Extraordinary Minister

At work, I got a call to visit a young woman whose baby had died. The family spoke another language, so I asked the nurses for the interpreter phone—it was a weekend and the language was not common, so there was no chance of getting an in-person interpreter—and instead of handing me a substantial blue telephone, she handed me a little candy bar phone. I called interpreter services, which wanted a code I didn’t have. I kept asking the nurses for help, and they looked kind of irritated.

I went into the patient’s room and said one word to her: “Sad,” in her language. She nodded. I then was able to get an interpreter on the line, though there was a lot of annoying static. After the interpreter helped me and patient introduce ourselves to each other, the patient said she didn’t really feel like talking, so I asked the interpreter to stay on the line—which he kindly did, remaining silent for 15 minutes—and I sat down next to the patient and took her hand. She rubbed my hand with her thumb, a trusting gesture that made me think of a child. After that, I just sat there. Every time I had the impulse to do or say something, I reminded myself silently, “There is nothing I can do to fix this.”

I wondered if the patient’s family members were angry because I was allowing a mood of gloom to settle over the room: we called the chaplain so she could cheer us up! The patient fell asleep. I continued to hold her hand for five more minutes, and then I made eye contact with the family members and left as quietly as possible. Somewhere along in there, the patient’s nurse came in briefly to check on her. She must have told her colleagues what I was doing, because when I got back to the nursing station, they were all beaming at me. I apologized for the earlier chaos while I was trying to connect with the interpreter, but they said, “No, no, that’s fine!”

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I was called to see a patient who was upset because he had been told his time was short. For the first time ever, I said directly to a patient, while looking him in the eyes, “You are facing the end of your life.” As when I told Emily what hospice means, it was received much better than I might have imagined. The patient didn’t cry or protest.

He started out by saying he wants it just to be over. In that I recognized our self-protective tendency to devalue something that is being taken away. I once heard BJ Miller say at a meeting something about how the trick is to completely value our life and see its beauty while also saying goodbye to it.

Going directly by the book—namely, The Four Things That Matter Most: A Book About Living, by Ira Byock, MD—all his books are superb—we discussed how the patient might bring people to mind and ask for their forgiveness; he was preoccupied with not always having been the kindest person. We discussed if there was anyone he needed to forgive, if there was anyone he wanted to say “I love you” to, and if there were people he needed to thank. “That would be a long list!” he said with enthusiasm.

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When I began Clinical Pastoral Education in June of 2016, I was worried about being with dead people. This has long since ceased to be frightening, though it still feels like a solemn and important thing. The thing I was most worried about was having to baptize a baby, most particularly a dead one. I was worried about being able to execute the ritual (acting as what the Catholic church calls an “extraordinary minister”; anyone can do this) and I was worried that it would somehow be just too hard to encounter a dead baby and also have to perform the short ceremony correctly.

Early in February of this year, I was musing that, two and a half years later, I still had not encountered this situation, and then it happened. I was on call and received a page. The nurse told me that a baby had died the previous day and its parents had declined spiritual care, but had changed their minds and wanted their daughter baptized, which would require bringing her back from the morgue. The nurse said she wasn’t sure whether the baby was “dysmorphic” or not.

I headed over to that campus wondering if I would encounter a horribly deformed child. A nurse there searched for and triumphantly produced a small bottle of holy water (which did indeed prove to have mysterious properties), and the family’s nurse and I went into the room. The nurse served as interpreter, and did a fine job. Her manner was perfect.

As it turned out, the baby was swaddled up to her neck in a blanket, and had a little knit cap on her tiny head. I believe she did have physical abnormalities, but her face was beautiful and perfect. I started by saying that we wanted to honor the life this child had lived inside her mother. At this, the mother wept, which was good: one important function of ritual is encouraging the expression of grief. I had studied my cheat sheet beforehand and easily performed the brief baptism ritual: “[Child’s name], I baptize you in the name of the Father, and of the Son, and of the Holy Spirit.” A sprinkle of water on the child’s forehead is to accompany the name of each being, so thrice. The opening of the bottle was unimpeded, yet I could not get a drop of water to come out: that was its mysterious property. The nurse finally dripped a bit of water onto a piece of gauze, proving it could be done, so I proceeded a bit more vigorously—I hadn’t wanted to drench the baby’s face in water—and three drops came out.

(Normally you’re supposed to have the whole forehead exposed and apply the water so that it drips toward the back of the person’s head, but because of the knit cap and the fact that the baby was lying flat on her back, I resigned myself to the water dripping down the baby’s face, but since so little came out of the bottle, it didn’t drip.)

Then I explained that the Catholic church does not recognize the baptism of a deceased person, but said we were honored to provide the ritual and blessing. To clarify, anyone can act as an extraordinary minister to perform a baptism that will be recognized by the church, but it has to be of a living person, of any age, in an emergency situation where the person will not live until a priest arrives. It is not permitted to baptize a dead person, but probably most priests will provide an appropriate ritual and the sprinkling of holy water, and I’m sure there are priests who go right ahead and do an actual baptism, as a gesture of kindness.