal districts, come from European countries.

We have a big task ahead of us: we must change society's attitude towards people with severe disabilities. Very big role in the formation of an inclusive society belongs to the goodwill ambassador of the children's hospice, Honored Artist of Russia Diana Gurtskaya.

His Holiness Patriarch Kirill of Moscow and All Rus', when visiting a children's hospice, said that the Church can solve state problems: what is entrusted to it will be fulfilled in the best possible way. The Church builds hospitals, universities, hospices. We are trying to change society and the world for the better.

The first clergyman to win such a prize, now canonized Saint Luke (Valentin Voino-Yasenetsky), a doctor and surgeon, upon receiving the prize said that helping the sick is the highest calling, and in this he sees the unity of medical work and church service.

I am very grateful to you for your high assessment of our work. Thank you.

We don't talk about death

Interview with Alexander Gatilin, Soyuz TV channel.

There is no need to bury a child while he is alive

Father Alexander, the hospice that you created has existed for 10 years. In those years when it was created, it was absolutely unique phenomenon. How did it all begin? Why did this particular topic of social service come to you and how did this idea develop?

Somehow everything happened naturally. As they say, God gave.

Probably, for every priest who stands before the throne it is very important not only to bear the Name God's people, but also to bring people the miracle of God and the healing of God, and the love of God. It so happened that in the church where I served, in the St. Nicholas Naval Cathedral in St. Petersburg, a lot of people came, families whose children were sick, and in a pastoral way we helped them, collected some funds, bought some medications, we invited specialists for additional consultation, but we wanted to do a little more.

We understood that within existing rules providing medical services the state does what it can do, and there is always the opportunity to do a little more for the church. At that time, as now, from the moment when a child’s illness is predicted to be incurable or the child’s treatment will bring great suffering, the child is discharged from the hospital where he was treated, under the supervision of a district specialist, a district pediatrician.

Unfortunately, the district pediatrician does not always have the opportunity to provide comprehensive medical care. This assistance is highly technological, it requires the use of painkillers, it requires very intensive therapy at home, good quality care. Because life and its duration will depend on this care. And 10 years ago, in many ways even now, this was not possible due to the existing rules for the provision of medical services by healthcare forces. And here the church found some kind of ministry for itself.

At first, we simply found people who would come to these parents' homes and take care of the children. Besides medical care, a lot of social assistance was provided. We understood that the child must continue to live, despite what happens to him. Yes, the disease exists, yes, most likely the disease is irreversible, but there is no need to bury the child while he is still alive. We must give him the opportunity to live a full life. Play, communicate, learn something new.

All our activities were related to organizing a child’s full life based on his physical condition. Doctors did what they could to improve functionality, relieve pain, enable the person to go out into the world. All other employees: psychologists, teachers and various volunteers offered each child a certain program that took into account his interests.

Thus, an understanding was born of what a hospice for children is. Hospice is a philosophy. At first it was just such an initiative group of people, and we had patients not many 10 years ago. We looked after six families. Over time, our activities became known, more and more people began to turn to us. large quantity people, and over the years we have grown to seventy families. And they could no longer reach such a number of people who applied on their own.

Photo — kidshospice.ru

Then a medical institution was created on the initiative of the St. Petersburg diocese, largely thanks to Metropolitan Vladimir. This institution, having received a license, began to professionally provide this assistance at home. With the support of the city administration and personally Valentina Ivanovna Matvienko, we received subsidies that helped us grow into an organization that organically entered the city healthcare system.

In addition to helping children medical organization, we were able to develop standards for providing home care. We were able to calculate which patients need such help, how many of them there are in the city, and what types of public medical services they need to provide. And if you build a hospital, then this is what it should be like, what the bed capacity is, what equipment is needed there.

But this goes far beyond the scope of social service of the Russian Orthodox Church. Now, in addition to serving as a priest, you also hold a serious government position; you are the director of a state hospice. This is generally a precedent. How did this happen?

It turned out very naturally, because when we gave such a program of activity to the state, the state considered that the Church knew how to do this in the best way and invited the Church to continue this topic and implement it. A hospital was built.

Those people who started this ministry, precisely as a church ministry, were hired and are still working to this day. And two hospitals have already opened in St. Petersburg, and a third one will open.

How many wards do you have now?

Now there are about 300 children that we see, these are residents of St. Petersburg, we see about 70 children from Leningrad region, there are mobile teams that come to their homes. The hospital receives about 20 patients for round-the-clock observation and 10 patients come to the day hospital.

Photo — kidshospice.ru

How long can children stay in hospital?

It depends on their condition and the range of services they need.

If the child's condition is so serious that it can be assumed that he has weeks rather than months to live, then the child is kept until last day.

If the child’s condition is better and the hospice’s activities are related to the organization of his full life, then he stays for up to 21 days, then goes home and returns to life in society.

For me, the most important thing in all this activity is that we grew up in an era when the Church was persecuted by the state and those of us who came to church without fear of what might follow after such a challenge to society, it is very important for us that changes have occurred and now society needs us and we can show this society that the church is capable of solving state problems.

This is the best we can do. And in the church there are people who have those spiritual qualities that are most in demand in such social service, in a hospice.

Smiling at the hospice

In this regard, I wanted to ask just how psychologically difficult such work is. How do you cope with this psychological burden, how do your employees and colleagues cope, how difficult is it and whether you need to be afraid of the topic of death. Unfortunately, in public consciousness this fear of touching this topic is present.

Fear is natural, because most often we transfer the fear of meeting the death of a child onto our own fears about our own children. People are afraid of this topic.

As for experiences, it’s probably easier for me than anyone, since I’m a priest and on the days when I perform the Liturgy, I appear before God, and my fears before the Face of God go away, I turn my empathy into prayer, and it becomes easier for me.

People who are less religious, who work in a hospice (and people of different nationalities and different religions work in a hospice) also find some mechanisms that help them not to become hardened, not to lose this necessary warmth and at the same time not to burn out from the inside.

Probably, it is very important that the right team spirit has been formed in the hospice, everyone there is very attentive to each other, everyone there smiles. Patients, parents, and employees, they live the same life. This probably comes from the very philosophy of hospice. We are not talking about death from oncology or from some other disease, we are talking about how to live when there is presence in your body incurable disease. We continue to live, we embrace every day of life, we find joy in every moment. This approach helps not to lose your presence of mind.

His Holiness Patriarch Kirill: “If you want to meet God, come to the children’s hospice”

Please remind us of the words of His Holiness the Patriarch, which he said when he visited the hospice.

It was an amazing visit, and I remember very vividly every minute of His Holiness the Patriarch’s visit to the children’s hospice. It was his birthday, which he decided to spend among the children and parents at the children's hospice. He was so moved that in his speech to his parents he said: “If you want to meet God, come to the children’s hospice.” He said that here the presence of God is felt in all rooms and to him, as the High Hierarch of the Russian Orthodox Church, as a highly spiritual person, this presence was obvious and for us this testimony is very important.

Photo — kidshospice.ru

The unusual life of a hospital facility

Father Alexander, let's tell you how a day is structured at the hospice. As far as I know, it is very intense and in this sense, every minute is really felt, a person understands the value of every minute.

The day starts normally. This is, after all, a hospital, a nurse comes in the morning and makes some conclusion about the patient’s condition in the morning, takes the temperature, but then things begin that do not happen in a hospital.

Each day has a theme or each week has a focus. For example, a week is dedicated to water or the sea, and during the day the child will encounter certain elements that will introduce him to the inhabitants of the sea or tell him about some of the features of this element. In the dining room he will be served fish or seafood; the dining room itself will be decorated with elements of the sea, shells or, perhaps, sea nets.

After the procedures, there will be creative classes in which children will draw water depths or some other scenes; maybe one of the submariners, people who sank to the bottom and took photographs and can convey their experience, will come. A film will definitely be shown.

Every moment when the child is left alone after the procedures, we try to fill with something and try to make sure that at this moment the child learns something new or communicates with someone interesting. But, basically, the procedures take some time and life is an ordinary hospital stay.

Dreams Come True!

In this regard, I would like to ask how active our famous compatriots are when you make an offer to come and talk about something interesting. In general, what is your social circle?

A lot comes to us famous people. It’s not even just that we invite them, it’s very nice that, having learned about us, they express a desire to come to us. More recently, the CSKA hockey club expressed a desire to become our boss, and this was a great joy for the boys who occasionally have the opportunity to come to a hockey match. And here the hockey club suggested to us that children would be more actively involved in the life of the club, perhaps going out onto the field and making the first drop of the puck, or having the opportunity to go out and ride around the hockey field with the hockey players.

Photo — kidshospice.ru

This is another example of how society fills the lives of children in a hospice with meaning. This is one of the most important aspects when you begin to comprehend what you have done in your life, and how effective your life is, how much you were able to realize yourself in this life. The participation of great people in your life gives you the opportunity to feel that you have really accomplished a lot, you can do a lot, you know a lot, you have met many - and this is a very important part of the hospice’s activities.

Related to this is one of your most famous projects- this is the fulfillment of the wishes of your wards...

This is the “Dreams Come True” project. It arose as a natural continuation of the psychologist’s activities in the patient’s family.

When a child’s condition worsens or when some serious operation is planned and the psycho-emotional status needs to be raised, or when after an operation you need to cheer up a little so that you have the strength for rehabilitation, the psychologist tries to find out from the child, from his family, what his secret dream is. .

This is the very secret one that lives somewhere in the depths. It’s not that he just wants to have a computer like someone he knows. But besides the computer, there is also a dream. And having learned this dream, we find people who would like to fulfill this dream. Of course, we give away a computer too. But here is that same bouquet of daisies in winter that he dreams of or about meeting with some famous football player or a boxer or...

What were your most unusual desires?

I guess I'm already used to unusual desires...

Well, a few examples to give this picture a little idea.

Well, for example, a child wants to meet some famous American band, which doesn’t even happen in Russia, and we understand that it’s impossible for us, with our small resources, to bring a world-famous rock band here. But children love, for example, the Tokyo Hotel group. There were several groups of them, so I purposefully do not name them, each of them. Or, for example, Adriano Celentano, a famous singer, a world star, but he is not traveling now, he lives in his villa and does not plan to come to Russia, but the child wanted to meet him.

Nevertheless, we find an opportunity to contact the group and the singer, tell them about the patient, even send a photo and a letter. We invited the boy to write a letter. Well, we can’t meet with Adriano Celentano now, but you can write him a letter, we’ll pass it on to him. He wrote, and in response he received a large poster with a signature, a personal response came in which it was written that he wished him strength to fight the disease, he wrote that he was worried about him and would pray that he gets better . He said that in life there are illnesses and the most important thing in these illnesses is not to lose heart, not to despair. Such a simply heartfelt letter was written, which brought the joy of meeting the child with this star.

I know that another one of the requests was to become a successful businessman. How is this done?

Very beautiful story. It rather shows that there is an element of creativity in every such story.

The team at the hospice always tries to fulfill exactly how the boy or girl feels, exactly how they dream. Well, in the minds of modern children, success is associated with certain attributes, that is, this is a job in a large company, this is a certain style of clothing, a jacket, a tie, some kind of leather briefcase, maybe even the car that he drives to work.

He was invited to work quite seriously, the company said that we are giving you the position of head of the department, we feel that your experience suits us, this is an interview and everything is absolutely serious, they told him that we need such a person. He was given money so that his appearance would correspond to the duties assigned to him, and he went to work on Monday.

They sat him at the table, told him to take a piece of paper from here and bring it here, and they offered him some kind of work. After some time we met, and I just saw happy person, because he was cooler than his classmates. A car met him, took him to work, he did some very important assignments, received a serious salary, he really was the idol of the class and after some time, he celebrated his 18th birthday, and he was able to invite his classmates to the billiard club , treated them to lunch there, and then they played. We invited a famous billiards champion and he showed a master class. Here's the story.

Children accept their illnesses more correctly

Let us clarify that the disease does not occur from birth, but comes already at some age, right? There are situations when a 15-16 year old child can live absolutely naturally, normal life, and something happens, a disease is discovered. This disease can last for months, it can last for years. That is, this, unfortunately, can happen to anyone who was born healthy. I'm right?

Illnesses happen, and none of us can escape illnesses, so we must prepare our souls for the fact that we bear part of the pain of this world and ask the Lord to give us patience to bear this pain.

We Christians must remember that we do not come down from the cross, we take it off the cross, and, wanting to become like Christ, we must prepare ourselves to bear part of this burden. Thank God, if anyone escapes this cup, but illnesses come to everyone, they come to children too.

What is most striking is that children accept their illness more correctly than adults. We practically do not encounter the kind of tragedy that an adult experiences, associated with dashed hopes, a failed life, and non-realization of oneself, in children. There are rather more vivid human feelings associated with the bitterness of parting, with an unrealized feeling of love. Adults somehow perceive and evaluate the effectiveness of their lives in a slightly perverted way, from the point of view of some kind of secular standards.

At the end of this program, I wanted to clarify up to what age children are considered children and potential wards of yours.

Since we have become government agency, we focus on the rules that define and regulate our activities. We accept children from 3 months to 18 years, but since it happens that the disease began in childhood leads to completion after the age of 18, we try not to leave children unattended.

For example, if a child was our patient before the age of 18, of course we cannot discharge him after his birthday. That is, we find a way to continue caring for him as long as possible and necessary.

I would like us to talk now about deeper, more intimate issues. And my first question is, do all children ask questions about God, do all children ask why they were given such a test, and how do you conduct conversations with them?

What's next?

The desire to live is so strong that even when things get really bad, the child is fighting for life, the parents are fighting for life, and the employees are fighting for life. Therefore, a direct conversation about how I should feel about death or what death is does not always happen.

But a person who thinks about what is happening to him, how curable his illness is, always wants to find a person to his liking, an interlocutor to his liking, so in simple conversations, meetings, conversations, passing by, over a cup of tea, he sometimes asks leading questions , as if probing you, trying to understand whether you are this very person.

And if you feel at this moment that the child wants to talk to you or the parent wants to talk to you, and you can answer correctly, then maybe you are the person who will give him this lifeline.

The conversation most often occurs indirectly, abstractly, not directly about oneself. It rather concerns the topic, what is death, and what will happen later, and why did my life turn out this way? And the information that you know must also be given in doses because you need to give the person the opportunity to comprehend what you told him. Children experience death differently than adults experience it. And with children of different ages Death needs to be talked about in different ways.

In the child's understanding, small child, let's say until 7 to 8 years old, everything around is alive. Plants are alive, objects are alive, he plays with inanimate toys, in his perception these toys are alive. In his conceptual stock there is no experience of death, no experience - living, non-living, everything is alive there. That is why it is so difficult to contain this, and therefore it is necessary to find the language that will help him, to make this experience of an adult person of death or meeting with the inanimate a laconic part of his conceptual apparatus, his philosophy.

Older children develop a fear of death, and most likely it is associated with the fear of being abandoned by their parents, the fear of losing their parents. Since he has never met what death is, he most often perceives it as if the living are buried in the ground and it’s scary to imagine how they put you in a coffin, close you, you are there alone, somehow there is no air, no mother, it is the most terrible thing for a child.

With age, the child begins to pay attention to the fact that there is a dead bird lying there, or one of the relatives has died, he begins to ask himself this question. And here it is very important that the people who are around the child can talk to him, can tell him that death is a natural part of our life on earth and everything that is born, everything that has life, will someday die. And this applies to the life of all living creatures, from a bird, an ant and even ending with a person. About the fact that people die because of illness, because of old age, or because their body is severely damaged. And this is a natural part of our life. It's sad, but it happens to everyone.

This conversation needs to be structured very carefully so as not to scare the child, but to expand his understanding of the world. We need to tell him that life does not end for a person after his heart and his breathing stop. It is necessary to tell that the Lord came to earth so that man would not disappear, that he himself, in addition to his body, his personality, his interests, with what he loves, with his values, which is called his own Self, goes to Christ, and Christ meets him. And there is the Mother of God and the Angels who will be next to him.

You can come to the temple and, pointing to the icons in the temple, talk about the life that the Lord spoke about. Because the temple setting itself is childishly fabulous, the child perceives the temple as a reflection of extraterrestrial reality, and in the temple it is easiest to talk about what life is like outside life on earth. Because candles, icons, clergy vestments, divinity, and the mysticism of the service - they all confirm the words of the speaker that this world exists, and since it exists, it can be interesting for a child. Once a child develops an interest in this world, then fear goes away.

Does your hospice have a house church?

And children often visit...

A service is held there weekly, both children and parents are present at the service, there are employees present, for whom the image of St. Luke (Voino-Yasenetsky) is the image of a good doctor, a real doctor. We brought a particle of the relics of St. Luke from Simferopol and tell both the staff and the families of the patients about this.

The image of St. Luke has always been inspiring for me, because he was a courageous minister of the Church and a doctor who became the founder of purulent surgery, who was the first to perform local anesthesia for brain surgery. During the war, under difficult conditions, he committed unique operations, was a laureate Stalin Prize despite all this, most spent his life in camps. This is a man from whose textbooks modern doctors still study. Even for non-church hospice staff, he is such an inspiring example.

I wanted to ask about your education. Did you receive any special skills to carry out such work?

I have a classical education: high school and St. Petersburg Theological Seminary and Academy. Medical education I didn’t specifically receive it, but since I’ve been creating a hospice for 10 years now, I’ve accumulated some knowledge that helps me solve the state problem well and correctly fulfill the mission of the Church.

Solve government problems better than the state

But when you started creating a hospice and took the first steps, because there was no experience in Russia, it was necessary to turn to Western experience, where, after all, hospices are a more common phenomenon.

They exist only about 20 years ago. Before that, they didn’t exist in the West either, so 10 years ago, when we started, this topic was new even for Western world. The first children's hospice was created in England, St Helen's Hospice, it was created 15 years ago. Five years later we were created. Recently there was a conference in Rome, which brought together all the initiative groups from America and Europe, I was pleased to hear that the St. Petersburg children's hospice is the most best example how it should be done. Because in the world these are most often just small initiative groups that do not have their own full-fledged medical hospital.

Of course, the best built hospice in Canada, Canada Place, is the only inpatient hospice in the whole North America. And when we were built, we undoubtedly took their example as a basis for some standards and took into account their experience. But what we have built here now is much better than what they have. And in terms of the number of medical services and so on.

Is it surprising that it turns out that the state has, as it were, withdrawn from this topic?

Not in any way. The state entrusted the Church with this matter. It entrusted her with significant financial resources, because this is a public institution, it rated our activities significantly higher than similar activities in other health care institutions, that is, the cost of public services per patient is estimated higher than in a regular hospital, it provides an opportunity for development, provides other hospitals in order to we could create similar institutions in St. Petersburg and other regions.

According to , the Church is now setting an example for society that there are government tasks that we can solve better than the state itself.

Don't die in the hospital, but live under medical supervision

You are inside this process. How does the hospice system plan to develop? How does the state see this system?

Was accepted the federal law“On the protection of the health of citizens”, which included article 36 “on palliative care”. From this moment on, palliative care as a legal term exists, and the state undertakes to provide citizens with full palliative care, citizens of all ages. Therefore, hospices will be created in the regions, and they will have funding. Each entity will be obliged to provide this type of public service.

Of course, I worry about what these hospices will be like in the regions. Will it be poor wards at hospitals, in which there will just be a few beds, and this will be the place where people die, and this will be scary place, this will be a “typhoid barracks”. Or it will be some kind of fairy-tale house, some kind of space, comfortably created so that a family can live there, live with a child, without feeling the pressure of the hospital environment and the rules that exist in every hospital. So that she can live in a family environment and live a full life. Do not die in the hospital, but live under medical supervision.

On the one hand, this depends on what funds the regions will allocate to children's hospices, on the other hand, it depends on what kind of people will participate in this work. And here is an opportunity for the Russian Orthodox Church to pick up and continue the work begun in St. Petersburg in the regions.

Where to start as a volunteer

Father Alexander, the audience is watching us in different regions Russia, if someone has a desire to initiate the creation of a children's hospice, where should they start?

You need to start with prayer, and turning to God and Mother of God with prayer, begin to act. First, perhaps, you need to contact the diocesan bishop and find out what activities the diocesan charity department can undertake, on the other hand, you just need to take some products, some things with you, go to the family to get acquainted, find out what specific There are needs in this family...

How can you find out about these families?

Come to the district hospital and say that you are a volunteer, or you want to attract some resources or somehow donate your time in caring for seriously ill people. That is, you always need to start with some specific actions. You can’t start a charity by talking about how to conduct it. You just need to spend a day with the patient, and the patient himself will teach you what he needs.

But here the question of unprofessionalism arises: a person will come, does not know what to do, he can only do harm.

Yes, I agree, I’m probably used to dealing with prepared people. And, of course, a person unprepared for what he encounters can cause a person more pain than benefit. Therefore, I simply recommend that before communicating with a family, you meet with people who are already caring for this family. And find ways to interact. I am sure that there are some already existing volunteer groups that will help you naturally prepare yourself and find an application for your talents.

Do you plan to develop methodological courses, conduct them in the regions, or initiate this work?

This year we will celebrate 10 years since the start of the children's hospice in St. Petersburg, and this date will be timed big conference, to which we invite representatives from all regions. We are ready to send our representatives to those regions that want to do something.

The Minister of Health Veronica Igorevna Skvortsova visited the children's hospice, as a result of this visit it was decided to create a training course for specialists and introduce the specialty of a pediatric palliative care doctor into the nomenclature of specialties, therefore professional training specialists will take place in St. Petersburg on the basis of the children's hospice and academy named after. Mechnikov. Preparations for this are underway, documents are being prepared, and specialists will be preparing.

Professionals should work in hospice

How is it going in higher education? educational institutions, is there a specialty?

There is no specialty, to introduce this specialty you need to do a lot and prepare documents, and, most importantly, prepare a scientific...

Is there any work being done in this direction?

Only you or all the same...

It cannot be carried out only by us, since we carry out practical activities, and textbooks and courses are prepared by people who have more opportunity to devote to science and writing the textbooks themselves. But we are already ready to open training courses. Certification will take place in accordance with the procedure established by law.

How are relationships built with the Synodal Department for Church Charity?

I am very grateful to Bishop Panteleimon, his visit to the children's hospice attracted the attention of the charity departments of the dioceses, the heads of these departments came to us from various dioceses, and I know that in the Khabarovsk diocese, in Irkutsk, the Pskov region and in other regions, priests came to us , are starting similar activities in their localities. With varying degrees of success.

Father Alexander, how difficult is it to find understanding among businessmen? How difficult is it to obtain financial support for such activities, and what will initiative groups in the regions face? They will find understanding or it will be more likely, as unfortunately often happens, “we only help those who can recover, who can get better.” You've probably encountered this too?

Such an understanding exists. It is important for a person, if he gives money, to know that this money helped someone. Therefore, in a conversation with such people, it is necessary to explain what hospice is and how its funds will help someone live in the most difficult period. The outcome of this meeting depends on the degree of trust. Without a doubt, the Church has more trust than any public organization, therefore, if the activities of the initiative group are carried out on behalf of the Church, without a doubt, you will have more trust from the business community. In general, there are always good people, so if you talk to people from heart to heart and talk about specific people, specific needs, they will give you specific money for specific purposes.

Father Alexander, you have enough big family, how do your loved ones feel about your ministry?

Thank God, the Lord gave me four sons, and my sons help me. First of all, because they accept me for who I am. I come home late, I don’t always have the opportunity to spend time with them, but whenever I am with them, I am very happy, and they are happy that they have the opportunity to be with me. In general, I try to spend weekends with my sons, we go skiing, we do a lot of interesting things together. They are such a great spiritual support for me.

Father Alexander, at the end of our program, what is the main secret in creating an effectively functioning children's hospice? What key tasks and goals should people who would like to do this have?

First of all, you need to understand that a children's hospice is not just an object of charity - it is a serious part of medicine. Therefore, this should be done by professionals. We need to find ways to interact with people who are doing this in one form or another in health care settings of this region, you need to treat them with understanding and gratitude for what they are already doing, and be co-workers with them, this should be a friendly and partnership relationship.

A very important feature is the preparedness of the person himself for this activity. If a person comes to work in a children's hospice because some internal problems prompted him to social service - personal unsettlement, or experienced tragedies - this person will transfer the tragedy of his life to communication with the patient. He simply understands the pain of another very well, since he has experienced it, but at the moment of experiencing this crisis, he is not able to simply experience, understand the experience, relieve the pain of another. He hasn't suffered through it yet. The one who has already been ill, survived, begged, the one who has been healed can help.

In order for the activity to be effective, it is best to communicate with someone who knows the soul. So that a person has some kind of experienced interlocutor, a spiritual mentor, a psychologist who has previously communicated with people who have experienced stress, or pain, or loss. Someone who could look at you from the outside. And he could help you find those soul powers that will make you useful to your interlocutor.

Father Alexander, thank you very much for your service, thank you for the conversation.

I really hope that the activities of the St. Petersburg diocese in serving sick and dying children and their families will find support in the regions. This is undoubtedly the work of the Church. This is without a doubt the responsibility that we, church people, bear before society. And if our experience is in demand, our work will be continued in the regions, society will look with delight at what we are doing, and this will be the best preaching of the name of Christ, the work of Christ, the mercy of Christ, the love of Christ, the miracle of God in this world.

It's hard when adults get sick. It's scary, sad, sad. They say about them: “I could still live...” And when children suffer from incurable diseases, it’s generally hard to wrap your head around it. Children usually have so much life...

There are more than 40 thousand terminally ill children in Russia. There is only one state children's hospice so far - in St. Petersburg. Its founder and permanent leader, Archpriest Alexander Tkachenko, likes to repeat: “Hospice is not about death; Hospice is about life.” How an institution whose name alone sends a chill down the spine of many managed to create a house of smiles, read in the MK material.

A nice historical building in the depths of a chic park with centuries-old oak and maple trees. It's a few minutes walk to the Neva. There you can take a boat from the embankment and end up, for example, in Valaam or Kronstadt. You never know where else! Life gives people so many opportunities when everyone is healthy. But most people don’t understand that even just taking a walk in the park is a great happiness.

Hospice residents - both patients and staff - know how to appreciate every minute. After all, the hospice knows very well what pain is. They also know that physical pain can be relieved with injections, but with mental pain everything is much more complicated, it can be much harder to endure. But the most important thing is that they also know what life is and how to make it so that even a few days of it are happy, bright, and calm.

It was not the doctor or the official who changed the situation, but the priest

There are many incurable childhood diseases - there are more than five hundred of them on the official medical list. Among them there are those when the count is literally days.

“Until quite recently, children from hospitals were simply discharged home with the words: sorry, we can’t help you anymore,” recalls the founder and director of the St. Petersburg children’s hospice, Father Alexander. - And now they are being discharged. And although only we, in St. Petersburg, have an inpatient hospice, such families are immediately picked up by government services. A team comes to the house: a doctor, a psychologist, a social teacher. They draw up a plan of treatment (pain relief) and assistance - psychological, material and human. Sometimes parents just need to understand that they are not alone. And sometimes the most basic thing is needed - to be with the child so that the mother can get some sleep or go to the hairdresser.

It so happened that the situation in the country was changed not by an official or even a doctor, but by a simple priest. Father Alexander never had anything to do with medicine, nor with hospitals. In the early 2000s, he served as a priest at the St. Nicholas Naval Cathedral. And people who are going through difficult times in their lives always come to church. Often those who simply have nowhere else to go for help.

“There were several parishioners whose children were very sick. I tried to help them not only spiritually, but also financially: I collected money, looked for medicines, nurses. Apparently, he did this quite successfully, because there were more and more such wards. Then I decided to create a coordinated help service. We called it “Children's Hospice” and helped at home everyone we found. Things got going. Two and a half years later, they registered a medical institution, renovated two wards in a regular hospital and opened the first palliative care department for children. Then the governor of St. Petersburg, Valentina Matvienko, allocated us several ambulances to serve patients at home, and it immediately became easier, of course. A little later, in 2007, the opportunity arose to transfer an entire building to a children's hospice.

The St. Petersburg Children's Hospice is so far the only such institution in Russia. But his experience was used to create a federal legislative framework. Thus, Father Alexander did not just create a separate hospice. He generally changed the attitude towards terminally ill people in our country. Largely thanks to his efforts in legislation, and therefore in life, such a concept as palliative medical care appeared (a direction in medicine when treatment of the underlying disease is impossible, but it is possible to improve the quality of life and save the patient from side effects).

The second state inpatient children's hospice, modeled after the one in St. Petersburg, is about to open in the Moscow region. A hospital was opened in Kazan a year ago. A children's hospice should also open in Moscow.

“Any forms of helping suffering families are good,” says Father Alexander. — The main thing is that people are not left alone with terrible disease.

Five star hotel with sad room

The St. Petersburg children's hospice is already thirteen years old. He has about 300 patients. The majority are at home; there are 23 children in the hospital - the space does not allow for more. Someone ends up here for planned hospitalization. And others when the disease becomes absolutely unbearable.

To be honest, the building itself bears little resemblance to hospital buildings. A pink wooden building - it once housed the summer residence of the Nikolaev orphanage.

“I immediately liked this place,” recalls Father Alexander. — Quiet, calm and not very far from the center. And again, a park where it’s nice to walk. You see, we have organized a children's playground in the yard. All equipment is specially adapted, including for children in wheelchairs. The child himself, without outside help, can go on both the swing and the slide. I saw such a gaming complex in England, and our friends helped deliver it to St. Petersburg. And we completely preserved the external historical appearance of the building - this was the condition of the Committee for the Protection of Monuments. I developed the internal content myself.

At the children's hospice, everything is special and made to order. The bed linen in the wards is colorful and cheerful, soft sofas, flowing curtains on the windows, a classroom with space on the ceiling. You can come to the hospice with your pets - cats and dogs. The dining room is more reminiscent of a restaurant: a cheerful interior, a collection of funny watches, and shelves with toys and cute figurines along the walls.

“This is all not just for beauty,” explains Father Alexander. “The child will be distracted by this doll, and the mother will be able to shove an extra spoonful of porridge into his mouth.” You can also order something special from the menu. For example, red caviar. And why are you surprised, it happens that after chemotherapy this delicacy is prescribed.

There are a lot of useful rooms in the basement: storage room, psychological play therapy room, swimming pool.

— The builders did not want to agree on the presence of the pool. But seriously ill children really need it - it’s both relaxation and exercise, and in general all kids love to swim. Then I came up with this move: according to the documents, we had already agreed on a hospital church, and I said that as a priest in the church, I definitely needed a font. So, according to the documents, this pool is listed as a “font (with hydromassage).”

On the second and third floors there are chambers that are more reminiscent of hotel rooms, with soft sofas, plasma TVs, and a pleasant, homely atmosphere. And there is also an unshakable rule in the hospice: the room is the patient’s personal space; entering here without knocking is strictly prohibited, even if chief physician, even the president.

— Distinguished guests often come to us. But we never change this rule.

There is also a cozy fireplace room where you can chat with your family, read books, or just be silent. Of course, there is also a hospital church, where services are conducted by the director, Father Alexander.

The fact that the hospice does not look like a hospital is the most pleasant compliment for the employees. When I noticed that it all looked like a five-star hotel, Father Alexander began to smile:

- That's what we wanted. I've thought a lot about what hospice should look like. As a hospital - no. As a kindergarten - no. Five star hotel with good restaurant- this is the ideal option. I even took the architects to Disneyland and put them up in a hotel at the park so that they could study everything properly and do the same with us. For example, there is no lobby with a registration desk, which is usual for hospitals - instead there is a nice reception desk, and behind it there are smiling security guards, we have two of them. They don’t just keep order, they are first and foremost reliable and kind man's hands who will help you roll the stroller and carry things.

There is a huge bowl of candies on the counter that is never empty. There is also a memorial funeral candle here. Its edges have already melted and burned:

“We light it when someone leaves us forever.” During days of mourning, it does not go out, either day or night. This is both a sign of sympathy for the parents of the departed child and a reminder to everyone that today is a day of remembrance.

I noticed that neither the employees, nor the doctors, and especially the hospice residents themselves, do not utter the word “death” in conversation. Father Alexander recalls that when the first patient died at their hospice, it was such a shock for everyone that many workers even had to be given time off so that people would come to their senses.

— Palliative care is not at all what doctors are used to doing. Any doctor wants to see the result of his work - recovery. He is taught this, he is aimed at this. But in a hospice there is no talk about recovery. And, unfortunately, deaths happen within the walls of our institution...

Down in the basement there is also a mourning room (here it is called “sad”), where parents and relatives can say goodbye to their departed child. Initially, it wasn’t even in the plan. She appeared after that very first patient died and everyone saw how the arriving orderlies treated the body.

“It horrified us.” And then the decision came to make such a sad room for farewell. This is also a unique facility for a medical institution. In many hospitals, moms and dads are not allowed into the intensive care unit, and in the event of death, they often give just a couple of minutes to say goodbye before sending the body to the morgue. I do not condemn this in any way; in large hospitals where thousands of people are treated, it is difficult to create the necessary conditions for goodbye. But rituals are very important. Parents need time to realize what happened, to cry, to grieve, it is important for them to gather the child together last way.

Working in a hospice is a test of humanity

From time to time, children in hospice leave, and nothing can be done about it.

“The existence of man on earth has a beginning and an end,” says Father Alexander. “Here we cannot escape the understanding of this, because the presence of the end is too tangible. And death is always scary, there is no need for illusions that someone can treat it somehow lightly. Of course, working in a hospice is hard. It's hard to see so much pain and tragedy around you. Some children were born with incurable diseases, some had terrible accidents, some found out that they had cancer in the prime of life - at 15, at 16 years old...

Father Alexander falls silent for a moment.

— For our employees it is important not only professional quality, but also spiritual. Not everyone is ready to meet people who are under such deep stress as our patients and their loved ones. And even those who are ready can break down and leave at some point.

- What about you? You're not leaving...

“I get tired too and sometimes I go somewhere.” But the main difference between me and other employees is that I am still a priest, and not just the head of a medical institution. In prayers I rest, I cleanse my soul before God. It helps. But the main thing is that I feel that I am doing my job: helping other people, making the world a better place - this is what I live for on this earth. A place like a hospice must have its own philosophy.

- So what kind of philosophy is this?

— About the need to hug every day, to find meaning in every meeting, every minute and every smile. The fact that hospice is not about death, hospice is about life, bright and joyful. If children smile here and parents feel good, then we have created exactly the institution they need in this difficult moment. I'm happy that we can do this. Many children, having undergone planned treatment with us, ask their mothers and fathers: “Send me to the hospice again.” They feel good here, they can eat tasty food, play, chat with peers, learn something new. Of course, we cannot save everyone from illness, but we can give bright and strong impressions.

I don’t know how, but Father Alexander can put everyone in this mood.

“When I came to work here, construction was in full swing,” says hospice employee Irina Kushnareva. — Father Alexander walked around the building under construction and said: “So, here there will be soft sofas, here we need to make a fireplace, hang curtains...” I knew perfectly well all the standards for medical institutions, since before that I worked in the Federal Compulsory Medical Insurance Fund, and always his stopped. What curtains? What sofas? This is strictly prohibited in hospitals. Well, he answered me, then go and change these rules. At first I was even angry, but now... and now we have everything. And I myself will do everything to explain to the inspectors that curtains are not a trifle, why it is so important... We all work here for the soul. There is no such thing as a day off. If necessary, we’ll go to work. Psychologists even go to funerals if called. And at the wake... And they simply often call patients, from vacation, for example.

Nastya

An unshakable belief in miracles is what pushes Father Alexander and everyone who is in one way or another involved in the children's hospice to perform small daily feats for seriously ill children. The St. Petersburg Children's Hospice has a project called “Dreams Come True.” Every New Year the dreams of little hospice patients and city hospitals are collected and all possible resources are activated to make these wishes come true.

— Someone dreams of seeing their idol, we will organize such a meeting. Someone wants the most sophisticated laptop, and we fulfill this, of course, at the expense of sponsors most often. Someone definitely needs to see a water park or receive it as a gift wheelchair with a control panel,” says Olga Shargorodskaya, head of the socio-psychological service of the hospice. - Recently a little boy, a fan of the cartoon about Peppa Pig, asked me to bring a real pig to him for at least an hour. It turns out that he had never seen live pigs in his little life.

- We try to fulfill everything! - Father Alexander enters the conversation. — After all, dreams come true have a unique psychological effect. I have seen more than once that this gives children the strength to continue treatment. But medicine, thank God, is not entirely exact science. And when God’s providence intervenes in human predestination, then everything can change. Miracles happen, I have personally seen them.

All relatives know that the most difficult thing for Father Alexander is to talk about the girl Nastya. She died of cancer several years ago.

— For any priest, the parishioners themselves are teachers. I didn’t invent what a hospice should be like. There was such a girl, Nastya...” Father Alexander falls silent for a while and lowers his eyes. “She had a severe form of sarcoma, one leg had already been amputated, and the question of amputating the other was urgent. I talked a lot with Nastya, and she talked a lot about what she had to endure and face in hospitals, what was missing and how many difficulties and troubles could have been overcome more easily. And it so happened that everything that we subsequently created was the result of this communication with her.

Father Alexander recalls how he once sent a young priest to her in his place. And he, seeing the young woman, beautiful girl dying without legs, he could not cope with his emotions and burst into tears.

“And she said to him so sharply: “So, dry your tears, I need you not as a mourner, but as a priest.” There’s no point in crying here.” And I realized that the patient does not always need our pity. If he wants to cry with us, then we give him our tears. Well, if he wants to talk about other things, then your tears will only interfere with him. In hospices, one must try to avoid the eternal compassion and sadness in the eyes of people surrounding the patients.

Father Alexander remembers well his last meeting with Nastya:

“Everything was already clear to everyone.” Nastya understood what was happening. I came to her at Once again give communion. And there was such a bitter understanding that we would never see her again. We prayed together and held each other's hands. And then she said: “That’s it, go. We’ll meet in paradise”... And I realized, God willing, we’ll meet again.

Archpriest Alexander Tkachenko
Director of the State Children's Hospice, founder of children's hospices in Russia, rector of the church at the Suvorov Military School and the church at the city geriatric center in St. Petersburg

Let's be honest: we are all tired of propaganda - no matter what ideas this propaganda promotes. We live in a difficult time of crisis, there are many people around us who find themselves in difficult life situation. These people do not need ideology, but specific help. And it is the Church in Russia that is especially active in helping those in need.

The St. Petersburg Children's Hospice, which I direct, was created on the initiative of the Russian Orthodox Church. Over the years of work, we have managed to solve the state task in the field of organizing palliative pediatrics and contribute to the legal registration of standards for the provision of pediatric palliative care. The Children's Hospice Hospital, created through the efforts of non-profit organization, we handed it over to the state. Thus our institution became a shining example interaction between the state, society and the Church in the field of helping seriously ill children and their loved ones.

We at the Children's Hospice believe that helping children with incurable diseases lies outside the realm of ideology. It is able to unite people with opposing views on life, each of whom must be able to professionally care for the patient, taking into account his spiritual needs, cultural and religious traditions his family.

I would like organizations that unite people without a religious worldview to contribute to helping specific people, rather than juggling ideas. We, in turn, will be happy to join forces with those who are open to works of mercy, regardless of their religious beliefs or lack thereof.

In 1989-1994 he studied at the St. Petersburg Theological Seminary, in 1994-1998 - at the St. Petersburg Theological Academy. While studying at the seminary, he studied at medical institutions in the USA and Great Britain in the specialty “Activities of a hospital chaplain.”

In 1995 he was ordained to the rank of deacon (served in the St. Sophia Cathedral of Tsarskoe Selo), in 1997 - to the rank of presbyter.

Member of the Public Council under the Ministry of Health Russian Federation.

In 2003, he initiated the creation of the Children's Hospice charitable foundation as part of the charitable activities of the St. Petersburg diocese. In 2006, the charitable foundation became the founder (initiated) the creation of the Children's Hospice medical institution. Led a group of doctors nurses, psychologists and social workers, who identified children in need of palliative care and organized systematic care for them and their families.

In 2004, at the invitation of His Beatitude Metropolitan of All America and Canada, Herman visited the United States on an official visit; participated in the return of Tikhvinskaya to Russia miraculous icon Mother of God.

In 2007, on the basis of a decree of the government of St. Petersburg, he received the building of the former Nikolaevsky orphanage on the territory of Kurakina Dacha Park for a children's hospice. Developed basic documents related to the organization of children's palliative care. Prepared for the opening of the first state children's hospice in the Russian Federation. Opening of the St. Petersburg State autonomous institution Healthcare "Hospice (children)" took place on June 1, 2010. Alexander Tkachenko was appointed general director.

In 2011, in the village of Lakhta (Olgino village), Primorsky district of St. Petersburg, he opened a palliative center of the Children's Hospice for children from regions of Russia undergoing treatment in St. Petersburg.

In 2014, by order of the government of the Moscow region, he received the Przhevalsky estate in the village. Konstantinovo to open a children's hospice there. In 2015, by order of the government of St. Petersburg, he received a building in Pavlovsk to open a Children's Hospice hospital for children from the Leningrad region.

General Director of the Imperial Cancer Research Fund.

He has a letter of gratitude from the President of the Russian Federation, is a laureate of the international award of the all-validated Apostle Andrew the First-Called “For Faith and Fidelity”, and was awarded a Certificate of Honor from the Federation Council of the Federal Assembly of the Russian Federation.

Public awards: imperial commemorative medal “Anniversary of National Feat. 1613-2013." (Russian Imperial House), medal “For Humanitarian Achievements” of the Austrian Albert Schweitzer Society.

In 2014, by decree of the President of the Russian Federation, he received the distinction “For Good Deeds”, and in 2016 - the State Prize of the Russian Federation for outstanding achievements in the field of charitable activities. In 2018, for his diligent service to the Holy Church, Archpriest Alexander Tkachenko was awarded the order St. Sergius Radonezh.

Children's hospice in St. Petersburg was founded by Archpriest Alexander Tkachenko to help children with serious and incurable diseases, as well as their family members. The St. Petersburg Children's Hospice is a partnership of three organizations: the Children's Hospice charitable foundation, the St. Petersburg State Autonomous Healthcare Institution "Hospice (Children)" and the autonomous non-profit organization "Children's Hospice", which was formed in 2016 through the reorganization of a medical institution "Children's Hospice".

Each of the partnership participants performs its own task, and together they complement each other, working to improve the quality of life of children at the last stage of development of the disease, as well as helping parents during the period of the child’s illness and after his departure.

Director of the children's hospice in St. Petersburg, Archpriest Alexander Tkachenko: We do not talk about death

In the “Fruit of Faith” program on the Soyuz TV channel, Archpriest Alexander Tkachenko, director of the first children’s hospice in St. Petersburg, spoke about his experience of working with terminally ill children: about life, joy and the fulfillment of his most cherished desires.

Father Alexander, the hospice that you created has existed for 10 years. In those years when it was created, it was an absolutely unique phenomenon. How did it all begin? Why did this particular topic of social service come to you, and how did this idea develop?

Somehow everything happened naturally. As they say, God gave. Probably, for every priest who stands before the throne, it is very important not only to bring the name of God to people, but also to bring to people the miracle of God and the healing of God, and the love of God. It so happened that a lot of people, families whose children were sick, came to the church where I served, the St. Nicholas Naval Cathedral in St. Petersburg, and in a pastoral way we helped them, collected some funds, bought some... then medications, we invited specialists for additional consultation, but we wanted to do a little more.

We understood that, within the framework of the existing rules for the provision of medical services, the state does what it can do, and there is always the opportunity for the Church to do a little more. At that time, as well as now, from the moment when a child’s illness is predicted to be incurable or the child’s treatment will bring great suffering, the child is discharged from the hospital where he was treated, under the supervision of a district specialist, a district pediatrician.

Unfortunately, the district pediatrician does not always have the opportunity to provide comprehensive medical care. This assistance is high-tech, it requires the use of painkillers, it requires very intensive therapy at home, good quality care. Because life and its duration will depend on this care. And 10 years ago, and in many ways now, this was impossible due to the existing rules for the provision of medical services by healthcare forces. And here the Church found some kind of ministry for itself.

At first, we simply found people who would come to these parents' homes and take care of the children. In addition to medical assistance, a lot of social assistance was provided. We understood that the child must continue to live, despite what happens to him. Yes, the disease exists, yes, most likely the disease is irreversible, but there is no need to bury the child while he is still alive. We must give him the opportunity to live a full life. Play, communicate, learn something new.

All our activities were related to organizing a full life for a child, based on his physical condition. Doctors did what they could to improve functionality, relieve pain, enable the person to go out into the world. All other employees: psychologists, teachers and various volunteers offered each child a certain program that took into account his interests.

Thus, an understanding was born of what a hospice for children is. Hospice is a philosophy. At first it was just such an initiative group of people, and we didn’t have many patients, 10 years ago. We looked after six families. Over time, our activities became known, more and more people began to approach us, and over the years we grew to 70 families. And they could no longer reach such a number of people who applied on their own.

Then, on the initiative of the St. Petersburg diocese, a medical institution was created, largely due to the merit of Metropolitan Vladimir. This institution, having received a license, began to professionally provide this assistance at home. With the support of the city administration and personally Valentina Ivanovna Matvienko, we received subsidies that helped us grow into an organization that organically entered the city healthcare system.

In addition to providing care to children as a medical organization, we were able to develop standards for providing care at home. We were able to calculate which patients need such help, how many of them there are in the city, and what types of public medical services they need to provide. And if you build a hospital, then this is what it should be like, what the final capacity is, what equipment is necessary to have there.

But this goes far beyond the scope of the social service of the Russian Orthodox Church. Now, in addition to serving as a priest, you also hold a serious government post, you are the director of a state hospice. This is generally a precedent. How did this happen?

This happened in a very natural way, because when we gave such a program of activity to the state, the state considered that the Church knew how to do this in the best way, and invited the Church to continue this topic and implement it. A hospital was built.

Those people who started this ministry precisely as a church ministry, they were hired and are still working to this day. And two hospitals have already opened in St. Petersburg, and a third one will open.

How many wards do you have now?

Now there are about 300 children that we are observing, these are residents of St. Petersburg, we are seeing about 70 children from the Leningrad region, there are visiting teams that come to their homes. The hospital receives about 20 patients for round-the-clock observation and 10 patients come to the day hospital.

How long can children stay in hospital?

It depends on their condition and the range of services they need. If the child’s condition is so serious that it can be assumed that he has weeks rather than months to live, then the child is kept until his last day. If the child’s condition is better and the hospice’s activities are related to the organization of his full life, then he stays for up to 21 days, then goes home and returns to life in society.

For me, the most important thing in all this activity is that we grew up in an era when the Church was persecuted by the state, and those of us who came to the Church were not afraid of what might follow after such a challenge to society. It is very important for us that changes have occurred, and now society needs us, and we can show this society that the Church is capable of solving state problems. This is the best we can do. And in the Church there are people who have those spiritual qualities that are most in demand in such social service, in the hospice.

In this regard, I wanted to ask just how psychologically difficult such work is. How do you cope with this psychological burden, how do your employees and colleagues cope, how difficult is it, and should you be afraid of the topic of death. Unfortunately, there is a fear of touching this topic in the public consciousness.

Fear is natural, because most often we transfer the fear of meeting the death of a child onto our own fears about our own children. People are afraid of this topic.

As for experiences, it’s probably easier for me than everyone else, since I’m a priest, and on the days when I perform the Liturgy, I appear before God, and my fears before the Face of God go away, I turn my empathy into prayer, and it becomes easier for me. Less religious people who work in a hospice (and people of different nationalities and different religions work in a hospice) also find some mechanisms that help them not to become hardened, not to lose this necessary warmth and at the same time not to burn out from the inside.

Probably, it is very important that the right team spirit has been formed in the hospice, everyone there is very attentive to each other, everyone there smiles. Patients, parents, and employees - they live the same life. This probably comes from the very philosophy of hospice. We are not talking about death from cancer or from some other disease, we are talking about how to live when there is an incurable disease in your body. We continue to live, we embrace every day of life, we find joy in every moment. This approach helps not to lose your presence of mind.

Please remind us of the words of His Holiness the Patriarch, which he said when he visited the hospice.

It was an amazing visit, and I remember very vividly every minute of His Holiness the Patriarch’s visit to the children’s hospice. It was his birthday, which he decided to spend among the children and parents at the children's hospice. He was so moved that in his speech to his parents he said: “If you want to meet God, come to the children’s hospice.” He said that here the presence of God is felt in all rooms, and to him, as the High Hierarch of the Russian Orthodox Church, as a highly spiritual person, this presence was obvious. And for us this evidence is very important.

Father Alexander, let's tell you how a day is structured at the hospice. As far as I know, it is very intense, and in this sense, every minute is truly felt, a person understands the value of every minute.

Each day has a theme or each week has a focus. For example, a week is dedicated to water or the sea, and during the day the child will encounter certain elements that will introduce him to the inhabitants of the sea or tell him about some of the features of this element. In the dining room he will be served fish or seafood, the dining room itself will be decorated with elements of the sea, shells or sea nets.

After the procedures, there will be creative classes in which children will draw water depths or some other scenes; maybe one of the submariners, people who sank to the bottom and took photographs, will come and can pass on their experience. A film will definitely be shown.

In this regard, I would like to ask how active our famous compatriots are when you make an offer to come and talk about something interesting. In general, what is your social circle?

A lot of famous people come to us. It’s not even just that we invite them, it’s very nice that, having learned about us, they express a desire to come to us. More recently, the CSKA hockey club expressed a desire to become our boss, and this was a great joy for the boys who occasionally have the opportunity to come to a hockey match. And here the hockey club told us that children will be more actively involved in the life of the club - perhaps going out onto the field and making the first drop of the puck, or they will have the opportunity to go out and ride around the hockey field with the hockey players.

One of your most famous projects is connected with this - the fulfillment of the wishes of your wards...

This is the “Dreams Come True” project. It arose as a natural continuation of the psychologist’s activities in the patient’s family. When a child’s condition worsens or when some serious operation is planned and the psycho-emotional status needs to be raised, or when after an operation the mood needs to be lifted a little so that there is strength for rehabilitation, the psychologist tries to find out from the child, from his family, what his secret dream is.

This is the very secret one that lives somewhere in the depths. It's not that he just wants to have a computer like someone he knows. But besides the computer, there is also a dream. And having learned this dream, we find people who would like to fulfill this dream. Of course, we give away a computer too. But here is that same bouquet of daisies in winter that he dreams of, or about meeting some famous football player or boxer, or...

What were your most unusual desires?

I’m probably already used to unusual desires... Well, a few examples to give this picture a little.

The child wants to meet some famous American band, which doesn’t even happen in Russia, and we understand that it is impossible for us, with our small resources, to bring a world-famous rock band here. But children love, for example, the Tokio hotel group. There were several groups, so I purposefully do not name them, each of them. Or, for example, Adriano Celentano, a famous singer, a world star, but he is not traveling now, he lives in his villa and does not plan to come to Russia, but the child wanted to meet him.

Nevertheless, we find an opportunity to contact the group and the singer, tell them about the patient, even send a photo and a letter. We invited the boy to write a letter. Well, we can’t meet with Adriano Celentano now, but you can write him a letter, we’ll pass it on to him. He wrote, and in response he received a large poster with a signature, a personal response came in which it was written that he wished him strength to fight the disease; he wrote that he was worried about him and would pray for him to get better. He said that there are illnesses in life, and the most important thing in these illnesses is not to lose heart, not to despair. Such a simply heartfelt letter was written, which brought the joy of meeting the child with this star.

I know that another one of the requests was to become a successful businessman. How is this done?

A very beautiful story. It rather shows that there is an element of creativity in every such story.

This 17-year-old boy, who was unable to finish 11th grade due to illness, completed 9th grade, and then an illness occurred and he had to be treated. And all his classmates passed their exams and began to enter college, but he couldn’t. And this pain from the fact that he is a loser, it lurked in my soul, and one day he expressed it, that nothing had worked out in my life. And the psychologist heard this phrase, said somehow in passing, and, after talking with one of the heads of large companies in St. Petersburg, he came up with such a project. He was invited to work quite seriously, the company said that we are giving you the position of head of the department, we feel that your experience suits us, this is an interview and everything is absolutely serious, they told him that we need such a person. He was given money so that his appearance would correspond to the duties assigned to him, and he went to work on Monday.

They sat him down at the table and said: I need to take a piece of paper from here and bring it here, and they offered him some kind of work. After some time we met, and I just saw a happy man, because he was cooler than his classmates. A car met him, took him to work, he did some very important assignments, received a serious salary, he really was the idol of the class, and after some time he celebrated his 18th birthday, and he was able to invite his classmates to the billiard club , treated them to lunch there, and then they played. We invited a famous billiards champion and he showed a master class. Here's the story.

Let us clarify that the disease does not occur from birth, but comes already at some age, right? There are situations when a 15-16 year old child can live an absolutely natural, normal life, and something happens, a disease is discovered. This disease can last for months, it can last for years. That is, this, unfortunately, can happen to anyone who was born healthy. I'm right?

Illnesses happen, and none of us can escape illnesses, so we must prepare our souls for the fact that we bear part of the pain of this world, and ask the Lord to give us patience to bear this pain.

We Christians must remember that they do not come down from the cross, they take them down from the cross. And, wanting to become like Christ, we must prepare ourselves to bear part of this burden. Thank God, if anyone escapes this cup, but illnesses come to everyone, they come to children too.

At the end of this program, I wanted to clarify up to what age children are considered children and potential wards of yours.

Since we have become a government agency, we are guided by the rules that define and regulate our activities. We accept children from 3 months to 18 years. But since it happens that a disease that begins in childhood ends after the age of 18, we try not to leave children unattended.

“Orthodoxy and Peace”/Patriarchia.ru