Tuesday, January 30, 2007


Serving the ER was much more exciting than going down the hallway greeting victims of chronic problems. ER is the stuff of drama, right? Be sure to wear the shirt with the reversed collar.

What if the chaplain gets traumatized? Right in front of everyone?

The town where the hospital was had a thing for lawns. People lived and died for their lawns. There was a lawn-of-the-month competition and the winner got to have a sign in the yard. It folded to stand up so that it wouldn’t be necessary to drive a stake into the grass. ER called me because of a mother who had just run over her four year old son with a riding mower. The blades mostly just chopped his foot. I walked into a room where the screaming child was being held down by his mother and the nurse while they waited for the doctor. The foot was pulped.

“Omigod,” I blurted. “Will he lose the foot?” The nurse shot eye-daggers at me. The mother said through her teeth, “We don’t know.” The child, understanding exactly what I said, fixed his eyes on mine and his screaming went an octave higher. The doctor came, a shot was given to the boy to slip him into unknowing and the nurse ORDERED me to take the mother out and get her coffee.

I did and collected myself enough to sit and talk more coherently. She began to shake and weep, now that she wasn’t on duty, and told me how she hadn’t even known her son was outside the house. She’d been backing up a few feet to make a sharp turn. The boy was determined to ride with her and ran up behind her. He’d been told a thousand times not to come near. I apologized for my tactless question. Gracefully, she said, “You only said what we were all thinking. Maybe it’s better for it to be out in the open.”

So one thing that happens when the chaplain freaks out, is that others take up the ministry.

Once I was flummoxed when I went to a farm family who had just lost the grandma. Four generations sat somberly in the “family room,” but the grandpa was laughing merrily. The others stared at the floor while I told the old man that I was sorry for his loss. “She was a good ol’ gal!” he told me, grinning. Some of the women were weeping.

I figured there was some kind of strange crossed-wires in the old man’s head. We visited about the “good ol’ gal” a little more, we prayed, and I left. I read about it. Not uncommon. Not necessarily something diagnosable like Alzheimer’s, just a startling reaction. Not really traumatic and not even a symptom of shock in this old man, though maybe he was taking shelter in unreality for a little while.

We had been told that black people, especially those from the rural south, might be very physical in their grief reaction. We should be ready for them to throw themselves against the walls or floor or furniture and to make sure they didn’t hurt themselves. A mother had just learned that her teenaged daughter, who had a heart defect she knew might kill the girl at any time, had actually died. She collapsed to the floor.

I’d seen “nurses” in white uniforms ministering to the overcome at intense evangelical rallies, especially in hot weather, so I’d brought along a damp washcloth. I knelt behind the woman with my arms around her and tried to soothe her face with the cloth. It did seem to help. For a moment I could feel in her the impulse to fling herself around so I hugged her from behind, holding her against me. Then she seemed to come to herself. “Let me up,” she said, and I did. Family members were there. In a while I left and I think she was glad to see me go. It was as though I’d prevented her from grieving properly.

Another incident was so shocking that decades later I’m still not over it. An older grandmotherly woman had come in for repair to varicose veins. Behind the nursing station was an examination room and she had been taken in there for a pelvic exam. At the time I couldn’t understand why she needed a pelvic for varicose veins and no one could tell me anything except, “It’s standard procedure.” Lately I’ve been reading articles saying that in teaching hospitals, in order to give student doctors experience, women who are unconscious for other reasons are often given pelvics without the knowledge or permission of the patient or family. Who could it hurt? Isn’t a pelvic a benign preventative strategy? After all, there was no charge for it in such cases.

The problem was that when they put the woman’s feet up in the stirrups, they dislodged a clot that killed her instantly. When I got there, this obese, late-middle-aged, white-haired woman was being given Code Blue resuscitation with all the vigor it was possible to muster. It was desperate. Her gown had been torn off and thrown to the floor, her arms were extended, her legs still in the stirrups with her private parts towards the door which stood open because there were too many people and too much equipment in the small room to shut it. There were tubes and syringes and racks of drips and the shock machine. Everyone was shouting, people ran past with samples of blood, and everyone’s face was frozen in shock. It looked more like a murder than a rescue.

I stood there with a weak smile on my face, no idea what to do, unable to understand what was going on. A ward nurse came up to me, angry. “Go to the elevator and intercept the family. DO NOT let them come here until we tell you it’s all right.” I did that successfully, though they had many questions and their impulse was to go to their mother. A short time ago they had dropped “Mother” off for what they thought was minor surgery and now they had been told that she was in extreme danger -- NOT that she was dead. A man I took to be her son was a tall, very handsome, “silver fox” rancher in cowboy hat and boots. The grown children were very quiet, almost paralyzed.

Finally word came that Mother had passed on. The family could visit. She was dressed in her own nightie, her teeth were back in her mouth, and she was peacefully arranged in a clean bed. She seemed just an old lady who had died of natural causes. The Silver Fox turned out to be her husband. He threw himself onto the woman and deeply kissed her over and over, almost like artificial resuscitation. Then, bouncing off the walls and wailing, he called, “Mommie, Mommie, Mommie” like a little child. His children stood away from him. I stood away from him.

A small black nurse, one of the most effective on that ward, came storming in the door and grabbed him in a fierce embrace. “It’s all right. She’s in Heaven with God! She’s at peace!” She rocked this poor man while over his shoulder she glared at stupid me who couldn’t think of what to say. I was still wondering if the hospital was going to lose a bundle in the lawsuit. Would I have to testify? Like that old man who giggled over the loss of his wife, I had taken flight from the real present.

But I still wonder about that man and his wife. What was the story of their relationship? Could I develop it into a novel? This is my way of dealing with my own shortcomings -- write them out, create a new set of events, invent a character who can forgive me, since it’s so hard to forgive myself. Maybe ministering to oneself is hardest of all, which is why one needs colleagues and mentors. But often they are too far away. Or it's too hard to admit one's own shortcomings.

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