Saturday, October 14, 2006

Reaching Out

You should be old enough to walk, I think -- I don't know much about babies -- but you aren't walking. Part of that's because your leg's hurt, which is why you're at the hospital. Someone at home hurt you, so you don't live at home anymore. The state got you out of there, and now you're being cared for by strangers.

The caregiver who brings you in clearly does care about you, and so does everybody else. The registration clerk cuddles you and coos; nurses want to hold you; the doctor tousles your hair, which makes you laugh. You don't seem to be in pain. The dressing on your leg needs to be changed, which is why you're here, but you're alert, looking around. Whenever you see a smiling face, especially a woman's, you reach out for that person.

One of your arms is hurt, too.

I smile at you as your caregiver holds you, so you stretch your arms towards me and whimper imperiously until the caregiver hands you to me. As I hold you -- carefully and awkwardly, because I don't have kids and never learned that balance-the-baby-on-the-hip thing that's supposed to come instinctively to women -- you start playing with my earrings, my ID badge, my necklace. You tug on my glasses, just like every other kid your age I've ever held, just like any kid who hasn't been hurt (badly hurt, deliberately hurt) by adults.

I wonder how you can trust big people, after what's happened to you. No one's ever hurt me the way you've been hurt, and even so, I'm not as trusting as you are. I don't know if I ever have been. When people hurt me even a little bit, I withdraw, shut down, build walls. My heart is calloused, and I protect it. I believe in and talk about and try to follow a God of love, but even so, I don't stretch out my arms to other people the way you do: not even to people I know. I reach out to give comfort -- that's why I'm at the hospital tonight, after all -- but much less often to receive it. I'm too afraid that I'll be left there, reaching; too afraid that I'll be ignored or, worse, slapped away.

I recently read a fascinating New York Times article about the biology of emotional healing. It turns out that our brains "mirror" those of the people we're with, which means that our emotional states -- and resulting physical states such as blood pressure -- tend to become synchronized. This helps explain why people with large, loving networks of family and friends live longer and recover more quickly from illness, and it's why visitors are so important to people in the hospital. "Sheldon Cohen, a psychologist at Carnegie-Mellon University who studies the effects of personal connections on health, emphasizes that a hospital patient’s family and friends help just by visiting, whether or not they quite know what to say." In contrast, "Social rejection activates the very zones of the brain that generate, among other things, the sting of physical pain."

Visits from loved ones are better than visits from strangers:
A case in point is a functional magnetic resonance imaging study of women awaiting an electric shock. When the women endured their apprehension alone, activity in neural regions that incite stress hormones and anxiety was heightened. As James A. Coan reported last year in an article in Psychophysiology, when a stranger held the subject’s hand as she waited, she found little relief. When her husband held her hand, she not only felt calm, but her brain circuitry quieted, revealing the biology of emotional rescue.
I think about all the lonely people I've visited in the ER: elderly patients careflighted in from hundreds of miles away, who have no family; homeless alcoholics; suicidal patients convinced that no one cares about them. I often suspect that some of these patients come to the ER, consciously or not, partly simply for the comfort of attention from other people, even if those people are overworked medical staff. Comfort from family is better than comfort from strangers, but comfort from strangers is better than being alone.

I always try to spend extra time with these patients. I can all too easily imagine being an old woman alone in an ER, desperate for human contact. I try to give lonely patients what I'd want if I were in their situation: someone to talk to, someone who cares about what's happening to them, even if that person's a stranger.

Sometimes, it's obvious how these patients have wound up alone. Just listening to them, you can see how they've made themselves unwelcome. You can imagine how their hurt, frustrated relatives and friends might tell the story. "We tried to be there for her, but she made it impossible. He's just too unpleasant. She forced us to walk away." Some patients only reach out to push other people away.

But some of these patients reach out for love, just like you do now, with your hurt arm and hurt leg. Some of them have that magical gift of being able to turn strangers into friends and advocates, even during a brief ER visit. They do this even though they aren't babies anymore, even though they aren't cute and innocent, even though protecting and comforting them isn't the appalled, instinctive first reaction of everyone who sees them.

We have to hold you down, to change the dressing. The PA asks me to help, because I'm there and you seem to like me. I hold you down, and you reach up to play with my ID badge. An EMT is holding you down, too, and he's made a little toy out of a gauze bandage. He tickles you with it when you turn towards him.

You're happy with the gauze toy and the ID badge. You hardly cry at all: only a little, at the end, even though what the PA's doing has to hurt. I don't want to think about how you've learned to stay quiet during pain. I don't want to think about how anyone could hurt a child who's so quiet, so alert, so loving.

After you've left, I talk to one of the nurses. We wonder what will happen to you. I'm trying to be optimistic; at least you're safe now. The nurse shakes his head, because he can't see any good outcomes. We can't want you to go back to your parents -- although I find myself praying for them, praying they'll recover from whatever made them do this to you, praying that somehow everything will work out -- but the alternatives are grim. "Foster care," the nurse says, his voice tight, and shakes his head again.

I think again about the hard cases I've seen here, the people who are alone, who've driven everyone away, who have nothing. Broken down addicts. Dying alcoholics. They were children once, too. They were probably as cute as you are. Maybe they reached out to strangers, before life hurt them too much and they stopped.

So this is my prayer for you, child: May you never stop reaching out. May you never forget how to transform strangers into friends. Although you probably won't remember all the love you received here tonight, may that love have seeped into your tissues, into your cells, into the nooks and crannies of your brain. May it be your blanket against the cold; may it cushion your heart from callouses.

May you never feel alone.


  1. Susan, I'm sorry you had to go through an evening like that. I'm also glad you were there for that little one. This is a beautiful post. Thank you for sharing it.


  2. My heart goes out to that young soul, and to all who do and should nurture them. May they all know light and joy. Thank you for demionstrating that each moment is a brand new day, filled to overflowing with possibilities.

  3. Thanks, Lee and Martyn. (Or should I say, You're welcome?)

  4. And thank you for that lovely prayer at the end and for being there for that little one.


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