Tuesday, July 22, 2008


Just back from the lovely GAC and LSM. More soon, but in the meantime, I know I have not posted for a month. There just was not enough time between the swing shifts of the hospital, the camp and other demands of the children, the ongoing saga of "is the dog going to die?" I have truly been enjoying the learning at the hospital. I know that this is a contrast to some of my peers. Over the next few posts, a view into my world. I could tell you about all of the wonderfully affirming visits I have had, but the challenging ones are...
After a spate of trauma calls where nothing resolves, which I was starting to expect would be my fate, I finally had a trauma calls that were more "normal" where everything had a flow and a conclusion, where family was available, and responsive, and where roles of the team were more clear and consistent. I realized that these calls felt almost “easy” after the prior ones, where family could not be found, or had absented themselves from the person's life. I will always remember the man who died alone. He had been falling for two days at the group home. When he finally collapsed and they decided he needed attention, he was brought in, bleeding and non responsive. He went from a trauma to a Code Blue. "Chaplain you've got to find us someone or some paperwork!" The only paperwork showed that he had no family. The emergency contact was a pastor. The pastor had been contacted by the nursing staff and told the patient was coming in- he then never answered his phone again and did not come for a day and half. The nurse at the facility was distressed as she looked everywhere for some piece of information, someone to call. There was no Power of Attorney or health care designate. How sad to confirm on a chart that this person has no one. He was schizophrenic and his family had "disappeared." The pastor later confirmed that family had never maintained any contact after the man became a resident. In the end it took a legal department and the late arrving pastor to decide to stop the machines. This man had truly been dumped. I found myself standing at a room where the person is about to be declared brain dead, praying for what could have been, knowing that if he had been brought in sooner he would have lived. Wondering what he thought as it got worse and no one comprehended. How much different than the Gerasene demoniac or any of the others Jesus touched? People sometimes ask where was God? In the medical staff and the chaplain who tried all they could. To love the one others have abandoned- for me a true living out of the gospel in caring for a soul even when there is no one to affirm it, there will be no response.

On another day, I was called by a Dr and asked to visit a palliative care patient who was struggling through issues of his diagnosis, losses in his life, and things he will miss after death. I entered this situation expecting that while those struggles would be significant, my presence was either expected or wanted. I knocked on the doorframe, and the patient was in bed. A woman who I later learned was his wife was seated next to him. I said hello, and introduced myself as one of the chaplains, and that I was stopping by to see how he was doing. I stated I could see he had company and could stop by later if it would be better. “It doesn’t matter because I have nothing to say to you. I told one of your other people the same thing. I do not want to be comforted, I do not want to hear about faith in my life, I do not want to talk about God. There is nothing you can say.” I offered that we did not have to talk about any of those things, I was willing to simply listen to his concerns, if he wanted. His wife interjected and stated,” We are ethical not religious people. You have nothing to offer.” The patient added, “ I don’t want to talk to you or listen to you. I thought I told them not to let you people in here. I want it on my chart that I don’t want to see any of you people here again!” I indicated that I understood, that I would note his wishes on the chart and said goodbye. I charted the event. Did the doctor know and simply hoped he would respond differently? Had someone else had a similar experience? Clearly the result was diametrically opposed to my expectation. I was not offended, or upset by this, but felt that I was clearly not only unwelcome but probably escalated his blood pressure while I was there. What could I use here? Probably just the sense to leave. Among the staff I am considered to have earned my palliative care "badge of honor" - being kicked out of a room. And I prayed for this man who has such grief and anger. I prayed outside his room even though in his mind such an act has no purpose.

Another patient encounter began because of a call by the patient’s sister in law to check up on the patient. She is a middle aged woman with COPD. I stopped by and introduced myself as one of the chaplains for the floor, stopping by to see how she was doing. She said, “I think my sister in law called- she always does. I don’t have anxiety but she does.” We talked about her condition and how 15 members of the family have COPD, two others have died, one recently. She told me she felt very supported and all about her loving family and husband and children. She knew what to expect and she was "fine." We laughed and shared stories. I offered prayer, and we held hands to pray. One of the things I mentioned was to sustain the family in their time of being separated from each other and to provide the restoration to the patient that would allow her to return home to those she loves. She had not mentioned separation issues- I don’t really know why I prayed that, but when we were done, she had tears in her eyes, telling me how much that had hit her, that she was missing everyone, that they cannot come because she cannot compromise her immune system. We talked some more and then she assured me she was feeling fine. Later that day I was paged, she was having extreme anxiety, the total opposite. I returned to pray and calm her, and then the next day, I was paged, she was now in IICU and having extreme anxiety, could I come? Each time I was paged it was because I happened to be the on-call person. When we prayed, I was slow and deliberate, and came back to several things more than once in the prayer. I could feel her relax her grip. Later in the evening, I stopped by at the end of my shift. She was off of the bi-pap and sitting up smiling and chatting with her daughter. I thought back to her statements about anxiety that she "did not have." My role was unexpected, but I am glad she trusted that she could call on us to respond. She continues to call sporadically, usually at night when she is alone and the world is closing in. For each of us, openness to God’s leading. I prayed for a person who thought she was strong enough, but who realized she was not.I was the face she knew, but it was not a familiar face that calmed here, but the healing power of God upon her soul. The first prayer was almost perfunctory in her mind, to placate her relative. The rest have been prayers of holding on to the edge of the boat just before Jesus calms the storm.


Gannet Girl said...

I am reading this in slow chunks; as you can imagine t is not easy content for me.

Re your first paragraph: early on in the summer, a patient of mine died without family. She had been surrounded by adult children for most of her stay, but they ultimately took out their anger on her fate by refusing to be preset for her last days. During her last hours, I was the only one praying at her bedside, where I returned whenever I had a chance. It was terribly sad to witness her ultimate abandonment.

Gannet Girl said...

On the second paragraph: I haven't had that negative an experience, but I have certainly have people dismiss my presence. It is so frustrating to know that you have so much to offer the dying and their families -- including those who have no experience of or language for or interest in faith -- and know that they are going away without the opportunity to add to their capacity to encompass what they are experiencing.