Will Wonders Never Cease

One day I was called to the ICU to help mediate a difficult situation. A woman, “Maggie” wanted to be taken off the ventilator. She had suffered a heart attack the week before, but her prognosis was not dire. The cardiologist was certain she could be treated with medicine following the heart catheterization that had opened a blocked artery. It was during that procedure that Maggie was put on the vent – standard for any surgeries – but for some reason when the medical staff tried to remove the vent, Maggie was not able to breathe on her own.

Maggie was lucid and clear about her intentions. She did not want to be kept alive on a vent, not even for another week to see if the medicine would start working. Her husband, a second husband and not the father of her children, was willing to abide by her wishes. One daughter was also willing to do whatever Maggie wanted.

The rest of the family, however, was desperate to keep mother alive, and that desperation was bolstered by the doctor’s opinion that it was too soon to remove the vent and “give up.”

This was a very dysfunctional family with a history of addictions and lots of unresolved issues. They all appealed to me to “talk some sense into my mother,” and I had to gently tell them that wasn’t my job. My job was to determine if Maggie fully understood her decision and then be her advocate.

On the tablet provided for her, Maggie wrote that she did understand she would die when the vent was removed and she was ready. She asked me to pray with her and for her, and continue to pray for her children after she was gone.

We held a brief prayer service and the vent was removed. I stayed with the family for about an hour, but somehow Maggie managed to hang on. I was called to another situation that took a couple of hours to resolve, and when I checked back, Maggie was still breathing.

It was the same by the end of the day, and the next day Maggie was awake, alert, and very much out of danger. The doctor was amazed. The family was amazed, and even Maggie was amazed.

More about Maggie next time.

Do Not Be Afraid

During one visit, Bob admitted to me that he was afraid of dying. Like many people of faith, he occasionally had doubts about heaven and eternal life because those concepts defy rational thought, but he had trouble voicing those doubts. After all, people of faith are supposed to be sure.

The first thing I did was assure Bob that he was not alone in having these thoughts. And it didn’t mean he had lost his faith. I reminded him of how Jesus prayed in the garden before his arrest, a prayer wrenched from the same fear and doubt Bob was experiencing.

That seemed to bring him some comfort, but he also said he was afraid of the pain and discomfort he might experience in the dying process. He knew as the COPD worsened it would become more difficult to breathe. In fact, there did come a time when he could no longer sing because he could not get enough breath. But if someone started “Precious Lord” I could see him mouth the words.

Bob’s last few days were spent in ICU, where medications helped with the painful process of dying, but it also numbed him to human interactions. That didn’t keep friends and family away, however, and the afternoon he died, the whole family was gathered. Everybody took turns standing at the head of his bed to talk to him or sing a song. I stood at the foot of his bed and waited.

Then it happened.

There was a hush in the room and I looked over at Bob and saw his spirit lift from his body. It was so quick, I almost convinced myself I didn’t see it, but the image of his smiling face is imprinted on my mind. The deep lines of fear and anxiety had been smoothed by the most beatific smile.

When I was able to share that with his widow later, she said it brought her great comfort to know that he was happy.

We Should Not Die Alone

One of my specialties when I was working as a chaplain was dealing with crisis situations in ER or ICU. I have always been cool under pressure, which was an asset when dealing with grieving families or families facing tough choices.

Sometimes I would have to try to contain the wild, demonstrative grief that had people flailing over gurneys and falling to the floor. Other times, it would be standing quietly while someone died with no family present.

That happened often when family members had been keeping vigil for days and days, and just stepped out for a short break. Almost as if the dying person wanted to do it alone.

But on rare occasions it was because family members did not care to be present for whatever reason.

One of the ICU nurses had a particularly hard time dealing with that kind of situation and called me one day in tears. A patient, who had been on a ventilator for several weeks with no hope of ever breathing without it, wanted the vent removed. She had two sons, who had seldom visited in those weeks, and they had different reactions when the nurse called to tell them what their mother wanted.

The first son said that was fine, and no, he did not want to come to the hospital when the vent was removed.

The second son said that was not fine, and he would come to the hospital with a lawyer if need be to prevent his mother’s wishes from being carried out.

The woman was conscious and able to communicate and had already signed a Do Not Resuscitate (DNR) order. The legal department from the hospital drew up another document outlining her most recent request and that was read to her before she signed it.

Then there was another conference call to the second son in which the doctor again explained that there was no hope of recovery for his mother, and we now had a document signed by her that she wanted the vent removed.

Legally, there was nothing else the son could do, but as the nurse said, if he cared that much about his mother to fight the removal of the vent, he could have cared enough to come and be with her when she died.

Everything was done to make the woman comfortable and before the vent was removed, I had a little service for her that she had requested. Then she nodded and the respiratory therapist turned off the machine.

The nurse cried. The therapist cried. And I cried. Not for the fact the woman died. But for the fact that she had to die with strangers around her bed.