Changed. Forever.

Most of us have those moments, the one where our lives are forever changed. If we don't have them ourselves, we know someone who has.

When it is us, we cope, we slowly adjust, we reimagine and reinvent our lives. When it is our friend, we support, we bring food, we futilely try to "make it better."

One of the dimensions of my job as a hospital chaplain is being exposed to these moments for others, people I never knew before. And with this exposure comes absorption of some of their pain.

My most recent shift was fraught with such experiences.

Early in the evening I was with six men who had gathered to remove life support from their brother/uncle. Four of them had flown to my city from Texas, and all of them bore a strong resemblance to Javier Bardem's character in "No Country For Old Men." All of our mothers told us that "appearances can be deceiving" and "don't judge a book by its cover," but I was unprepared for the incongruity of how gentle, loving, and tender these brothers/nephews were, eagerly holding hands all around while we prayed for God's mercy.

A lovely, too-old-to-still-be-driving octogenarian mistook the accelerator for the brake pedal, causing a five-vehicle accident and most likely her husband's death.

A pedestrian hit by a car as he crossed the street to the train station on his way home suffered a massive skull fracture and intracranial hemorrhage; his wife and son live so far away that he had already been taken to surgery by the time they arrived. "But I had just spoken to him!" she said over and over, trying to take back time. It will be days before the heavily-sedated patient will be allowed to attempt to wake up; and only then will he will be able to be assessed for brain function, for mental capacity. And during that time the family will spend hours driving to spend hours at the bedside, waiting without any idea of the outcome. "This will be a long process," the resident said and I noticed she didn't use the word "recovery."

All of these lives changed in a moment.

And perhaps the saddest story is the one about the man of -- oh, how do we phrase this? -- limited intellect who called 911 for his bedridden mom who had stopped breathing. The two of them lived alone together in an unhealthy environment. What will become of poor "Ben," now that she is gone?

Changed in a moment.

Forever.

How Can I Let Her Go?

I was awakened by the beeper at about four o'clock in the morning. It was a Code.

When I got to the patient's room, there were family members huddled outside the door, clasping their hands and sobbing. The Code was going on, and before very long, a pulse returned.

The patient had only been admitted to the hospital twelve hours earlier. She had end stage renal disease and several other problems. She needed dialysis. Complications had ensued in the dialysis unit and she was sent to a critical care floor. The need for dialysis was complicating her other problems.

The family members were the patient's daughter, the patient's aunt, and the patient's niece. The daughter is an only child and there was no mention of a husband.

The resident spoke kindly but frankly to the daughter. The patient was very, very sick. She needed dialysis, but her blood pressure was probably too low and heart rate too slow for her to sustain the procedure. In all likelihood, the resident said, once dialysis was started, it would just be a matter of time until the patient Coded again.

The daughter's wedding day is November 1.

A terribly sad situation.

The patient was only in her mid-fifties, but she had been abusing her body with alcohol for a long time,

It was agreed that a slower form of dialysis would be attempted. Pressors were given, and the patient was prepared. I prayed with the family and left.

Oddly, I was able to fall back to sleep, but not for long. At 6:15 the beeper announced another Code and I grimaced when I saw the room number.

The fiancé has joined the family by now and was holding the patient's daughter as she sobbed, "She's my mom. How can I let her go?"

The nurse and the resident spoke at length with the daughter. In time she came to a place where she understood that her mother's body was simply giving out. Her lungs were filling with fluid, her need for dialysis was overwhelming, and the pressors would only help for so long. Her liver was cirrhotic as well; the patient was shutting down.

At the mention of the liver, the daughter became more focused. "What will you write is the cause of death?" she asked. "Will it be cirrhosis?" The resident said that it would be end stage renal disease, and the daughter was relieved. It was important that liver cirrhosis not be the cause of her mother's death.

Born Too Soon

While each hospital encounter is unique, there are situations that are similar.

But I've never experienced anything remotely like this one.

A nurse from Labor and Delivery phoned. She sounded upset. Her patient, we'll call her Ruthie, had delivered a 22-3/7-week baby boy about two hours earlier. The baby was alive, but would not be for long. And Ruthie would have nothing to do with him. She didn't want to see, much less hold him. She would not talk about burial or cremation arrangements. She would  not talk about her baby. She just wanted to go home. The man with her was of the same mind. The couple were in their thirties, and "weren't from around here." Neither, in fact, is a citizen of this country.

The nurse couldn't stand the thought of the baby's being all alone, dying, and going to the morgue. She was staying with the baby and loving him. She wanted to know what would happen to the baby and whether there was anything I could do.

Mindful of my boss's instructions not to hesitate to contact the nursing supervisor if I found myself in an untenable situation, I went to find her. The sadness of the situation was shocking to her, as well. She spoke with the sweet nurse and made began the process of contacting social work to assist with making the infant a ward of the county. As we talked, my role became clear to me.

I went up to the delivery floor and sought out the nurse. She told me that the doctor was with the baby, and together we went in. He was very, very tiny, and his breaths were not close together. He was under a warming lamp and wearing a little green knitted hat. The doctor had her hand on him. I asked them to join me in prayer and thanked God for creating this beautiful child, and asked God to receive him back into his loving arms. I made the sign of the cross on his forehead and blessed him. He would not live much longer.

The parents would have nothing to do with me. They did not want to be consoled and they did not want to plan and they did not want to talk. They wanted to be left alone.

Born too soon to a mom who wanted him so much that she got all mixed up when nature failed her, this baby will be with me for a long time.

It was a terribly sad situation. This brief little life was supported by a loving and gentle doctor, a caring nurse, and a chaplain called in desperation.

His parents didn't even give him a name. But as I stood there with my finger on his tiny forehead, I thought about my own firstborn and knew that he wouldn't mind sharing his name. I will think of him as Thomas.