Last year was my first New Year’s Eve spent in New Orleans. I celebrated with my group of new friends in a fascinating way – a jubilee was held at one’s house, and amid good food, great wine and stimulating conversation we bonded into one. Then, at the appointed hour, we all sat and shared slices of a single King Cake. A New Orleans communion involves more than remembering Who is responsible for our existence and why. Each one of us, as we ate, shared his or her best memories about 2008 and what made it unique, and our hopes for the coming year. Every share and hope was toasted with fervor by the entire group. After three months in residency, I had learned to open up to the extent that I shared how grateful I was for the new friends I had, how I felt as if my life were truly beginning after being on hold for many years, and that I looked forward to more learning in 2009.
Unfortunately, I am present in spirit only at tonight’s Jubilee because every other chaplain had plans for this year’s end and I was asked if I would please work this night. I accepted before remembering what a joyous experience we’d had last year. Initially I felt extreme disappointment over missing this evening, and if I'm being totally honest maybe even a little resentful (I realize that that makes no sense, but when do emotions ever make sense?) but I have to say now that I think it better that I was here. Once again God called me to put others first, to be part of someone else’s life experience, and to learn from it a lesson for my own existence.
When I arrived this afternoon, I was told about the two patients at highest risk: Tom, who was quite elderly, and Paul, who was only 25 but had a very weak heart. They were to try something experimental on Paul that would help his heart to function at the rate of a normal, healthy heart for as many as 8 consecutive hours. I’m guessing that this would save him the tremendous sacrifices that heart transplant recipients go through, because his nurse told me that he absolutely refused a transplant. He chose to live life on his own terms, which meant he would not allow his immune system to be destroyed and then replaced with steroid therapy and someone else’s heart. The doctors wanted Paul to reach a slightly higher level of good health function before they tried the experiment, but it wasn’t to happen. Three hours after I arrived, he coded and died. His mom told me afterward that he couldn’t bring himself to live a life that was less than what he considered normal for a 25-year-old, so he did many things that a person with heart problems really shouldn’t even be able to do. As is usual, the medical professionals were frustrated and confused by this. His nurse told me that he had ignored medical advice, did what he wanted, and now he was paying for it - not in an unkind tone, but in a manner that made it plain she couldn't quite understand that decision. But what stuck out to me was that he’d asked his nurse early this afternoon if the two could talk in private, without his mother present (so she wouldn’t be upset). The nurse closed the door behind them, and he said to her point blank, “I’m going to die, aren’t I?” She skirted the truth a little, as every doctor usually does (I understand this; how can we truly know?), and replied, “There’s a very strong possibility that you will, yes.” And he told her that he wanted to sign a DNR order while he still had the capacity.
His nurse was very puzzled by his refusal to consider organ transplant, to live a life too full of restrictions and too void of natural activities. His mother understood perfectly, though, as she explained to me after he died that Paul had always understood that he would not live to be an old man. What was important to him was quality, not quantity. Looking down at Paul, I thought of all the things I’ve learned this past year, all the changes I’ve made for the better, and how very much every patient visit now is filled with quality words – and not a quantity of words. I’ve become the open-hearted minister I so longed to become when I first searched for a residency in CPE, and so I said a prayer asking that God welcome him home and that the good memories his family and friends have remain alive to keep their hearts warm until they are one day reunited. Simple, short and heartfelt – that’s what authentic ministry is for me.
The Spanish have a New Year’s Eve tradition of downing twelve grapes to the twelve chimes on the clock as it strikes midnight, followed by a toast. Tradition holds that if this is done, the following year will be prosperous. Yet I have no grapes here in the office, no chiming clock that will give me twelve bells of renewal, and – alas! – no Cava to drink in toast afterward. Nevertheless, I celebrate Jubilee with my friends in absentia, I down las doce uvas de la suerte in principle if not in deed, just as I believe Paul does with his family and friends in their memories, by thinking of all those quality things that have entered and enriched my life, and now make me a more complete person. 2009 has been the finest year of my life so far. On the stroke of midnight in the EST, where I was raised, I offer up the final salud! to this year and say that I fully expect even more quality in 2010. God welcome you home, Paul, and thank you for reminding me that quality over quantity is what matters in life.
