On call

A newly minted hospital chaplain’s first call of duty stirs up a mixture of memories, fears and doubts.

By Laurie Eynon | For the AJC

The pager awakens me at 4 a.m. I am sleeping lightly, as I always do when I’m on call, in the basement quarters of the hospital where the medical residents sleep, just down the hall from the morgue. I, however, am not a doctor-in-training; I am a chaplain-in-training.

“There’s an imminent death on 4,” the nurse says. “Seventeen-year-old boy. Complications from the flu.”

Though I am groggy, adrenaline and apprehension kick in. First, of course, there are the circumstances. Seventeen? The flu? But there’s also the fact that I am a middle-aged woman who’s only been doing this job for a few weeks.

Not so long ago, I’d been writing advertising copy, sitting at a computer, wondering if touting the merits of overpriced items was what I wanted to do for the rest of my life.

The universe obviously was alerted to the fact that I was open to a life-changing opportunity, so I got one. Along came a serendipitous move from Indiana to Atlanta where my husband was offered a job at Emory Hospital. While checking out the hospital’s website, I stumbled upon the page for Clinical Pastoral Education, the hands-on, jump-in-with-both-feet training program for chaplains. I talked my way into the program even though I was missing the usual credential — a divinity degree. I did have an undergraduate minor in theology and experience as a youth worker in a Presbyterian Church. But mostly, the head of the program thought I had the right temperament and interesting life experiences. She decided to take a chance on me.

I knew, just knew, it was the change I’d been seeking. My confidence was high — naively high, as I look back on it. It’s not like I didn’t realize people would die on my watch. I just imagined them to be octogenarians whose loving families held their hands as they peacefully exited their long, happy lives. I could handle that.

Up on the 4th floor, I don my infection-control garments and enter the room. The boy’s mother looks weary but welcomes me. The handsome young man on the bed is unresponsive, still as a mannequin, except for the rhythmic up and down of his chest as a machine breathes for him with a whooshing noise. His eyes are wide open, almost surprised, as if to say, “Huh? C’mon, is this a joke? I’m only 17!”

Earlier in the day, his classmates and teammates had lined the hallways all day, but now it is just his mother and me in the middle of the night. His mother chokes up several times as she tells me what a fine boy he is. She holds his hand and strokes him. With my gloved hand, I take his other hand and listen to his mother pour out a glut of memories and feelings. She leans down and kisses him. Her mask and gloves are long gone. It’s her son, after all. Infection control, be damned.

“Go on, my sweet boy,” she whispers to him. “It’s OK to go.”

I ask her if she’d like me to pray and she says yes.

I begin to pray, my breath hot under my paper mask. I remember a more experienced chaplain telling me that, in situations like this, no one would remember exactly what I said, just how I made them feel. I am glad for this because my words, though from my heart, seem woefully inadequate in the scope of this tragedy.

Soon his vitals are flat on the monitor, but the respirator keeps whooshing. When the nurse comes in to turn it off, there is total silence in the room.

I sit with the mother next to her son’s still body. We hold on to each other as we wait for the funeral home to come.

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When I stumble back to the on-call room, it is almost daylight, but I fall into a deep sleep only to awaken abruptly two hours later in a state of absolute hellish anxiety.

The first person I call is Jon, my son in college 400 miles away.

Jon nearly died when he was 16. It had nothing to do with the flu; it was the result of a football injury to his spleen and resulting complications. He was in and out of the hospital for an agonizing three months and four abdominal surgeries. How agonizing was it? Well, I can remember sitting in my car in the hospital parking lot with all the car windows rolled up, screaming at the top of my lungs.

Jon eventually recuperated. Still, I knew, have always known, that I had a vulnerable spot around that event — I just didn’t expect it to show up unbidden in the middle of the night. But there it was: hospital room, handsome young man, anxious mother.

Just to infuse this event with more drama, when Jon answered the phone that morning after the boy’s death, his voice was hoarse and he coughed incessantly. He had the flu. He’d seen the doctor and was on antibiotics for a secondary strep infection.

Every alarm button in my head went off. I got a sick feeling in my gut. I called repeatedly to check on him; he stopped answering my calls. “You’re scaring me,” he said. But I could not shake the notion that he could be the next victim of whatever horrible infection had killed the boy.

Jon was much better in a few days, of course, as most people are who get the flu.

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In the name of full disclosure, I have to go back another 20 years. Back to Indiana. I’m at another hospital bedside, another child of mine. This time it’s my daughter. She’s almost 6 and she has leukemia. Unlike my son, she will not recuperate.

Kristie, my daughter, was 3 when she was diagnosed. She lived another three years with chemo, radiation and horrendous side effects to her treatments.

The last week of her life was spent in a large, gray windowless children’s ward where the small beds were partitioned off by flimsy curtains. Clear fluids hung from poles and tubes snaked into her tiny arms. Clueless staff wandered in and out, cheerily chirping, “How are we doing today?”

“Read the chart before you come in, idiot,” I wanted to say. “She’s dying.”

When they did realize that indeed there was a deathwatch going on in the room, they left hurriedly. They resisted returning. Several times, I had to search for a nurse because the IV bag ran dry.

The curtains did little to muffle the sound of other children crying or laughing from other “rooms.” After all, some of the young patients were simply recovering from tonsillectomies or other simple surgeries from which they would recover and go home and grow up. They, or their families, had no idea what was going on behind our curtain.

Because it was a major university teaching hospital, groups of young residents would often enter with an older, experienced doctor who explained in brusque clinical terms what was happening to my lovely daughter, as if she were a specimen in a jar. The young residents’ faces were horrified. No one dared look into my eyes, as wild and sleepless as they probably were.

I would have been grateful if they had bothered to engage me. I wanted someone to acknowledge my pain, even just my presence in the room. I wanted someone who would hold my hand and tell me how beautiful my daughter was and let me tell them stories about her, someone who might bring me a cup of tea.

She died without fanfare or drama. Her temperature had been 107 degrees for many days and her organs just shut down. It was 7 o’clock in the morning. Children were waking up and crying. Nurses were busy preparing meds and trays. It was over.

Many years later, when I saw the movie “Terms of Endearment,” I identified strongly with Shirley MacLaine’s character. Perhaps you know the scene: Her dying daughter is in pain. Pain meds are past due. The nurses keep saying they’ll get to it. Eventually, MacLaine’s character charges the nurses’ station like a wild animal, demanding that they stop chattering and “GIVE MY DAUGHTER HER PAIN MEDICINE!”

Had I been an older and more confident me when my daughter died, I may have had the gumption to be as fierce as Shirley MacLaine, but I was 26 and scared. So instead I wrote an emotional letter detailing my experiences surrounding my daughter’s death and sent a copy to anyone in the hospital who had any authority. People, especially children, should not have to die this way, I wrote. Families needed compassion, privacy and honesty.

All this was only vaguely poking into my subconscious the night of that traumatic on-call. Later that week I was lying on the couch with the TV news on. I was barely paying attention when suddenly I heard the newscaster announce there had been 12 flu-related deaths in the Atlanta metro area that week. Eleven had been residents of nursing homes; the other was a high school boy who’d had a college athletic scholarship. I started to sob great, gut-wrenching tears.

I thought of the boy’s mother and what she must be feeling at that moment. Perhaps she was trying to hold it all together for the sake of her other children. Perhaps she was in her car with the windows rolled up, screaming at the top of her lungs.

Maybe this experience was telling me I wasn’t cut out to be a chaplain. I had a choice. I could turn in my badge and go back to advertising or teaching. My son, Jon, who had borne the brunt of my anxiety, was urging me to quit. My family and friends could not imagine anyone wanting to do this kind of work.

I thought again about the boy’s mother. When I left her, she thanked me sincerely. But I had felt ineffectual. I wanted to be more comforting, although short of having Jesus walk in and raise the boy from the dead like Lazarus, there was nothing that would have sufficed. All I could do was be there.

Eventually I sought out my chaplaincy mentor, a wise and caring soul, for counsel. “Showing up is enough,” he reminded me. “Your presence is enough.”

It all sounds good in theory.

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Later I dug through a memento box and found the letter I wrote to the hospital when my daughter died. I took it in to my supervisor and read it. He smiled ruefully.

“How much different your daughter’s death could have been for you,” he said. “Someone like you, the chaplain, should have been there with you, the mother.”

There were few chaplains in hospitals in the 1970s. The whole concept of Clinical Pastoral Education was a relatively new phenomenon back then. Atlanta’s first such program began in the 1950s at Grady, but it was many years before the concept was widespread.

But I suddenly realized my mentor was right. What I had needed most when my daughter died was a hospital chaplain.

The point may seem obvious now, but not to me at the time. My daughter’s death had been 25 years earlier. Emotionally, I had pushed it aside. I had healed, moved on, made peace, blah blah. But, of course, you never do. It’s always with you.

So I stayed with it. I am a hospital chaplain. Despite my lack of the usual qualifications, I now work in a prestigious Atlanta hospital where my work is valued and praised.

It has not been an easy journey. It has required a lot of soul searching because what I bring into any room is really, well, myself. “I’m here,” is what I’m saying to my patients. “I’ll stay with you through whatever happens. I’ll listen to you. I’m here for you.”

I’ve witnessed many, many deaths since that 17-year-old boy. Some, I’m ashamed to say, I hardly remember. But I will never forget that one. It is etched in my memory with almost as much clarity as my daughter’s. It was the night I became a real chaplain.

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