Disclaimer: In order to protect patient privacy, some of the details of the cases I write about have been changed. This is true in everything I write, unless I have been given permission to do otherwise. The end.
The other day I was called into a patient's room. She is very sick. A tube runs down her throat and a machine breathes for her. There are other medications dangling from IV poles. I once saw something written by a physician about the number of "lines" a patient has. If it is above a certain number, it is almost certain the patient will die. I don't remember the number. I wouldn't tell you if I did. Because I'm not a doctor, and I don't want you counting the IV bags in your loved one's ICU room. Let's look at our loved ones instead.
Family members stood around the patient's bed. They requested a chaplain visit, and so I came by. After introductions were made, which included me greeting the patient out of respect, we began to talk with one another.
I can guess that the family wants me to pray with them, but I don't jump ahead to that. First, we talk. I hear some of the surface details first. How she came to be sick. How it was for the family when she was taken to one hospital, and then finally she was transferred over here.
"She's was doing really well since the last time," said a daughter. "We thought we were going to lose her then, but she recovered." The woman heaves a shaky sigh. "She has had a few good months."
And now I'm listening closely. Because I am curious as to what the daughter thinks will happen. I want to know what her hope looks like, what flavor and texture it has. Because I've counted the IV lines and have an almost certain knowledge of how this will end. But they don't know that. And really... can I know for sure?
On another night I was on-call, there was a Code Blue called for a youngish woman. Her heart had stopped, and doctors and nurses, pharmacists and everyone else you could think of, were crowded around her with a crash cart. Nurses took turns doing CPR, driving her chest down to keep her blood moving, while probably breaking a few ribs in the process. Drugs were administered. And then a pulse. The heart rhythm didn't look good, but they could stop doing CPR for the moment. The blood pressure was moving in the right direction... and then it wasn't. Suddenly the patient crashed once again. CPR was needed, again. A river of medicine shot into her body, again.
This happened for hours. For most of the night, actually. I sat with the family in the waiting room, and I knew for certain this woman was going to die. It was only a matter of when the family would allow the team to let nature take its course. Because it was the medicines keeping her alive. As soon as they wore off, she'd crash all over again. You don't have to be a doctor to know that you can't live on epinephrine for the rest of your life.
After countless rounds of this, the family decided that if her heart stopped one more time, that the team should refrain from extraordinary measures. But her heart didn't stop any more. As they had decided to let her go, she turned a corner.
In the days that followed, I was sure that this patient would have serious brain damage. Our brains need oxygenated blood. When our hearts stop... even with the ACLS protocols running at full tilt... it is difficult to get enough blood to vital organs (like the brain) for any length of time. But as she roused, she was completely with it. I would visit, time and time again, only to find her stronger... smiling... joking with family. Family that I would have told that first night, "Let her go. There's nothing more they can do." Now... Reader... you may be thinking, "Don't practice medicine." But I wasn't the only one shaking my head. The doctor on-call figured she would die as well, and was just as surprised as I was. But she lived. She went home, somewhere in the hollers of eastern Kentucky. It was an honest to God miracle, not only that she survived, but that she didn't spend the rest of her days taking her food through a tube.
Back to this other patient... the older, sicker one I mentioned at the beginning. Their family has finally asked me to pray. I asked them what they would to pray for, and the daughter said, "That she'll be healed."
And this woman WILL be healed. It may be death that liberates her from the medicines and the machines, and God may receive her into a Home where no one gets sick anymore. Or it may be that she recovers in the traditional way. One never knows.
Sometimes I think prayer is like throwing bread crumbs in the air, hoping that a bird will fly by and catch them. You never know what's going to happen. We know that God isn't a Cosmic Santa Claus, who exists to give us what we want if we just pray hard enough. Plenty of people have died of cold or hunger with a prayer on their lips. A thought which makes me uncomfortable. There's always a theological answer to these questions. Panentheistic process theology offers theory that makes these deaths somewhat palatable. But in the world of flesh and blood, no answer can stand in the face of suffering. To blame it on a "fallen creation" is to be lazy. To accept that no answer will work requires a bit more humility.
I prayed for this woman, her family. As best as I could. And before the bread crumbs fall to the ground, or disappear forever, I have taken the hands of this sick woman's children into my own. In the quiet, we watch, together. They are not counting the lines. They are just looking upon their loved one, sending her prayers and love through the tears in her eyes.
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