Leaving

I have started processing and unpacking my summer CPE experience.  So here are some of my assorted and sundry thoughts.  

People leave the hospital in two ways, the front door or the back door.  The front door they are wheeled out, often carrying balloons and flowers, met at the front door and their car is pulled up by valet.  They are generally escorted by a beaming nurse and a gaggle of family members.   Success.  A battle has been won.  If they leave by the back door it is through the loading dock, picked up from the morgue by mortuary transporters in stiff dark suits, escorted by a grim faced security guard who would probably rather be somewhere else.   Loss.  All those life-saving interventions are for naught.

The family leaves in two ways too.  Either with their loved one or without.  It is this latter leaving that is the hardest part.  After a death occurs, the family is given some time to sit with their departed loved one.  They can say their goodbyes.  There is so much that goes on behind and during and after this leaving.

When the chaplain's office gets a page of a death, you really have no idea what you are walking into.  Sometimes we had a few minutes warning of an actively dying patient.  Often we did not.  Stopping by the nurse's station.  The death packet paperwork already spread out.  A nurse on the phone with the coroner's office.  All deaths are reportable.  Another nurse on the phone with the donor services agency.  Checking eligibility to bring life from death.  I wash my hands, walk into the room, peering around the drawn curtain.  There is a palpable absence in the air.  There once was one more soul in the room.   I stand awkwardly in this private grief.  I sometimes pray.  I sometimes do not.  I bring coffee, water, kleenex.  I will ask for consent to donate tissues.  I will ask for mortuary information.  I feel my heart strain in my chest.  This is not a daily part of very many people's jobs.

As the family prepares to leave I gather the last belongings into the plain plastic "patient belongings" bag and clip it shut.  With as much care as I can muster I hand it over, with it I hand over a piece of my heart.  They are preparing for a leaving.  They cling to these belongings as if they were still clinging to their loved one.  A watch.  A phone.  A wallet.  So much lost, yet, tangible items in hand make it seem unreal.  If they still have a phone, why don't they have a person?

I escort the family to the front door.  They are missing a branch of their family tree.  I return to the patient floor.  The body is bagged and tagged.  It is preparing for a leaving.  A patient transporter arrives to transport the patient for the last time.  All the way down to the windowless basement morgue.

The call to the mortuary is awkward.  Do you say "you can come pick up Mrs. Smith?"  Is she still Mrs. Smith? Or is she "The Decedent"?  I feel a responsibility to hold this person's humanity.  My last bit of patient care is to walk the death paperwork down to the morgue and place it on the counter.  I never took the elevator.  It felt like the honorable thing to do would be to use my own two feet for this last part of the patient's journey.  I always open the door to the cooler to check the tag on the body bag. I feel responsible for caring for this person, even in death.  I wish this person well, say a quick silent prayer for them in the cold of the morgue, among the stainless steel and tile and silent and cold companions.  They are not leaving.  They have already left.