A mixed bag but lots of tension for Rebel Rev

My senior colleague was unfortunately going to be off sick for the next few months. I knew this would be tough, as I would have to step into the space she left behind, but not over do it to my own detriment. I was going to have to learn to pace myself better as well as learn the administration of the service which my colleague usually does.

I have developed quite a good working relationship with the staff on ICU. I regularly wander through and chat to staff and say hello to patients and their visitors. That then stands me in good stead should I be called in in-extremis as I’m already a familiar figure.

During my wanderings I had gotten to know a particular patient and his family very well. Due to his obesity he had serious heart problems. He needed an operation and was trying to lose weight so that he could have the surgery. We got on really well and had regular bantering sessions. His daughter was due to get married that summer and there was a real question mark as to whether the patient would live that long. The family asked me if there was any way that the daughter could get married in the hospital at her father’s bedside. I looked into it and found out that it was possible.

The paperwork took a while to sort out and we had many lovely conversations around the bed about all sorts of things. The patient was a real questioner and I encouraged him by telling him there was no such thing as a stupid question. He asked me one day why you had to shut your eyes when you pray? I said you didn’t and explained that you could pray at any time and in any way that you were comfortable with and said that some people close their eyes so not to be distracted. He then asked me for the words of the Lord’s prayer so that he could join in when I prayed for him. He felt he couldn’t before because he was meant to keep his eyes shut. He also asked if he could be confirmed as he now knew that he could pray with his eyes open. I was sure this would be alright and said I’d arrange it with the Bishop.

One day when I arrived he was a bit uncomfortable and told me he had a tummy ache. I explained that I had just been praying for a little baby on NICU who needed to have a poo. The patient asked would I pray for them both in my prayers that day. Every day after that he always asked after the little baby. I wrote out a prayer for the baby and gave it to him so that he could pray it whenever he felt like it. He was really pleased with this.

The paperwork came through and the daughter was given a special licence to marry at her Dad’s side. Plans were made for the weekend amongst much excitement.

The Tuesday morning that week I had a call from a friend’s husband. He told me the devastating news that my fiend had had a massive stroke and was not expected to survive. She was only 39 and they had a 4 year old daughter. I speedily made arrangements for a parish colleague to cover me for emergencies at the hospital as I was the only chaplain in that day due to my colleagues long term sickness absence.

My friend, lived about 2 hours away. When we arrived at the hospital her husband was there on his own. We spent some time together then a doctor came to talk to him. He asked me if I would come with him to hear what the doctor had to say. The doctor gave him the awful prognosis and asked if his wife was on the donor register. She was and he explained she would like everything used that could be. The doctor said the transplant co-ordinator would be in to talk to us next.

The co-ordinator turned up and took us through the process. We went with my friend to the anaesthetic room where they would disconnect her from the ventilator. The plan was that when she stopped breathing they would take her into theatre to remove her organs. Unfortunately my friend started to breathe for herself when they disconnected her. The co-ordinator explained that this sometimes happened and if she died in the next 2 hours her organs could still be used.

While we were waiting for my friend to die my mobile phone started to vibrate madly in my pocket. It kept going off, so in the end I excused myself to answer it. It was my colleague at the hospital to say that the patient whose daughter was to be married has suddenly deteriorated and would not last much longer. He and the family were asking for me. I felt awful. I knew I couldn’t leave my friend but I also wanted to be with this patient and his family. I gave my colleague messages for them all and promised that no matter what time I got away I would come to the hospital on my way home.

I went back into the anaesthetic room and felt really heavy with emotion. My friend didn’t stop breathing, so after 2 hours we went back to ICU with her to wait for her to die. By the evening we were all rung out so I persuaded Mark to go home and have something to eat. We went home and picked up his daughter and half heartedly tucked into some fish and chips. I left him around 10pm.

I kept my word and came into the hospital around midnight. The patient had died and his family had finally left. He was laid out but still in the room. I gently unwrapped his head and anointed him and gave him a blessing. I just wanted to rest my head on him and weep but I knew I couldn’t as some of the staff needed support. They were upset at the way he had suddenly died before his daughter could get married.

I went home feeling completely drained. The next day I spoke to the family and they asked me to come to the funeral home and do a ceremony with them. We arranged that and I took the same oil that I had anointed the patient with and got them all to anoint him too. It was very touching and very moving.

My friend died the next day. I felt useless as I was so far away from the situation and had my work commitments. A humanist funeral was arranged as my friend had no truck with organised religion. In my opinion the funeral was awful. It was bland and had no substance to it. This woman was a loud and bubbly character. When she laughed people stopped in their tracks. This service didn’t seem personal to her at all. Her husband asked me to read the poem that I had read at their wedding 5 years earlier. He also asked all the mourners not to wear black but to wear as much colour as possible. As I looked up and saw all the colour that represented what a colourful person my friend was, I felt very sad at the greyness of the ceremony of her funeral. It made me more determined than ever that any funeral I was involved with would always have substance.

When it came to the patient’s funeral I shared the ceremony with the families vicar and gave the eulogy. The patient had given me messages for his wife and son and daughter to be given out at the funeral. It was a very emotional occasion and there were lots of tears as well as much laughter. It was a fitting tribute to this larger than life character who had given so much love to his family.

Both my friend and this patient were lovely, lovely people, with hearts of gold. They would do anything for their families and left behind some devastated people. What is so sad is this could have been prevented if only they were able to control their weight. I do not understand what drives people to stay obese. I understand that people get hurt by all sorts of things and that obesity is like a blanket that protects them from future hurt. I also understand that, for them, food brings comfort. I sometimes wish I had enough love to go round that would take the hurt away from these people so that they could lead their lives and carry on giving love into their old age.

I felt quite wrung out by all these events so on the spur of the moment went away to Norfolk on my weekend off to get away from everything and re-charge my batteries. I’ve learnt the importance of regular breaks while I’m working in such a demanding job. If I don’t take good care of me how can I encourage patients and their relatives to do the same?

  

Early one crisp and cold February morning I was called at home to say that a patient had died suddenly and the family needed something. When I arrived the wife and one son were standing around in the corridor while the patient was being made presentable by the nursing staff. The wife had a vague C of E background the son was more spiritual than religious. They were also waiting for another son to arrive from Oxford. I was told this son was very religious and part of the anglo-catholic tradition.

While I was chatting to them they were asking lots of questions and wanted to know where would be a good church to have the service. The patient was a popular man so there would be a large congregation. I felt they were very earnest about getting it right and doing the right thing by this patient. I spent several hours talking to them about all the options. During this time the patient was moved to the mortuary.

When the other son arrived I did a ceremony with them in which I tried to encompass all their varying beliefs. This meant it needed to be traditional as well as liberal as well as spiritual. I can’t even remember exactly what I did now but I know the family were pleased as I received a lovely thank you card and a letter saying how helpful they found what I had done.

The tricky part for me in doing these multi-faceted rituals is not to lose sight of what I believe. I need to be always respectful of what other people believe but I also have to maintain my own integrity. So far this hasn’t been a problem.

One day I was bleeped by A&E to say they had a patient dying in resus and the family were religious. As I was talking to the family I realised that they went to a local church. I asked them if they had contacted their vicar. They told me they had so I just stayed with them until their priest arrived. 

We were chatting quite easily to one another. The man who was dying was elderly and loved and they were sharing stories of his life with me. 

The family priest arrived in a flurry of activity. I shook his hand and he said he was in the middle of preparing lunch for 8 people. I was appalled. This was not a very pastoral thing to say as you greet a family at such a difficult time. 

Then I recognised him and realised he was a leading light of Forward in Faith or backward in bigotry as I refer to them in private. It's an organisation that is anti women priests. I then felt I had to say something pastoral and theological to this family in front of him to show how valuable my ministry as a woman was. Why did I feel the need to prove myself though? It was a horrible situation to be in and I almost felt his disdain for me and all female priests ministry. 

I hope that family received something despite the differences of the priests with them that day.

One night I was called out to the Stroke Ward. When I got there I discovered a delightful man who was preparing himself to die. His speech hadn’t been affected so communication was good. He wanted some reassurance about the dying process and what would happen to him. I thought he was talking about heaven so started talking about going into the arms of a loving God. He said he knew that but what would physically happen to him. This was a new one on me and I wasn’t sure. I encouraged him to speak to the nurses. He said many of them didn’t like to talk about death but he thought I’d be ok with it. I told him I was ok with it and I promised him I would get the answers and get back to him on that one. He then talked to me about how he felt to be leaving his wife after their 60 years together. It was all I could do not to weep with him for the sadness he felt at the pain he would cause his family. I reassured him that love always has pain as the flip side because great love involves great risk and that risk is the pain of parting. When you love someone or have been loved by them it always hurts when they are no longer physically there. But we wouldn’t live our lives with out that love. He understood this and knew he had been fortunate to have 60 years of love. I knew he and his wife needed to experience the pain as the working out of that love until they were to meet again.

I went back the next morning with a leaflet I had found from the Macmillan Team about the physical process of death. The patient was quite frail by then and not able to speak as much. I read the leaflet to him and he nodded at times. I slipped out of the room when his wife and daughter arrived to give them space for those last precious few hours. He died peacefully later that day.

Wow what a privilege. I thank that man for sharing his final journey with me. He was so steady and ready to meet his maker. It’s such a shame that so many people are uncomfortable talking about death. We’re all going to go one day. Death needs to be embraced and not feared. If there is no God then it’s just like falling asleep. We don’t know when the defining moment of sleep comes, we just close our eyes and know we’ve been asleep when we wake up. If there is no God then we won’t wake up. If however, there is a God, as I believe, then we will wake up surrounded by love and light and be invited by a loving God to know whether what we have valued in our lives has eternal value. Again this is nothing to fear. I hope that people don’t see me as the “Grim Reaper” but I do hope they know they can always talk to me about death and dying.

As I was coming to the end of my second year as a chaplain I was presented with one of my biggest challenges. A toddler had suddenly and unexpectedly died on the children’s ward. I was called by a very distressed member of staff who said they didn’t know what to do, the family were wailing and crying and praying to God to raise their daughter from the dead. I said I’d be there immediately but inside I felt all wobbly. How on earth was I going to make sense of any of this.

When I arrived the staff told me the child had come in with chicken pox and in fact was better so they were making arrangements for her discharge later that day. What had happened was that suddenly the child started bleeding from everywhere and stopped breathing. Resuscitation was immediately attempted but this proved futile and the little girl died.

When I went into the room, much of the equipment was still strewn about amongst bloodstained clothes and blankets. The mum was sobbing uncontrollably and the dad was running out of the room then running back in and saying “In the name of Jesus I command you open your eyes” There was another woman wearing a white bloodstained shirt who was on the phone and alternating between crying and saying prayers. I latter found out she was the toddlers aunt. A senior nurse and the divisional manager were in the room and they were tidying up and getting ready to wash the child. Another nurse was trying to console the family. The non-verbal communication between us as staff spoke volumes about the awfulness of the situation and how helpless we all felt.

I stood in front of the mum and placed my arms on her shoulders and said how sorry I was for her pain. She threw herself on the floor and nearly knocked me over such was the force of her grief. The dad came in and I offered my condolences to him. He was angry and would have none of it. He said we must have faith and pray that God would raise the child from the dead. He also told me this was a test of their faith. I felt awful because I just don’t agree with that kind of theology and I don’t believe in that kind of God. God doesn’t test people’s faith by killing their children. If that was the case I couldn’t be a person of faith. Even though I didn’t agree with their theology I had to let this family express their grief the way they wanted to. They were waiting for their pastor to arrive.

While we were all waiting the nursing staff cleared the room and washed most of the blood away. The parents didn’t want the child formally washed as they were still hoping for a miracle. During this time I held the mums hand, I read them some Psalms, but not any that would enforce their religious view. I prayed, although I found this really difficult and I began to talk to them about the ultimate healing can sometimes be death. I also talked to them about a God who watched helplessly as his own son died but because Jesus died in that way and rose again that is why we can believe in everlasting life. I didn’t know whether any of it was going in.

Eventually their pastor arrived and I gave them some space and myself and the nursing staff left the room. From the nursing station we could hear the shouts and raised voices as they tried to pray their child alive. It was having an awful effect on the ward staff, patients and visitors alike. I gave them about 20 minutes. During this time I encouraged the staff to talk to me about the events that had lead up to this awful situation. That is always the first stage of any debrief. Everyone was traumatised by events.

After 20 minutes I went in and stood quietly at the back of the room. The pastor in a big booming voice would say a prayer and then roughly shake the little toddler. Dad would also do the same. It was heartbreaking to watch. I knew I couldn’t let this go on indefinitely on the ward due to the needs of everybody else, but how was I going to shift them.

I stepped forward and said that I had some oil and would they like me to anoint the child. They wanted this. I said some general prayers about us not knowing or understanding God’s ways and praying for God’s  transforming love to come into this situation. I got them each to anoint her too. They seemed slightly calmer and I said that we were going to need to move the toddler to a quieter place where they could continue to be with her and pray and get any other relatives to come but that we needed to move away from the ward area because of disturbing any of the sick children. I said that the mortuary had a room that was private and any noise they made would not disturb any one. They accepted what I had to say. I quickly went and phoned the mortuary staff and warned them about what was going to happen.

When I got back into the room Dad had picked up the child and wanted to carry her to the mortuary. I wrapped a blanket around her whilst nodding to the nursing staff to let them know this was ok. We went down the back steps and across to the mortuary the whole time I was praying that nobody would stop us to talk because it would have been obvious that Dad was carrying a dead child.

I was so relieved to get then into our visitors room at the mortuary without incident. The mortuary staff and I took turns at being with the family for the next 5 hours until they were all prayed and cried out. It was really important to enable them to express their grief how they wanted to without necessarily reinforcing their beliefs. Because I patiently waited for them to be ready I was eventually able to do a goodbye ritual. Afterwards I reassured them of on-going support and watched them dejectedly walk away. The mortuary worker and I then sat down with each other to try and make sense of all that we had witnessed. This of course was an impossible task.

I then went back to the children's ward to look after the doctors and nurses who were very upset and wondering if they did everything they could. The consultant also needed a few moments with me so great was the impact of this little girls death.

Along with several of the nursing staff I went to the toddlers funeral. The family were grateful for what we had done but most of the hospital staff felt they hadn’t done anything and some were still wondering if they had missed anything that could have prevented the death.

I supported staff through debriefs and regular visits to the ward but it wasn’t till the results of the post mortem came out that staff really stopped giving themselves a hard time.

I have taken to popping into the chapel on my way home and handing all those I carry with me in my heart and mind and the work of the day over to God. I literally leave them on the altar. It was one of those days where only God could make sense of it.

One day I had a call from the maternity ward to say a patient wanted to see a chaplain. We do not have many requests from the maternity ward so I was intrigued. I was wondering if I was going to get to bless a living baby for a change.

In fact it turned out to be a very different scenario. The patient’s brother had been murdered. The funeral was going to happen the next day and due to the patient having an emergency caesarean section she was going to miss the service. She felt devastated about her brother’s death, extremely sad at missing the funeral yet she also had the joy of cradling her baby daughter.

The next day, at the time of the funeral, I went and said some prayers with her and a friend who was supporting her. I showed them a picture of a candle I had lit in the chapel with the brother’s name on a card in front of it. They took some comfort from this.

It’s hard to face these awful situations. Sometimes I feel so inadequate and I think who am I to try and make sense of it all? Like the bible says “I am who I am” and in my own limited way I am prepared to keep struggling and to stand alongside those who suffer. I don’t have all the answers but I can enable the questions. Sometimes it's about learning to live with those questions.

Working with death while grieving is hard

Another mixture of posts that show staff need to have their grief acknowledged in order to provide an effective service. The only way this is possible is if we get better at talking about death and its impact on us.

Getting back to the day to day life, as a chaplain one of the things I was keen to develop was a teaching role with staff. I have been gradually building these sessions up. Sessions I ran included talks about the role of chaplains and rituals at the time of death. I also ran some domestic violence awareness courses. All this had been good in that it had broken down some of the misconceptions about chaplains amongst the staff. Whenever I get the opportunity I remind staff that we are there for them too and not just the patients and their visitors. I also helped to run the breaking bad news course for new medics.

This has led to several staff members coming to chat to me. The issues have ranged from marital problems, difficulties in offering care to a dispersed family with elderly parents living abroad, bereavement support, complex family relationships and coming to terms with past hurts. Sometimes staff have approached me for support with work related issues. Recently that has become more so with cuts that have been made and the threat of future cuts.

One of the staff support activities that I got into was to acknowledge and support the work of a particular ward. They’d had an unusually rough time with a number of untimely deaths amongst their patients. One of these was a young man in his 20’s who unexpectedly went into cardiac arrest and couldn’t be saved. It deeply affected every member of the team, especially the other young men.

I put together a little ceremony, which happened on the ward. The liturgy needed to contain elements that appealed to all faiths and those of no faith. I used a bowl of salty water to symbolise tears and a central candle and gave each staff member a small candle, which symbolised the light and life of the many patients that they had cared for. The ward manager read out various poems and chose some music. It was only half an hour but it was a very emotional occasion for the staff and gave them an opportunity to stop and think and acknowledge their feelings.

The next day one of the young male nurses told me that he had slept better that night than he had for months. He thanked me for making it possible for him to move on. I think this is important. Many staff don’t get the opportunity of going to patients funerals but they sometimes need a space to say goodbye. That was provided on this occasion and helped. It’s something maybe to think about in future for the whole hospital.

One night I was called to the bedside of an elderly woman, She was dying having had a second stroke. The first one had been 18 months earlier and that had left her unable to speak and walk so she had been in a nursing home. Before that she had been incredibly active and a powerful force in her family’s life. Even though she couldn’t speak after her first stroke she could still communicate what she wanted. The patient’s daughter was an only child and the relationship between the two of them at times had been really difficult. The daughter went on to have three daughters of her own. It seemed to me from what was said that the patient had been an exceptionally good grandmother. It also seemed that she had tried to make up for maybe not being that great a mum by being a fantastic grandma.

As the daughter and granddaughters talked to me over the few days it took for the patient to die, it became clear that there were some deep wounds. I encouraged the daughter to name her hurts and speak them out loud to her mum as she was never going to get another opportunity to do this. I said I felt that her mum had tried to atone by the way she had been with her grandchildren and that she wouldn’t want her daughter to carry that pain any further in her life. Now was the time to lay it down and let it go. Bravely she was able to do this and we were able to have a little ceremony and anoint her mum and begin the process of laying the ghosts of the past to rest.

While all this was going on a very good friend of mine was dying. She was in Maidstone Hospital. I visited when I could and chatted on the phone to the rest of the family when I couldn’t get there. Diana was a hospital chaplain herself and had been very instrumental in shaping the way I approached priesthood and chaplaincy. The last time I saw her in a state where we could communicate I knew I had to take my own advice and say to her all the things that I would never have another chance to say. In this case they were all very positive things. During this conversation I asked Diana if she wanted to be anointed. She smiled and opened herself up to me in a posture that is symbolic of being anointed.

In my short time as a chaplain I have anointed many people. Anointing Diana was the hardest thing I’ve done in a long time. It was a beautiful moment and she was very serene and peaceful and it is a memory that will stay with me forever but it was really hard. Afterwards I got back to my car and wept. It was some time before I was able to drive.

 The next day, back at work, I found out that the family of the elderly patient who had died, wanted me to take the funeral. I agreed to do this as they were all so dispersed around the country.

The funeral was early one Friday morning. I had spoken to Diana’s family the night before and they didn’t expect her to last much longer. I was very heavy hearted as I arrived for work that morning. I put on my professional mode and set off for the funeral. Just before I arrived at the crematorium I realised I didn’t have my robes with me. I was aghast at what I’d done and couldn’t believe I had been so stupid. The chapel attendant at the crem was great and rigged me up in something. It wasn’t perfect but it would do. I then opened my folder only to find that I had put the wrong funeral in it. At that point I almost lost the plot. I went into the chapel to take a moment to try and compose myself before the family arrived.

When the family arrived I confessed that I was not properly dressed and that I had forgotten my notes. I was extremely apologetic and said I wasn’t normally so dis-organised. They were extremely gracious and accepting of what I said. In part, that is due to the relationship I had built with them over the time that I had been visiting, but it is also due to the vulnerable position people are in when attending the funeral service of a loved one.

The service went smoothly and fortunately I remembered most of what I had written in the funeral address.

I had never done that before and I hope I’ll never do it again. My own grief over Diana was having much more of an impact on me than I had anticipated. That bit of forgetfulness was a warning sign to me to take care of myself.

Over the next couple of weeks I felt very fragile and my colleagues shielded me from some of the more traumatic situations in the hospital. The problem of a hospital chaplain grieving is that they can’t not be involved in other people’s death or grief as that is part of the daily work. One of the impacts of the strain of trying to remain professional whist feeling so vulnerable was that the forgetfulness continued. This came to a head when I had forgotten to tell my colleague about two occasions that I would be out of the hospital all day. On one of the days she had to come in on her day off. It was a trying situation all round.

Fortunately I had a weeks A/L booked already. The holiday really helped and gave me some space to just be myself. The forgetfulness has lessened but the effects of Diana’s death will be felt for some time I’m sure.

Diana was my soul mate and I really grieved her death and the loss that it brought to my life. Whenever people have died that I’ve been connected with, I’ve always been able to carry on chatting with them. I believe they are in heaven and that they can hear me. It has always helped me still feel some sort of closeness. With Diana all I felt was an enormous void! We were very often in contact via phone or text message. All of a sudden there was just nothing. It was an awful pain. At times I felt overwhelmed and could feel myself becoming tearful with patients or staff. I never did break down in front of anyone but I came close. It’s not that I think crying is wrong but when it’s your own stuff it has no place in someone else’s pain or trauma.

The work of the hospital continued. Despite my grief I had to be alongside the dead and dying and the bereaved. Eventually my pain lessened and became part of my experience. In fact now I find it has been a useful experience because I more readily understand the void that someone’s death can leave. From my woundedness I’ve been able to be a more effective healer because of that deeper understanding.

A teenage girl had an impact on me shortly after the last encounter. She had been suffering from bone cancer for many years. Her family had taken her home to die but at the last minute had panicked and called an ambulance. The crew found the situation difficult, as did the A&E staff. The resus attempt was futile and the young woman was allowed to die with her family around her.

I was wandering through the department late that evening, as there had been a staff BBQ. A member of staff called me over and said they had just been trying to contact the chaplain and filled me in on the family situation. I went in and chatted with the mum and dad and the other siblings. They were all very upset. Dad told me he wasn’t religious and wouldn’t take part, I told him that wasn’t a problem, that as a Church of England chaplain I was there for people of all faiths and none. Mum told me she was Roman Catholic. I asked if she wanted a RC priest and she told me she had asked for that. I double checked with staff and they apologised for shoving me in with the family and that they had called for the RC chaplain. I went back in and explained to the family that the priest was on his way. Dad asked me to stay and mum said she’d like me to say some

prayers. I did a little ceremony with them getting them all to anoint their daughter/sister in their own way. They all participated. I was talking to dad afterwards. I gave him this Native American quote:

“When you were born you cried and the world rejoiced. Live your life so that when you die the world cries and you rejoice”

I said I could tell his daughter had lived her life well by the tears flowing for her and that was a good thing.

The RC priest arrived shortly after this and I left them to it. I wrote to the family and invited them back to the “Remember Me” event. This is a non-religious service to remember all those who have died in the previous year. They all came. The dad spoke to me and said he had found our chat helpful and that he had used the quote I gave him during his eulogy to his daughter at her funeral. To me that showed me, what I already hold as a deep conviction, all people have a spirituality and need to be embraced at those awful moments in their lives. That father found a meaningful encounter with me because I allowed him to express his spirituality how he wanted and didn’t make him fit into a prescribed religious formula.

The same night as the awful situation of non-acceptance of the teenagers impending death, I was also called to a family whose elderly mother was dying. The daughter wanted me to pray for her mum but wanted me to wait until her mum was asleep in case seeing me worried her. I did as the family asked but I must confess it made me feel a little awkward.

While I’m in the hospital I never wear all black. I often have a brightly coloured jumper on, or a different coloured clerical shirt or trousers. The reason for this is so I don’t look like the “grim reaper” I do think it’s my job to put people at their ease and break down any barriers they may have. People will always make assumptions and have stereotypes about priests. Once people get to know me I know I challenge those misconceptions.

Getting back to this family I think the issue was more that they didn’t want their mum to know she was dying. She probably knew anyway and may have wanted some comfort for what she was facing. I had to abide by the families wishes but promised I would also look in the next day.

I did pop back several times before mum died. Mum’s impending death was never openly discussed. I think that is so sad. We need to get better about talking about death. We are all terminal. It will happen to all of us so why don’t we embrace it? I have planned my funeral and made my wishes known. It always helps families if the person dying has said whether they want burial or cremation and what kind of service. It’s much better to have a personal send off than one that could be for anyone, for example one where only the name is familiar.

If this blog helps anyone talk about their wishes with loved ones then it is worth reposting it.

Varied responses to death all of which are "normal"

More reblogs for Dying Matters. A mixture of stories to illustrate the very varied responses to death. There is no one size fits all. What's important is to be alongside each individual or family where they are at.

 

It's amazing how many awful things happen very late at night. One night after midnight I was called in by the A&E staff. A man in his late 40’s had suddenly died after a suspected heart attack. When I arrived I found his wife was in a state of denial and her only support was from a neighbour. The neighbour was doing a sterling job but I gently probed about other family members. She said she had no-one. I asked her what she wanted me to do and she said “could you wake him up for me?” Initially I felt a bit stumped. I’d never been faced with such outright denial. I took my courage in my hands and gently told her that I couldn’t wake him up because he had died. She just said “Oh yes, I’d forgotten” I tried to engage her in a goodbye ritual but felt it was going over her head. I said some formal words nonetheless so at least she could hear them even if it wasn’t going in. I sat with her for a while. I felt totally inadequate. I just didn’t seem to be making any connection. After about an hour she decided she was going home for a cup of tea. I spoke briefly to the neighbour who assured me he would look after her.

Driving home I had to struggle with my feelings of inadequacy. As I got back into bed I “handed” the situation over to God. I felt better for that.

I later found out, through a colleague, that the woman was the same at the funeral visit and subsequent funeral. I wonder where she’s at now in her life?

That’s sometimes the difficulty with chaplaincy. In a parish situation you get the opportunity to continue the journey for longer with people. In the hospital I only get to accompany people for a short while and I often never get to know the end of the story.

 

By now I was feeling pretty well established as a hospital chaplain and nothing much phased me. I was happy to be on-call and not worried about what I might get called to. One night I had a call to come out to a 74 year old woman who was dying. Her family were present. The only strange thing about the request was that they wanted holy water. I checked that the patient wasn’t Roman Catholic and was assured she was Church of England.

I turned up with the holy water and my oil for anointing and was really surprised to find the patient was conscious. She was dying from heart failure and is often the case, was still aware of what was going on. This threw me as I hadn't yet experienced it. By then I had attended the bedside of many dying patients none of them had been remotely conscious. My words had been aimed more at the relatives than the patient. This situation meant I had to say words that meant something to a woman who was just about to make the most amazing journey of all. I felt inadequate and ill equipped. I checked that the patient didn’t want to speak to me alone and then stumbled through a liturgy. The family and the patient were very appreciative but I felt I hadn’t done a good job.

This taught me a valuable lesson. I now always ask if the patient is conscious. What I should have done was to take a few minutes out once I was aware what this family wanted and prepare myself and compose myself.

Another occasion, in the early hours, I was called into A&E. A 45 year old man had suddenly collapsed and died. The family had asked for a chaplain to come and say some prayers. There were lots of very distressed relatives already there when I arrived. They asked me to wait for the rest of the family to turn up. In the end there were about 25 relatives present. The room in A&E is very small. The body was on a trolley. I stood beside it. The family spilled out of the room and into the corridor. I tried to project my voice so they could all hear.

 

My practise is always to invite the family to anoint their relative and to say anything they want at the moment of anointing that honours their relationship with the deceased. They all took turns to file in and place their finger in the oil and anoint their relative. A man came forward. He didn’t put his finger in the oil. He just stared at me. Then he said really angrily that my God had killed his brother. He was pointing his finger in my face and saying“It’s your fault, you and your God, that’s why he’s dead.” I let him rant. Then I asked him if he had kids. He said he did. I asked him would he do anything to deliberately hurt them and he said no. I said I didn’t believe in the kind of God he believed in. I believed in a God who was a loving and kind parent like he was to his children and that bad things happen and we just don’t know why. With that he slumped at my feet and wept. His friends helped him up and led him away.

Violence doesn’t frighten me. I’m very familiar with it. I’m sure that helped me in that situation. It made me aware how vulnerable we are and what a target we are for people’s projections of what they think they believe in. I hope I did a good job that night by allowing the man his anger.

 

One day just as I was preparing to go home I was bleeped by children’s A&E. A 2 year old had suddenly become unwell. Resuscitation had not been successful. The family had asked for a chaplain to come and say some prayers.

When I arrived there was obviously great distress. The young mum was cradling her son, her sister was sitting next to her silently weeping and their mum was trying to be there for them but couldn’t keep the tears back. It turned out that the sister felt terrible because the baby had become unwell at her house and stopped breathing. She had tried to do CPR. She felt it was her fault that he had died. Gradually more of the family arrived. I was shocked to find out that one of the family had recently been murdered. As an extended family they were still mourning for this young woman’s death and now they had another tragedy to cope with.

I did an anointing, naming and blessing ceremony with them. They took turns holding the baby and anointing him.

After this as I sat with the mum and she started to tell me about her life. She had two children and they were put on the “At risk register” due to their dad’s violence to the mum. This had been so severe that it had put her in hospital and he had gone to prison for it. He was out of prison now but was not allowed any contact with her or his children. I was touched by this young woman’s desire to do the right thing. She wanted the dad to be told as soon as possible. Then she told me she had just sent the sister round there. I suggested this might not be the best way to go about it and it was better left to the police to inform him. I felt she had enough on her plate without having to deal with a potentially violent man. She agreed and phoned her sister and got her to come back.

I had been with the family for a couple of hours by then. I stepped outside the relatives room and asked what the hold up was. The Sister from A&E told me that they had been told to wait for the police, who wanted to see the body and talk to the family due to the children being on the at risk register and the sudden nature of the baby’s death. The Sister said she would phone the police again and see why it was taking so long.

Another couple of hours passed and the nursing staff changed shift. The new nurse who was looking after the family assured me she would keep chasing the police and find out what the hold up was.

By this time the baby had become cold and was going stiff. The mum had noticed this. She started rocking back and forth and saying “Please wake up. Please wake up” The rocking became more persistent and the strain in her voice was unbearable. Several members of her family had their heads in their hands. I was struggling to know what to do. I suddenly remembered the story “Water bugs and dragonflies” I said I’d be back in a moment and I ran over to the office and got a copy of it. I sat down next to her and said I was going to read her and the baby a story. She was still rocking and by now wailing. As I got into the story I could feel people’s demeanour change and they started to listen. By the end of the story you could hear a pin drop. Afterwards I just placed my arm around the mum and she lay her head on my shoulder and we just stayed silently like that for a while. Companionable silence is an extremely effective tool.

Six hours had now passed since I was first called and I hadn’t had a break or a drink or anything to eat. I excused myself and went back to the office for 15 minutes and had a cuppa and some chocolate and listened to some nice music. I felt odd leaving them but I knew I had to look after myself. I’d be no good to anyone if I conked out.

About half an hour after I arrived back, some police officers arrived. I wasn’t impressed by their attitude as they weren’t being very apologetic for keeping them all waiting so long. They explained that they needed to have a look at the baby and while that was happening they would have chat about what had happened. The mum found it hard to give the baby over, but she did. She then told the officer the sequence of events. He didn’t write any of it down and his phone kept ringing. He eventually gave his phone to a colleague and asked him to answer it. The colleague came back into the room and interrupted the statement and said he needed to talk to him urgently. The officers left the room. They came back in a few minutes later and said they were sorry but they weren’t allowed to continue and that the area team would be taking over this case. They explained that they were on their way from Gravesend and shouldn’t be too long.

I was absolutely dumbstruck. The baby was brought back in and given to the mum and they left. About an hour later the other team turned up and it all started again with mum having to hand the baby over. This time they were apologetic from the start and seemed to have a better attitude. Before they started I said I hoped they were going to take notes of what the mum was saying so that she didn’t have to repeat it all over again. I also asked if they could arrange for someone to go and tell the dad as this was weighing on the mum’s mind. I also stressed the importance of not giving any details of where mum was living due to him being out on license and the terms of the licence were no contact with mum or children.

I could tell by the way they were looking at me that they were wondering how come a priest was so aware of the terminology. It was really helpful to have had the background in working with domestic violence in order to support this young woman effectively.

They took the statement and said they then wanted to go back to the sister’s house first and then go back to the mum’s house. The police left with the sister. I then had the difficult task of getting the baby into the mortuary.

At times during the 8 hours that I had spent with the family I had been asked to hold the baby. Mum said she wanted to take him to the mortuary. I said she could do this but she wouldn’t be able to come into the working part of the mortuary. She asked me if I would take him for that last part.

Before we went over to the mortuary I spoke to the nurse who was coming with us and told her that this was going to be the flashpoint. During my chats that evening the mum had said to me that she was dreading that moment. That she had known where her baby was for every minute of his life and he had never been left alone. How was she meant to leave him?

We sat in the relatives room of the mortuary for a while and then I stood up and said she needed to say bye for now and that she could come back the next day and spend more time with him. She stood up but couldn’t quite hand the baby over. I gently lifted him from her arms and the nurse took hold of her. The mum really wailed at that point and I quickly left the room so as not to prolong the agony for her.

Once on the other side of the door I took a deep breath and tried to compose myself. The porter opened the fridge door for me and I gently laid the baby in there. The porter then said how hard he found seeing dead children. I then spent some time with him and how it affected him. I made sure the paperwork was done and I left the mortuary and went back to the mum in the relatives room.

When I said my goodbye to her I gave her a hug and told her to feel free to contact me if there was ever anything I could do. I watched this young woman walk away. She was trying really hard to be strong but she was slumped as she walked. I wondered if she was ever going to recover and I wondered if I’d ever hear from her again.

As I got into my car the radio flickered to life and Robbie Williams dulcet tones emerged singing “Angels” I wondered whether this family were going to be able to sleep that night knowing their little angel was gone for good.

As I got nearer home I decided that I wasn’t going to cook as it was now 1am. I remembered a late night chippy and picked myself up a bag of chips to take home. I sat at my dining room table half eating the chips and half staring into space and I began to start processing the events of one amazingly intense night.

When I talked about it with my supervisor he pointed out the many complex roles I had held that night. I had been the point of continuity. The doctors and nurses had changed shift but I had stayed throughout. I had been a bereavement counsellor to the extended family over the murder of the young woman as well as the tragedy of the baby’s sudden death. I had carried out a priestly function in anointing the baby. I had been carrying out staff support in looking out for and allowing the nurses and porter to express their sadness at the events. I had advocated for the family to the police and I had given some practical advice with relation to the domestic violence and the implications of contacting the dad. I had also physically carried out other roles in taking the baby to the mortuary and placing him in the fridge.

I hadn’t seen it like that but my supervisor was right. It was a very intense night with varied interactions with many people and it shows the complex nature of chaplaincy.

 

Death and children

This reblog for Dying Matters Awareness Week focuses on children and may provoke some tears.

Summer continued a pace and with it came a little lad on our PICU. He was 12 years old. He had a very big operation and lived somewhere in the Home Counties but had come because of my hospitals children’s surgery specialism. I had been chatting to his mum for a while about all sorts of things and I discovered that this young boy liked motorbikes. I started chatting to him about the various bikes I had ridden over the years.

Before I left I asked if there was anything that I could do. Mum said no but thanks for the chat, the young lad said there was something. I told him to spit it out, but he was a bit reluctant. In the end he said the one thing that he wanted was to be able to talk to his dad on the phone. I was slightly perplexed as to why this was a problem. Then he told me that his dad was in prison. I said I would do my best to see what I could arrange but no promises.

I phoned the prison and spoke to the chaplain there. He told me that he was aware of the situation but without external verification they had not been able to do anything about it. As I had phoned that was all the confirmation they needed. They then were able to get the boys dad and he had several chats on the phone despite the expense of patientline. The little lad was made up. He was so pleased to have spoken to his dad. He astounded the medical staff with the speed of his recovery. I’m sure some of that was down to him being content and feeling listened to and valued.

A few weeks later I got a card from this young man. In it he wrote:

“Thank you for your help so I was able to speak to my Dad at Elmley prison. Keep enjoying your bike. I hope to ride my mini moto very soon”

It’s so important, as far as I’m concerned, to be approachable so that people feel they can ask you anything and that you won’t sit in judgement over them.

Around this time whilst on call one night I had a very strange call out to HDU. A patient who had been on ICU was now with them and aware enough to realise that her baby had been delivered still born while she was unconscious. She had requested to see the baby. She wasn’t well enough to be taken over to the mortuary, so the baby had been brought to her. She now didn’t want to give the baby back and the staff weren’t sure what to do. It was a Sunday evening and the other staff that might be helpful, like mortuary workers, wouldn’t be around until the morning. In desperation they phoned me.

When I arrived the whole family were visiting and taking turns to hold the baby. After chatting with them I said the baby could stay till the end of visiting time then I’d have to take him back. Mum was very reluctant. She was still a bit dazed and also had learning disabilities. That meant I wasn’t able to give her the booklet about what to do after your baby had died, as she couldn’t read. It was an extremely hot day. The baby needed to be put back in the fridge. My problem was how to explain this with other small children around in a way that wasn’t going to upset them and that they could all understand.

I explained about the staff in the mortuary and what good care they’d take of the baby. I also explained that they would take some nice pictures if they wanted some. I went on to say how beautiful the baby was and explained that the only way to keep him looking so beautiful was to keep him cool. The 5 year old then asked me why. Oh dear! How was I going to answer that? I explained that we had blood going round us and we could drink nice drinks in this warm weather and that helped us keep cool but the baby couldn’t do that, so he would go all droopy like a flower that doesn’t have water, so the way to keep him looking so beautiful was to put him somewhere cool. The whole family accepted my explanation and allowed me to take the baby. I’m not sure it was the best explanation in the world but it was “good enough” for the time being and gave me the chance to take the baby away.

I went back to the ward after and spent some time with the mum alone. She was in hospital for weeks and that delayed the funeral. During this time she developed a good relationship with the mortuary staff and felt supported by the hospital in general.

This woman has been in and out of hospital since then and I have been able to support her with all sorts of things including filling in benefit forms for her and her 21 year old daughter who has become her carer. The role of a chaplain is extremely varied.

Shortly after this I met another woman who was struggling to come to terms with the loss of her baby but in very different circumstances. The baby was a very much wanted first child but the mum had taken the very difficult decision to terminate the pregnancy after a severe spina bifida was detected.

I met with mum before she delivered the baby. She asked me if I would bless her baby after she was delivered. I went back after the baby was delivered but mum was in a lot of pain and very tired after a very long and painful night. She asked if I would come back when she was feeling better. After talking to her we agreed to meet in the mortuary. She said for me not to knock but just go in when I arrived.

That day was one of those days. I was feeling tired and fed up. There were lots of demands on me and I was struggling to keep up with them. When I arrived at the mortuary the scene that greeted me was one that was so beautiful it stopped me in my tracks. The mum was cradling the baby and gently rocking her and reading her a story. The story was sleeping beauty and every time sleeping beauty was mentioned the mum changed the words and used the baby’s name instead. I stood behind her witnessing this scene with a lump in my throat.

Later when I was saying goodbye to that woman I thanked her for giving me such a beautiful moment in my day. A few years earlier I had been to a talk given by a Buddhist about beauty. He had said about how you could find beauty in everything, even the mundane like tying your shoelace. I had thought this was navel gazing in the extreme. I also wondered what beauty could be found in the death of a child? What that woman showed me that day was that there can be beauty amongst even the great sadness over the death of a child.

Around this time I also got to meet a family whose premature baby was in NICU. This family had already had two other premature babies. One had lived and one had died.

I gradually got to know the family better and was able to support them through the roller coaster ride of the ups and downs that their baby son was taking them on. This family had no faith or religious affinities but I was able to support them despite our differences.

At one point it looked like they had turned the corner. The baby had moved further down the unit to the area where there is less intensive care and things were looking up. Then the baby worsened and started to go downhill again.

One very hot evening just as I was preparing to go home I came around the corner and literally bumped into the parents. They were extremely upset. I brought them into the office. Over a cuppa they told me that there was no hope for their now 4 month old baby. It had been decided to withdraw treatment. They had come away from the unit to try and get themselves together and to wait for their daughter to arrive with her grandparents.

One of the things about dealing with a religious family is that it gives room and a framework for a ritual. When dealing with a non-religious family you have to create your own ritual. Rituals are quite important to mark endings. I encouraged these parents to think about what they wanted to do or say to honour their son and wish him well in his death. They decided to think about it and go for a walk while they were waiting. At the door the mum asked me if it was right to bring their 4 year old in and let her be part of what was going on. I said I thought it was really important and that she had been visiting him and was looking forward to having a baby brother at home. She needed to be allowed to say goodbye. At this point the mum started crying again. I hugged her and she just sobbed, then her knees buckled and she sank to the floor. I sank to the floor and continued to hold her. She just kept crying out “I can’t do this again, I just can’t do this again” When I pressed her as to what she couldn’t do again she said she just couldn’t hold another baby while he died, that she had done that once before and she couldn’t go through that again. The dad also said he couldn’t do it. I was still holding her and trying to reassure her and she said to me “ You give such good hugs. Will you cuddle my baby while he dies?”

Inwardly I gulped, but outwardly I reassured these parents that I would do anything that they wanted that they thought would be helpful.

I went to the unit when all the family had arrived. I encouraged all of them to say their own individual goodbyes as well as a joint family goodbye. I encouraged them to tell the baby what they were going to miss about what they had wanted to do with him. I then stepped behind the curtains and allowed mum and dad to spend some private time with the baby. During that time I hugged a few of the nurses who were finding it all very sad, as they had nursed this little boy for four months, as well as the doctors who were present. After a while Mum came out and she left and went to the relatives room. Dad then held the baby as they started to withdraw and then when he couldn’t take it anymore he handed the baby to me.

I looked at this tiny baby who was the most precious thing to his parents and I thought about the amazing trust that this couple had put in me. I sang to him and gentle rocked him while he slipped peacefully from this world. What an amazing privilege!

What did I learn from all that? I learned that chaplaincy is a complex role. When I came out from behind the screens to give the parents some private time I wasn’t able to take a breather because my attention was then on the staff of the unit who were finding the situation tough. I also learned the importance of being around and being part of popular culture. My conversations with parents inevitable start with chats about “Big Brother” or the football or Eastenders, or Harry Potter or the Da Vinci Code. These are not necessarily things, except the football, that would have been part of my life before. They have value though. As I build a relationship based on these chats people begin to see me as a person. The clerical collar stops being a barrier. From there the relationship can deepen if necessary and I’m not a stranger who comes in and says a few prayers and goes in their hour of need.

I also learned the importance of looking after myself and having good and regular supervision. It was an immense privilege to be asked to hold this little baby and an enormous position of trust, but it wasn’t without its cost to me. I needed to go home from the hospital and be very gentle with myself and begin the task of processing the experience.