Tears

During the year after I earned my first unit of CPE, I deliberately took some personal time away from my pastoral formation and worked at Macy’s in Phoenix’ illustrious Biltmore Plaza. One of my co-workers was a nursing student, and she told me she’d been taught that expressing emotion of any sort, especially crying, is absolutely verboten in her profession. I said bluntly that I think that’s nuts. Of course I expect my doctors and nurses to be competent in the face of tragedy – that’s partly why they go through such extensive training. But I think it’s ridiculous to forbid them to express ANY sorrow over the loss of a patient, or a hopeless diagnosis. Try as we might to deify them, they are human, too. Now, after a year as a chaplain, I’ve realized that they go through the same complex process I go through in separating the emotion from the facts. I think what happens is, they learn early on, as I did, to distance themselves from patients and situations so that they can function without expressing emotion in the present. Then they go home and deal with the frustration, anger and sorrow in private. Sometimes you might think that a doctor or nurse doesn’t feel it, but you couldn’t be more wrong. Oh, they feel it – and many times afterward, as a sort of venting, they’ll talk to the chaplain. It’s a tough process to learn how to keep emotion from affecting your behavior, but it’s absolutely necessary in this profession.

Unfortunately it can be tougher for a chaplain since emotion is largely what drives our visits, and because we ourselves must offer support to the medical staff. We’re also on hand for every death of every type, and the sad truth is that many people associate the chaplain solely with death. During an interview for a residency at a medium-sized hospital two years ago, I was touring the facilities with the on-call chaplain when a Code Blue was called. When we arrived in the ICU together to find two 40-something women clinging to each other while their mother fought cancer, one looked at us and gasped, “Oh God, it’s the chaplain….she must’ve died!” One time during this residency, I responded to a Code Blue called for a 20-something patient who’d passed out in her bathroom, and upon seeing my clerical collar, her mother cried, “MY DAUGHTER DOESN’T NEED A CHAPLAIN! SHE’S NOT DEAD!!!”. Part of a successful CPE program is learning, so instead of feeling affront, I learn to be more sensitive to people’s impressions – i.e., when I visit a new mom whose baby is in the NiCU, the first thing I say is that I’m here to greet ALL new moms and I’m so happy that she had a healthy birth. Unfortunately, when I respond to a death, no explanation of my presence is necessary. Everybody knows why I’m there.

I’ve been present for so many deaths now that I’m beginning to understand how the doctors do it – how they function professionally in the face of grief, without letting emotion even show, much less color what it is they say and do. It’s been a long time since I’ve cried after a death. I feel bad just admitting that on paper, but it’s true. After a while, you just don’t react in the same way. Yes, it’s always sorrowful, especially when it’s unexpected or due to some horrid disease instead of natural causes, but usually I compartmentalize my emotions and work out the sorrow in different ways, after I’m away from the hospital. This ability is especially helpful if I’m attending the death of a baby. I think if I were a mother who’d just lost a child, I might feel resentful seeing someone else cry tears over my child. That sense of ownership of emotion is part of the grief process. So if I cry when I attend a death, am I grieving for the death of someone I never knew? Or am I grieving for myself? What, exactly, have I lost that causes me to cry?

Chris was an extremely handsome man, though initially I couldn’t tell from all the tubes attached to him. He was rushed to the hospital yesterday after a drug overdose that led to cardiac arrest. One of his family members told me that he had fought addiction for so long, he’d been through rehab, he’d tried to clean up. In the end, though, the demon got the best of him. I’d been told ahead of time when I arrived tonight for the overnight on-call shift what the issue was, and in making rounds I commented to the charge nurse on duty in the NiCU, “I can’t imagine ever doing that”, and she said, quite seriously, “I can. Not that I’d do it, but I can understand needing that escape.” Chris' extended family was openly grieving when I arrived for the withdrawal of care. The tubes were removed, and he went almost immediately, as if he’d been just waiting for a release that heroin never provided. The family had done so much grieving already that they were past the point of needing extensive pastoral care; in fact, they left the room less than ten minutes after his heart stopped. They, too, had fought the demon, worked out the emotion, and now had release. I felt like a fifth wheel for the most part, though I tried to offer comfort, and also said a prayer shortly after he died. I had extensive paperwork to write afterward, and about 15 minutes later I looked up into the room where his nurse was taking away machines, removing tubes and restoring some semblance of humanity to his appearance. Observing Chris, I realized that without all the tubes, he looked like actor Leonardo DiCaprio, who is one of my favorites.

During his dying process, I had wondered about the demons that chased him, caused him to retreat from life and escape through drugs. Was I really any different, I wondered, though my method of escapism was social isolation? Had I not done the same thing myself far too long? It was almost as if through Chris's death I was being taught a lesson about escapism…I’d done it myself, just as the nurse claimed. I simply hadn’t used drugs as my means. Facing up to that was a very tough thing for me, and brought a lot of feelings to the fore. Sometimes the emotion is so strong that you can’t wait until you’re away from the hospital to deal with it; you need to right then. For that reason, I found myself crying after I left the unit and returned to my office shortly after midnight, tears of grief over what I myself had lost – and tears of gratitude that I’ve managed to best my own demon and am moving forward. Afterward, I googled the word ‘tears’ and on Wikipedia, found this quote about crying: an emotional reaction considered by many to be a uniquely human phenomenon, possibly due to humans' advanced self-awareness. So apparently, my advanced self-awareness led me to react emotionally over what I’ve lost and what Chris and his family have lost. That sounds too intellectual to me. The reality is that the last of my grief over what I’ve lost is being expressed, both right after the visit and right here. Like Chris, I, too, have finally found that release I sought. It’s a damn good feeling – and though he had to go to Heaven to get it himself, I am firmly convinced that Chris, too, finds it a damn good feeling. Rest in peace, brother.