A Big Mistake

04 Nov
November 4, 2014

My first twenty-four hour on call at a major trauma center hospital as the chaplain resident made me very, very nervous.  After 5 p.m., the rest of the chaplains went home and I was responsible to cover the one-thousand-and-one-hundred plus patients alone.  Some of them resided in the nine Intensive Care Units.  Helicopters came and went with critically ill patients and organs for transplantation.  My pager alarmed frequently, sometimes with a code blue for the resuscitation attempt on a patient whose heart or breathing had stopped.  Drama was the order of the night.  I wondered if I could eat or shower without missing a page.  Would I be able to sleep at all?  I was expected to work through the next day at noon.

Around midnight, I was called to the surgical trauma unit by a physician, who explained to me that his patient had been pronounced “braindead,” legally dead in that American state.  After suffering major trauma in a traffic accident, this patient’s brain was not functioning any longer; two neurologists had determined this over a period of time.  The patient’s daughter was flying in from another state and would arrive shortly.  He would tell her this news and he wanted me to be there, as the chaplain.  I agreed to be there.  I was determined to be my most empathetic self for the daughter.  I stood at the bedside of the patient, who was attached to many machines, including a ventilator (breathing machine), and prayed silently.

The patient’s middle-aged daughter arrived in a hurry, rushing into the glass-walled and curtained ICU room.  She stopped at the bedside and picked up her mother’s lifeless hand and held it a moment, then put it down.  I was on the other side of the bed.  When she looked at me, I introduced myself and we had a short, but deeply emotional conversation about her and her mother before the doctor came in.  He explained who he was and ran down the medical history of her mother while she was in his care, ending with the fact that she was now “braindead.”  He said the word a number of times, “braindead, braindead.”  It made quite an impression on me.  He didn’t explain to the daughter that it meant legally dead and that they would shortly remove her mother from all this equipment, such as the ventilator, and all medications designed to keep her mother’s body’s blood pressure up and her mother’s heart beating.  Braindead is dead, you see.  I guessed he was going to disclose that in the next conversation.  It was probably pretty overwhelming.  He left the room.  The daughter began to process his brief conversation with her.

She said, “Can we get a cup of coffee somewhere?”

“Sure,” I said.  “In the cafeteria.  I will show you down there.”  I was relieved that we were leaving the ICU and the patient’s bedside.  It was a place of tension, there by the monitors and her mother’s non responsive body.  We both relaxed a bit as we walked out of the ICU toward the elevators.

“Well, I tell you what…No, I shouldn’t say…” she stopped.

“What?  You can tell me.  Really,” I urged her to speak.

“I shouldn’t say this at a time like this, but that doctor was incredibly good looking!” she exclaimed.

I laughed and waved my hand downward in a dismissive gesture, “You’d have to be braindead not to notice.”  Then, I was horrified at what I’d said.  I was shocked.  Literally, my mouth hung open.

She icily responded, “No, only one of us is.”

“I am…so sorry,” I stammered, as we rode the elevator down to the cafeteria silently.

We still got coffee together and she forgave me for my horrible, braindead gaff.  I empathetically listened to her and her detailed story of her life with her mother, her grief, and what it might be like if she needed to say goodbye.  I knew it was not “if,” but rather, “when.”  I was preparing her for the next step, when she would hear the news that brain death is death. She would be losing her mother.

It was grace to me that she didn’t reject me after my big braindead mistake.  I hope that it was grace to her that I was there too.

I learned that healing happens in relationship and goes far beyond what you say.