I was paged by a nurse who had seen me visiting with another patient on the unit earlier in the evening. Sounding exasperated, she told me that a patient who had earlier that day received a palliative care consult regarding her brain tumor had “freaked out” and was now screaming non-stop prayer. She asked me to come immediately. From the patient’s chart, I found out that death was not necessarily immanent, but that the patient would not be living as before and, if she ever is to leave the hospital, will probably require constant care. When I arrived at the unit, two nurses ran up to me and desperately asked, “Are you from psych?” When I told them of my role, they seemed excited and ushered me to a room from which screams were being emitted while a crowd of about six nurses stood around outside. A nurse shouted over the screaming “Are you here to STOP THIS?” The crowd laughed. I said, “I’ll do what I can.” As I entered the room, a nurse sitting at the bedside got up out of his chair and fled the room. The patient was sitting upright with bedclothes tossed aside holding her head. I could see bruises on her arms. The room was undecorated and garishly lit in the night.
I guess I was hoping for a miracle. That the patient would stop her screaming, throw on a happy smile and greet me joyously. We would share a chat like old friends. I’d confide in her that she had me worried there for a moment and we would share a chuckle. We would pray together and she would be left calm and peaceful in the face of her tragedies. The doctors and nurses would carry me around their unit on their shoulders chanting my name, “Alex! Alex! Alex!”
Patient: HAIL MARY FULL OF GRACE THE LORD IS WITH THEE BLESSED ART THOU AMONG WOMEN AND BLESSED IS THE FRUIT OF THY WOMB JESUS HOLY MARY MOTHER OF GOD PRAY FOR US SINNERS NOW AND AT THE HOUR OF OUR DEATH AMEN…
Me: (Should I interrupt? Prayer is one of those things you shouldn’t interrupt. This sounds like one of those prayers that has specific words so maybe the end will come. Oh wait, it just went by.) Hello, my name is Alex, I’m the chaplain. What do you prefer to be called? (Oh my, I guess did interrupt.)
Patient: HAIRY MARY…. I like to be called by my first name. HAIL MARY FULL OF GRACE THE LORD IS WITH THEE BLESSED ART THOU AMONG WOMEN AND BLESSED IS THE FRUIT OF THY WOMB…
Me: (Thank goodness she said something to me! I’m well on my way to success!) Well, hello, Mary. How can I help you this evening?
Patient: JESUS HOLY MARY MOTHER OF GOD PRAY FOR US SINNERS NOW… I just want the phone number for the chaplain! AND AT THE HOUR OF OUR DEATH AMEN…
Me: (Wait a minute… That’s me!) I’m the chaplain!
Patient: HAIL MARY FULL OF GRACE THE LORD IS WITH THEE BLESSED ART THOU AMONG WOMEN AND BLESSED IS THE FRUIT OF THY WOMB JESUS HOLY MARY MOTHER OF GOD PRAY FOR US SINNERS NOW AND AT THE HOUR OF OUR DEATH AMEN…
Me: (Now what…) … Um… Is there anything I can do for you… Y’know… As the chaplain? …
Patient: HAIL MARY FULL OF GRACE THE LORD IS WITH THEE BLESSED ART THOU AMONG WOMEN AND BLESSED IS THE FRUIT OF THY WOMB JESUS HOLY MARY MOTHER OF GOD PRAY FOR US SINNERS NOW AND AT THE HOUR OF OUR DEATH AMEN…
Me: (I’m super confused. I thought she wanted the chaplain. Does she realize that I’m in the room?) Mary? Hello, Mary? I’m the chaplain and I’m right here with you.
Patient: HAIL MARY FULL OF GRACE THE LORD IS WITH THEE BLESSED ART THOU AMONG WOMEN AND BLESSED IS THE FRUIT OF THY WOMB JESUS HOLY MARY MOTHER OF GOD PRAY FOR US SINNERS NOW AND AT THE HOUR OF OUR DEATH AMEN…
Me: (Okay, now I’m feeling very uncomfortable. I wish I knew what she wanted.) Mary, would you like me to keep sitting with you, or would you like me to leave the room?
Patient: HAIL MARY FULL OF GRACE…. I want you to go away. HAIL MARY FULL OF GRACE THE LORD IS WITH THEE BLESSED ART THOU AMONG WOMEN AND BLESSED IS THE FRUIT OF THY WOMB JESUS HOLY MARY MOTHER OF GOD PRAY FOR US SINNERS NOW AND AT THE HOUR OF OUR DEATH AMEN…
I stood up to leave and shrugged at the nurse who was slowly inching his way back into the room as if it were covered with spiders. I re-entered a hallway full of disappointed nurses and went to chart. I returned the next day, since 4E is my unit, and saw that there were family members out in the hallway.
Me: Hi, my name is Alex, I’m the chaplain.
Family member: Hi, I’m Mary’s eldest daughter, Diana.
Loved one: Hi, I’m Diana’s boyfriend.
Me: (With concern since Diana has red eyes.) How are you doing?
Family member: Not so good. I have no idea if she’s going to die or what. Death doesn’t seem immanent. I want to know when it is going to happen.
Me: I think it’s hard to put a timeline on these things, but you should be able to talk to somebody to make plans. I’m going to check in with Mary and then I’ll find someone who can talk with you about death and planning. (I enter the room where Mary is not praying but shouting irritably at a nurse.) Hello Mary, my name is Alex and I’m a chaplain.
Patient: I could tell you were a chaplain as soon as you entered the room.
Me: (Finally!) How can I help you today?
Patient: You can go away right now!
Me: (Leaving the room) Okay, but I’d like you to know that we have 24 hour spiritual care services here at the hospital, so you can have your nurse page us whenever you feel like you’d like to see a chaplain.
Patient: GO AWAY!
Me: (Back in the hallway with the family who is chuckling ruefully) Well, we’ve got chaplains in the hospital 24 hours, so please do have a nurse page us if you need us. I’m happy to come in to get sent back out anytime! I’m going to go bring Mary’s nurse Mindy over here so that you can talk with her about death and planning.
Family member: Thank you.