Chaplain’s Diary: Dying Together

A major survival tactic of hospital chaplains is to avoid becoming attached to our patients or their families.  No matter how good our boundaries, sometimes the people just suck us in emotionally.  This is one of those stories.  In fact, last week I flipped the lock, opened the door and kicked aside all of my personal attachment boundaries when I adopted one of my patients. 

Last Monday started off like any other day.  Sunshine lit my way to work, morning prayer with my fellow chaplains woke my mind, then I prepped for patient visits.  On rounds in the ICU, I encountered a new patient who I will call Mike.  This man was dying, which is common in the ICU, but his story was unique for several reasons.  Mike was homeless and he had no family.  Mike had a friend listed as an emergency contact but when the nurse called to inform the contact that Mike’s health was dire, the friend told her in no uncertain terms that he was “done with” Mike. 

I looked through the clear glass door to the room and saw a middle-aged man covered in stained sheets, his stomach bloated to four times its natural size.  Wires and tubes ran from Mike’s hands, elbows, chest, mouth and nose to machines, monitors and IV hooks.  One of the machines breathed for Mike but his chest barely moved.  The nurse reported that before he lost consciousness, Mike told the doctors, “If you think you can save me, go ahead and try; but if I look like I can’t fight anymore, let me go.”  The doctors would be deciding that afternoon whether to withdraw life-support — a decision that family usually makes.  I told the nurse that when they decided to withdraw care, to please call for the chaplain on call — no human being should have to die alone.  Six hours later I got a page to return to Mike’s room for his death. 

—————

When I get to room 216, I take a full breath hoping to chase away the tremors that are pulsing through my body.  It isn’t fear moving me; it’s reverence.  (I’ve learned that dying and death are sacred moments that are an honor to share with others.)  I step in the room and pull up a chair along the bed rail as the nurse, Jen, uncovers Mike’s arms and hands.  Without hesitation, I grasp Mike’s swollen right hand in both of mine.  I curl his stiff fingers around my palm and squeezed lightly.  It takes ten minutes for Jen and a respiratory therapist to unhook and detach Mike from the lines and tubes, machines and medicines that were preserving his life.  Finally, they remove the tube supplying air to his lungs.  Jen washes Mike’s face free of tape residue and dried blood.  She pauses to watch the monitors for a few moments and then withdraws to the hallway.  Mike and I are left alone together.  Softly, I introduce myself to this dying stranger. 

“Mike, my name is Corrie.  I’m here to stay with you.”

I pause because tears are already smearing my vision and voice.  All I see is a puddle-like image of a man swaddled in a gray cloud.  I blink a few times and wipe my face on my shoulder, not willing to let go of Mike’s hand for even a second.  My eyes trail up his arm, bruised from our medical interventions and scarred from Mike’s intravenous drug use.  I gaze at his face scruffy with a three-day beard and his thinned, spiky hair.  Except for the scars and bloating, he looks like anyone I might pass at the supermarket.  I wonder what Mike’s story is, what paths he traveled in life, what wounds he suffered that led him to this end — septic, scarred and abandoned, his only home a stained bed in room 216. 

Mike died over an hour.  The vitals monitor shows little change for the first thirty minutes.  Occasionally, Mike grimaces or his fingers twitch in mine.  His breaths are quick and raspy.  I speak with him on and off, pray silently, cry and breathe.  I try to match my breath to Mike’s but I can’t do it — I needed more air than he does.  Half way into our time together, my hand now numb in Mike’s, I break my silence.

“Mike, I don’t know what your story is, except that you don’t have a home or family.  I want you to know, that is no longer true.  Today, I’ve become your family.  Please know that I am here with you, until the end.  You can go quickly or take your time; it’s your choice.  I’m not going anywhere.”

For the first time, I realize there is music playing in the room.  The nurse must have left it on as companion for Mike.  The volume is very low, but I recognize Shawn Mullins’ Lullaby… 

she grew up with
the children of the stars
in the hollywood hills and the boulevard
her parents threw big parties
everyone was there
they hung out with folks like
dennis hopper, bob seeger, sonny and cher

now, she feels safe
in this bar on fairfax
and from the stage I can tell that
she can’t let go and she can’t relax
and just before
she hangs her head to cry
I sing to her a lullaby, I sing

everything’s gonna be all right
rockabye, rockabye
everything’s gonna be all right
rockabye, rockabye
rockabye

I sing along with the chorus, hoping and praying that this song, my voice, our clasped hands, my God will soothe the grimaces and twitches from Mike’s body.  Soon his vitals begin to fall.  Over the next twenty minutes I watch his heart rate and blood pressure sink low.  They plateau for the last ten minutes.  By now, Mike only takes two soggy breaths a minute.  I can feel his body sinking deeper into the mattress.  The monitor begins to flash and beep, a shofar alerting us to a pending Jubilee.  Jen comes in to silence the monitor and stand next to me.  Mike takes a breath that sucks his tongue to the roof of his open, cracked mouth.  His body is limp on the mattress; his hand pins mine to the bed.  I can’t leave now.  It’s the sacred moment.

It’s okay, Mike.  You can let go.  Let yourself relax.

Mike stops breathing.  His heart stops pumping.  Jen waits for the final electric current to blip across the monitor.  I see the flat line from the corner of my eye and think, ‘he’s free from all this pain.’   Jen gently closes Mike’s eyes with her pinky finger.  She writes the time of death on the board over my shoulder, 17:34, and leaves the room. 

I clasp Mike’s hand between mine for a final few seconds.  One last squeeze, I wipe my tears, take a deep breath and stand up.  I lay Mike’s hand on the bed and cover his chest with the blanket.  I breathe again and think that though his life may have been scarred and painful and lonely, his death wasn’t.  In his death, Mike had a place to lay his head, a hand to hold, a lullaby, and most importantly, family.  He didn’t die alone.  We did it together. 

Goodbye, brother.

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