I once read a book entitled Random Family: Love, Drugs, Trouble, and Coming of Age in the Bronx by Adrian Nicole Le Blanc. As the title indicates it is an intense portrait of lives filled with drugs, abuse, violence, incarcerations, dysfunctional families etc. It was so wild I almost found it hard to believe. It certainly was not a part of my own experience. Now I know the book was real!
One Sunday morning I was called to the Emergency Department for a Code 10. The patient had attempted suicide and was revived...at least his heart was revived.
As the story unfolded, I learned that he had posted a suicide note on Facebook that morning and a close friend saw it. She in turn notified his mother who found him unresponsive and pulseless. Emergency responders were able to revive him to the extent that he had a heartbeat and blood pressure. Now he was in our ED on life support.
Eventually his mom arrived very distraught as one might imagine. Her appearance revealed a life fraught with physical and perhaps psychological and emotional challenges. As the morning wore on, she shared her story about her own very poor health, death of her seven siblings from cancer, suicide of her husband at a young age, prior incarceration of this son while her other son is currently in prison, and more.
The patient's “baby mom” arrived. By “coincidence”, she had been at work here at the hospital (through an agency) and heard the Code 10 called and felt immediately she knew who it was for. Their son who is 6 yrs. old was at home with family. She had a quiet strength although very tearful and emotional she was realistic in her expectations for a good outcome.
The neuro intensivists and Nurse Practitioner examined the patient to evaluate his status. They performed many tests to evaluate his brain function. During this time the “family” remained in the patient’s room. I chose to remain as a quiet, calm presence in this emotionally charged situation. The patient’s mom was alternating between, tears, anger and blame.
At one point I quickly left for a few moments to get some Care Notes for the “family”. I picked two which dealt with how to tell a child about the death of his parent. They were colorful and meant for a child to see.
I arrived in our office and was immediately paged back to the ER. On arriving the neuro- intensivists said to me “I was the one who paged you. They really need you now. The news was not good”. I was appreciative of the fact that he recognized that spiritual support was much needed and that he took initiative to request it.
The mom shared that her other son was currently incarcerated locally and she wanted him to come in to see his brother before he died. This began a LONG series of phone calls trying to get a human rather than a recording. Frustration set in with phone multiple options, "push "1" for...push "2" for ...all on a Sunday morning when much of the working world had a day off. At one point a woman did answer at one of the phone numbers from the many attempts and put me through to the lieutenant at the correctional facility. He who was familiar with both brothers and also knew one of the other chaplains here! Synchronicity! The news, however, was not good as there had to be permission from a higher authority and transportation arrangements made which could not be done on a Sunday. Time was of the essence in this situation as he could be dead in hours. .
The patient's mom also requested a visit from her Orthodox Church priests. A call was placed and the promise was made that they would arrive that day. Unfortunately, when they did arrive the patient was being transferred to ICU and then admitted there. This is generally a lengthy process and they did not stay.
When my shift ended it seemed that all did not go as hoped. I had to trust that all would be resolved that evening and it would all be over soon, however, this was not to be the case.
The pt. was in ICU on Monday morning. I spoke with the “baby mom’ and she told me how she brought the child to the ICU to see his dad. She felt it was particularly important as the patient had promised the night before to see his son that day and now would not be there. She brought home the Care Notes and the child asked that she read them to him. She told me the plans she made to help him though this time.
Back in the unit, the report was passed on that the patient's brother was coming to visit from jail...but was he? Or, was it that passed on to the hospital staff because I tried to initiate it Sunday? The catch was that I told the Lieutenant at the correctional facility that the patient would probably die in hours. Was the message passed on to the Monday crew so they could make the arrangements? No one knew for sure. That began another set of endless phone calls only to find out that the phones were not functioning at the facility and so there could be no contact. The end??
The priest was called again and this time two of them came to be with the patient's mom and to pray the Orthodox prayers over the patient. By afternoon the word came that the prisoner would arrive. He did, in his orange uniform and shackles on both wrists and ankles, escorted by two Correctional Officers (COs). He was walked slowly to the bedside where he said his farewell and cried inconsolably. After a few minutes, I asked the COs if I could go in the room and offer some prayer perhaps. They agreed. The prisoner asked me about heaven, told me some of his story and concerns. He asked many questions of me. I answered, supported and suggested he might talk with the correctional facility’s chaplain. By that time the UNYTS nurse and nurse manager who had entered the room were able to support him as well. Having been a volunteer in several prisons over the past 10 years, I was acutely aware of repeated stories by the men and women about how they were not able to be at the bedside of a dying relative. They have shared their suffering because of this. This motivated me to make sure this did not happen in this instance.
The next morning the pt.’s room was empty as the body, still expertly kept “alive” by the nurse and doctors, was on the operating room for the "harvest" of organs. "Harvest" in the usual sense of the word is gathering the fruits of our labor, from the soil, bushes and trees, to provide nourishment to our bodies. Perhaps this word was intentionally used as this body, although it had experienced many "droughts", was still able to provide new life to others.
This is a sacred story because of the humanness and goodness of all who were present. For me it shows hope.
It was about the mother who though suffering her own illnesses and addictions wanted her incarcerated son to "be with" his brother as he lay dying.
It was about the incarcerated brother, though imprisoned for his crimes, still poured out his grief with a multitude of tears as he stood by his brother with his shackled arms and legs, his humanity very evident.
It was about him still having human dignity and being invited to touch his dying brother's hand, to reconnect skin to skin, give him a kiss. It was about being offered tissues to dry his so human tears.
It was about the ED nurse who cared for the patient and family and gently shared what she could about his condition.
It was about the compassionate UNYTS nurse who rode the waves of the patient's mom's unpredictable emotions and quick changes from calm to anger with her own peaceful, compassionate presence.
It was about the doctor who recognized that the family needed something he was unable to provide and his call for spiritual help.
It was about the new ICU nurse who broke down into compassionate, tears of deep connection and understanding as she watched the brother's anguish as he said "good-bye" and "I love you". She was affirmed for showing her own humanity.
It was about the nurse manager who calmly attended to organizing and overseeing the patient's, family's and staff needs.
It was about the nursing staff that tended to this patient and enabled all that had to be done to his body in order to bring life to many even in this tragedy through his promise of organ donation 10 yrs. before.
It was about the caring, compassion, non-judgmental attitude of all within the midst of the messiness of broken lives and death. It was about the man who had lived with the patient's mom for 26 years and left her for another woman, who came to the hospital and was at her side to support despite their past.
It was about the synchronicity of my schedule change two months ago so as to work Sun, Mon (and Tues) in an effort to meet our patient’s and family’s needs (whoever they may be and no matter their past) with some consistency.
It was about goodness and hope and life in the midst of dysfunction, addiction, crime and broken relationships.
It is a sacred story.
BCC Mercy Hospital