Friday, February 29, 2008

Chaplain Rambo: A Mary Sue Fantasy

Note: This post is about domestic violence and abuse. If you're sensitive to triggers, please be forewarned.

This week at the hospital, I learned that dying, or learning that you're going to die, isn't the saddest thing in the world. The people weeping around your bedside are devastated, but that's because you lived a full life, because you loved and were loved. Loving and being loved is cause for joy, even or especially in darkness.

The saddest thing in the world is the person who's never had a chance to live: the person who's been beaten down for so many decades that there's almost no self left, the person who's learned to live with being punched and kicked and insulted, because "that's all I have, and I'm too old, and where else can I go?"

The saddest thing in the world is when the ED staff says, with one voice, "We can send you to a shelter!" and you tell them, "I'm too scared, I'm too scared, I want to go home!" And when the ED staff says, "You can press charges," you say, "No, I can't. I'll be killed. I've been promised that." And when the chaplain asks the ED manager if there's any way for the staff to press charges, the manager says no, there isn't: not unless the injuries are life-threatening.

How much brutality does it take to threaten a life?

The saddest thing in the world is when the only home you know is one where you aren't allowed to have friends, because your partner's bigger than you are, and has forbidden it; where you aren't allowed to go to movies, because your partner has forbidden it; where it takes untold courage even to give your neighbors a Christmas card (sneaking, whispering, "you mustn't say I did this!"), because your partner has forbidden it.

The saddest thing in the world is defending a partner who's "nice sometimes," who occasionally buys you "oranges if they're cheap enough." The saddest thing in the world is having only ever had one person who loved you enough to defend you from swinging fists (but that was when you were a small child, and your defender's long dead).

The saddest thing in the world is when you have to tell the hospital chaplain, "I drink because then it doesn't hurt so much when I get hit."

The saddest thing in the world, for the chaplain, is watching you leave AMA, clutching the list of shelters the social workers have given you. You've told us you're going to stay with a kind relative. We all think you're lying. We all think you're going back to the partner who's killing you. There's nothing we can do about it.

And the chaplain, watching you leave, watches the doctor and nurses and social workers retreat into the brisk indifference they have to cultivate, the detachment that allows them to survive dealing with things like this day after day, hour after hour. The chaplain can't detach. The chaplain vents to various staff, seeing in their glazed eyes that she's making their own detachment more difficult, making their jobs harder.

The chaplain feels utterly miserable.

And the chaplain concocts a wish, a fantasy. The chaplain wishes that, when you were begging us not to let your partner into the ED, when you were asking frantically how many locked doors there were -- the chaplain wishes the partner had shown up. The chaplain thinks about how she would have blocked the doorway to your room, would have stood there with her hands braced against the doorframe. The chaplain thinks about how she would have told your partner, "If you so much as touch me, you're going to jail, and that's a guarantee." The hospital has very little tolerance for people who threaten staff, even volunteers.

The chaplain knows this is a dangerous, stupid fantasy, and knows further that if it came down to it, there's no guarantee that she wouldn't have buckled in terror. The chaplain knows that her supervisors would thoroughly disapprove of this plan, that it could even cost her the volunteer job she loves so much.

She nourishes the fantasy anyway.

And meanwhile, she prays for you, remembering the doctor who said -- with glazed eyes, sounding bored and detached and barely polite -- "Oh, well. I guess all you can do here is pray. That's something, right?"


  1. Anonymous12:10 PM

    As a teacher ones sometimes gets these kinds of fantasies also. Not with cases this extreme (because we do get to, are mandated to, report) - but similar enough that one recognizes the fantasy. I'm sorry for, and praying for, everyone.


  2. Thanks, Kristen. Hospital personnel are mandated reporters for child abuse and elder abuse, but (I guess) not for people who fall in the middle.

    I thought the DV laws had been changed so the victim didn't have to press charges for the abuser to be locked up. I guess it's only cops who can do that, in the actual moment.

  3. Anonymous3:15 PM

    It may be all any of us can do, but if we do it, well, prayers do get answered, don't they. Let's pray that person learns they don't have to be abused.


  4. I'm a chaplain intern in a state mental hospital. The story you tell is too familiar. The woman--and it's usually a woman--has lost all sense of value between her mental illness and lifelong abuse.

  5. I can't imagine Arizona is any different that the rest of the world, but we are required to ask if the police were at the scene of anything we believe to be a crime, and call them if not...

    And they HAVE to arrest someone if a domestic violence has caused an injury. I've seen it too many times, where both partners are drunk, one hits the other requiring stitches, and, despite the other spouse begging not to, the "hitter" goes away for the night wearing shiny matching bracelets

  6. John -- That was how I thought and hoped it worked here, too, but the ED manager said that we can't release a patient's name to the police without that person's permission. We can advise people to press charges (as we certainly did in this case) but can't do it ourselves unless it's a life-threatening injury -- which I persist in believing remains, in this kind of situation, a very fuzzy category.

    Maggie: So how do you handle these cases? I was doing as much ego-boosting as I could think of, combined with frequent repetitions of "God loves you, and you don't deserve to be hurt, and everyone here at the hospital wants you to be happy." I asked the patient, "What makes you happy?" and got a delighted smile and a long list. One item was drawing, so I got crayons and some paper and said, "Please draw me a picture. I'll take it home and hang it up, and everytime I look at it, I'll pray for you." (The picture's hanging on my filing cabinet right now.) When I think patients don't value themselves, asking them to do something for me -- pray, draw, whatever -- sometimes helps, I think. "I value this thing you've done, and I need your gift." Often they respond to that.

    All I can hope is that I (and the social workers and the nurses and the doctor) have planted a seed. But I very much doubt that it's the first time this scene has played out.

  7. I've only had to make a phone call to the state twice so far, and neither call was technically my patient (given that I'm still a student). But I think for me the saddest part has been when the social worker for the state calls me back later and says, "frankly, there's nothing we can really do - there's just not enough evidence...." That's what kills me.

  8. You might want to check on Arizona law, as the ED manager might be wrong. There are cases where HIPAA is trumped...


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