A storm unleashed in our hearts
Martha Serpas considers the anguish when the need for connection during final moments goes unmet.
One of my jobs as a chaplain, my most important job, is to connect families. This vocation begins as soon as the trauma pager goes off: “42 y.o. F GSW 3 min,” for instance. Very shortly a shooting victim will arrive in the trauma bay, and my task is to identify her. If she is able to speak or she has a driver’s license, the steps are easy. When I’m lucky, her name shows up in hospital records along with a next of kin. I make the call.
When the family arrives, stricken, disheveled, I am paged again. My actions are in the interest of connecting the patients and their loved ones as soon as possible. (The presence and support of people the patient loves is as much a part of recovery as any treatment.) I settle them in a family room and get water. (Extreme stress shuts down salivary glands.) I find the attending or resident. They explain the injury and the procedures. Many times the patient is already in surgery. The family has been waiting — excruciatingly waiting — thinking “God will save him” or “I know she’s going to die,” neither of which any of us
knows. I have to point that out. Deciding on an outcome is a way to avoid the pain of uncertainty. Everyone reaches a pitch when the doctor comes in, they expect something definitive, but there’s only more waiting.
I can usually take one or two people back to the trauma unit. It’s down a long hallway past a set of locked doors. My badge swings the doors open. Family members look nervously into every doorway. They are reaching a pitch again that only the sight or touch of their loved one will calm. They are focused, and as I lead them around the curtain, their gaze solidifies, creating a field around the gurney. People cry. If the patient is banged up or in a neck brace, the first touches are tentative and gentle. This is fear and love, turning ever so slowly into just love. The patient, if conscious, is relieved. The family members are relieved. I am relieved. This intense connection ends their needing my constant presence. I’m as irrelevant as a match after the candle is lit. We say goodbye and sometimes hug. I’ll check on them periodically through the night.
But the new coronavirus situation results in much the opposite focus. Chaplains are required to deliver the news that there will be no reunion, no touch, no relief. I ache for my colleagues who are working in affected hospitals now. They have to, repeatedly, tell families they can’t see their loved ones — even if the situation is end-of-life. From 6 feet away and wearing protective gear — distancing, impersonal — they have to explain the quarantine. They have to go into family rooms and sever hope. They have to leave the anxious there — waiting — with only an unknown outcome out there somewhere coming in like a sneaker wave.
My aunt was just such a patient. She was in a senior community in New Orleans. For two and a half weeks, her daughter was not allowed to see her. (My aunt had a slight fever that resolved, but she tested positive for the virus.) Finally, my cousin was allowed a 10-minute visit. She dressed like the Michelin Man, face shield and gloves, and went in. She wasn’t sure her mother recognized her. “Does she even know I’m here? Can she tell it’s me?” One of my colleagues would have said: “She knows you’re here.” That may be true, but one wants a physical connection, the physical comfort that is still possible in this world. It was not a mild case of COVID-19 that shortened her life. I believe it was being deprived of her daughter’s daily company. Behind my cousin’s questions is a fear that her mother felt abandoned.
Last week the Pope offered a prayer and benediction on the occasion of COVID-19. He spoke about the story of Jesus calming the waves. The disciples’ means of asking for help was to accuse Jesus of not caring about their predicament, hence not caring about them. “Do you not care about me?” the Pope said, is a phrase that “unleashes storms in our hearts.” To feel unloved is terrible. To be deprived of the opportunity to offer love may be worse. Some victims die alone with a few doors between them and their families. The chaplains hold the key cards but have to stop themselves from using them.
The chaplains, the spiritual care connectors, are now circuit breakers. They are being asked to do their anti-jobs: on the job retraining that runs against all of their instincts and experience. They are keeping people who love each other apart. It pains them. It is a moral injury, that is an emotional and spiritual wound resulting from acting against a deeply held belief or value. First associated with soldiers, moral injury today is more and more affecting people on a different kind of front line.
Chaplains need chaplaining, too. The morning report allows the overnight and morning shifts to do more than hand off cases. It’s a time to restore the community and reinforce the bonds of common purpose before an emotional day. After handling a rough case, one chaplain usually turns to another for support and processing. Now the chaplains must forego morning report and keep separated during the day. One of the directors of Tampa General’s Department of Pastoral Care and Education, where I did my training, wrote me to ask for poems she could post on the walls of offices, conference rooms and hallways. “We need all the support we can get.”
I sent funny poems, contemporary psalms and prayers. I sent Adam Zagajewski’s poem “Try to Praise the Mutilated World ,” which appeared on the back cover of The New Yorker’s 9/11 issue: “You watched the stylish yachts and ships;/one of them had a long trip ahead of it,/ while salty oblivion awaited others”.
I sent Anne Sexton’s funny and painful poem, “The Rowing Endeth”: “I am mooring my rowboat/at the dock of the island called God.”
I sent “Prayer” by Marie Howe: “My days and nights pour through me like complaints/and become a story I forget to tell.” I wanted to send myself to them, and I also feared I would not be able to bear the anguish if I could.
While most of us are sheltering in place and lightheartedly complaining about the too-nearness of our families, some are caregiving through a painful Plexiglass of the soul. The intent, of course, is not to isolate the sick and dying or to deprive families of one another’s touch. It is, perversely, to keep us safer and healthier, to keep more of us alive. Ironies like these are inevitable during a time of crisis. Chaplains are living the extremes of life that often go unacknowledged. They carry these paradoxes when they reunite (or not) with their own families at the end of their shifts. The strength to change radically as practiced in a trauma bay may be what we are all asked to find in ourselves through this pandemic. As Lucille Clifton writes in “new bones,” “other people think they know/how long life is./how strong life is./we know.”