Thursday, March 27, 2008

Idle ramblings

So, one night I was working in the inpatient hospice and a patient was dying, and he'd only been there an hour or so and I didn't know a thing about him. (That's not all that uncommon; I think sometimes when patients come over from one of the nearby hospitals they get to our floor and it is so QUIET that they can finally hear themselves think, and mobilize themselves to get on with dying instead of wondering what that latest overhead page means.) I did learn that he was a real adventurer, piloted planes, I can't remember what all else. Eventually it was time to call the mortuary and my favorite wild driver showed up, and oh, yes, it was snowing to beat the band. I met him at the ambulance entrance and asked if he had his GPS up and operational. OH yes, he said, with a twinkle in his eye. Good, I said, because this one? I think he'd like a little ride. YOU GOT IT, said the driver, and it made me feel happy to think that our late patient was getting his last ride from someone he'd probably have really liked knowing.

One night I was working a shift in the hospital and got called to the emergency department to offer support to the mother of a toddler who had accidentally ingested something toxic in the home. Poor mother--she was there by herself because she has another child who has long-term health problems and had just had surgery and was requiring round-the-clock care at home, and so her husband was home taking care of that child, and mom had run out the door with no socks, shoes, coat, or hat to get to the hospital with the sick toddler, who had to be intubated and hooked up to IVs and monitors and so forth until the toxic stuff worked its way out of the system. Poor mother--best she could figure, the ingestion happened while she was in the middle of some procedure the other kid needs and this toddler just grabbed something--YIKES, little kids grab things so fast--and now the mom was feeling terrified, guilty, lonely, lost, terrified, sick, exhausted, terrified, you can just imagine. And more or less in shock because all this happened so fast and there was the toddler on a ventilator heavily sedated.

Kind nurses had found warm no-skid socks for mom's feet and gotten a chair right outside the trauma bay and water for her, and the staff chaplain just going off shift had been there for her. She worried me because she would alternately sob, desperately and convulsively, and stare ahead with no expression at all. As she began to talk a bit and told me her story, of the other kid who has had so many challenges, of her good and faithful husband who felt so torn but knew a parent needed to be with each child, of their lives, so focused on kids right now that they haven't even had a chance to build a friendship network since moving to this state to be near the best care for the other kid, of her terror that the toddler wouldn't pull through, I began to see how much she and her husband had fought for these children of theirs, how devastating this day's incident was, how truly she believed herself to be an awful mother. She began to shake, then told me she was moving into a panic attack, "I can't stand that I can't do ANYTHING." "I know," I said, "That has to be the worst for a mother--right now you can't go in there and take care of your little one and make it better." "I can't do ANYTHING," she wept, shaking. "Well," I said, "We can pray." I began to talk, very softly, about how we could ask God, the great physician and healer, to touch the toddler, take the toddler into God's hands, and work with the strength and resilience of the child's body, of how we could ask God to be present with just the strength that child needed in the moment, of how we could trust in a loving God to be completely present and completely concerned with the well being of the toddler, of how we could ask God to guide the hands and hearts and minds of the doctors who were involved, and of how we could ask God to enfold the mother as well in warmth and tender care, and grant her as well the necessary strength...I kept trying to use very concrete, even tactile images so that mom could "see" and "feel" with her body, hoping that would ground her to fight the panic. She kept reaching out of her panic to nod along with my soft voice and eventually drew a deep, shuddering breath and said, "Better now."

Shortly the doctor came out with an update. He said the toddler "should make it through this." I asked him to repeat what he'd said and checked to verify that she had heard those words. We got mom into the trauma bay to see the child for a few minutes, and I know that helped, probably helped both. The respiratory therapist especially was very kind, telling mom the good signs she was seeing. Eventually the toddler had to be transferred to a specialty children's hospital, because when a little kid needs to be in ICU, your best bet is to have critical care specialists who are trained to focus on kids. Mom talked to the dad a couple of times and asked me to talk to him once, because I was calmer. I stayed with mom until the transport team was ready to take both of them. We gave the little one a sign of the cross on the forehead and a last word of blessing before they took off. The little kid looked even littler on the pram, with all the monitors and the tube for the vent. The mother was still terrified but now calmer (we'd also gotten her a blanket and orange juice since she hadn't eaten), and ready for the next steps. You *know* you are tired when you can't wait to get to the new hospital because you know they have comfy chairs next to the kids' beds in ICU and maybe you can get some sleep at last.

Puts lots of things into perspective.


Blogger Eliza said...

Oh that poor mother. I am so, so glad that you were there for her. I don't think I've ever been offered a hospital chaplain at a time like that but there was once that one child (less than eighteen months old) was severely dehydrated from rotavirus and inside the ER they were trying for the "nth" time to get a line and starting to make grim faces at each other, and dad was in there, and I was outside in the vehicle with the infant on the NG-tube with the breathing difficulty and the babysitter, administering feeds and drugs, and everyone kept telling me to go home but I couldn't leave the older one until they'd successfully gotten an IV in and I was sure that one would be OKAY...ugh. That poor DAD. Poor all of them.

10:09 AM  

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