Thursday, August 30, 2007


You're elderly, and you look frail, but you're cheerful. I don't know why you're in the ED. When I introduce myself as the chaplain and ask if you'd like conversation, prayer, or a blanket, you brighten and ask for the blanket. And indeed, it's chilly in here. The staff, always on their feet and running, tend to keep the thermostats turned down to 55 degrees, forgetting how easily patients lying motionless on gurneys get cold.

I crank the thermostat up to 65 and get your blanket. When I give it to you, you beam up at me. "You're a sweetheart! Thank you!"

"Are you warm enough now? I can get you another one."

You hesitate. "Well, I'd like another . . . but I don't want to be greedy, and I know you're busy."

"It's no trouble at all," I tell you. When I give you the second blanket, you look as if you're about to weep with joy.

"You're an angel." I hear this a lot from patients when I give them blankets. Warm cotton makes people feel loved.

We chat about nothing in particular, until you ask me, politely, "Do you live in a hotel?"

"No," I answer, startled. "I don't. Do you live in a hotel?"

"Oh, no. I'm homeless." Your tone is still cheerful, matter-of-fact.

Concerned, I leave the room to find your doctor. Do we need to get you a shelter bed, or call social services? But the doctor shakes his head. "No, that patient lives in a group home. They tell me there are episodes of confusion."

I go back into your room. "You're not homeless," I tell you gently.

You cock your head. "I'm not?"

"No. You live in a group home. They sent you here to see the doctor."

"Really? A group home? What's that?"

"It's a place where people who need certain kinds of care live together, along with the people who take care of them."

"Oh, I see." You think a minute, and then frown up at me, anxious for the first time since I've met you. "Are they honest?"

I don't know any more about your living situation than you do, but you trust me to tell you about your life, for no other reason than that I've given you some blankets and talked to you. And so I find myself saying, "Oh, yes. It's a good place."

"That's good," you tell me, contented again.

But as I leave the room, I wonder if I said the right thing. I don't know if they're honest. I don't know anything about them. I told you what I wanted to be true, instead of what I knew to be true. When I told you that I knew your caretakers were honest, I wasn't being honest.

Why did I offer such facile reassurance? The truth would have been, "I don't know, but I hope so. They sent you here to make sure you were all right, so they seem to care about you and to be taking good care of you."

Why didn't I say that? You trusted me to tell you about your life, and I couldn't bear to seem less than trustworthy, so I lied. I couldn't bear to make the darkness through which you're navigating so calmly even deeper. In your place, I'd be terrified: terrified at not knowing, terrified at having to depend on the kindness of strangers. I marveled at your lack of fear, and I couldn't bear to give an answer that might frighten you.

And so all I can do now is pray that the lie I told you is, in fact, the truth.


  1. Anonymous9:19 PM

    It's a white lie of reassurance. Clearly it bothers you, so you must go to where he lives and see how it is.
    I would say it to someone who needed to hear it. How difficult would it be to check later?

  2. In fact, I'm in no position to check later; I don't know the name of the facility, and finding out at this distance (this happened quite a while ago) would be difficult even if it were appropriate . . . which I'm not sure it would be.

  3. You told her the best answer you knew at the level of detail she could comprehend. The second answer might have confused someone already having mental status issues. Your supposition was not wrong, given her demeanor implies someone *is* taking good care of her.

  4. Susan, my grandmother chose to be in a nursing home but soon forgot where she was and would often get confused. When she felt safe she really liked the place but changes upset her. I'm glad you were there to help that lady feel safe even if it was telling her something you didn't know for sure. We all have lives that have both good and bad things. I'm reasonably sure that when she is at her care facility there are at least some things she really enjoys. My grandmother liked having someone bath her.


  5. Susan,

    one can really only be judged on the intent of our words and our actions, and your intent was beautiful.

    The truth of the matter, if we can imagine to know your patient from the few written lines, is that she won't remember what it is you said to her. Such patients live from moment to moment (is it a blessing or a curse?) and the fact is that in the moment that you were with her, she felt safe. That's what really matters.


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