off call - chaplain

A few weeks ago, Steve's friend Vito called.  He had just gotten a great suit for 75% off and thought Steve should go look.  Steve told me "the way the world's going I'm going to need a dark suit soon."  Whatever.   I'm all for a handsome man suited up for whatever reason.  By nightfall Steve had an amazingly priced, beautiful suit.


But now, every once in a while, I wonder....when is he going to have to wear the beautiful suit?  A call will come.  From whom?  Someone.  Our hearts will sink.  The suit will come out of the closet.


Tonight Steve got a phone call from a friend, telling him that another friend just got home from an oncologist.  The test showed cancer has spread all over his chest.  Terminal.  This man is younger than Steve.  He has little children.


No.  Oh no.  Is this the suit?


I watched Steve on the phone.  Shock.  Then horror.  Then such sadness.  And helplessness.  Unchecked tears.  I thought about how different those hospital words sound when uttered in my living room.  Go away bad words.  Every day I console strangers who have just heard those words.  But here, in my house,  I don't know what to say.  So I told Steve "If I had my white coat on, and we were sitting in a consult room I would be really comforting."  Then I put my head on his shoulder and we sat quietly.


We have no might against this great company that cometh against us; neither know we what to do: but our eyes are upon Thee.  2 Chronicles 20:12 KJV

reunion

My morning started with a page.  Trauma.  MVA.  18mo.  Oh dear.  Not a baby.  I rushed out of the on-call room.  At the elevator I was interrupted with another page.  I stepped into the nurses station to call.  It was the ER greeter.  "I have a Mr. Green here.  Could you escort him back to be with his family?"  This happens all the time.  I told her I was heading to a trauma, but as soon as I could get away I would come help Mr. Green. 


A minute later I was almost to the trauma bay.  I could hear loud crying, presumably from the 18 month old.  But before I could get through the door, an ambulance man stopped me.  "Hey, I really need some help.  Can you come with me?"  What?  But no one else was around so I followed him out the doors and up to an ambulance.  


He swung the doors open and suddenly I was looking at a blood sprinkled family.  A mom, a baby, and two children.  The little girl was holding her arm to her chest.  The little boy had a medium sized cut over his eye that was bleeding.   The baby was wide eyed and unharmed.  The mom just wanted to get inside to be with her 18 month old who had gotten the brunt of the wreck.  She was wheeled in, with the assurance that we would be with the other three.  We pulled the kids out of the ambulance and onto a stretcher and wheeled them inside.  They were shook up.  I had them tell me about the wreck while a nurse checked them over.  I told them their mom was just in the next room and would be right back.  I asked for a couple blankets.


Then the boy said "I thought my dad would come fast.  My mom called him as soon as it happened."  Your dad?  Oh no.  "What is your last name?"  "Green."


I left the kids with a nurse and literally ran to the front desk.  Poor, frantic Mr. Green was pacing.  Scared out of his mind.  I brought him to his three kids.  Then to his wife.  Then to stand near his 18 month old who was getting a CT scan.  I was so moved watching his worry and relief and concern.   His tight hugs followed by careful once overs.  His furrowed brow and comforting smile. The huge amount of love evident in so few words.  Reunion.


And then Jerry showed up to relieve me for morning report.  All of a sudden I was quietly walking alone back to the office.  But I couldn't shake this family.   It wasn't until the next morning that I found out that everything turned out OK for the Green family.

 I go and make ready a place for you, I will come back again and will take you to Myself, that where I am you may be also.  John 14:3 Amplified Bible

glue

I was two steps behind the doctor as we hurried into the consultation room.  3 men and 1 woman sat waiting.  The doctor jumped in.  "I'm so sorry Ma'am, I have bad news.  James didn't make it." 


That is a horrible moment.  To witness that shock, the unbelief, the confusion. Wild grief is volatile and unpredictable.  It is hard to be with someone on that roller coaster.  To listen as she calls her daughter and his brother and is hardly able to speak.  To have her look at me and ask "what happened again?" To put my hand on her shaking arm willing her strength.  That intensity of grief is contagious.  I had to remind myself "this is not you."


Soon the doctor left us alone and over the next two hours the story unfolded with weeping and laughter.


The three men and James had worked together for years in an industrial adhesive company.  One look at my confused face and they admitted "Ok, it's a glue factory....but without the horses." We all cracked up.


James had been a widower for many years and work was his whole life.  These men were his family and buddies for long shifts every week.


His only other outlet was online poker.  He played in the evenings and on the weekends.  One day he played against Joan.  She beat him.  After the game they kept chatting.


Within 3 months Joan had moved to Spartanburg.  In one year they had married.  "We were old and we knew what we wanted," Joan told us.  The factory buddies told her that James had never been as happy as he was these last two years.  The kleenex box was passed around the room.


The men began to tell Joan work stories.  Like the time James crashed the fork lift.  The practical jokes he liked to play on Smith.  How willing he was to switch shifts when one of them needed to. How he knew everything about an assembly line but couldn't change the oil on his truck to save his life.  How everyday he had two ham sandwiches for lunch.  "Who do you think has been making those stupid sandwiches for the last two years?" Joan piped up.


Then it was her turn to talk.  About the trip they were planning.  About the little tidbits from these men's lives she'd picked up as James talked about his day.


The coroner came in needing details of James' collapse at work.  The day was dissected.  From the moment James said he needed to get a little fresh air, to when he started vomiting, to when he borrowed a phone to call Joan, ("he said he loved me and would call back when he caught his breath") to when he passed out.


Suddenly two hours had passed.  Family members were arriving. These strangers had become friends.  I loved these earnest men giving Joan their phone numbers and promising food and transportation and friendship.  I loved this grieving woman, hugging me tightly,  who had, until today, been enjoying a second chance at true love.  Somehow, in that little room,  we had all gotten her through the worst two hours of her life.


Out in the hall I passed a nurse who looked at me sympathetically and said "wow, you have such a horrible job."  Yeah.  Horrible. And yet wonderful too.  Tonight I got to be part of the glue that held this group together.


God existed before anything else, and God holds all creation together.  Colossians 1:17

paying respect

Day after day, census after census, visit after visit, room after room. My feet are dragging. And then I step into someone's life or someone's death and realize that this experience is momentous and unforgettable and fresh for them.  They are not just another name on a list, but a full story, a valued and loved human being.


I am astounded by the level of respect and dignity that is practiced in every hall in this hospital.

I stood in an ICU doorway and watched a nurse working with an unconscious patient.  She talked to him in a soft, confident tone.  "Mr. Jones, I am going to have to take a little blood.  I'm going to try to get it from your vein right here.  It will only sting for one second....There we go, good job."  Mr. Jones never blinked or winced or moved.  But it was obvious that she was aware of him as a person.

I shadowed my supervisor on several visits.  In two rooms the patients were unresponsive.  In both rooms he walked over to the patient first, touched them, introduced himself and called them by name before turning to talk to the families.  When the families wanted prayer, he went back to the bed and included the patients in the prayer time.

Our hospice house has the most beautiful tradition of honor.  When patients come in they are told "you will not be slipped out the back door.  When you die you will go out the same door you came in."  After a patient has died, their family chooses a song that represents them - Country, Gospel, Opera, whatever.  A special hospice quilt is placed over the patient.  A single rose lays on their chest. As the patient's song fills the air, all employees and any available guests stand in the great room and form a path that the patient is wheeled through right to the front door.  I am moved every time I am a part of it. 


Honor, dignity, value, respect.  Because you are a human being.  A child of God.  A gift.  And I am too.

For I am the Lord, your God,.....you are precious to me. You are honored, and I love you.  Do not be afraid, for I am with you.  Isaiah 43:3-5 NLT

down down down

During busy on-call nights I spend a lot of time in the elevator.  I push the #1 button for first floor and wait for the inevitable, robotic words - "Going Down".  Sometimes I don't  even hear them.  But on dark nights, with many trips to the ER and Onc, when I'm already tired and overwhelmed, when there have been too many weepy verbatims and too few weekends, the elevator voice feels prophetic.  "Erin, you are going down."

Our supervisor continues to remind us of the riches to be mined from down times. That we need to befriend the darkness.  William James refers to..."the blessing of the "twice born", those who have experienced real distress in their lives and yet have managed to make meaning from that experience.  Because of their experiences, these "twice born" understand and embrace the richness of life that incorporates suffering.  Those who have suffered are often more sensitive to and compassionate with others who are suffering."

Here's to hoping that going down gets us somewhere better!

And God is able to make all grace abound to you, so that in all things at all times, having all that you need, you will abound in every good work. 2 Corinthians 9:8 NIV

bear hunting

Today I spent 30 minutes with a real live bear hunter!  As he lay alone in a tiny room, troubled by intestinal problems, he was eager to talk.  Dentist by day, bear tracker by night, this elderly gentleman from east Tennessee regaled me with tales of hunts and dogs and 45 caliber guns.  One night he was walking in the woods when he heard his coons baying.  He went running in the direction of the noise and fell off a small precipice.  The 15 foot fall was cushioned by a thicket, but when he finally hit the ground he landed on one of his dogs - 10 feet from the cornered bear.  He told me about a bear's distinct smell. "Like the smell of a mother wart hog foaming at the mouth." (Oh so thats what it smells like..) From his fallen position he aimed his gun and in two shots the bear was dead.  


One of his coons had been "gutted" by the bear, but they were standing on a rock, so the exposed guts had not been dragged through dirt or leaves.  With a needle, thread and a flashlight, the bear hunter put the dog together and sewed the 1 ft gash closed.  Then the hunter and his dogs hiked back to the lodge.  Yep.  That's the terrifying tale he told me.


Everybody has a story.  I talked to a marriage counselor who barely lived through a motorcycle wreck, yet gave relationship advice to the paramedic who sat with him all the way to the hospital.  I talked with a man who worked for a local mill for 70 years.  A Greek woman whose restaurant business family moved to Spartanburg in 1925.  They had to learn to cook American diner food because people here wanted hamburgers and pecan pie not baklava or moussaka.  I've talked to several chaplains who were experiencing the other side of the hospital experience.  I've listened to drug addicts who kept telling me that they were totally equipped to deal with a premie baby.  In every room there are great stories waiting to be shared if the opportunity and prompting is given.


Every day I am surprised by the levels of love, commitment, disfunction and courage I encounter.  I'm also learning to see a piece of myself in every story.  Watch out bears!


Listen, dear friends, to God's truth, bend your ears to what I tell you.  I'm chewing on the morsel of a proverb; I'll let you in on the sweet old truths, Stories we heard from our fathers, counsel we learned at our mother's knee. We're not keeping this to ourselves, we're passing it along to the next generation— God's fame and fortune, the marvelous things he has done. Psalms 78:1-4 The Message

triage

20:01 code trauma male 79 mvc
20:05 code trauma male 30 burn
20:06 code red - fire first floor
20:09 code trauma male 53 femur
20:10 code trauma alert female 51 mvc
20:13 code trauma male 45 mvc
20:14 code blue icu
20:19 death neuro

I like this definition -triage: the sorting of and allocation of treatment to patients and especially battle and disaster victims according to a system of priorities designed to maximize the number of survivors.  


I've always thought of that word in terms of long ago or far away battle fields.  But tonight when the pager went crazy I found myself making choices, determining priorities and running back and forth between trauma bays and consult rooms trying to decide the urgency of pastoral care needed.  The mass of medical personnel, blaring fire alarms and blinking lights added to the excitement.  The distorted femur on one man and the peeled back skin on another added to the drama.


I went from crying with a family bent over in grief at the loss of their matriarch to rejoicing with a family who's father survived a horrible wreck with only a few broken ribs.  The traumas were stabilized and then sent to major care or ICU.  The burn victim was flown to the burn center.  The grieving family went home.  My little parts were done.


22:17 quiet

God is a safe place to hide, ready to help when we need him. We stand fearless at the cliff-edge of doom, courageous in seastorm and earthquake, Before the rush and roar of oceans, the tremors that shift mountains.  Jacob-wrestling God fights for us, God-of-Angel-Armies protects us. Psalms 46:1-3 The Message

thankful

no sun.  cold snow.  on call every four days.  and busy, busy nights.  traumas and codes and deaths and visits that run into each other.   ICUs and ER have become familiar and well worn.  I'm always tired.  We were warned about this season.  But now that the externs are here and beginning to train, it seems almost unbearable to hang in there til February.


I have to intently focus on the things I am grateful for.  At the hospital here are a few I thought of today:
       The whole, regular size tube of toothpaste that I finally gave in and brought to leave in the on call room.  No more squeezing the last drop out of a travel size.  I can brush my teeth in style.
       Marsha, the wonderful breakfast lady, sees me coming and hands me a to-go box with a hot, hard boiled egg in it.  I don't even have to wait in line.
       The seven externs here to work weekends and who look at us like we are wise sages - The Residents Who Know All.  It reminds me of how much we have learned and its fun to be one of the smart ones for a little bit.
       Jerry, our volunteer chaplain, brings "mouth watering*" meat recipes in regularly, thinking it might tempt me to abandon vegetarianism.  It doesn't.  But I love his enthusiasm.
       Our rolling chairs that allow Cathie, Vicki, Nathan and me to spin around from our computers, form a circle and talk about Manek Kolah, the variety of EC greeters, paganism, 2 Corinthians 12:9, books we want to read, and blogs we need to write.


And out of the hospital I'm thankful every day for my ear piece that keeps me connected to Karen in the land of warmth, and Jenn in the frozen Asheville.  I'm thankful that the Black Eyed Peas "...gotta feeling" that pumps me up.  I'm thankful for my Mad Men dvd's and that some genius invented hot chocolate.  And I'm thankful for my three Miller Men who make every minute of the daily two and a half hour of commute totally worth it.


See, who said January was so bad?

Never stop praying.  Be thankful in all circumstances, for this is God’s will for you who belong to Christ Jesus  1 Thessalonians 5:17,18 NLT

*you know how right before you throw up your mouth waters?

new

Jan 1.  2010.  I am walking the quiet halls of the hospital, far away from Time Square, from party hats and bubbly, from boisterous countdowns and resolutions.
But it is a new year.  I am reminded of the creation story.  In pastoral theology and at bedsides we have talked about it.  It reads differently in the hospital.

 ¹ In the beginning God created the heavens and the earth.
     I like the feeling that for a little bit everything was perfect.  No brokenness or pain. That God had a plan and everything went His way.  I like the security I feel when I picture Him being bigger than all the heavens and all the earth.
 ² Now the earth was formless and empty, darkness was over the surface of the deep, and the Spirit of God was hovering over the waters.
    Was it as formless as the grief that flowed out of the chest pain center consult room tonight?  Was it as empty as the hearts of the parents who walked out of NICU without a baby? Was it as dark as the future of the boy who caused the accident?  And if so, how can I help all these people to feel that the Spirit of God still hovers?
   ³ And God said, "Let there be light," and there was light. ⁴ God saw that the light was good, and He separated the light from the darkness.  
Even in these dark rooms there is a lot of light.  For some families it is Jesus, plain and simple. For some it is faith in God's sovereignty, or their religious tradition.  For some it is the blessed hope of an eternal future that lights their darkness.  For others the glow comes from the love of family and friends.
^5...And there was evening, there always is in the hospital.
and there was morning make it soon Jesus.
- the first day.  Happy New Year!


God, make a fresh start in me, shape a Genesis week from the chaos of my life.  Psalms 51:7  The Message