Beep . . . beep . . . beep. . . beep . . . beep . . .beep.
The effect of the sound, when it comes at 1:55 or 2:13 or 3:01 in the morning, is little different than that of a dentist's needle finding a nerve. Its message is clear: Emergency . . , Tragedy ... A family has been visited by death and needs my services. In my half stupor 1 complain. I need to sleep. Is it asking too much to want to get through the night without a call?
At once another side of my brain says, This is death time. This is their time how can you drowse? A minute more for you? Sleep's mercy may not visit them for days.
I chide myself for my annoyance.
"We've had an expiration on 5-East, station 1," says the voice on the phone.
An expiration. Even nurses sometimes have a hard time calling it by name. It's not an "expiration." It's a death.
It is Mr. Schreiver, 51. Critically ill a few days ago--thought to have been recovering. Not expected to die. Mrs. Schreiver and two sons, 18 and 23, were visiting until 9:00 last night.
I dial the home number, but not before a missed heartbeat and a prayer.
Two rings, three, four, and five. I know on the third ring a suddenly alert wife is thinking, A telephone call at this time means . . .
On the fifth ring I can sense a trembling hand on the receiver, a panicking mind trying to convince itself that this is a wrong-number call.
"Hello?"
"Is this Mrs. Schreiver?"
"Yes."
"This is Chaplain Gallagher at Porter Memorial Hospital. I'm afraid I do not have good news for you. About 15 minutes ago your husband developed some serious complications. We're not sure yet what caused the problem. . . . Are your sons at home with you now?"
"My younger boy is here. . . . How is my husband, Chaplain? Is he going to be all right?" "I'm sorry, Mrs. Schreiver; I have to tell you he didn't make it. The doctor and nurses did what they could, but he did not respond. Your husband has died."
The moment that follows is filled with a lifetime.
"Thank you, Chaplain. Thank you."
Numbness, grief's anesthesia, has taken her by the hand. I hope it will lead her to readiness for pain.
"Will you be coming in?"
"Yes; I'll come right away."
"Do you have someone to drive you?"
"Yes, I can get someone to drive me."
Many chaplains complete a training program called CPE, clinical pastoral education. It's an emotionally grueling program that drags out for scrutiny your perceptions of God, of your inner self, of justice, and of death. There are times during the course and the subsequent examination when you wonder whether God has much to do with the other three items. And if He does, what kind of God He is. You go into the program with what you think are the right answers; you emerge with only some of the right questions.
Chaplains learn early to avoid answers that antagonize: "Everything will be all right." "Don't cry. You'll be OK if you keep trusting the Lord." "It happened for a purpose." "God needed your loved one more than you do." "I understand just how you feel."
Such expressions may be well-meant, but they hit the grieving as pitiless assumptions, building anger on sorrow.
Chaplains leam that an arm around the shoulder and a simple "I'm sorry" is, in these situations, the pinnacle of theology.
Does God still love me?
As I enter Miss Dreyton's room, I see that she lies weeping in her hospital bed. It is 2:00 a.m.; her nurse called me. The nurse hurts for Miss Drey ton I sense it in her voice.
"Miss Dreyton? My name is Ed. I'm a chaplain. Can I talk with you for a little while?"
"Yes, please talk with me."
"Your nurse tells me you are very ill. I'm sorry to hear that."
"Can you tell me, Chaplain, does God still love me?"
I am not prepared for the question. She continues. "I've been a teacher all my life. I've never been married or had any family. My whole life has been with the children in school. Chaplain, I have really loved them! But now I'm sick; I can't move or read or look after myself, and the doctor says it may be a very long time before I'm well. I've always tried to live a good life, and I've always believed in God, in Jesus Christ. But now I'm not sure. ... I wish I knew whether God still loves me."
This hospital is one of hundreds in the United States run by Christian organizations. Many of our patients are from Christian backgrounds; others are Jewish, some Muslim, and some claim no religious faith or interest. Chaplains must be responsive to all: they can't help letting their own faith guide them, but they cannot be proselytizers.
I take Miss Dreyton's hand in mine. She does not know it, but in my helplessness I visualize placing my hand in God's.
"Do you remember reading about the crucifixion of Jesus? I'm not sure I fully understand what happened there, but the thing that stands out most for me is when Jesus said, 'My God, My God, why have You forsaken Me?'
Do you think God had forsaken Him?"
Miss Dreyton's eyes glisten in the dim, reflected light.
"No, I don't think God had forsaken Him--but I'm sure He felt like it."
"You know, I have a feeling that God might have been closer to His Son right then than He had ever been before. What do you think?"
"I think He was."
"If that had been the last thing Jesus said on the cross, I'd be very unhappy, wouldn't you?"
Miss Dreyton smiles, a lovely smile that children would like.
"Do you remember what He said last of all on the cross?"
"I think it was, 'Father, into Thy hands I commend My spirit.' "
"That was it. Miss Dreyton, I think you have every right to feel as though God has forsaken you. I would probably feel the same way if I were in your place right now. The important thing is, God feels for us when we feel that way; He feels with us when we hurt. He hates the hurt as much as we do, just as He hated it when His Son hurt. For some reason He can't take away all the hurt just now, but He hurts right along with us, and loves us just as much as He loved His own Son. If we remember that, we might be able to say not just 'Why have You forsaken me?' but also 'Father, I commit myself into Your hands.' "
Miss Dreyton is quiet for a few moments. "Chaplain, would you say the twenty-third psalm for me?"
"The Lord is my shepherd; I shall not want. He maketh me to lie down in green pastures: he leadeth me beside the still waters. . .' "
CPE, books on grief, seminars on pain--all are valuable resources for a chaplain. But when a call comes, you feel naked, unqualified. If there is such a thing as a textbook case, I don't know a chaplain who's met it. With every call I must consciously replace a moment of panic with a self-reassuring "I'll play it by ear" and a prayer for the assisting Pres ence so often felt. When one walks into a room knowing nothing but the bare facts of the situation, and sometimes only the family's name, one must trust that one's intuition will do its work.
How is my baby?
"Chaplain, call extension 5666--stat."
That's my summons to the emergency room. It's early evening; I inquire at the ER station.
The charge nurse looks unsettled. "We have a baby in number 2. The mother is in the waiting room. She doesn't want to talk with a chaplain."
I look into room number 2 and see a baby boy who is dead. Oh, he hasn't been declared dead yet. A half dozen professionals are working on him. But they know, as I know, that there's little hope.
Chaplains are not medically trained; they can't make diagnoses. But with experience they can make pretty good guesses as to what looks relatively good and what looks bad. They keep their guesses to themselves, but their guesses help prepare them for what needs to be done.
She said she doesn't want to talk with a chaplain . . .
I stop at the door of the small, private waiting room. "Are you Ms. Jonston? My name is Ed. I'm a chaplain. I just want you to know that I'm here if you need me. Can I get you some coffee?"
The lady is agitated. "No, I don't want anything. How is my baby?"
The doctor enters.
"Ms. Jonston, when did you notice your baby was having trouble?"
"After supper I put him down. Then about a half hour later I went into the room and he looked blue. I didn't think he was breathing."
"What did you do then?"
"I didn't know what to do. I don't have any money or any insurance, so I didn't know what to do. I'm just on welfare. I ran over to my next-door neighbors', and they came over. We had an argument about whether to call an ambulance. Then we called one."
"We're still working on him, but it's not looking good. We may not be able to save him." "I can't lose my baby! He's all I have. I don't have a husband. I just had the baby because I needed someone. Please bring him back to me..."
The doctor motions for me to follow him out of the room.
"This baby is not responding. We're going to stop." He speaks matter-of factly, but not without feeling. I've heard people say emergency and critical-care doctors become calloused about death. Believe me, it's a necessary facade, and often a thin one.
We tell her together.
I suspect the mother's anger at her loss, at herself, and at God will be directed at me, and I am right. The screaming and the hitting and crying eventually sub side. There is nothing to say, little to do but let the emotions take their course.
I lead her to room number 2. She holds the baby, rocking back and forth with silent sobs. I leave her alone with the child until a nurse says, "The body is cold. I think it's time."
Ms. Jonston wants to leave the hospital now; she does not wish to speak with me. But there is a paper to sign, arrangements to be made. She is angry again.
There is no perfect way to introduce that paper. "Death Discharge Report," it's called. It intrudes into the pathos like a joke in a funeral parlor.
"Ms. Jonston, what has happened here is a tragedy. I do not want to take anything away from your feelings. But the nurses and I need to know how to proceed. Your baby deserves a proper burial, proper arrangements. If you will cooperate with me, I will try to help you."
I find a funeral home that will accept the case as a SIDS (sudden infant death syndrome) death and bury the child free. The mother is grateful; for the first time I can talk with her about her needs. A neighbor arrives to take Ms. Jonston home. Before she leaves, we hug.
Amid the traumatic and tragic, chaplains have bright times. They see full recoveries follow critical moments. They see families brought together with tears and hugs for the first time in years. They see patients laugh or smile when there seems little reason for joy. They see nurses, doctors, therapists, and volunteers give personal touches that go far beyond job descriptions: a nurse uses her day off to take a discharged patient on business errands; a doctor spends hours of unbilled time helping an emphysema patient prepare for death; a therapist brings a child a new toy; a volunteer makes several difficult phone calls for a distressed patient; a nurse who has a pilot's license flies a terminal cancer patient to her home in another state so she can die among family and friends.
But there are always the question marks, large and small. Why is this patient impossibly angry at every nurse who enters the room? Why did the brothers and sisters of this AIDS patient refuse to visit him on his last Christmas ? Where is this inebriated patient's wallet? Why are this patient's 27 relatives crowding the hallway and disturbing the nurses on my shift? Why is this man's estranged twin brother ignoring his deathbed plea for reconciliation? Which one of these "Mrs. Smiths" is the patient's current wife? And why, oh, why did I say "Hang in there" to the girl who tried to take her life by ... you guessed it.
I return to the chaplains' office, images of Ms. Jonston's fury and of her hug pounding in my mind.
