I had just gone to one of the ICU’s to chart my work from the previous 8 hours. Things had finally slowed down enough and 3:30am is typically not the busiest of times for me. I had already worked five Level 1 traumas, 2 of which were Trauma Codes, meaning they were not breathing as a result of their injuries and resuscitative measures were being performed.
Unfortunately those 2 did not survive. Of course, my night had not started out any better. Perhaps I should have suspected it was going to be one of those nights when no sooner had I gotten to work I was called to provide support to the family of a patient who just died because of a brain tumor. I began my shift dealing with death. It seems I would be ending my shift the same way.
I never like receiving a page to the ER at 3:30 in the morning. It is rarely a call for information. Often it is a call to provide support to someone under the influence of drugs or alcohol. This was not. As soon as I introduced myself over the phone as the chaplain, a calm but eerie response was given, “Rex, we have a 7 week old Code coming in.” It is later determined that the child is 7 months not 7 weeks old.
There are a lot of calls that simply fail to stir anything within me. Then again, there are a lot of calls that turn my stomach as soon as I hear them. I literally cringe when I get a call like this. My forehead and face tighten up and I kind of squint. If you are close enough to me then you will hear a soft moan. I announce to myself and a person sitting several feet away, “I am going to the ER, we have a 7 week old Code coming in.” I am hoping for a response of concern, but she isn’t paying attention. Perhaps I am hoping to hear her validate my feelings of despair and trepidation. I needed to say it out loud to take some of the bite out of it. I did not repeat myself, I simply went to the ER.
I always like knowing what I am walking into when I receive a page. I get irritated when the operator puts the name of a unit on the page and not a phone number. I like to call ahead and know what is happening. As I walk I begin to prepare myself. I immediately begin a walking prayer: “God help me to be sensitive. Help me to know when to speak and when to be silent. God let this call amount to nothing. Let it be an overstatement. God let this child be alive. Help me be with the parents Lord. Oh, God what in the world is going on? Why a 7 week old baby? God help me.”
I begin to remind myself of what empathy is all about. Since I learned how to “be present” by doing certain things, I begin to rehearse all the things I know to do in order to “be.” I am so hoping this call isn’t going to turn out to be a tragedy. I arrive in the ER and the pediatric code team is assembled and waiting. Several minutes later a group of firemen roll in with a baby on a gurney and they are doing CPR. I immediately look for the parents to be coming in behind the firemen. This is not the case. It is reported that the family is at the scene being questioned by police. They will be in route to the hospital soon. So I just watch.
The skin color of the baby is not right. I have seen too many codes and too many deaths and the skin color is too often an indicator for death. It’s always and uneasy sight for me to see grown men and women doing CPR on an infant. They use two fingers to rapidly press down on the chest hoping to give some rhythm to the heart and maintain some blood flow. It looks like any one of those compressions could crash right through her little chest. But they keep pushing. Her entire body moves with each compression. The bag they use to pump air into her lungs is making that dreadful sound it makes when blowing air into an empty cavern. You can hear the emptiness with each compression on the chest and each squeeze on the bag.
They start talking about how much epi (epinephrine) she has been given. It is a powerful drug that helps stimulate the heart and makes it beat. You can hear them say “we have a pulse, but it is still flat line. We have no heart beat. How long was she down?” “We don’t know.” “How long have you been coding her?” “Thirty minutes.” “We still don’t have a heart beat. She is still flat line. Stop the compressions. Do we have a pulse?” “No.”
I only turned my head for 15 seconds to ask the police officer for some information. When I looked back into the room they had already called it. They stopped the code. At 0401 they pronounced her dead. She had only been here 11 minutes. Oh no, not dead! Not this! I am dreading the arrival of the parents. For a split second I wish something bad for the parents. I wish the police would take them into custody so I won’t have to deal with them. My stomach is churning. My stress level is high. My face is tight. My frown is obvious. I have entered the empathy zone. The staff has come to recognize my posture and expressions in such situations.
It feels like the air has thickened. Everything seems to be moving in slow motion. I call to the Pediatric ICU to request some clothes for the child. I call the Neo-Natal ICU to request a Polaroid camera and a death packet for an infant. I go and check the family room to make certain it is reasonably clean and tissue equipped. I go back to the patient. I stand outside the room and just watch and wonder. I hate this. Don’t get me wrong, I love what I do. I am so glad that I can represent God’s presence and love and concern and mercy to so many people who go through sickness, death, and dying. I am so glad I can be there for the families. But I hate this. I would trade a hundred Sunday sermons for these moments any day of the week.
The security guard comes around the corner and tells me that family has arrived. I quickly ask the doctor to stay close because I will soon need him to tell the family what has happened. I go to the family room and the baby’s mother is sitting next to her mother draped across her lap. Both have a look of terror on their faces. They assume the worst when I introduce myself as the chaplain. They ask me how she is doing. I simply tell them that the situation is very grave and I will go get the doctor to come and speak to them right away. Mom begins to cry with more intensity.
I take the doctor into the family room and he sits down and gives them the news. There is no good way to say it. Mom and grandma know it, but they have to hear it. Mom is just about lifeless at this time. She can not hold herself up. All of her strength is being used to cry. The grandmother is doing her best to hold on to her daughter. She is doing her best to not cry as much as her daughter is crying. She wants to be strong for her daughter but the look on her face is enough to tell me that she is crying with all of her might.
Waves of grief come and go with varying degrees of intensity. Mom pauses long enough to ask a question, “what am I going to do?” The fact of her daughter’s death has briefly entered into her reality. But she quickly goes back to denial. “No, no, no, no momma. She’s not gone. Momma.” Grief takes over for a few more minutes. Grandma is trying so hard to keep it inside of her. She wants to take care of her daughter. She doesn’t want her daughter to have to take care of her. I encourage her that she doesn’t have to be strong. “Let it out. Don’t hold onto it. You don’t have to be strong right now. Let it out.”
Grandma cries some but she continues to try to be strong and courageous for her daughter. More family arrives and with each new family member the story begins to be told, “my baby, she’s gone.” And with each new proclamation comes a new wave of grief, different than before. More than thirty minutes have passed. I entrust the care of the mother and grandmother to a volunteer counselor. I need to go make sure the baby is ready for viewing. I need to make a couple of phone calls to the donor network and the medical examiner’s office. Perhaps I just need a break from the grief. I need to go and breathe. I need to go ask God some questions.
The nurses have taken the baby’s footprints and handprints and put them in a booklet for the parents. We cut a lock of hair off the little girl’s head and we place that in the book. The book is done. The phone calls are done. The baby is ready for viewing. I return to the family room and invite the parents and the grandparents to come to the room. I explain to them that the child will go to the medical examiner and that they will not be able to do certain things with the child because of the investigation.
What I cannot say out loud is, “baby’s aren’t suppose to die like this. Babies do not just die. They have to figure out what happened.” Of course I know that baby’s do sometimes die without reason. I am just looking for something to make sense. Did I mention that I hate this? I hate not letting the mother pick her baby up and rock her and hold her until the reality of her death is more certain. I hate this medical examiner stuff. It is so easy for them to give the order from the other side of the telephone. They wanted me to put a police officer in the room to make sure “evidence is not tampered with.” I volunteer to take on that responsibility so that I can minimize the intrusion into the family’s processing of this horrific event.
If only there was a reason. And so I sit and I stand and I watch them grieve. There is nothing I can say or do. I just stay with them. In between waves of grief they look up to ask a question. I do my best to answer what I know. I repeat what the medical examiner told me. I want to distance myself from that as much as possible.
Mom is sitting in a chair next to her baby’s bed. She is stroking her daughter’s hair and running her finger over her face. She pats her chest. She lays her head down on her daughter’s hand. She cries. Over and over and over she keeps saying “my baby girl, my baby girl, my baby girl. I cannot leave my baby girl.”
And there in her hand she has some sort of make shift rosary bead type object. Mom’s lifeless arms are too week to move with any amount of control and purpose. Repeatedly they slump from the baby’s side to her own side like heavy bags of sand being drug from the bed to the floor. On one occasion I hear a noise. She has obviously dropped something. She does not seem concerned and so I do not get concerned. The grieving continues.
30 to 40 more minutes have passed. Mom continues to cry and speak and question and cry and despair over having to leave her baby. The baby’s father comes over and attempts to comfort her. When he does he draws her body close to his and she is pulled away from the side of the bed just enough to see it. There it is. It is a cross. A shiny silver cross sits on the floor at mom’s feet, under the bed of that lifeless little girl. That was the noise earlier. I focus on that. A cross. A lonely cross. It must have broken off the mother’s chain.
The cross lies on the floor and represents so much of the same anguish I am witnessing in these parents. The cross of Christ. What a lonely cross. How can I share the hope of that cross? How can I explain that they are bearing the pain and suffering of that cross just as Jesus did? I still want to say it is not fair. I know the price Jesus paid was so tremendous and so unfair. But it seems so far away from the pain that sits before me. “I know it was your only begotten son. I know he did not deserve it. I know it cost you so much. I know. But God…it is their daughter, their 7 month old daughter. Their sinless daughter.”
I cannot fathom it. Nor can I fathom all that the cross of Christ signifies. His pain was real. His loss was real. It did hurt. It did strike Him at His very soul. It did rip every bit of life out of Him. “My God, how did you bear to see your Son die for nothing He did of Himself, and yet know He died for everyone and all of their sins? I cannot imagine what you went through. But whose sin is this child bearing? God give me faith for my doubt.”
What a lonely cross. I hope that the parents will find strength in that cross. I hope the parents will find a Savior at the cross that can identify with them in every way. I know that they will if only they turn to Him. And so perhaps the cross they bear is not as lonely as the cross Christ bore. Because their cross is not borne on their own shoulders. Yes, it is heavy. Yes, it is painful. Yes, it is theirs. But no, it is not lonely. For Christ stands at that cross with them bearing the full weight of that burden. And so perhaps it is not an accident that the cross fell onto the ground directly under the mother’s feet and under the bed of that lifeless child.
It is from that position Christ says with assurance: “Come to me, all you that are weary and are carrying heavy burdens, and I will give you rest. Take my yoke upon you, and learn from me; for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light” (Matt. 11:28-30 NRSV).
For Christ carries us on His cross. When I cannot understand and when I cannot fathom life’s events Christ steps forward and gives me hope that although this family may feel alone in their pain and suffering, Christ is carrying them and will carry them until they can again stand on their own. It was a lonely cross for Christ but He made certain it would not be lonely for us. “God give them rest for their souls.”