During a shift at County Hospital in December, I was in an elevator with two sheriffs, each of whom was stabbing repeatedly at the “close door” button on his side of the elevator. One turned and explained, “Drive-by shooting: we have to secure the car.” Walking toward the chaplain office, I saw a car parked outside with both doors flung open, and a bleeding young man being carried toward the emergency department on a stretcher.
In the chaplain office, I mentioned this to two other volunteers. One has been around for a while and instructed the other to go to the emergency department. (Which he did not do. He told me later that there’s no point—that the only people who are going to be near the patient for the first several hours are doctors and nurses.) I described the sheriffs’ behavior in the elevator but, as I took a breath to continue my anecdote, the senior volunteer said to me, “Enough. Enough.”
This was annoying: Who is she to tell me when to talk or not to talk? Aren’t we supposed to be able to debrief with each other? Maybe she was trying to finish up her charting or maybe she’d heard enough upsetting stuff for one day, which I can understand, but maybe there’s a politer way to say so. I went away fuming.
At my paying job, I encountered a patient who had very impulsively committed a horrendous act of self-injury. He was open and easy to talk to. I spent half an hour with him, hearing about how he came to do this unbelievably awful thing, about his spiritual beliefs, and his plans to move forward with his life.
Afterward, I could not rid my mind of images of the act itself, as I imagined it—it was the very first thing I thought of when I woke up the next morning—and recognized this as secondary trauma, but I wasn’t sure what to do about it. I know it is important to talk to someone, but whom?
As I walked home in the evening after having seen this patient, I found myself seeking out pleasurable sense experiences, things that seemed to affirm life: the beautiful green expanse of Dolores Park, the smell of evening settling over the shrubs, a charmingly appointed apartment lobby with an ornate daybed, lights strung in trees. It makes more and more sense why the arts are so much a part of chaplaincy. Poetry and music and dance and literature bring beauty, joy, healing, sometimes laughter. Here’s something I hadn’t expected: because people frequently bring patients flowers, and because they often end up at the nursing station, hospitals are full of flowers!
When I got home, I called my ex-CPE supervisor, Anita, and told her about my patient. She was suitably horrified and recalled that I had said it helps me to write about things that bother me, so maybe I would want to do that. She also said that she finds it helpful to use the “empty chair” technique to express herself. She said maybe I could sit opposite an empty chair and say why this patient’s story frightened me.
I hadn’t realized that it had frightened me, but once I thought about it, I concluded that fear must be at the root of what we strongly react to. At first I didn’t think I was afraid that I would take that kind of impulsive action against myself, but that possibly I feared one day getting into the state of emotional misery that preceded it: what if my happiness goes away and I can’t figure out how to get it back?
But later I could see more clearly that this patient had felt abandoned and unloved, as I have at times, and he turned his bad feelings on himself, as I have at times, so I think the fear was not due to encountering something unrecognizable but just the opposite: seeing that this patient was on a continuum I have personal experience of, so could that happen to me? In the end, it was an example of projection: assigning “irrevocable self-violence” to this other person, and then being horrified by it, as if it had nothing to do with me.
During dinner the evening after meeting this patient, I lit red candles. The last time these candles were lit, F. was here, so it had been at least 18 months. They afforded a beautiful, festive touch.