Saturday, February 03, 2007

GREEN WITH EMPATHY

A man who was well known by the hospital staff came and checked himself in. He had a syndrome that caused his body to store copper instead of passing it on through as is normal. The accumulation of copper was destroying him, despite medical attempts to get rid of it and the condition was debilitating, so by this time he had lost his job, his marriage, his children, and his house. He made a little money by selling newspapers in a kiosk. And he was definitely green.

He was a bit of a rogue and the staff wasn’t excited about taking him in, but he insisted that he was going to die on a specific date five days in the future. The doctors were afraid he was going to attempt suicide, and they hoped that maybe they could find some way to help him. There was a possibility that he DID have something life-threatening. He insisted that he couldn’t speak, so the negotiating was done on scrap paper.

I was sent in to see if I could understand him. I liked the guy and had fun kidding around with him via pantomime. He didn’t seem suicidal. I went to the medical library and began to read all the articles on the syndrome. I reported the results back to him, saying, “I’ve read so much about this syndrome that I’m starting to develop the symptoms. Are the whites of my eyes beginning to look a little green? You may have to shove over and let me into that bed with you!” Very improper. “You’re cute,” he wrote.

Then a nurse caught him talking on the phone to his girl friend and the doctors wanted to throw him out as a faker. At that point he really did get distraught. I went back to my reading. Finally I found the key when I looked at his chart again and noticed his birth date. One article had said that victims of the syndrome never lived past their fortieth birthday: the date he said he would die was his fortieth birthday. The doctors let him stay, he didn’t die, I gave him a birthday card, and he left with his girl friend.

That was a lucky one. Here’s a failure. The hospital was in a town full of machinists, men who stood on their feet all day on cement floors. A little too late it was realized what this did to their circulation and heavy rubber mats were provided. In the meantime a lot of the older men lost all the circulation in their feet and some became amputees.

This particular older man had married a young wife. The whole basis of their relationship was dancing -- they had met at a dance and they both loved it. They’d only been married a few months. Now his foot had been amputated above the ankle. He felt that his marriage had been taken with it. He was a crip, he would never be able to dance again, she would stop loving him.

I thought that if we could just talk reasonably about it, he would come to understand that with a proper prosthesis he could dance and it would be fine. But I was not prepared. He flipped over the covers and here was this raw stump -- no bandage at all -- with big rough stitches holding a flap of skin over the end of the bone. It looked like something the butcher did. He said he wasn’t a Christian and didn’t see what praying would accomplish.

The doctors said that treating the amputation this way reduced the risk of infection and that many tiny tidy stitches would not allow the skin enough looseness to shift around during the healing. They said the worst pain came from allowing the wound to heal too snugly and neatly, so that it drew tight over the end of the bone.

I came back another time before his discharge. His wife seemed shocked, but not ready to file for divorce. He wouldn’t talk to me. Then he was gone. There was only a tiny window of opportunity to help with a disastrous life change. I hope someone else was effective.

These “chaplain” stories are secular. The next one is specifically Unitarian. A Unitarian woman had cancer of the larynx. She was quarrelling with the nurses because they wouldn’t tell her anything. She couldn’t understand how she could swallow after the operation. She understood that air went through the larynx and could go through a hole after it was removed, but what about food? How did the esophagus fit into all this? The nurses told me that the less she knew the better off she would be. She should just trust her doctor.

When they weren’t looking, I stole their nursing book and took it to the woman’s room. I was very stupid -- I didn’t read what it said about a laryngectomy before taking it to the patient, but if I had been she, I would have wanted to know the truth as straight as I could get it and to be an active decision-maker. She seemed pretty tough to me. So we read it, side-by-side, word-by-word, exclaiming sometimes at a discovery or sucking in our breath with shock.

She had been a smoker, lifelong. She said she knew that’s probably what gave her the cancer and she didn’t care. She had LOVED all those long afternoons of gossip with friends over coffee and cigarettes. She had felt terrifically sexy flirting with her husband while the smoke rose like a French movie. But now she had made HIM quit cigarettes! He would not leave her. They were best friends and lovers, no matter what. We talked about what it meant to lose one’s voice and made a list of people she wanted to speak to one last time: her two daughters would be the last. We wrote a little prayer of relinquishment, saying goodbye to her voice.

After the operation she breathed through a tracheotomy and had a little vibrating machine she held to her throat to get some barely intelligible language out. I experimented with it a bit and then she showed me what she could do. Not bad. On the day she went home, the couple called me to come say goodbye. Her husband had brought her a white scallop shell fixed to hang by a red satin ribbon over the tracheotomy hole. They were glowing and left saying they were making a new beginning.

I don’t know why some people are able to look at things and figure them out while others give up and go under. It doesn’t strike me as being religious, though I think whatever it is influences what kind of religion people choose or even whether they look for a religious community. Many people think of religion as something pertaining to an individual, none of anyone else’s business. It hardly seems fair that resilient people who are able to recover find supportive communities and the others who work hard and are equally deserving seem unable to connect.

The senior chaplain, a man much respected, said to us again and again, “When you are suddenly told you have a serious life threat and you are thrown onto your back in bed for a while, it is a great opportunity! Not everyone has a chance to stop everything and just reflect for a bit. It’s a precious gift to have time to take stock and see if you’re doing what you really want to do.”

There was another Unitarian family (I love it when the positive examples are from my tradition!) who insisted on having a Unitarian chaplain and NOT a Christian. (Some Unitarians are Christian.) A bad sign. The woman had delivered a still-born infant. She had had a daughter early in the marriage and then, when she thought all babies were in the past, she became pregnant again. The daughter, a pre-teen, was included in the discussion of what to do. Taking time off for a pregnancy would mean that the budget would be tight. Some pretty nice trips to fancy places would have to be given up. What would this do to college funds? Space would have to be made for a nursery. Briefly, they considered abortion. They were pro-choice people.

The choice they made was to change their lives and have this baby. They decided that the baby was a message to them to reassess their priorities, maybe to live a little more for others and more for the future. But now after the nursery had been decorated and other less reversible preparations were made, now the baby was dead. They were in shock. We talked and I agreed to attend a home memorial that they would organize later.

The core of the memorial was how wonderful it had been to think about having a new baby, how much they had cherished the pregnancy for itself and especially the grace of the mother. They said the realization that the baby brought them remained. They suggested that the baby, a messenger, had fulfilled her task. Then they winked and served their friends a choice of devil’s food cake or angel food cake, even though saying that they didn’t believe in either Heaven or Hell.

I could only hope to support them in their determination to find a positive way to go forward. They didn’t need a Unitarian chaplain -- they were autosalvific. They knew how to save themselves and were afraid that a Christian might interfere with that. It took me a while to figure out that in this case doing very little was just fine. What was needed was to get out of the way.

What’s that prayer? God grant me the strength to intervene when it’s needed and the grace to withdraw when it’s not needed and the wisdom to know the difference?

2 comments:

Anonymous said...

Mary--What powerful stories of peoples' lives. Thank you! I wonder if the way in which one reacts to the large and small tragedies depends upon the view that one has of him/herself. If I saw myself as a dancer, losing a foot would be far more tragic than as if I saw myself as a harmonica player.

Unitarian vs Christian: When Hunky Husband and I wed the second time (we were married 19 years, divorced 11 years, and have now been married another 19 years), we had a Unitarian minister officiate at the ceremony in my Albuquerque home. My mother was pleasantly surprised at the Christian-like prayer that was offered as a part of the ceremony. Mom was a Baptist.
Cop Car

prairie mary said...

Thanks, Cop Car. The art of ministry is in large part a matter of sussing out the people so as to deliver what is needed. NOT just counseling, but also whatever part of the Great Traditions fit the situation.

Prairie Mary