Elizabeth

I met them many years ago when I was part of a clinical pastoral education group and serving as a chaplain at a large inner city teaching hospital. It was my first day on the oncology floor and the last thing I wanted to do was to walk into the room that housed a 16-year-old girl, newly admitted. I'd expected the oncology floor to hold a much older population. But walk in, I did, and thus began a relationship that would be intense over the next eight months. Elizabeth had broken her arm in a car accident, and in the local emergency room in upstate Pennsylvania the x-rays had shown a bone tumor close to her shoulder. The tumor was malignant and would need to be removed. But first Elizabeth would need to undergo many rounds of in-hospital chemotherapy in an attempt to shrink the tumor before the surgery. In all likelihood, Elizabeth would lose her arm to cancer in an effort to preserve her life.

By way of an odd coincidence, I was connected to this patient and her family. They came from a "town that nobody ever heard of" that was about three hours away from Philadelphia. The same town where my father-in-law lived. Elizabeth's parents, Jean and her husband, were his veterinarians. They knew my father-in-law and they knew his Brittany spaniel and his spiteful cat even better.

It turned out that Jean, then, became my patient rather than Elizabeth. Every few weeks when Elizabeth would be admitted for her chemo, I'd pick Jean up and we'd go to the cafeteria where she could share her fears, her worries, without Elizabeth's having to hear them. During this time usually the social worker would visit Elizabeth so that she, too, could share. Jean and I became close.

On the day of the operation, I was with Jean and her husband when the surgeon came out to report to them. I stayed long enough to hear him say, "We were able to save her arm," and then I went back up to the oncology floor, happy to be the bearer of good news in a setting where there was precious little of that.

This wasn't the whole story, however.  When I found the chemo nurse on the onc floor and told her that Elizabeth's tumor was gone and her arm was saved, she wasn't elated.  Instead, she said to me, "Well, that may well be.  But that arm will be totally useless; it will just hang by her side and atrophy."  How quickly my joy turned to confusion.  I didn't really know how to feel.  I'd been praying for preservation of the arm; I guess I thought it went without saying/praying that the preserved arm would be functional. 

My clinical pastoral education experience came to a close that very week.  I never had the opportunity to visit Elizabeth or Jean on the floor again.

Six months later, at Christmas, I received a card from Jean.  "If you're ever in the neighborhood," she said.  But no mention of Elizabeth's useless, atrophied arm.  I guessed the family was thankful she was alive, thankful she had the arm.  The prospects at the get-go hadn't been all that optimistic.

The following summer my husband and I were invited to a surprise party for his father.  We needed a place to change into our party finery following a long car ride, and it couldn't be Pop's place.  I emailed Jean.  We followed her directions out to a beautiful property with an amazing view.  It was good to see her, to see her husband, and to introduce these important people to Joe.  Elizabeth had finished her first year of college and wasn't living at home.  But she had come by that day and was inside making lunch.  I felt shaky and nervous and my stomach was tied up in knots.  I didn't know if I could bear to see this beautiful girl with her useless limb.

And then the door opened.  And she came out.  Carrying a plate with a sandwich in one hand.  And a glass of milk in the other.  It was all I could do not to cry right then and there, with the joy of a year before now an honest-to-God reality.

Over the years the Christmas cards have continued with quick check-ins. Elizabeth graduated college.  She started a photography business.  Elizabeth married.  Life was good.

And then, years later,  I received a most welcome message:  Two weeks ago, Elizabeth gave birth to a little boy.  And this time I didn't need to hold back the tears.  Tears of pure joy.

Stillborn but Still Born

The early part of the morning had been quiet; then the beeper went off and it was the kind of call that a chaplain dreads.

A young couple had come into hospital the previous afternoon to deliver their third child. Upon hooking the mom up to the monitor, it was found that the baby had died due to a nuchal cord. The mom had to labor, and about fourteen hours later she delivered Lindsey, a little girl with a cleft lip and some other problems.

The family was new to the area, in the middle of a job change, no family in the area, no church affiliation yet, no local friends. They talked about their 4-year-old daughter at home who was expecting a little sister, and needed to figure out how they were going to tell her what had happened. They had a 2-year-old son as well. Dad's parents were gone and Mom's mother very ill; their situation couldn't be much sadder.

They wanted to have Lindsey baptized, and so we talked about blessing vs. baptism. Baptism of a stillborn is theologically unsound, but I have done it anyway if it was important to the parents. This couple agreed to a blessing which was done with the same holy water and language as used in a baptism, only saying "bless" in place of baptize.

I liked them so much. After the blessing, I left them alone with their baby.

I returned a couple of hours later to deliver the certificate of blessing I'd prepared. The nurse told me that mom was having trouble giving the baby up but it was time for her to do that. When I went into the room, the dad was holding Lindsey and the mom was looking through the box that held the foot prints, the photos, the little cap and other things that the hospital had gathered for her. Off to one side was a metal table with wheels; this would be used to take the stillborn baby down to the morgue. Of course the mom was having trouble!

Dad asked if I wanted to hold the baby and when I had her it seemed as though it might be easier for the family if I took the baby from the room in my arms instead of the nurse taking her away on the metal table. We prayed together and they kissed her goodbye. It was so sad, and yet handing the baby to the chaplain (instead of putting her on the wheeled table) was somehow metaphorical for giving her back to God, and they were able to do that.

I was scolded by the nurse for risking infection by taking the baby in ungloved hands, but I didn't care. It was the right thing to do.

Miss Myers

I see myself as a dinosaur: I hardly know anyone else who knows and can use Gregg shorthand. I learned mine in high school and have used it for more than fifty years, in one way or another. My teacher stressed the importance of our shorthand being perfectly legible; one never knew when another stenographer might have to interpret our notes and transcribe.

When my children were little, I used to buy their Christmas presents and wrap them immediately to prevent snooping.  So that I didn't forget what was inside each package, I'd write the contents in shorthand on the package tag.  It drove the kids crazy; they'd try to get my sister (another shorthander) to tell them what it said.

I use my shorthand at work, of course, and at meetings I attend for church.  I write my gift list in shorthand so that if my family finds it, their surprises won't be spoiled.

Here's my best shorthand story:  I was spending a night as the on-call chaplain at our local hospital.  The beeper was being very well-behaved and it seemed I was in for a quiet evening.  I stopped by the family lounge, where people wait for news of someone in surgery.  A small gathering there looked anxious, so I approached them.  It seemed that their person had been in surgery far longer than they had anticipated; they had had no word, and were very worried.  I offered to check into it.  I went to the OR suite and checked in at the main desk; someone there was able to give me a progress report about the patient, giving me a great many details which I wrote down on the little notepad I carried.  I was glad to be able to take good news to the waiting family.

Since it was still pretty quiet, after doing the visits I'd been requested to handle, I sat down with the patient census to see if there were any recognizable names.  There were a couple of patients who came in and out fairly regularly, and I liked to check on them.  And, of course, I would want to visit people from my church or neighborhood.  Up popped a name I recognized immediately, a name I'd not thought of for thirty-five years:  My high school shorthand teacher.

I went up to her room and she looked up expectantly.  She was alone.  "Miss Myers?" I began.  "I don't know if you remember me."  She looked me over and she did.  She'd been my homeroom teacher as well as shorthand, so I'd been with her for three full years. I hadn't been the easiest student.  We settled in for a visit; she wanted to know about my life and I wanted to know about hers.  She had been retired for some time; her brothers and sisters were all gone.  She lived in a retirement community and this was the first time for her to be hospitalized. It was all overwhelming. The next day would bring surgery for her breast cancer.  She was terrified.  She was thinking through what her life had meant.

I spent a long time with her, listening, reassuring, praying, listening some more.  As I got up to leave she stopped me asking, "Do you ever use your shorthand?"  "Of course I do!" I assured her, pulling the pad from my jacket pocket.  "In fact, I used it just before I came up to see you!"  Since there was no information that would identify the surgery patient, I showed her the notes I'd made at the OR desk and her sweet anxious face lit up.  "Oh!" she exclaimed.  "I can read every word!"

"I Thought It Would be Charles"

Better minds than mine have analyzed the Trayvon Martin tragedy and better writers than I have expounded on it. It would seem there would be little to add.

But I write nonetheless because I know Trayvon's case is not unique. There have been many Trayvons.

During my seminary years, I spent ten weeks one summer doing Clinical Pastoral Education at an inner city hospital setting. I had regular floors and departments that were my "parishes," and every sixth night and sixth weekend day, the entire hospital was mine to cover. Throughout that time, I never had a single night where I was not awakened from my on-call room to come to the Trauma Unit because of a shooting. Larcenia, a young black girl who had been sitting on her front steps in search of some cooler air than in her row house, was the exception; she was the victim of a senseless drive-by shooting and she never walked again, never had feeling of any kind from her mid-section down. Larcenia was 14.

But, as I said, she was the exception. Because more often than not, it was a young black male who had been shot. Sometimes it was an act of vengeance; sometimes there was gunfire from multiple players. And sometimes it was random, thoughtless shooting. Perhaps for sport.

One night the victim was a young black man named John. He was seventeen years old. He lived, thank God, but not without compromises in his quality of life. My job was to talk with him, to get his identification information, and to ask him who I should call at home. John was a sweet guy. He had no idea who had shot him or why. He believed it had been a white guy in a car. And he asked me to phone his grandmother. When I reached the lady, I told her as gently as I could that I was the hospital chaplain, that John had been admitted, and he was alive and talking to me, and wondered if there was someone who could bring her to the emergency room. I'll never forget what she said to me: "Did you say it was John that was shot? I always thought it would be Charles who would get shot."

It was unfathomable to me that this woman, and probably many, many other African-American mothers and grandmothers actually lived with the expectation that their sons and grandsons would be shot. I couldn't wrap my mind around it -- and I've later learned that this is due to white privilege.

That summer was more than twenty years ago. How little progress, if any at all, we have made.

"Well, You Did It"

I was the on-call chaplain that night.  This meant that I was the only person from Pastoral Care in the hospital.  I carried the beeper and had a quiet little room where I could sleep if things weren't busy.  My shift began at 5 p.m. and would end at 7 a.m.

The beeper went off around eight o'clock.  It was the head nurse from the ER.  A woman had been brought into the hospital after a successful suicide attempt.  Her family had been contacted and would be coming in to see her. Would I please go to the viewing room and wait for the family. 

The woman was in her sixties, not unattractive, and dressed in casual clothing.  There were no marks on her; she had taken pills.  I felt uneasy as I waited with her, and this was unusual.  The viewing room felt exceptionally cold.

When her adult children arrived, they were angry.  They did not seem at all sad.  "Well, you did it," said one of them.  And the rest of them echoed that sentiment.  They berated their mother for what she had done.  They were very, very angry.  But they showed no signs of wanting to leave.  It was confusing.  My task was simply to Be With Them; if I could do more, that was good.  But I was at a loss as to how I could work with this family.  Their anger was so bitter and pervasive.

Then came a knock on the door.  It was a cousin, who was a pastor in the Swedenborgian tradition, a Christian faith very, very different from my own Lutheran one.

"Well, she did it," they told him.  They remained stiff and angry as he looked first at the mother and then at them. 

The cousin waited a bit.  Then he said, "You know, we are only accountable for those things that we do when we are not being forced and when we are not in pain."  Another pause.  "And she spoke with me many times about the pain that she was in."

And then they began to grieve, and the room felt warmer.     

Cranberry Girls

It was a terrible shift, really. One of the worst I've ever had.

There were two Codes on the same patient; he didn't respond to the second one.

There were five traumas, one of which was a man about whom the paramedic said, "Be very careful with his shoes. They cost a thousand dollars." For those of us in the trauma bay not yet directly working with the patient, our attention was instantly diverted to the floor.

Ugh.

There were a couple cardiac arrests. Neither patient responded. There was a death of a very sick man whose surviving sister's main response was that she did not have the money to pay for his funeral. A visit to a patient whose husband and daughter hated each other and didn't try to hide it.

And the worst was at the very end of the shift. Another cardiac arrest, this one for a man in his twenties. And someone had mistakenly brought the patient's siblings back to his cubicle without the doctor's having met with them first, to let them know he had died.

It was a blur of horror, the ultimate awful, awful shift.

Except.

As a hospital chaplain, one doesn't receive very many happy calls. But on this dreadful day there was one. And it was truly wonderful.

It was a nurse from one of the intensive care units. It seemed that her patient's daughter's wedding had been scheduled for that day. And the patient was still in an ICU and unable to go to the church, much less the reception. And so the dear bride unselfishly knew what to do. The nurse wanted me to tell her that it was okay to have a wedding in the waiting area outside the ICU; they would bring the patient from her room for the ceremony. I said that of course it was all right, but was she sure that was the right place? I suggested an alternate venue: the hospital chapel, a beautiful setting on the ground floor. Would the patient be able to be brought there for a 20-minute ceremony? Yes, she would. I told the nurse to let the nursing supervisor know what was going on and made a note to wander downstairs around two o'clock.

Shortly after one o'clock, there was a bit of a commotion in the lobby. Men in tuxedos, little girls in fairy princess flower girl dresses, a half dozen bridesmaids wearing cranberry dresses, and the bride, resplendent in her sparkling gem-studded dress, all shaking off snowflakes and providing their own flurry of activity had arrived and were heading up to visit the mother of the bride. They paused here and there for photos. And I was called away for another situation.

With a few minutes to spare, the latest awfulness was resolved, and I made my way to the chapel. The nursing supervisor was there, helping the bride and groom make the room their own. Photos were made of the couple at the altar with the snow falling in the window behind. "How can I help?" was my immediate question. The supervisor sent me up to the ICU to escort the wedding party to the ground floor. It took two elevators to hold all of us. Everyone was settled in place and soon the guest of honor arrived in her wheelchair with an oxygen pack and a nurse or two. And then it was time. Somehow the little organ began playing "Here Comes the Bride," and the four little flower girls and the ring bearer escorted the bride and her older brother into the chapel. I closed the door and became the self-appointed guard so that no one would disturb this magical moment.

So, the worst shift ever ultimately came to an end, as they all do. It will be a shift that will stay with me for a while. I'll forget the deaths, the impoverished sister, the traumas (but maybe not the shoes), the cardiac arrests and the codes. What I'll remember is the bride -- beautiful inside as well as out -- and those lovely young girls, tall and proud in their cranberry gowns, doing the right thing.

The Good Neighbor

It happened again on Saturday night. A too-young man experienced cardiac arrest, leaving behind a too-young widow and children: 10, 8, and 5. There's a slide show of images that plays through my mind: the tremendous efforts of the emergency room team, the stoicism of the patient's German mother, the sincerity of the in-charge physician, and the despair of the wife. The slide show tends to stick, however, when it comes to the response of Sandy, the next-door neighbor.

My experience is that humans are programmed against willingly taking responsibility for their failings. The preschooler who says he did not get into the chocolate cake, despite the icing evidence around his lips. The motorist who says, "It was yellow, officer. It wasn't red." "It wasn't my fault; don't blame me." We just do not want things to be our fault. It's how we're made.

And yet, I've seen it time and time again in our emergency room. A sudden death and the family member will say, "She wasn't feeling right all afternoon. I should have brought her here sooner." "I should never have let him go upstairs." "I should have checked on him earlier." This uncharacteristic claim of responsibility on the part of the bereaved, I think, is some mixed-up attempt of the psyche to buy back time, to get a do-over, to change history. A form of bargaining, a way to postpone accepting the unwelcome reality.

When we walked into the conference room, the two neighbors were anxiously waiting for good news. But it wasn't to be. The nurse told them, gently but clearly, that the patient had died. One of the women had done CPR at the scene. Her immediate response to the unhappy news was, "I should have done more! I should have continued the chest compressions! I should have . . . ." Taking the responsibility for this death upon herself. The wise nurse very, very quickly put a stop to it. "There is nothing you could have done that would have changed the outcome."

Sandy struggled to accept this. Then her thoughts turned to the practical. She telephoned her husband who was with the children, children who matched her own in ages. A plan was devised that he would take all of the kids inside and put on a movie. And after the movie, the kids would all have a sleep-over. Just like they often did. They'd have one more night of their normal lives, and their mother would somehow find a way to tell them in the morning. Sandy was organized, caring, decisive. She had tried to save the man's life and now she was protecting his children. Could anyone have a better neighbor?

I left the two women in the conference room to return to the wife and mother, to tell them of the plan for the children. The wife was doing the typical cycling from excruciating sorrow to attention to detail. She'd phoned her own mother. Her mother-in-law had called the patient's brother who was on his way to the hospital, coming from about an hour away. The pastor would be arriving in a few minutes. It would be okay for the neighbors to go home; she had enough support.

When I returned to the conference room, the other neighbor was holding Sandy in her arms. The families were so close, the loss so devastating. The organized, efficient Sandy had vanished. "I should have started the CPR sooner! I didn't do the chest compressions right! I could have done more!"

"No," I told her in a voice stronger than I knew I had at that moment. "You did nothing wrong. You did everything right. The outcome wouldn't have changed. Sandy, you gave him a chance."

I wonder if she'll ever believe me.