Heart Work

One of the units I’m assigned to is pre-op, but I’d never had a conversation with anyone there until Thursday. Usually I just walk through the unit and smile and say hello to patients waiting to have surgery and their family members. On this day, a patient immediately engaged me and talked for 45 minutes about her long and really terrible medical history, which has involved two organ transplants so far. For one of them, she went to another country where they give you an organ from whichever criminal they have most recently executed. According to this patient, they test these organs for some things but not others, and she ended up with an organ that wasn’t very good.

During our talk, I began to feel a little green around the gills. I mindfully noted, “Very unpleasant, very unpleasant,” and noticed the feeling of my feet on the floor. I felt completely drained after our visit. One of the staff chaplains told me later that we don’t have to listen to a tale of this kind. We are welcome to interrupt and bring the focus back to something more immediate. At the place where I did CPE in the summer, we were instructed to study patients’ charts before seeing them, but here we don’t have to do that, and so I have no idea what is wrong with most of my patients unless they happen to mention it. Reading charts more than once made me very queasy, but it depended on the day, and I knew it was something I would get used to in time. It may well be that I end up realizing that I can be of more help if I do know in some detail what a person is dealing with. There is a difference between a joint replacement in an otherwise healthy person and stage four cancer.

On that same day, I got a phone message from F. saying that he wanted our relationship to be over. We have taken turns saying this to each other, or announcing a break, for many months, but I’m thinking maybe this was the real end. It is sad. I have seen the very dear facets of his personality, and I have many wonderful memories of us. Likely no one will ever be that in love with me again. But over the past year, I have too often seen parts of his personality that I find intolerable, and I have not been able to think of any way to get the nicer, more reasonable fellow back. That person seems to be gone for good, and I would rather spend my very limited social time with people who are cheerful, rational and tuned in.

So that was a hard day, and also a day when I rode my bicycle to work, which I have done only a few times. I like getting fresh air and saving money, but I felt wiped out by the end of the day. Maybe cycling to work is just too much exercise right now. I made a stupid mistake before I left work, as well. I’m also assigned to post-op, where people wake up from anesthesia, so I thought I’d swing by and see if the double transplant woman had survived her procedure. In post-op they said she’d gone back to her room on the transplant unit, so I went there and found her looking as if she’d spent the day at a spa. She was wide awake, looked great, and started complaining immediately. Fortunately, her doctor came along within ten minutes, so I could say, “Nice to see you after your procedure!” and leave.

The transplant unit is kind of a bummer. A pall hangs over it. I literally have the easiest units in the hospital—mainly joint and spine surgeries, though some of those are being done on cancer patients—and now I’m wondering if I only like this so much because I don’t have to hang around the transplant unit, or a neurological ICU, or an oncology unit. Also, the thrill of having the identity of chaplain is wearing off. I’m going to continually have to drop that and refocus on just being awake. If I don’t want to be “the chaplain” and if I get depressed visiting gloomy units, is this really a good career path for me?

Also on that day, I saw a patient whose baby (now several years old and perfectly fine) was born very premature and was in the ICU for more than a hundred days, an experience which permanently changed the patient’s perspective about what is important in life. When I went into his room, I asked how his day was going, and he politely asked in return how I was doing. I said “OK” and he picked up on that right away and inquired further! I decided to be honest and said, “I had a visit with a patient earlier that affected me; it’s kind of stayed with me.” That was all I had to say and the conversation went on. It felt good not to insist on being The One Who Is Fine (Let’s Talk About Your Problems), and when I recounted this exchange to the aforementioned staff chaplain later, she approved of my having been honest and not having insisted on remaining somehow above the patient.

We periodically get emails from the manager of the spiritual care department, Sarah, second in command to Paul. They always make me smile. We got one this week that began, “Dear hardworking and heart-working chaplains!”