Tuesday, January 17, 2006

With the Ears of a Chaplain

I have been listening with interest to the reports of the status of Israeli Prime Minister Ariel Sharon. I am, of course, conscious that there are significant political ramifications to his condition. However, I listen with a different concern, another ear.

I have spent the last 25 years in health care ministry, full or part time. Much of that time has been spent in intensive care in general, and in neurological and neurosurgical services in particular. It is that experience that shapes the way I hear news of Sharon’s condition.

The latest reports are that members of the family are seeing small movements, small signs that give them hope. They play a tape of a grandchild’s voice, and his eyes move. They speak, and he seems to move, to respond.

The doctors are more cautious. They speak of reflex responses, of random motions from random neurons firing in the brain. They know all too well that it takes more than the flutter of an eyelid, the withdrawal of an arm, to demonstrate purpose and intent, to document that in fact there’s someone in there.

I have been with families in that situation too many times. I know too well how much a family can hope. Events that seem inconsequential, even invisible to health care staff are understood by loved ones as incontrovertible evidence: the person they love is not only physically alive but cognitively intact. Somewhere, behind those tubes and lines and wires, behind the blank, often swollen face, there is still a person, the same person they knew and loved before the injury.

These can be difficult times for me as the chaplain. Let me be clear: I believe in miracles, and I’ve seen more than my share. Still, I dread the question that may come next, the question they will ask the chaplain because when the doctor’s there he or she is too focused, too authoritative to ask; or because most of the time the doctor isn’t there at all. “Chaplain, have you ever seen someone this sick, this badly injured recover?”

I have to stop and consider how to address that question. Ever? I’ve been in this business a long time, and I’ve seen a lot of patients. This sick? Much of the time we don’t know just how sick the patient really is; there are too many variables, even with all the technology we can bring to bear. Recover? What would it mean to recover? How able was the patient before this happened? How far could this patient go, even with the best of care and all the time in the world? Are they asking about physical function, or basic activities of daily living, or complete physical and intellectual wholeness? If I am to answer this question with integrity, I have to think this through.

For good or ill – for good and ill – I’ve had years to think this through. So, when the question comes I can review what I’ve learned about this patient and about this family fairly quickly. I will not lie. I do not want to destroy hope, but I dare not give false hope. The families of the Sago Coal Mine disaster have shown the cost of that. There are matters beyond my control, promises I can’t keep; and I must speak carefully. “I have been a chaplain a long time. I believe in miracles, and I have seen some. But, no: I have never personally seen someone this injured recover to be the person they were before.”

This is, of course, not what families want to hear. And I would be pleased to be wrong, and happy to give thanks. But it is the most honest answer I can give. It does not deny what God can do. It also does not deny all the patients I have seen who did not recover. It honors the family’s question with the honesty and integrity it deserves, and with all the love and compassion I can muster.

And so I pray for the Ariel Sharon and for his family, not because of his political position or his international stature, whatever they may be. I pray because I know the road his family is walking, a road I have walked with other families on their way to grief.

1 comment:

d said...

I liek your response here. That is very upfront and honest. You;ve left room for a miraculous receovery but prepared them for death or major sickness/injury too.

I would add too that as a Christian chaplian, you can remind them that Jesus is the ulimate physician (He came to heal us of our human lot) and that whether we are healed here on Earth is one thing, but ultimately He can heal us from our fallen selves, whether we are christians yet or not.