I finally felt like I was a chaplain after I had been about four weeks into my internship. I was feeling exhausted and that my job was merely tangential to that of the nurses and social workers. That it was not anything really special, just a nice additional service to make people's lives easier. I had gotten a page from the medical ICU that a family wanted a Lutheran pastor present at the extubation (withdrawal of life-saving care) of their loved one. There was not a Lutheran pastor in the hospital, but there was a Lutheran chaplain, so they got me.
I showed up to a room with a ton of family members present, as well as a couple nurses, a social worker, and a respiratory therapist. The patient was intubated and hooked up to a dozen monitors of various types, he was at the end of a prolonged illness. The family asked me to spend some time with them because they were not sure how quickly the patient would die after being extubated. I led the Lutheran Commendation of the Dying, a rite that happens shortly before the time of death. At this moment, with the nurses, respiratory therapist, social worker and family circled around the bed, their heads bowed, I knew that I was offering something that no one else in that room could. I finally felt like a chaplain.
An extubation is a brutal thing and this was my first experience with one. I held hands with the patient's sister who had not spent much time in the hospital until this point of her brother's illness and was not used to this sort of thing. There is a lot of gasping for breath (not all of it from the patient) and sometimes the patient is immediately peaceful and sometimes they are not. Sometimes they die within a matter of minutes, sometimes it is hours or days. This particular patient looked immediately peaceful and I spent about 30 more minutes with the family, it was about 7:00pm in the evening. Before I left, the patient's spouse asked me to offer a blessing for the patient. I did, and made the sign of the cross on his forehead, his face visibly relaxed. The patient died early the next morning before I arrived for my shift.
The time spent with this family was an incredible blessing. I had the opportunity to spend over an hour with them, at one of the most intimate times of their family life. The family remarked that my being there helped them to hold the presence of God in the room in the midst of uncharted territory. They felt a little less alone. I believe that is the biggest gift that the chaplain can offer, presence and accompaniment. Indeed, I think that this is what the pastor can offer in times of need as well. To show up, walk with others, and tell the truth in the form of the Gospel.