Friday, July 31, 2009

The Quiet Room

I did CPE my senior year of seminary at Northside Hospital in Atlanta. It was an amazing place to be. My supervisor (rest in peace MCB) was amazing and insightful, as was the assistant (thank you LR). And my group was amazing. I had one good friend there (I love you LS) who supported and encouraged me in a way others couldn't or wouldn't. We also had another woman, second career, who was great for the group, and an international, conservative male who confronted and challenged me often. While I didn't always welcome his presence in the group, he helped me grow in many ways I could never exactly name, but know exist.

Chaplaining where I did was a gift. It is the hospital with the most births of any in the US every year. More than 18000 births each year. Unfortunately that also included a fair number of miscarriages and stillbirths (roughly 450 each year).

As such, I did a lot of grief work. Each time I was on call (save twice) I dealt with at least 3 deaths...both infant and adult. I cared for many families in crisis and very difficult situations in addition to patients on the gastro/general surgery floor during rounds.

My first call on my first night on-call was for a death in the ER. The doctors were anxious when I got there, not wanting to tell the family without me present (as a first time chaplain on her first call I was not convinced I was the one they should be anxious to see). Once at the ER, I walked behind the doctors to the "quiet room" where they told two sisters that there 40-something year old sister was dead. Both women cried. One fell into my arms and crumpled to the floor. I rocked and held her there for what seemed like forever before she even looked up to see who I was (namely an unnamed stranger). "Trained" for this situation, I talked with the women and told them what to expect when we went to the room (a body cool to the touch, a tube in her mouth) and when they were ready I took them to the room. I told them it was okay to touch her and to talk to her, and they did. They cried and lamented and told her they loved her.

I spent nearly 6 hours with that family that night. In and out of the ER, trading one family member or friend for another to go and say goodbye. I would leave and take another call (there were at least 2 other deaths that night as well) and then come back and check on them.

I spent many more days and nights at the hospital. I cared for family after family who grieved the death of a loved one. I walked people through saying goodbye. I held them. I gave them space. I told them what to expect. I answered questions. And I listened. I learned many many lessons from my time at Northside, far too many to articulate them all, but each of which is priceless.

I learned that people grieve differently. Some will scream, some will hit, some will cry, some will wail, some will not say a word. Some will want to see their loved one, and some will not. Some will be scared, and some will deny the reality that is before them. And each of those responses is right for them. There is not one way or a right way to grieve.

I learned that most people do not confront death with any kind of regularity, familiarity, or ease. People do not know what to expect (neither from the situation or from themselves). As a caregiver, it is important to walk people through the situation and explain what is happening and what to expect, what might be true for them. Not all people need this, but from my experience the majority do.

I have learned to be a buffer for the family, asking questions and making requests they won't, or don't know they can. For a person that does not need an autopsy, I ask that they be extubated before the family comes in so they look a little more normal. I get the family water and juice and tissues, telling the nurses that I have worked in a hospital and can manage if they show me where to go (assuming they have much else to do). I also let the nurses know when the family has questions or when they are ready to leave and need to do the paperwork.

I have learned that there isn't generally urgency at the hospital. The family can take as much time or as little time as they want. Each hospital is different and if you do work with a hospital, it is good to know their policies (ERs can be hard if they are busy and need the bed, but generally there isn't a rush to move the person and so people can take their time).

I have learned to affirm people and assure them that what they feel is normal, healthy, and ok. Grief takes many shapes. So whether the person has peace, or is angry, or can't believe it, I say it's ok....because it is, and they need to know that, that they aren't expected to feel a particular way.

I have also learned that I need to give myself space to grieve too. It is hard to bear people's pain. It is hard to see person after person get sick and die. And it is important to grieve.

This post didn't go the direction I expected. I meant to start with the "quiet room" in order to share that when I got a call to go to the hospital last night and was taken straight to the family in the quiet room I knew it wasn't good. It's the place the hospital puts you to tell you serious and bad news. This isn't always true, but often. It can be used for a large family or for a loud family that they need to contain and allow space to talk or make decisions, but often it is a private and quiet space so a family can cry and lament and grieve on their own.

Sadly, that was the case last night. After 5 minutes with the family, the doctor came in and shared the news. LB had died. I was with the family nearly two hours as we talked and waited, saw LB and shared prayers, talked and waited, and listened and talked some more all before finishing the final paperwork and heading home.

LB was a dear man, who was gentle and soft spoken, convicted of God's love for EACH person regardless of religion or race. He was committed to justice and not afraid to share his two cents. He was a wonderful man, an insightful professor, and a loving father and husband.

God Bless you LB.

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