Wednesday, May 23, 2007
My hospital shift this week was, even more than most are, full of reminders of mortality: two patients who'd come to us from home hospice care; a patient who'll soon be in hospice care; a patient grieving the recent death of a beloved spouse; a patient, initially cheerful, who began weeping with worry over a son in Iraq; and a code (although that patient was alive when I left the hospital).
In August, I'm going to be the guest speaker at a three-hour med-school seminar on end-of-life issues. I'll be talking to the students about grief and leading them in some writing exercises about the subject. This shift was definitely material for that, but right now, I'm merely numb, unable to extract teaching moments. I'm glad that I have a few months before the seminar.
I keep reminding myself that there was balance in the shift, too: lots of cute little kids who loved the stuffed animals I gave them. I'd gone to the dollar store and stocked up on teddy bears and bunnies and handpuppets, and put each in a individual plastic bag so it would stay clean in the ED. I gave lots of those away, and the nurses gave some away, too.
Also, many patients requested prayer, and were exceptionally grateful for my presence. So in that sense, it was a good shift.
But I've been beating myself up over an unfortunate interaction I should have avoided. Near the end of the shift -- actually, a few minutes after I should already have left -- the family member of one of the dying patients asked to talk to me. This family had asked to see the chaplain when they arrived, and had repeatedly thanked me for my prayers whenever one of them saw me in the room or in the hall. So when the relative motioned me into a relatively quiet hallway, I was happy to oblige.
"Is anyone in your church pro-life? I'm very involved in that, and we're always looking for new people."
I shouldn't have let myself get pulled into a discussion, but I was tired, and I felt closer to this family than I have to many others. I should have said -- what should I have said? "It's not appropriate for me to discuss politics here"? "I'd love to talk, but I'm past due to go home"? I honestly don't know.
Instead, I tried to explain as respectfully as possible that a) I don't know where most people in my parish stand on the issue and b) while I'm profoundly ambivalent about the issue myself, I'm simply not comfortable denying legal access to safe, low-cost abortions.
Predictably, this unleashed a barrage of statistics from the relative, who wanted me to know just how many babies have been killed since abortion was legalized. I tried to explain that my focus tends to be on what we aren't doing, what we need to do, for kids who've already been born: homeless kids, hungry kids, uninsured kids. I talked about what a struggle it is for even my affluent friends to find affordable daycare.
This developed into an intense, moderately heated discussion, as medical staff walking past gave us mystified looks. It stayed respectful, though: we agreed that it's an incredibly complicated issue, and reassured each other that God loves all of us. Both of us tried to understand the other's point of view. At the very end, I told the relative, "Good luck. You're facing something very hard right now," and only then did it occur to me that at least some of the urgency about saving the unborn came from the relative's powerlessness to save the beloved patient.
Duh. Brilliant, Susan.
And how would I have responded differently if I'd realized that sooner? Probably I would have said, "It's awfully hard not to be able to save people, isn't it?" That was the subtext of the conversation anyway, but if I'd recognized it earlier, I might have been able to get the relative to talk about the more imminent loss, the immediate loss, and about the theological issues it raises for this very devout family.
Is this a teaching moment after all? The presentation of deferred grief in the relative of a dying patient?
Instead, I feel like I fell flat on my face and did a really bad job for someone in pain, although at least I learned from it. (Gotta love that 20/20 hindsight.) I'll be far more sensitive to this sort of dynamic in the future. That doesn't make me feel better about this interaction, though. I just have to trust that another chaplain, somewhere down the line, will be better at getting to the core issue.