On standing in the midst of trauma

As a chaplain who responds as part of the trauma team at my large regional trauma center, I occupy a strange role. While the rest of the trauma team rushes to put on lead vests and gowns and masks and hats, I stand quietly. 

When a patient arrives by air or ground I listen to report from the paramedics, listening for our patient's name, age, location & whether or not their family knows where they are. I work with police and other EMS workers and charge nurses to find and notify family members. But a lot of the time I just stand quietly. 

Early in my career, I struggled with not having a "task" in the midst of trauma response. But an emergency room tech at the hospital where I worked in Colorado stated it best, "chaplains represent comfort. You remind us that God is with us in this mess. You help us keep going." 

In a trauma response I care for patients, but I also care for staff. 

Recently I responded to an extraordinarily difficult trauma. The traumas that involve grave injuries with little chance of survival wear on medical staff. It causes our staff pain when a patient is unidentified and their family doesn't know where they are. This situation involved all of these factors. 

I just stand in the pain with our staff and remind them that they are cared for. I believe that my calming and quiet presence is a steadying influence. That my "care through proximity" for the team contributes to resilience. I'm available if they need me, and they know my face for future situations. I accompany physicians when they notify family members that their loved one has died. I exude a quiet strength, and like caring for my patients, my message is, "I am here with you." 

chaplaincy series: death midwife

I attended your death as a midwife. Along with a nurse and a social worker as your birth attendants. I attend death like a midwife attends birth.  I cannot do it for you.  I can only be with you as you do the hard work.

I hold your hand, swollen with the IV fluids of failed resuscitation attempts. Edema from the kidney failure that the bedside dialysis failed to reverse. My fingers leave indentations on your skin. Your nurse wipes your forehead with a cool cloth, with the tenderness of a mother and her child.  Your social worker draws the curtain to your room, to give you some privacy as you do the vulnerable and animalistic work of dying.

Your dad had to go back to his home. He sat vigil at your bedside for two weeks. But he couldn't be there any longer.  But today, your death day, he calls and we put the phone beside your ear. We repeat over and over again the messages of encouragement from your father.  "You are loved."  "Your dad loves you."  "Your aunt loves you."  "Your mom is waiting for you."  Because your mom died when you were a child.

We sometimes turn on the music channels on your television. But the muzak doesn't seem to fit you.  I turn on the music in my own phone.  It somehow seems like you would want to hear Mumford and Sons and Avett Brothers.  Because you are, after all, my age. You have tattoos. You have a gauge piercing in your ear.

We are helping you to birth your own death. Your breaths are further and further apart. Your heart slows and stops.  Your nurse places her stethoscope on your chest.  She looks at you and looks at us and her tears fall upon your face. My tears fall upon the floor like rain.

Only at the end of this birth-death, there is only absence, not presence.

I am a chaplain…I am a death midwife.

Chaplaincy series: nurse for spirit and soul

Truthfully, it is impossible to put into words much of what I experience as a chaplain.  This series is an attempt. 

Today, I saw your daughter’s brain.  With her depressed skull fracture.  Where the crushed bones and matted hair opened up into the space that makes her who she is. She came in wearing rhinestone jeans, a grey satin bra, and a sheet soaked through with blood. Blood filling the stretcher. I want you to know that I saw her purple painted toenails. I want you to know that I saw your daughter.  I saw a teenage girl.

I waited at the doors of the emergency room to meet you when you arrived. I saw you and your wife and your son running across the parking lot. I knew it was you. I felt your desperation. I saw it in your eyes. I heard it in your voice. I felt it in your hands when I took them into mine.

I want you to know that I saw your beautiful daughter. I prayed for her in the midst of the trauma room. And though my surgical booties and gown and mask and cap covered me and made me look like any other person in that room, my only job was to hold the hope of her soul. To will her into staying with us.

And as I stripped off my surgical attire, to meet you in the emergency room, I meet you like I would want to meet someone if I was in your position. Calm, kind, exuding gentle strength. A guide to accompany you through this hostile foreign land where you never wanted to be. To hold your hand and bring you cool water and saltines after you throw up in the wastebasket in this tiny and airless room.  And to let you know with my presence that I will go with you wherever you need to go.

I’m a chaplain.  A nurse for the spirit and the soul.