No, that’s not a typo – the word is elpis. It was one of the easiest words to learn in my Biblical Greek class. Though it sounds remarkably like the name of a certain singer associated with Memphis, it has nothing to do with music. Originally inspired by Greek mythology, it means hope. But our professor stressed that its implications go far beyond our modern understanding of what hope is. It was never used in conjunction with a desire, or a wish that something might or might not happen. No, elpis means something that goes beyond a wish – it’s an expectation. Furthermore, it’s the expectation of something truly grand. It’s used over 50 times in the New Testament, in reference to the reward that awaits those who have faith in God’s promises to us. I used to think it refers only to the parousia – the End Times that Paul refers to so often in his letters. I’m not so certain anymore that it doesn’t include other things as well.
I was in the midst of a routine on-call shift. I’m not sure the word “routine” ever fits in chaplaincy, though – every person’s situation is unique, and that sort of undermines the challenges the patients, their families and the medical staff face. I was paged to the cardiology unit at 12:30am to cover the death of a patient who’d been here less than a day. Roughly seven minutes later, as I was walking toward the elevators to that unit, my phone rang. The house supervisor (the RN in charge of the entire hospital) was asking me to come to the ER because there was a situation involving a young car accident victim. I explained what I was doing (death is about the only thing that could preclude an immediate response), and that I’d be there as soon as possible. The wife of the gentleman who had died had been told to expect this; he was 80 years old and had suffered from dementia for years so it was one of the few times when one can actually say that death is a blessing. On average, when I respond to a death, I spend about two hours with a family as they process what’s going on and begin to accept how different their reality will be from now on. With this one, I spent about an hour, and part of that included talking with the nursing staff, who wanted to unload a little about some of their own frustrations.
When I arrived in the ER, there was a very tall young doctor talking to the family members of the accident victim Brent, a 21-year-old who had been thrown from the SUV in which he was riding when it blew a tire on I-10. Three of his friends had been killed instantly; all were wearing seatbelts. He was not, so when the vehicle rolled, he was ejected. The main injuries he suffered were to his head and his face, and his hips had been badly dislocated. It was tough to gauge from what the doctor said whether or not he held out any hope of survival for Brent. I spent several minutes hearing background from one of the nurses and when I went to see the patient in the room, his parents had disappeared. I was struck immediately by the sight of his face; half his lower lip had literally been ripped off. It made me realize how lucky I’ve been that I don’t often see the graphic reality that the ER staff deals with on a daily basis. They seemed calm enough in the face of his appearance, so I thought maybe it’d be okay. He’d have a very long road to recovery, of course, but in the end he’d go home. That happened a long time ago with the sole survivor of a helicopter crash; though we didn’t expect him to survive even 48 hours, he walked out of here four months later. Of course, the biggest rehabilitation for that guy was learning to live with the fact that his closest friends had all perished in the crash. I knew that Brent would have that to face, and wondered how we could address that.
One of the ER nurses led me down a side hallway toward a place where she thought she’d seen his parents go; in the open doorway of an unlit office I saw an X-ray lit up on the computer screen and gasped audibly. “That’s Brent, isn’t it?” and the nurse confirmed it. I’ve not been trained to read these pictures, but based on what the doctor had said, it was obviously the man in question. The spine and skull were fully vertical, whereas the pelvic bone and hips were bent at about a 45-degree angle. I gave a brief prayer of thanks that Brent was unconscious; I couldn’t imagine how painful that would feel to someone who was awake. The nurse and I traipsed all through the back of the ER before coming back up toward the family consultation room to find them huddled together – some in chairs, some sitting on the floor next to the others. There were enough chairs spread throughout the room, but I suspect the need for physical closeness to each other superseded that for comfort. Brent’s parents had long since divorced and both had remarried; all four parents were there, along with Brent’s younger brother Brad. The unity among the four really impressed me; I’ve heard so many horror stories about stepparents who can’t even tolerate each other’s presence that it was refreshing to see four who were fairly amicable. It was so obvious that I don’t believe Brent’s accident was what had united them; they were simply a group who managed to live without rancor toward each other. I spoke about hope, and at one point actually mentioned the young man who had miraculously survived a different accident. In retrospect, I don’t suppose many chaplains would mention something about someone else’s situation in the midst of this. Maybe it was a reassurance only to myself, a way of ignoring the fact that sometimes shit just happens. And that’s what it was: nobody had been drinking, nobody was speeding, it was just a tire that blew while driving on a highway. I mean, the worst thing was that Brent was not wearing a seatbelt. But was it the worst? His three friends died instantly. I’m not a parent, so I can’t imagine trying to choose between instant death or a slow and painful attempted recovery. As it is, Brent’s family wasn’t focused on the long term at that moment. His stepmother was crying nonstop, full of guilt because they’d had a terrible argument earlier that day and she feared that his last memory of her would be some horrible (her description) things she’d said to him. I was so drained, and the situation so dramatic, that there was really nothing else to say. After a prayer with Brent’s family, I retreated and let them have some time to themselves.
Two nights later, I was on-call again, and I saw that Brent was in one of the ICU units. It’s tough to admit it, because it makes me feel like a coward, but I avoided a follow up visit until after visiting hours were over. I couldn’t bring myself to face his family again; I felt like a charlatan, offering false hope through mentioning someone else. However, I’ve learned over two years as a chaplain to at least talk about it, so I admitted to his nurse that I’d avoided his family, and why, and how ashamed I felt of that. Brent’s nurse grew misty eyed as we spoke about it; apparently, every staff member who came in contact with the case and this patient and his family was affected in a way that we don’t often express. One might think maybe it was a maternal thing, but Brent’s nurse was a young man about 30 years old, with no children of his own yet. He said he understood completely, telling me how difficult it had been for him, too. Neither one of us could explain what it was about Brent that made it so tough; we both admitted to having seen cases more tragic, though I’m not certain if tragedy is something with various levels. It made me feel a little more human, though, to hear that others were reacting the same way. Over the next week, I worked three on-call shifts, and visited Brent each time, toward the end of visiting hours when the family often was not there. I knew that the day chaplain assigned to this ICU would have followed up, so there was no need to push the issue. Instead, I spoke to Brent, prayed for him and his family, and always followed up with the staff. To a person, every one of them was very emotional over this patient, more so than usual.
Eight days after the accident, Brent was declared brain dead by an extensive battery of tests. After much tearful discussion, his four parents and his brother agreed to donate his organs – a very healthy heart, liver, two lungs and two kidneys – to whomever might be able to have a better life with them. I was not present for the transfer of Brent to the agency that recovers organs, a fact for which I was profoundly glad. Not because of the emotional aspect, but because I still felt ashamed of the false hope I’d offered his family and didn’t want to face them. It was the doctor who relayed the news to me; a doctor I know fairly well after two years, who began to cry as she told me that he was brain dead. It’s only the second time I’ve seen a doctor cry. We spoke of the same things I’d discussed with his nurses, and the doctor admitted that she’d had the same reaction everyone else had. Not one of us could explain why this case was so tough, but the fact that we all felt it validated our emotions.
It was only well after the fact that I realized the other side of this whole situation: if Brent had been wearing his seatbelt, he’d have been killed instantly along with his friends. But because he wasn’t, he donated six organs to people who may not be alive as I write this were it not for the fact that he was ejected. The hospital at which I work is a national leader in organ transplants; people travel here from four states and even Puerto Rico with the hope of receiving a new lease on life though an organ transplant. The 63-year-old man who was aware that necessary procedure for the new heart he was getting would mean he had to cease certain activities, but at least he could watch his grandchildren grow older. The 53-year-old recovering alcoholic who had actually been approved for a liver transplant, and joyfully told me that she had lost all desire for alcohol. The 32-year-old young mother whose family knew since she was six months old that she would eventually need a new heart, and who received it on the first day of the New Year. I’ve heard countless stories from people like these. Each one of them was excited, full of hope that what had been relegated to a mere existence could be transformed back into a real life through someone else’s generosity. A hope like that is something most of us don’t really experience except when we encounter such extreme situations. It’s not just hope, it’s ELPIS. A great expectation, of something magnificent that was promised to us in advance: a new life. A better life. Because of Brent’s family’s unselfishness, that elpis was realized for at least six people. In the end, I realized that the hope I offered his family was not in the least false; it was just not the sort of hope they were expecting. Brent lives on in a half dozen people, and will continue to be a part of his family’s lives and the lives of others as a result. I like to think that elpis has indeed left this building, and has gone out into the world multiplied in the lives of Brent’s family and his organ recipients, to share the promise of a new and better existence in a multitude of ways.
