Yesterday I was on call and intended to goof off all day—I think I was worried that I’d have a profound experience with a patient that would make me feel I’d made a stupid decision regarding TWMC. But at about noon, I’d run out of non-work activities, and also had to acknowledge that my numbers for the week looked pretty pathetic, particularly after not having seen a single patient all day Wednesday. Number of minutes spent seeing patients; number of minutes spent looking at charts prior to visits, charting after visits, and traveling to or from or otherwise preparing for visits; number of patients seen; number of initial visits, etc.
So at noon I went to one of my three floors and visited all the good candidates for visits, including an old man I had seen before and liked right away. After our visit, while I was still on that floor, he received bad news and asked to see me again. He’d learned that he has a tumor and said he would like a prayer. I asked what we should pray for and he said he hopes that if he has to have surgery, “I come out a winner.” Here he choked up. I felt very touched by our encounter, and indeed felt that maybe I’d made a big mistake; maybe I should email TWMC first thing Monday and take back my resignation. Or maybe they will say, “We respect your decision, but would you like to come in and discuss it in person?”
At three p.m., numbers much improved, I was going to go to another of my floors, but was paged to attend to a dying patient. Her family wanted a priest to come and perform last rites and also a chaplain to come. I summoned a priest—they only come if the patient is Catholic and if a specific sacrament is needed—and he performed the rite and offered absolutely wonderful prayers as the other five of us stood with him around the body of the dying woman. He told the dying woman, who was unconscious, that she could release all fear or trepidation, and to lead us into the Lord’s Prayer, he said something like, “At a time like this, we can call upon God as we call upon a loving parent: Our father … ”
After the priest left, the woman’s two daughters said they did not want to see their mother die and that they wanted to leave, with their husbands. I said that was fine, and that I would stay with their mother. Then it occurred to me that maybe they didn’t really want to go, but were scared of being with a dying person. I’m surprised people would want their loved one to potentially die alone, but I can understand being afraid of witnessing the moment of death. I added that if they would like to stay, I would stay with them and keep them company, and all four of them ended up staying. The young, tattooed nurse felt bad about not being able to hang out there with them and said to them, in reference to me, “You’re not alone—thank goodness.”
We sat there together for more than two hours, and eventually everyone relaxed and one of the daughters told me about her mother, the flowers she grew and the dresses she sewed and the meals she cooked. After the mother’s heart stopped but before the breathing machine was turned off, her children left the room. I told them I would stay until she had passed. In her final moments and just after, I put my hand on her forehead and told her all was well, and that she was very loved. After she was gone, I said, “Rest in peace,” and at the doorway, I bowed to her.
We have a template we use for chart notes, where we fill in various pieces of requested information. I deleted most of the template, and entered the names of the patient’s daughters and their husbands. I referred to the patient by name instead of as “pt” and I typed in what her daughter had told me about her, so that my note could be a small memorial.
At this point, I was even more sure I’d made a terrible mistake regarding TWMC.
I went to the apartment where we on-call chaplains stay, where I have never gotten a page later than 5 p.m., and at 7:40 p.m., just as I was thanking the pizza delivery guy, a page came in: a patient was actively dying at another campus and his wife wanted a priest. I spoke with the wife on the phone and found it difficult to explain, in my limited Spanish, that since her husband wasn’t Catholic and therefore not in need of any sacrament, we couldn’t ask a priest to come. She was Catholic and just wanted to talk to a priest. For that, we have on-call chaplains, but this particular on-call chaplain was about to scarf down an entire pizza and was thus disinclined to serve. The woman was under the impression that I myself am a priest: “Are you a father?” (Hmmph.)
I told her I would call her back and called the nurse to ask if there was a staff member around who could translate for us. The nurse said there wasn’t, but that the woman’s son should be able to do that. I said it was fine to give him my cell phone number, but never heard from him. I rationalized that if they really needed me, they would have called, but I definitely felt guilty. I should have just gotten in a cab and gone over there. (I found out the next day that the patient died about 20 minutes after his wife and I spoke. She sounded remarkably composed, another reason I didn’t rush to her side.)
Don’t worry, I didn’t go unpunished for this. At 9:35, just after I’d gotten in bed, yet another page came in, again from a different campus. A family had gotten the news that their loved one was going to die and wanted a chaplain to come. It didn’t sound as if the patient was actively dying, so I called Samantha to see if we still go in that case: yes. So I got in a cab and headed over there, at this point past compassion fatigue and into active hostility. In the woman’s room, all hard feelings forgotten, I offered a prayer, which was pronounced “beautiful” by one of the 10 family members present.
My cab driver on the way back was born in 1944 and didn’t go in for pot smoking and all that in the 1960s; he was a boxer. Later he traveled with bands as a roadie: Santana, Journey, Natalie Cole. I told him my very first concert was The Spinners, with Natalie Cole, at the Bowen Field House at Eastern Michigan University in Ypsilanti in 1976, when I was 14. “That was me!” he said.
Yes, my decision regarding TWMC was correct. I will take the long way to whatever the destination turns out to be.