I've been wanting to write about a couple of death encounters I had at hospital, but I don't have the words to say what they meant to me, so I'll just let you sit with them here, unexplained.
I was attempting to visit the units I've been assigned to as a volunteer Chaplain intern, geriatrics, Medical Intensive Care Unit and the ICU Holding while I was concurrently serving an on-call shift, so as you might expect, it was a bit too busy for me to be doing both effectively. As I was charting one patient's notes when a loud-speaker announced a "Code 199" in the Radiology unit. A "Code 199" is when a patient's heart has stopped, and all pertinent members of the clinical team, including the Chaplain, are to respond immediately.
The other chaplains in the spiritual care office looked at me, and I realized that I was the House Chaplain at the moment, so I sprang to my feet and raced to the scene. Most of the time, a "Code 199" in such a capable hospital is resolved almost immediately, and I usually breathlessly arrive to see relieved doctors patting each other on the back and smiling as they are already returning to their regular activities.
This time, I turned up and counted thirty people surrounding a man on a table. The room atmosphere was not unlike a social event, with everyone talking, but none of the loud, dramatic shouting that one might see on television. The only way one could tell it was not a relaxed atmosphere was how the wrappers of various sterile medical equipment were allowed to fall on the floor. The doctors, many of whom I suspect entered this profession as adrenaline junkies, were cheerfully working away on the young man on the table, cracking jokes as they took turns compressing his chest. At one point, someone started an enthusiastic round of rhythmic clapping to help a staff member keep the correct time on the chest compressions.
A helpful nurse informed me that the young man had just been informed two weeks previous that he had lung cancer. His sister was on the plane from Utah to visit him. The doctors worked feverishly, but his pulse had petered out to nothing. In the end, after working on him for thirty minutes, the doctors stepped away. I could feel the man willingly draw a hand-out of energy I was offering for his needs.
The man was still breathing, even though he had no pulse. A strained debate arose. Two doctors exclaimed that they had never seen something like this before. By now, the young man must have anoxic brain damage, and did not have a long-term survival rate, but it is not supposed to be the doctors' call to make whether to save somebody like that. One doctor was so disturbed at this point that he had to step out into the hallway. In the end, they decided that they had already honoured the young man's wishes by attempting resuscitation for thirty minutes. The room was silent as we all waited for him to die. His face did not change after he was gone, but we all did. The very room did.
The contrast between the upbeat work on the living man, and the obvious disappointment that shone in the doctors' faces after his death was chilling. I walked around to help the staff members and offer to be present when the family was appraised of what had just occurred. When I returned to the Spiritual Care office, another Chaplain told me he had heard the Code 199 was intense, and asked to help relieve me of some other calls that I had for that day. My pager went off, and I was alerted to the needs of another patient and family.
Every hospital seems to have a phrase they use for "pulling the plug." Our particular euphemism is "Comfort Care," because the patient is given drugs both to relieve pain and oxygen hunger as well as anxiety. When I showed up for an elderly gentleman's removal to Comfort Care, the nurse was surprised that I had come so quickly! The drugs hadn't even arrived from the pharmacy yet, and the family keeping vigil at his bedside had taken a brief lunch-time break. I said I didn't mind, and that I would hang out with him and keep him company.
Suddenly, and to the surprise of the nurses, he began to die. There had been no indicators that this would take place, and his death had been scheduled for later on, but obviously he had other plans. I heard, when I got started with chaplaincy, that loved-ones often go when the family is taking that one bathroom break, or catching a wink of sleep.
One nurse called the family while the other nurse rubbed his chest and told him to hang in there because his daughter was coming. The family pounded up the stairs and flooded into the room. "You people-pleaser!" A sister shouted with a teary sense humour in her eyes. "Trying to sneak out when we're not here so you won't bother us! Well, we're here now, and we want to be with you when you go!"
The oxygen machine pumped as if he were breathing, but it was not him, and it was not his wishes, so he did not accept it. He continued to die without any assistance or resistance. (A nurse would later uncomfortably step in to remove the breathing apparatus, visibly disturbed by the rise and fall of the dead man's chest. But it did not bother the family, or myself, or the man who had died. It was not his breath.)
His daughter asked me to pray him out, so I grasped his hand and looked into his eyes. The family's encouragement of him was almost chant-like as I prayed. "Go to mom" a son whispered. "it's okay," a sister breathed lovingly, "you can go now!" As I prayed I was gazing deep into his eyes. With his family around him, I saw the life slip from the body, like a deer springing into the woods.