By Scott Hurd

“Help! Help! Help!” The repeated cries carried down the hospital corridor as I quickened my pace. 

I turned a corner and the yelling stopped. There was my mother lying in a bed, flanked by two nurses failing in their effort to remove her IV line. 

Her matted hair was greasy and its receding amber color revealed stark white roots. The nails at the end of her arthritically gnarled fingers were dirty from compulsively picking the scabs on her arms. Her disease had caused her to forget many things, such as the importance of personal hygiene. And that the middle-aged man standing before her – me – was her only child. 

She looked at me intently, and for a moment there was a glimmer of recognition. And then it was gone. “Oh look,” she declared triumphantly to the nurses, “This nice man has come to help me!” 

I was glad that, at least, she’d identified me as a nice man. But her assessment changed when I agreed to restrain her so the nurses could remove the IV. The cries resumed. “Help! Help!”

The line was finally removed, the nurses left, and I took stock of her room. Opposite her bed was a dry erase board listing her meds, her doctor’s name, and warning that she was a fall risk. One section was designed to humanize patients, so they could be seen as something more than a diagnosis and a treatment plan. “Things you should know about me,” it read. “I play the piano,” was Mom’s answer. Except that she didn’t.  

As typical with Alzheimer’s disease, Mom’s short-term memory failed first, but echoes from the distant past lingered. One echo for Mom had something to do with a piano. A gauzy recollection had somehow become her present reality. It bore little relation to whom she’d been. And it showed just how tangled her mind had become. 

“The tangles” is what medical professionals casually call Alzheimer’s, as it likely results from threads of proteins becoming twisted and tangled in the brain. The longer they get, the more dangerous they become. Eventually, brain cells start to die. Memories become clouded. Entire chapters of the past can get erased – such as Mom’s love of needlepoint. 

That dry erase board should have listed needlepoint, not the piano. Mom was prolific and talented, mastering complex stitches and advanced techniques. Her works were framed and upholstered. They won prizes. They were auctioned off. 

I still have her first completed project, with its sun shining upon a tree-shaded house. She made it for me. “Clean up the world tomorrow,” it says. “Today just do your room.”

As her disease progressed and her world shrank, a nearby needlework store was the last place she could go on her own. She went a lot, buying yarn that largely went unused. Her final creation was a belt with nautical signal flags. It had a simple pattern, suitable for beginners. She’d enthusiastically show it to us, but after a while no progress was made. For her, it had become an unattainable aspiration. For us, it was a sad finale to an accomplished past. 

When my parents hastily rushed into assisted living, Dad, shaking from Parkinson’s disease, directed the movers to the few things they would take. The unfinished belt came, as did miles of yarn, crammed unceremoniously into a single bottom cabinet drawer, where it sat for over a year. I don’t think it was ever opened. 

I was the one to open it, after they’d both died. Years of accumulated materials and remnants of projects from decades past were mashed together into a tangled web, colors clashing in unlikely and unfortunate combinations never intended to be made. Intact balls of untouched yarn mixed with half-disintegrated spools, while wispy, Medusa-like single threads snaked over and around like kudzu entombs a decaying trunk. Any remaining order was concealed by confusion.

Staring for some time, I wondered if I could separate it all, hoping that something might be salvaged. But the tangles were just too great, the effort too futile. It was too late to clean up Mom’s world. I simply shut the drawer. 

I hope she’d be happy, if today I just did my room. 

Scott Hurd is the author of five books published in four languages, including Forgiveness: A Catholic Approach. His writing has won awards from the Association of Catholic Publishers and the Catholic Media Association, and has been nominated for a Pushcart Prize. Recent essays and reviews have appeared or are forthcoming in Pembroke Magazine, Salvation South, KAIROS Literary Magazine, Streetlight Magazine, and Ohio History. He is married to fellow writer Diane Kraynak, NP. 

By Nancy Glass

Her voice was loud and insistent: “Michael, get up! GET UP! Open your eyes and GET UP! GET UP NOW, Michael. I COMMAND YOU, in the name of God, GET UP!” 

Michael wasn’t going to open his eyes. I knew that. But I’ve gotten ahead of myself: I need to go back to the beginning. 

The first time I visited Michael’s home for his initial hospice evaluation, his mother, Leila, told me she had named him after the Archangel Michael in covenant with God—a phrase she repeated many times—in gratitude for learning she would finally bear a son after years of infertility treatment. All these years, she had been proud as he grew into a tall, handsome, muscular young man. She was proud of his academic record, his athletic abilities, his deep faith, and his kindness to other students. Then two years ago, his illness began suddenly with unrelenting headaches, followed by nausea and vomiting, and then finally, trouble with his balance. Their trip to the emergency room one evening resulted in Michael being diagnosed with a large brain tumor, soon followed by two major surgeries, aggressive chemotherapy, and radiation treatments. Michael had faced his diagnosis with courage and had accepted the therapies without complaining. He had gone back to school, but he couldn’t play football anymore. Still, all in all, he did “well” for several months. 

But just the week before, after Michael underwent a repeat MRI scan for worsening vision, the oncologist told Leila and Michael the tumor was growing, and that there were no further curative treatments to offer. His oncologist told me that Leila listened patiently, then told the doctor she remained convinced God would save her son, and that Michael’s recovery would glorify God, showing everyone God’s power and grace. For this reason, she had been reluctant to accept the hospice team into her home, since Michael “wasn’t dying.” She accepted the referral, though, hoping the weekly nurse visits would reduce the frequency of their trips to the medical center. Before I could even go into his room, Leila insisted on telling me — with pressured, staccato speech — about Michael’s Most Valuable Player trophy in his role as a defensive tackle for his high school football team, about how strong he was, about his deep faith and his conviction that he would soon be healed. She told me she wouldn’t let anyone come into the house if they were not Christian and couldn’t share her faith in his healing. I was raised in a traditional Protestant home, and I certainly wished for Michael’s recovery, even wished that faith could be a powerful enough factor, but I knew this cancer was a bad actor. I mumbled something affirmative in response, then bit my lip. 

As I entered his room, I saw a large adolescent boy slumped down into his wheelchair, facing my direction with unseeing eyes. Michael was now completely blind from tumor recurrence, and his legs were paralyzed from tumor metastasis to his spinal cord. This much I already knew from reading his hospital chart. I knew he had metastases in his lungs now too, and I could already see from the doorway that he was working hard to breathe. Leila stood protectively beside Michael. After I introduced myself, I began my assessment. 

“Michael, are you feeling short of breath?”
“No, ma’am; I’m okay.”

His lung sounds were wet and wheezy, and his respiratory rate of thirty breaths a minute did not sound like “I’m okay” to me. I had the impression he was answering what he knew his mother wanted to hear. Soon after this exchange, Leila went to the kitchen to prepare a kale smoothie with vitamins for Michael, every teen’s dream snack. As soon as she was out of earshot, Michael asked me softly, “How much longer is this going to drag on?” Then, without waiting for an answer: “Why is God punishing me? I’ve been praying every day, but nothing’s changing. What could I have done that was so bad?” I was just telling him that nothing he did caused his cancer when Leila returned with the kale smoothie, chatting about Michael’s great appetite, how the smoothies were shrinking his cancer, and how he needed to get back to the gym to prepare for football season. I looked at her with raised eyebrows, looked at Michael, and back to Mom. “Wow”, I thought to myself, “This is going to be really hard”. Michael slumped lower in his wheelchair, withdrawing from the conversation. I concluded my exam and asked a few more questions, concerned that Michael’s respiratory distress was likely to worsen quickly; then I reviewed the use of the morphine we’d ordered for his breathlessness with Leila before I left. I felt sad and frustrated that I hadn’t been able to establish a workable connection with Leila and worried that Michael was going to suffer an unnecessarily difficult death. 

As I stepped outside the house, his stepfather, returning from work, stopped me. We introduced ourselves; then he immediately spoke of his concern: “Doc, I don’t know what to do. The rest of our family all sees that Michael’s dying, but my wife keeps talking like he’s going to get up and walk.” 

“I know,” I said, “I’m worried too. Michael knows what’s happening with his body. I think all we can do right now is support Michael and Leila. We can’t force her to see what she isn’t ready to see. In the meantime, his nurse will visit at least twice a week and check in with Leila every day or so by phone. Let’s stay in touch, okay?” 

Sure enough, within days, we had to transfer Michael to our inpatient unit to manage his breathlessness more aggressively. Leila was exhausted from being up with him almost constantly. I adjusted his medications so he was able to breathe more comfortably, and the nurses kept a close eye on him through the evening, while Leila caught a much-needed nap. At about three o’clock in the morning, Leila pushed the call button, asking Michael’s nurse to come to check him, saying that his breathing had changed. 

In fact, Michael was not breathing at all. He was dead. No heart rate, no breathing. When the nurse told Leila he had passed, she became angry: “He is NOT dead. He is ASLEEP!” She began shaking his shoulders, slapping him across his cheeks, and yelling at him. 

“Michael, wake up. Open your eyes. Take a deep breath. I know you are sleeping. Wake up. Wake up. God is not ready for you.” She began praying loudly and demanded that the nurse leave the room. Her prayers were shrill, repetitive, insistent, and audible even through the closed door all the way to the nursing station. 

“God, I made a covenant with you for Michael’s life. He cannot die. He is not dead. “Wake up, Michael. God has a plan for you. He promised me.”

Twenty minutes later, hearing more voices, the nurse re-entered the room to find a cell phone propped by each of Michael’s ears, as female voices prayed and begged him to wake up. At the same time, Leila climbed up onto the bed and began performing CPR on Michael — I can only imagine that scene — blowing her breath into his mouth and pounding on his chest with futile, jerky motions, all the while praying aloud, demanding that God give Michael back to her. 

The charge nurse had already called me to come in to help because they were unable to reach Leila’s husband. After another half hour or so, we were finally able to awaken him and told him that Michael had died. He contacted Leila’s pastor, and the two of them came to the hospice. Our team—the nurse, the social worker, the hospice chaplain, and I— all huddled outside the door, wondering what to do next, while her husband and pastor tried to comfort Leila. It was several hours before they persuaded her to go to the pastor’s home to be with his wife and mother; the pastor promised to stay with Michael’s body until the funeral home arrived. Finally, leaning on her husband and the pastor, Leila allowed herself to be led out of the building. 

For many patients and families, religious faith provides hope and comfort during times of uncertainty. In this case, however, it seemed to me that Leila’s powerful faith served as a kind of resistance, keeping her from connecting with Michael and allowing them to find some peace together as he died. She made Michael feel guilty for not praying hard enough, and he internalized the feeling that he had somehow deserved this fate. How lonely he must have felt, not being able to express his deepest feelings as his body changed. It was also sad that Leila refused to let the hospice team have open conversations with him. Was he afraid to die, afraid of God’s wrath? Or was he able to achieve some measure of peace with the idea of meeting his Savior face-to-face? The hardest part for me after his death was that she never responded to our bereavement counselor’s attempts to reach her over the next year, never answered my calls, and never responded to any member of the team’s voicemails or texts. Years later, I still wonder if Leila was able to sustain her faith in the face of what she saw as God’s broken promise. Did she come to an acceptance of Michael’s death as His will? Or did this enormous loss rend her faith irreparably? 

Sadly, I’ll never know.

It’s been my experience that most individuals with a strong faith and engagement in a faith community are eventually able to make the transition from anger and questioning to acceptance of their loss as God’s will, a transition that may be strengthened if the survivors’faith community includes strong cultural ties as well, as it did in Leila’s case. Those whose faith does not include regular attendance of services or participation in a community of believers may have a harder time holding onto their faith in the face of a tremendous loss like the death of a child. Each family’s experience is unique. Regardless, the path of grief is a long and circuitous one in which the yearning for the deceased never goes away. Hopefully, in time, the mourner creates a new life that encompasses the love for, and memory of, the beloved. 

Dr. Nancy Glass is currently Distinguished Emeritus Professor of Pediatrics at Baylor College of Medicine and Texas Children’s Hospital. During her long career, she practiced pediatric critical care medicine, pediatric anesthesiology and pain management, and pediatric hospice and palliative care. Now retired from active clinical practice, she continues to teach on end of life topics, mentors young students and physicians, and guides narrative medicine sessions for medical students. She recently received her MFA in Writing from the Vermont College of Fine Arts. She lives in Houston with her husband, enjoys classical music, and is an avid birdwatcher.

By Bailey Sutliff

This is for the empathetic medical student — the student who chokes back tears in patient rooms during rounds; the student who frequents the restroom after seeing their patients as a way to seek a private space to collect their thoughts (or shed a tear); the student who never missed points on the “empathetic statements” checkoff list during a simulated patient encounter; the student who takes home their patients’ stories and continues to bear that weight while going about their day; the student who cannot remain unaffected by a devastating diagnosis; the student who isn’t able to pretend that these people aren’t people. This is for that student. And one of those students is me. 

I don’t have all the answers. In fact, I don’t have any answers. That’s not what this is going to be, although I wish it was. This is an outlet for other students who feel things like I do. You are seen, you are heard, and your feelings are valid. And it’s cathartic for me because frankly it’s not often that I encounter another person that struggles with this to the extent that I do. And this is not just about being an empathetic person. This is feeling the feelings of others so deeply that it can be debilitating — not to the point that it affects my work, but to the point that it affects me. Deeply. Being in medicine, this is a far too frequent experience. And I’m only in my third year. 

I have always been an empathetic person. As a child, I would cry if I saw an elderly person sitting alone at a restaurant; however, I think this may be a common experience. But it went far beyond that. My brain begins to create a backstory for this individual which somehow would end up with my picturing the end of the person’s life. I was always thinking about the end. And that has never changed. Everything in my mind is ending–graduation, moving, etc. It is all just one step closer to the end. I recognize this is my own problem and twisted thought process to work out with my therapist, but I feel compelled to share this in case anyone else feels the same way. Because these feelings can be isolating.

Medicine was not real until my third year of medical school. At my university, that’s when you start your clinical rotations. And this is when things became so much harder. All of the disease processes that I was learning about for the past two years came to life. And they were impacting real people. At first I was fueled by the blind excitement that I was actually getting to see patients. I hadn’t thought about the negative situations that I would soon face. I had just come off of Step 1 studying and I was eager to be in the hospital. I couldn’t wait to show my residents and attendings everything that I had been learning. It was my time to shine. The learning curve with rotations was pretty steep, especially starting with internal medicine. But I quickly fell into a routine and just tried to keep up. I was just starting to get the hang of things when out of nowhere, I learned what a rapid response is. 

During a rapid response, the patient isn’t actively coding, but they’re acutely deteriorating, unstable enough for medical staff to have a crash cart on standby and  providers for resuscitation. I saw my first one called on a 19-year-old man. And I was just trying to stay out of the way, but also trying to learn. It’s a very fine line. I watched our attending command the room and handle the situation with ease. He looked like Superman walking out of there. I just knew the patient would be fine. But then we arrived the next morning to hear that he passed away overnight. I had not had to deal with a death until that moment. I recognize that makes me an extremely lucky person. My first thought went straight to this patient’s father and how he had lost his son. My heart broke for him. Out of nowhere it seemed, he would now go home with a gaping hole in his life and in his heart. These aren’t just patients we’re treating. They are real people with entire lives, lives that are literally in our hands. That was just my first time witnessing it. And I tell this story not to focus on the empathetic side of things, but more to set the scene of my third year. 

Onto the next rotation where I was sent to see a gastroenterology consult, the sweetest 91-year-old lady you’ve ever seen. And I already have a soft spot for the elderly. She was surrounded by family members and in obvious discomfort. She couldn’t keep anything down for days and felt miserable. In the softest, sleepiest voice I’ve ever heard, she asked me, “Will you please just put me to sleep…forever…please?” I grabbed her hand. I didn’t know how else to respond to that. I’m just a medical student. This wasn’t the type of stuff that we’re tested on. But I held her hand and I told her I would do everything I could to make her feel better. I told her I would talk to the doctors and immediately go double check on her nausea medication (Zofran) with her nurse. I gave my best comforting look to the family members and stepped out. I went straight across the hall to the bathroom and cried. Then I wiped my tears and went to ask her nurse about the Zofran. 

Neurology. I am not strong enough for it – which I learned during that rotation. It was during my week on the stroke team, specifically the ICU. I was assigned my first comatose patient, an 87-year-old man who had a large stroke paralyzing him on one side and leaving him with expressive aphasia. I saw him as soon as he came in, still intubated. He was asleep. Alone. But he looked strong; he was a large man. I did my best exam, reported back to my residents, and went on with my other patients. The next day his wife was present at the bedside and he was extubated. I was eager to do another exam and find out more information. As I asked him questions, he was unable to respond. But he followed commands and knew what I was saying. I knew this was his aphasia and his frustration was palpable. But it wasn’t until his wife began to speak that he started to cry — the saddest cry I had ever heard in my life. A cry laced with frustration and anger. A cry that was the only way he could express himself. The only way that he could be heard. And it was loud. My chest started to hurt. I knew if I didn’t find a way to politely excuse myself soon that I would also start to cry. His wife was rubbing his chest and shushing him, trying to calm him down. I made small talk with her and quickly wrapped up my exam. During that conversation I found out that he was a physician. My eyes watered. I realized he understood everything that was happening to him. He knew how this would end. He knew his prognosis. I told him before I exited the room how much I admired him and squeezed his hand. I headed straight for the restroom, except this time it was all the way down the hall. I couldn’t stop the tears and I was suddenly thankful for my mask. But this time I took a bit longer to console myself. Once I finished drying and fanning my face, it was time for rounds.  

Emergency department. Trauma after trauma rolls in. ABCDE. CT. OR. Repeat. Until a 33-year-old man came in following a work accident. His pericardial effusion was too far gone. He couldn’t be resuscitated. I see it this time. All I felt was fear, the sadness wasn’t there yet. I see his body and I’m mentally transported back to the cadaver lab. It all happened so fast it just doesn’t seem real — until suddenly it does. It’s time to tell his family. My resident brought me along. I’ve never been a part of one of these conversations before. Now that I have been, I think it’s the worst part of medicine. He had five family members waiting in a little side room. As the resident updated them on the situation, their lives broke apart right before my eyes – the screams, the jumping, the tantrums – the realization they just lost someone so close to them. I watched as five different reactions unfolded in front of me. Life is so short. Telling that patient’s family, for me that made it real. I felt like I was going to be sick. I made my way to the restroom as usual. I try to escape the screams. I break down. But why am I crying? It felt so selfish. I wanted to call every family member and friend I had and tell them how much I loved them. That’s all I wanted. But instead I washed up. I put my hair up in a ponytail. I walked back to my desk and put my jacket on like a coat of armor — like it was going to protect me from these feelings. I don’t know that it actually did, but it helped me get my job done for the rest of my shift. I finished my cry on the way home at 11 pm.

I really do wish I had an answer because I would share it with you. Writing this piece brought back all of those feelings and they cut just as deep. They say you’ll get numb eventually. I honestly don’t think I will – I hope I don’t. I think being this way is what makes me who I am. It’s what makes me connect with my patients. It’s what drives me to care for them and picture the effect that my care will have on the rest of their lives. And their family’s lives. I don’t think this makes me weak, even those moments when I do have to take a breather and cry. I think it makes me human. It makes me stronger and I think it will drive me to be a better physician in the future. I may carry the weight of my patient’s stories a little bit longer than others. I’ll always take a little bit of each story with me in every patient I see — that’s the best part of medicine. At the end of the day, it’s the patients who build their doctor. I’m glad I’ve gotten to share some of the patients who are building me. And I’ll always have my coat of armor to protect me. But in a year, it’ll be a long white coat.

Bailey Sutliff is a medical student at UAMS. She grew up in White Hall (Jefferson County) and attended college at the University of Central Arkansas where she obtained her bachelor’s degree in biology. In her free time, she enjoys volunteering, traveling, playing tennis, and reading. She currently lives in Little Rock with her two miniature golden doodles, Charlotte and Stella. Ms. Sutliff is passionate about Women’s Health and plans on pursuing an obstetrics/gynecologic residency. 

By Peg Newman

Please note: Patients and staff names have been changed and details that could identify individuals have been changed.

It’s easy to forget what those first months were like. I drove to work on the Southeast Expressway; a highway once clogged with rush hour traffic was near empty. COVID followed everyone everywhere – TV, radio, print media, the Internet, signs on doors to any stores still open. Phone calls with family members and friends were dominated by stories about COVID. Any news predicting a vaccine was always exciting but most stories were about hardships, isolation and death.

Brigham and Women’s Hospital where I worked as a chaplain had the intensity of a war zone. I remember walking down hallways on the COVID floors and glancing into the rooms as I went by. Room after room had patients on ventilators, a scene mimicking a futuristic movie about the end days. Some hospital entrances were closed and staff were rerouted to enter at one of two entrances where staff were required to put on fresh masks, cleanse their hands, and attest on line or via cell phone that they were symptom free. 

Elevators posted occupancy limits with people waiting for space as they stood in socially distanced lines. Administrative staff whose jobs could be put on hold were redeployed to fill newly created roles like monitoring safety procedures and managing the ever-increasing need for equipment and supplies. People installed Plexiglass dividers in the cafeteria, offices, and places like the emergency room waiting area with unavoidably close seating.

It took time to get used to wearing personal protective equipment. To be optimally effective, two tight fitting rubber straps held in place the first N9 masks that stretched to the back of your head. Those masks were so tight that people who wore them for a half hour or more usually had indented marks across their cheeks. At first the gowns, another form of PPE, were made of a strong paper-like material but after their depletion, the new ones consisted of a plastic that didn’t breathe. In other words, if you got warm, you got sweaty. The plastic face shields were challenging especially for people who wore glasses, the clear plastic fogging up with the moisture of one’s breath. Being one of those glass-wearing people, I ordered various products on line that were supposed to eliminate the fog – sprays, treated cloth, rub-on creams – but none of them worked.

Before leaving a room, we had to discard our gown and gloves in the trash by the door. Then, entering the hallway, we cleansed our hands with alcohol, put on fresh gloves, and removed our face shields. Next, we used sanitizing wipes to disinfect our face shields before we slid them back into a plastic bag or hung them on a hook in the hallway. In case that process left a droplet of COVID on our gloves, we pulled them off inside out and then discarded them. After cleansing our hands and putting on new gloves, we removed our N95’s and placed them in plastic containers. Peeling off our final pair of gloves, we put our regular masks back on and cleansed our hands with alcohol. 

In the early days when donning and doffing (putting PPE on and off) procedures were rigorously adhered to and limited supplies meant masks and face shields had to be reused, five pairs of gloves had to be put on and taken off to avoid contaminating N95’s and face shields. Those of us who went from one floor to another had to carry our PPE in a brown paper bag (like a grocery store bag) wherever we went. To be safe, we had to follow this laborious protocol with new patients who had not yet received negative test results that ruled out COVID.  

From the environmental staff who cleaned patient rooms to the food service workers who delivered meals and picked up trays, everyone’s job took on a new intensity but the nurses bore the largest share of stress. It was more than just the long hours spent with patients and learning new strategies to care for those patients with a new, sometimes unpredictable illness. It was nurses who most often talked to family members, sometimes taking several calls during their 12-hour shifts. Listening to a mother’s fears, a son’s angry questions, or an elderly husband’s confusion took an emotional toll. Sometimes their questions left no answers. Often reassurance was the only thing that could calm the anxious person on the other end of the phone, but when the prognosis was grim, there was little the nurse could say. 

One night I got on an elevator with a nurse I didn’t know. Coat on, on her way home, she glanced my way. Seeing my ID with the word “Chaplain” in bold letters, she looked at me and said, “I’ve been a nurse for over 30 years and I’ve never, never, seen anything like this. This kind of suffering, all the deaths. Sometimes it doesn’t feel real. But then you see it is real.” Getting off the elevator, she added, “And then you come back tomorrow and do it all again.”

I wondered what I could possibly have said if time permitted a response. I was in awe of the nurses who spent their days in patient rooms on the COVID floors, especially the ICU’s. I tried to offer words of support and concern for their well-being but I felt terribly ineffective. I knew I made a difference with patients and their families but with nurses I feared sounding patronizing or insincere and the right words were sometimes hard to find.

Both freshly minted residents and well-seasoned doctors had to find ways of coping as they faced new challenges and many deaths. One night I was paged: “EOL prayer COVID, Janet Jones rm 909.” EOL means end of life. I quickly looked up Janet’s information. She was 54 and a Catholic who had received the Sacrament of Anointing of the Sick two days earlier. I grabbed my brown paper bag of PPE and headed to the ninth floor. When I arrived, I was surprised to see four doctors huddled, talking quietly outside Janet’s room. 

Visitors were not allowed in the hospital but an exception was sometimes made when a patient was actively dying. “Is their family in the room?” I asked.

“No,” replied one doctor, the only female in the group. “Our patient died alone. We got to know her pretty well. We were hoping you could offer a prayer. We have iPads. I can go in the room with you and the others can stay in the hall on Zoom.”

Properly suited up, we went into the room. I asked, “Can you tell me about Janet?”
The doctor started to give me medical information, but quickly realizing I was looking for something more personal, she explained, “I didn’t know her that well but everyone really liked her a lot. She had a great sense of humor and was so grateful for anything you did for her. I know she has two grown children. Gary called her daughter a little while ago. He said she was pretty broken up.”

Aware of the three doctors waiting in the hallway, I unfolded my paper with the traditional Catholic Prayer of Commendation and read it slowly, pausing where I always paused, hoping as I always hope that the words offer comfort. Then I added a few words of my own, asking for comfort for her family and the doctors and nurses who gave her such wonderful care. The doctor added, “Rest in peace Janet. You put up a good fight. Thank you for being such a great patient.” 

Walking down the hallway toward the elevator, I thought about how unusual my visit had been. I appreciated meeting a group of doctors who felt the need to pause, take in the sadness of the moment, and honor their patient. I wished that sort of thing happened more often. I was reminded that all of us in every role had inner lives that were not often shared with others, sorrows that could grow lighter if shared with others.

---

Banning visitors from the hospital was no small matter, not for the patients and not for their loved ones. The threat that a visitor could bring COVID into a setting where people were already sick left no room for discussion. The threat was real. Also real were the fear and loneliness the patients had to endure – the increase of their fear and loneliness, the grip of anxiety and worry among family members. Some relatives sat in parked cars outside the hospital just to be close to their loved one. 

In those first weeks and months, the chaplains connected patients with their families, sometimes through FaceTime, more often with family Zoom calls. It didn’t matter if the patient was intubated and non-responsive – families wanted to see their loved one. Some nights all I could do was set up Zoom calls. Not being tech-savvy, I found the logistics challenging, but I saw how important these calls were. On some calls, there were family members scattered across the country who came together remotely to talk to each other as well as to the patient. 

One call in particular showed me the impact a Zoom call could have. The patient was an 80-year-old woman named Bernice. Her son requested the call and wanted to include Bernice’s two sisters. The three sisters in this loving and prayerful family turned out to be triplets. Bernice was intubated and medicated for comfort. Her short white hair was neatly combed, her skin pale. She looked uncomfortable with the breathing tube extending from her mouth to a machine at the side of her bed. Entering the room, I set up the call and then prepared the family members.

“I think you all know that Bernice has a tube in her mouth that helps her breathe. Sometimes family members are distressed when they see this but it’s there to make sure a person gets enough air into their lungs. To keep Bernice comfortable, they give her medication so she won’t be able to respond to you but it’s very likely she can still hear you.”

Adjusting the position of the iPad so everyone could see Bernice, I suggested, “Why don’t you talk for a while before we pray.” 

“Bernie,” both sisters called to her at the same time. Bernie opened her eyes for just a moment and everyone knew she was there with them. Her son and each triplet told her how much they loved her and that they were praying for her. If Bernice could have spoken, she could not have found words more meaningful than her silent moment of connection.

---

Bernice was not the only patient I saw who broke through the haze of an intubated and medicated state shortly before dying. Marty’s wife Evelyn was at his bedside. Their four adult children and a few other family members had gathered in one person’s home to see Marty on a FaceTime call and to be there to hear the prayers when the chaplain arrived.

After a few minutes of conversation with Evelyn, I asked if it was a good time pray. She nodded. I explained that I was going to pray the Christian Prayer of Commendation which is a sending forth, a time when we will ask Jesus and all of Marty’s loved ones who have gone before him to welcome him home. 

Then, as I often do, to include the family more actively in the prayer, I asked that we pray together the Lord’s Prayer. Shortly after we began, Marty, though silent, began to move his lips. It might have been the sound of his family’s voices or the familiarity of the words from a lifetime of praying the only prayer that Jesus taught his followers, but Marty moved his lips, clearly trying to pray with us. His family knew he could hear them and that he could take their last words with him as he died.

One of his daughters suggested that the family sing together. A young voice loudly suggested “This Little Guiding Light of Mine.” The words go on from that phrase to say that the light will continue to shine. It can’t be hidden under a bushel basket. It ends, “let it shine, all the time, let it shine.” I suggested to everyone in Marty’s family that it was his light that would continue to shine because they would be carrying his light in their hearts for the rest of their lives. Just as I thought my comment may have sounded trite or corny, I noticed the nurse who had stayed in the background nodded as the tears rolled down her cheeks, my comment reminding myself that it’s often the simplest things, words or deeds, that can have the greatest impact.

Chaplains often reassure one another that it’s okay if patients see you cry – as long as you’re not sobbing – because it communicates your care and concern. I’ve said that to student chaplains a number of times but during the worst days of COVID, I found that I wanted – needed – to be in control of my emotions. My feelings, positive and negative, felt very close to the surface. I sometimes found the smallest thing incredibly touching and meaningful when in truth it was ordinary, something I would barely react to in normal times – a compliment from a patient or a family member or the offer from a colleague to make me a cup of tea. 

More troubling was the tendency I had to lose patience or get angry much too easily. Looking back, I see that I had little compassion for chaplaincy residents who had a hard time dealing with COVID. Fortunately, I knew enough not to verbalize my thoughts. I suspected I was being judgmental and perhaps unfair but what I really wanted to say was, “If you can’t deal with this, you have no business being a chaplain.” 

---

Though COVID swept through the hospital like a tsunami, it also called forth generosity. Restaurants wanting to acknowledge the nurses and other staff sent in prepared meals at no cost. With the arrival of spring, people donated dozens and dozens of pots with bright yellow daffodils for staff to take home. Others papered bulletin boards with notes mailed to us by appreciative family members and sometimes with notes from appreciative COVID survivors. Shown hanging were enormous signs throughout the city thanking hospital staff for their service. There was even a billboard expressing gratitude. Passing it every day on my way to work, I felt reassured that people knew what was going on in our hospitals and nursing homes and appreciated what staff were experiencing. It made a difference.

A team of four priests volunteered to help. They moved into the dormitory of a nearby college and responded to emergency calls in the city’s four largest hospitals. The priests were generous with their time, compassionate, and willing to do more than just the sacramental visits for which they had signed up. If they were afraid or even just nervous to be close to people with COVID, they hid it well. They donned their PPE like everyone else and graciously told the nurses how much they appreciated the work they were doing. Their ministry often extended to calling family members to offer comfort. They made me proud to be Catholic.

I was also proud to be part of the team that provided care at Brigham and Women’s Hospital and there was something we did that reminded me to feel good about our work. When a COVID survivor was being discharged, an announcement was made over the PA system beckoning all available staff on the first floor to come to the front entrance where a nurse or a family member would be pushing the patient’s wheelchair through the lobby toward the door. Everyone clapped and cheered and offered congratulations. Though we congratulated the patient on their recovery, we also expressed our acknowledgement of the difficult work of a large team of dedicated staff. It was so easy to dwell on the losses; important was the reminder of a great many successes.

Staff in all departments needed things that made them feel good, not just because of the work they did at the hospital, but also because of the dealings in their personal lives. None of us were immune to losing loved ones. I was in the office one morning when Sally called. She didn’t tell me her position but she said she worked at the hospital but now she was a patient. At first, I thought she called to ask for a chaplain to visit her but then she explained, “I’m hoping you can visit my father. He’s a patient too. My mother was a patient but she died a few days ago. We all got COVID at the same time. My father is sick but I think he’s suffering more from a broken heart than from COVID. I’m getting better but I know my father thinks I’m not telling him how sick I am. He keeps saying he can’t lose me too. Could you reassure him and maybe pray with him?” 

Everyone – chaplains, nurses, maintenance workers, phlebotomists, kitchen staff, security guards – brought COVID home with us. For some it was fear or anger. For others it was a feeling of helplessness or even despair. For me, it was patients. The idea of leaving work at work has long been considered a part of good mental health for people who work in human service. It’s spoken of as if it’s actually a choice. I can only speak for myself. It’s not always a choice. Even though I try, sometimes there are people I just can’t leave behind. 

Such a person was Chuck. I was paged to the ER to provide support for the husband of a woman who died of COVID. Donning my PPE, I stepped into the room where a man stood holding his wife’s hand. After the usual phrases like “I’m so sorry for your loss”, I asked Chuck to tell me about Coco, his wife. Often people say only a few things that come to mind but Chuck took the opportunity to tell me about everything from their courtship to the birth of their children and then their grandchildren. I felt like I almost knew her – her love of gardening, her belief that she was an excellent cook (secretly debated by those close to her), her philosophy on raising children, and much more. 

Just as I thought the visit was beginning to wind down, Chuck began to tell me about the day, the hours before she died. Coco had been sick for a couple of days but over the course of this day, her breathing was becoming more and more labored so he decided to bring her to the hospital. Due to her weakness and trouble staying awake, he settled her into the back seat where she could lie down. While driving, he could hear the worsening of her labored breathing. Sometimes several seconds would pass between breaths. This time seconds passed and then a minute. Chuck knew Coco had died.

“I didn’t know what to do. I couldn’t turn around and bring her home. I wanted to pull over and get in the back seat with her but I was afraid I’d fall apart and I wouldn’t be able to drive so I just kept driving. When we got here, I didn’t tell them I knew she was dead. They put her on a stretcher and brought her in.” Chuck was choking back his tears. 

We prayed together and then I walked with Chuck back to the area where he’d left his car. We hugged. I watched as he walked over the valet who had parked his car. I wanted to walk over and wait with him. He looked so alone. However, my pager reminded me that there were other people waiting for me to visit. The memory of my time with Chuck and Coco came home with me that night and stayed with me a long time.

---

Though there were times when I was exhausted physically and emotionally, I never had to wonder if my physical and emotional energy would return. I’d had plenty of practice during the early years of the AIDS pandemic when I ran a residence for people approaching the end of their lives. I’m drawn to suffering; it’s not where I live now but it’s familiar territory. The more painful or difficult a situation is, the clearer it is to me that I might be able to make a difference. Most situations I face in my work cannot be fixed, but making a difference makes a difference to me. It’s what I’m called to do. 

Peg Newman is a certified chaplain who lives and works in the Boston area. For nine years she ran a residence for people with HIV/AIDS but when AIDS was no longer a terminal diagnosis, she returned to school to become a chaplain. She has worked in large city hospitals as well as several different prison settings. Currently she is writing a memoir.