Thursday, June 12, 2008

Strange Confluences of Events

OK, so it all started with being called to ICU. Mom of a patient in distress. Daughter's "outcomes are not expected to be good." The nurse says. I know what that means- not is good is final. Through screaming, crying, anger, reminiscing, unpacking of enough baggage to fill more than one Faulkner novel, I not only see why the despondency generally. The mom had reached her end of patience ( which may not have been much) and had yelled at the daughter with AIDS. Mean words, that ended with Mom saying she can't take it anymore - she is going to kill herself. Daughter leaves in a snit, it is 99 degrees outside, and after walking too far she collapses from heat stroke, and is in a coma. These were the last words between them.
Now here is the mother. Wanting the daughter to wake up- not likely. And as we cycle through it all, the mother speaks present tense- I can't go on. I'm going to kill myself, I could take pills. I know she might have pills, or she might not. I have been there an hour. It has been hard. She has gone on and and on - I have barely been able to say a word. Now she is clutching on to me and sobbing.
"Did you say you want to kill yourself, or you do not want to?"
What to do? I can't take her to mental health voluntarily. I can't leave her there. I could excuse myself to sort this but how long can I be gone? We are into the third of four stages. But what if I am wrong? What do I have to use?
"you said you want to be here when your daughter wakes up, because you are such a loving mother."
" How will doing this change your wish to be here?"
Silence- for the first time
"Do you want to be here to tell her you love here when she wakes up?"
"What does that tell you? Can you hold on for her?"
"I think I can"
"You said you want to be in a support group for families with AIDS - you want to be heard and to help"
"Do you remember the social worker is coming tomorrow."
"I can't be here until 2"
As we talked on we made plans for the next day, we prayed each sharing prayers. She prayed "Lord thank you for the woman who came to see me- I don't remember what her name tag said but I am glad she came"
We made a plan- a different plan for tomorrow, not the frustrated plan of today.
Lots of other things may come, but this crisis passed.
A mother of a dying daughter. A woman whose illness cancelled a long planned family trip. The list could go on. How is God present and speaking? In the presence of ordinary people who are willing to be sent. In the gathering of two or more in God’s name. In the times where for some reason a person in need found or was found by another who really didn’t need to be there then, but was. In the bright light of the person who has experienced a near death experience and finally feels it can be shared with someone who will not judge it, but believes in the light.
When I started this program, I was worried I would have nothing to say, that I might not know what to pray, or how to be present with someone. It is a learning experience, but I have abandoned the idea of props for a lot of things I do pastorally. Most of the time what I need shows up, or is already there, just waiting to be manifested. What is needed by the patient shows up. While I may not fully see this in the midst of the moment, I usually see it later when I step back. But other times I see it then and can be in awe.
Where I struggle is in “trauma.” But if I am honest, I can say that there is a reason it is called “trauma.” It is best to focus on my role and not the big picture. Don’t look at how tall the mountain is, just start taking steps. To know that situations are fluid. That I will have bad days, and so will others. To know that not everything can be resolved and that is how it is for reasons beyond me. That what I am feeling is often very internal, not external – so I can either bring it out and ask for help, or accept a low level of discomfort as normal- part of being human. Just like everyone else. Processing this has allowed me to begin to have a more realistic handle on the concept of competence.
I am getting to know the team of fellow interns, residents and staff better, and to experience different styles. I have come to appreciate even more the mutual concern that is prevalent, even when I don’t know it. The person who thought of calling to see if I was OK. The person who chastised someone who was to relieve me and who was late-“get down there and relieve her in the trauma bay!” The ability to process stressful circumstances when I needed fresh perspective. And the chance to laugh when we are all confused.
I am experimenting with new styles, and trying to embrace some of the concepts in The Skilled Helper. Oddly, it was when I was at my wit’s end that it kicked in- the reflective question that made some one pause.
In my first supervisory session I mentioned having a chance to continue to work on diversity awareness and language issues, particularly with the Latino/a population. Later that day, I did a visit where I was again faced with a closed door of a particular patient, and was ready to leave a note. The door opened and a woman emerged to tell the nurse the patient was feeling nauseated again. The sign on the door said “Spanish-speaking only.” I asked the woman if she was related- she is the daughter. We discussed how the request for pastoral care had not been able to be met- door closed. While today was not good because of a scoping procedure, I got an update on the patient and new concerns, found out that several family were taking shifts each day. Coordinated when the daughter is there and she is willing to translate. Confirmed there was no wish for a priest or communion, but a visit would be appreciated. I then spent time talking to the daughter about the balancing act she was doing, and in the last two years she has lost a brother and father. It was a good visit there at the door, and I think she valued my efforts to bridge the gap and the respecting of the family’s situation and needs.
I am ready to begin The Art of Listening. I hope to read other options that have been offered to me as resources. As I head into my first overnight on call, there is anxiety ( it is Friday the 13th and I am on alone), but I see that I am only alone if I make the choice not to reach out. And that even when I think I am at my wit’s end, there are things that are there if I can self-talk and then accept the anxiety as energy. And I am amazed at how what I need or want to see often presents itself. While this week had watershed moments, I am feeling supported.

Two years ago to the day my life was altered by a family suicide. This week, I paid it forward in one more strange confluence of events.


DogBlogger said...


Ivy said...

It sounds like God was there to meet you and patients/family members at every step. May his grace surround and support you tonight.

Diane said...