The privilege of collecting tears

One day I was called to the ward where an elderly man made an impact on me. His wife was dying. She was nominally C of E and he nominally RC. They had been married for 72 years. He was very strong while all his family were present. I used to pop in early in the morning when he was there on his own. For those few days that we chatted he would break his heart over the separation that he was about to experience. He told me that they had never been apart. Not even during the war because he had a job that kept him at home. His whole face would crinkle with grief as he spoke of his memories. As official visiting time got near he would blow his nose and become the stoic man that his family knew. I was so pleased he allowed himself to cry with me. The patient died and I watched the family walk away surrounding the surviving spouse. Somewhere deep inside of me I suspected that this man would soon follow his wife.

Around this time the woman that had cancer and believed God would heal her came back into the hospital. She was very poorly and the chemotherapy she had endured for system control was not helping.

When I visited I found she was more receptive to me. We talked about lots and I would pray with her regularly and read to her from the Psalms. She grew frailer with every passing day. On Maundy Thursday I knew she didn’t have much time left. With her families permission I did a liturgy which involved them anointing her and in turn she anointed them. It was very touching. At the end I gave her a hug. I said it was a good time to die as it was Holy Week. I wished her well for her journey and said she would have a few choice questions for God when she met up. I asked her to give God my love. She smiled at me. As I walked out the door she weakly raised her hand and started to sing “I know that my redeemer liveth” I left the room smiling. The reason for the smile was that I had accompanied this woman on her journey and been privileged to see her shift from her fundamental perspective of expecting God to heal her to one where she not only knew she was going to die but she embraced it. Wow. Amen!

Theological and cultural differences lead to a hard time on the children's ward

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.

The grim reaper or a midwife to the soul?

At the time of writing this my full time colleague had been off or several weeks and I was feeling the strain of working so much on my own. In my opinion it is not good to work in such a demanding role in isolation. I had built up some good relationships around the hospital and could go to some of my colleagues for support. This is not the same though as working with someone who you share a set of spiritual and religious beliefs with. I was also feeling swamped with work. It’s hard to suddenly go down to one fulltime person when there are usually two.

My usual way of dealing with these things is to put my head down, grit my teeth and get on with it. This however is not good stewardship of myself, so I asked for help from the hospital management and from the Diocese. I also asked for help from the local clergy. I was very fortunate. The Diocese were able to arrange for a local curate to come to the hospital one afternoon a week. The hospital management said I could get someone each week on a locum bank hours contract and I also built up a list of 15 volunteers from local churches to cover the emergency rota. All this made me realise how much work the two of us full timers do. We work a 37.5 hour week and then do another 45 hours on call. This of course is spread out 24/7. There is a retired cleric who always covers a Friday night, otherwise it’s down to just two full timers. If one of us is off for any length of time it puts a severe burden on the other person.

Saying all this, I love a challenge and I rose to it and really enjoyed trying to co-ordinate and develop so many different aspects of the chaplaincy service.

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.

Priests who are poles apart in more ways than one

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.

Holding the tension of difference

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.

Filling a blank wall with positivity

I had been around ICU quite a lot and had picked up that there was a woman who was quite seriously ill. She was being ventilated but was awake. I would often wave to her as I went past. On one particular day the staff stopped me and told me that she had just been told there was nothing further that could be done for her. They said she was really fragile and could I see if there was anything I could do.

I went and introduced myself and said that staff had told me she had had some bad news and I was wondering if she wanted to talk. She indicated she did. Communication was difficult due to her ventilation and so I had to lip read. At times I found it very frustrating that I couldn’t understand her. She told me she wasn’t religious but she was spiritual. She had been told that there was no further surgery that could be done and she would likely die very soon. She was really scared. I asked her if she wanted me to anoint her. She asked what that was and then said she wanted something but maybe not that. I said I’d go away and create something and come back to her.

I came back a few hours later with an Iona liturgy that I adapted. She took great comfort from it and seemed more peaceful afterwards. I continued to visit this woman and much to everyone’s amazement she began to improve and was eventually moved to a ward. I carried on visiting her over the year that she was an inpatient. She went through a really down time where she became quite depressed. She was staring at a blank wall so I decided to turn it into a positivity wall.  I used to do her a thought for the week, which was a short quote. These gradually filled the wall and became a strong talking point amongst her visitors and the staff. In fact staff liked it so much that I used to pin one up on the notice board outside the chapel. Eventually the woman went to a more specialist hospital. By then she was more positive about her future and how she was going to cope.

A hard decision with split loyalties

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?