Intensive Care

This afternoon I headed downtown to check out a member in the hospital. It’s a bit of a drive from the South Nashville location where my church is, and I always spend that drive time listening to NPR and wondering what I might find when I get to the hospital. It’s a hit or miss proposition these days, for folks are much less likely to call the church and let the pastor know what is happening. That leads to confusion at times, since others in the church expect the pastor to be in touch, while more often than not the pastor is the last to know anything. Some of this mindset (among the elderly primarily) goes back to the time when hospitals called local churches as a matter of course to keep them up to date on their members. However, in a world obsessed with privacy, these courtesy calls no longer happen, and in the post HPPA era it’s often difficult to find out if the person is even in the hospital at all.

As I drove down today I knew what I hoped to fine. This member (we’ll call Mrs. Anderson) has been struggling with a variety of ailments for a while. She has been in the ICU for a week, and was placed on a respirator to assist her breathing several days ago. When I last visited her during the Thanksgiving holiday, she had a tube in her throat and was unable to talk but was still alert and there was a glint in her eye. By all indications she would be coming off the respirator in a couple of days, and I envisioned that she would be breathing on her own today when I visited.

I parked in the garage across the street. One of the perks of being clergy is that many of the hospitals have special parking areas for ministers. In most cases this saves time in having to wander through the garage aimlessly looking for a parking space. That’s true at this hospital, but the pastor parking is on the 7th floor about a block away from the main elevators in the hospital. It’s a good chance to get some exercise, and most of us look for any chance we can get.

Every hospital ICU department is different. Most have a central waiting room, often right across the hall from the ICU units. This hospital’s waiting room is at the other end of the hospital, about as far away from the pastor parking as one can get without leaving the building. But it’s a good walk, and it also offers a time to center one’s self and prepare for the coming visit.

Many colleagues of mine proceed directly into the ICU without checking in with the nurse’s station. Generally pastors are given a free reign as regards visits and usually don’t have to conform to the formal visiting hours. However my time working in hospitals as a chaplain has made me sensitive to the needs of the ICU staffs, so I usually check in before. This gives the staff time to prepare the patient if they are in the middle of a procedure, and basically communicates that I respect what they are doing and don’t want to get in the way.

So, after checking in I headed to the Neuro ICU, where Mrs. Anderson was located. She was in a different room than last time, located in the back, and I anticipated that perhaps she was improving since she was further from the nurses station.

I came to the glassed in room. It was filled with equipment. A nurse sat in the chair in the corner of the room. Mrs. Anderson was asleep, tube still in her mouth, and connected to the machines that are cleaning her blood.

I turned to the nurse. “Have I come at a bad time?”

Looking up from the novel she was reading she replied, “No. I’m just waiting for her dialysis to be finished.”

“Has she been alert?” I asked.

The nurse shrugged her shoulder. “Not really . . . at least since I’ve been here.”

I explained who I was and went to the bedside. I make it a practice to not wake folks when they are sleeping in the hospital. A hospital is not a place where one can rest easily. In fact, many folks often need to go home to recover from the regular interruptions in sleep that occur when one is hospitalized. Some colleagues are not as considerate. “They are expecting me to visit,” they say, “so I better wake them and let them know that I am here.” I understand their concerns, but these folks need sleep more than they need me. I can (and do) leave a business card to let them know that I dropped by.

I stood there quietly looking at this saint. Days earlier as we talked (actually I talked and she nodded her head a lot) there had been a glint in her eye, a sign that her sense of humor was intact. Today, however, there was only the signs of REM dreaming, and discomfort as the respirator filled her lungs with air with a rhthym that was far too regular to be normal. I stood there looking and praying. I prayed that God would give the doctors and nurses wisdom. I prayed that our understanding of medicine would lead to treatments. I even prayed for a miracle or two, knowing that it’s up to God to make those decisions.

Yet, in these situations I often find myself praying another prayer. “God,” I say, “…don’t let this person linger.” There is a time, after all, for everything under heaven, and one of the downsides of our medical technology is that far too often we prolong the inevitable rather than helping someone make the transition from life to life. Is it really humane to be aggressive in treatment when the chances of recovery aren’t good? Is there a point when we should pray for God to alleviate the suffering of our loved ones, even when that means that we will suffer at losing them.

We don’t really know the prognosis for Ms. Anderson. It may be time, and it may not. Earlier in the week she clearly said that she wasn’t ready to give up the fight to beat her illness, but as we agreed then that time may come.

I stood quietly, watching and waiting. I hoped that she might wake up, but I hoped that she would stay asleep as well. I was aware of a pair of eyes burning into my backside and the nurse watched from the chair to see what I would do. But I didn’t have to “do” anything, other than holding her hand and praying. The breaths continued on. Blood flowed from one tube to another as the scrubbers removed the impurities from her blood. She lay back, dreaming perhaps of another place.

After several minutes, I was done. I thanked the nurse and began the long trek back to my car. There was an elderly woman being led up and down the ICU unit, obviously walking for the first time. She was nervous and wobbly as she attempted to regain her balance in the midst of her pain.

So was I.

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