Saturday, May 16, 2009
Heckuvaday, Part I
In Which Life Imitates Television
Y'know those TV hospital shows where everything's always going wrong at once? In the ER, three patients are dying at the same time while three others have gotten into a fistfight, and upstairs two newly-divorced-from-each-other surgeons are trying to separate conjoined twins while on the roof, a desperate husband holds hostage the Care Flight crew because his wife has to be coptered to another, fancier hospital now, and the SWAT team is climbing up the side of the hospital to intercept the husband when one of them has an asthma attack, requiring a heroic intern -- the one whose affair with one of the surgeons precipitated the divorce, and who's also deathly afraid of heights -- to climb out on a ledge to administer a breathing treatment, and meanwhile there's a fire in the administrative offices that's trapped the CEO and the President of the Board, who've been feuding for months, in the same closet, and the fire has also blown out the power in the NICU, where noble, harried doctors and nurses are agonizing over which tiny babies they'll save by blowing air through drinking straws, since the backup generator's failed and none of the respirators are working? And through all this, there's nary a chaplain to be found, because hospital TV shows have never heard of chaplains, not even Scrubs, which is set in Sacred Heart Hospital?
Yeah, you've seen that episode. More than once, probably.
My shift this morning wasn't quite that dramatic, but it's as close as I've ever gotten. It started as just another sleepy weekend-morning shift; for the first hour, I didn't do much except restock the blanket warmers and speak to a couple of patients. Then a few more drifted in. I was having a pleasant chat with a delusional patient (whose reality sounded like the aforementioned TV episode, but who was extremely polite and coherent) when the fire alarms went off. I went into the hall to see what was going on. Apparently there was a fire in the hospital kitchen. The ER staff matter-of-factly closed all the doors in the department and kept about their business, although the fire alarm -- which consists of an ear-splitting klaxon and miniature strobe lights blinking above each doorway -- made it really hard to think straight.
While I was out in the hallway, I saw a group of staff outside one of the trauma rooms. I went to investigate. Sure enough, a patient had been brought in by ambulance and was coding. A nurse told me that family was coming in.
I ran back to the delusional patient's room, concerned that the noise and lights might have triggered panic, but the patient was calm and cheerful. So I returned to the trauma room and watched the code, as the klaxon wailed and the strobe lights gave the ER the aspect of a surreal disco club. One tech, standing on a stool for height and leverage, had just spelled another to do chest compressions when I turned and saw five or six firemen clad in full protective gear, including large scuba tanks, trooping through the back of the ER on their way to the kitchen. I think that was when I thought, Is this a TV episode, or what?
The klaxon and disco lights finally stopped shortly before the patient died, which in turn occurred shortly before the family got there. I was sent into the waiting room to speak to the family, but because I'm not supposed to tell people their loved ones have died -- that's the doctor's job -- I made somewhat strained small talk until the nurse motioned us back into the department.
"How're they doing?" she asked me in a whisper.
"They don't know! I didn't tell them! The doctor has to do that."
We ushered the family into an empty room just as the case manager came up to me and said, "There's been a death upstairs. The family wants to talk to somebody."
I blinked and gestured at the first family. "When you have time," the case manager said.
I went in and joined the family, who were starting to get alarmed, especially when the nurse brought in a box of tissues. The doctor came in, looking frazzled and slightly annoyed -- I think he'd been hoping that I'd tell them -- and gave them the news. The family took it better than we'd all feared. They didn't cry. The nurse cried. I was sad, but didn't cry.
The family said they didn't need my services, so I went upstairs to talk to the second bereaved family, who'd asked for my services. I prayed with them and talked about grief and listened to their pain. I shared (very briefly) some of my own experiences from my father's death, and one of the relatives nodded emphatically. I think we found common ground.
On my way back down to the ER, a nurse stopped me and said, "We have a patient who's just gotten a bad diagnosis. The family's very upset. Can you talk to them?"
I spent about twenty minutes with that family, although the nurse was really doing a much better job of pastoral support than I was. The diagnosis was life-changing, but not fatal (a relief to me after the previous two episodes, but not much comfort, at that moment, to the family).
Oh, and while all of this was going on, another chaplain -- a specific professional chaplain, not yours truly -- kept being paged to the ER entrance, and every other person I saw asked me, "Are you Chaplain _______?" and I kept saying, "No, I'm not Chaplain ______" and showing them my name tag. I would have gone to the ER entrance anyway, to find out what was going on, except that I had too much else to do, and by the time I had time again, whatever had happened was evidently over.
I got back downstairs forty minutes before the end of my shift, having not even visited half the ER patients yet. I zipped around the department and saw most of them, I think, before I left. A lot of people wanted prayer, but nothing was quite as dire as the earlier sequence.
Amid all that loss and pain, what hit me hardest was walking into a room and seeing a patient (alert, cheerful, not terribly sick) who looked like my father. He had the same eyebrows.
Last week things were very slow, and I wondered what I was doing there. This week, I didn't wonder that at all. I'm glad I was there. I hope the families were, too. As stressful a shift as it was, it was also intensely satisfying.
But I really, really hope that nothing like that first paragraph ever happens at My Hospital.