Saturday, March 31, 2018

Code Emma

Toward the end of February, I saw a patient at work who seemed very bright and well educated. His manner was affable, he was open and forthcoming, he smiled frequently. And his life was nearly empty of people. In a mild, almost offhand manner, he shared how he had been very generous with this person only to be abandoned in return, and how another person had not so much as telephoned him while he was in the hospital.

It was somewhat chilling, because he was so much like me: not someone who seemed terrible, not at all. He seemed to have many fine qualities, yet his attitudes (per my own analysis after 45 minutes of conversation) had made it so that he had ended up alone, or at least feeling alone.

Being with so many people who are dying has certainly made me think about my own death—where? with who present? with a tube down my throat?—and also about how best to care for my health while I still have it. But maybe the most important gift is getting to think about how to live between now and death. I still have a chance to learn to be more tolerant, to notice what I have received rather than what I haven’t, to nurture my relationships as best I can. I have today, anyway.

This makes me think of another patient I saw recently, one who was very generous. During our visit, she called to the nurse outside the room, “Can you please bring me a cup and some ice? I want to share my raspberry drink with the chaplain.” Later she said, “This hamburger is really good. You should have half of it.” I remarked on her readiness to share, and she said, “I was raised that way.” I imagine that she spends very little time thinking about who hasn’t come to see her, and I’ll bet she has plenty of visitors, including whoever had brought a vase crammed with beautiful white roses.

While I was charting at work one day, an announcement came over the P.A. system of a “Code Emma.” I immediately consulted the back of my badge, where there is a cheat sheet that explains what various codes mean. The person sitting to my left did exactly the same. We did not see this code on our badges. Someone behind us explained, “It means AMA—that someone is leaving against medical advice.” The patient who was trying to escape, in her wheelchair, was my favorite patient, the one whose chart contains a note by a nurse saying that the patient’s room was filled with smoke and when the nurse entered, the patient threw a pipe behind her bed. “Nurse was unable to retrieve pipe,” the note concluded.

To this day, this patient smokes in her room all the time, to the ire of the care staff, and does other things her doctors would prefer she didn’t. I could easily imagine her wheeling herself away from the hospital with all her might, joint dangling from her lips, but there was soon an announcement saying, “Code Emma all clear.”

Toward the end of the day, I had a text message exchange with another chaplain in which I feared I might have caused offense, so I sent a note saying that if strained feelings ever arise, I am happy to process. My colleague texted back, “Can I call you right now?” He wasn’t upset, but wanted to share some things that pertain to his work as a member of the chaplain team. We ended up being on the phone for quite some time and had a really nice talk. I was glad I had made the offer.

After all that patting myself on the back about my insight about F.—that we weren’t even in the same relationship—I texted him around that time, my first attempt to contact him since running into him on the street last June. This is what I wrote, in a series of three texts:

You may have heard this already, but if not, I wanted to let you know that [S.] died at Laguna Honda a month or a month and a half ago.

I am sorry. You were a wonderful friend to her.

I hope you are doing well. I think of you every day, I miss you every day, and I send you love and good wishes every day.


He didn’t reply. Not in an angry way, not in a friendly way, not at all. (Why would I think he would possibly reply in a friendly way? Yet I did.) In the most bereft moments after I texted him, checking my phone and seeing nothing, I gave myself the meditation instructions Howie often offers: “Just this moment.” One moment at a time, the period of wishing F. would text back—even angrily; just something—passed.

At work, I found myself using the same instruction often, along with, “Relax.” It made things seem very easy, very doable. Certainly I can do whatever needs doing in just this moment: taking a step, noticing what I see, pressing a key on the computer keyboard. In this year since losing F., I have employed many helpful practices and had many clarifying insights, and probably every bit of that was necessary at the time, but maybe the ultimate lesson is that, while many perspectives are useful, liberation doesn’t come via thought, but from turning toward what is—the sorrowful feeling, the knot in the gut—in just this moment, over and over. How wonderful that this is so easy to do. How unfortunate that it is so eminently easy to forget to do.
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