I am just about to finish a nine-month hospital chaplaincy internship at a major urban hospital.
This has been the main reason why my posts have fallen off so sharply.
It’s one thing to be processing one’s own grief and PTSD from sudden loss, and another thing entirely to be helping other people manage theirs. Both these things were at play and overloaded my circuits.
There’s compassion fatigue, and then there’s plain old PTSD. I’ve seen things I’d have rather not seen. The hospital’s ER was like a war zone. Stabbing victims, gunshot wound victims (which I came to know by the abbreviation GSW), people who had been in motor vehicle accidents (MVAs)…Burn victims who made the entire ER area smell charred…Fall victims who had severe head injuries. After a while I could tell who was and wasn’t going to make it. If they were shouting bloody murder, I was relieved. It meant that one wasn’t going to die that night, thank God. I saw countless intubations, on-the-spot surgeries, blood on the floor…The cleaning people had a busy job in the trauma unit of the ER. I watched and I prayed. I felt drained by it all.
I would watch them come in and die in front of me, and then later, I would be called to accompany the doctor(s), possibly a nurse or two, and police staff to the death notification. I started doing this in June (for my first unit) and never have I gotten used to death notifications. It tears my heart out every time. The keen, intense nature of fresh grief would pull me back into flashback mode and I’d have to fight my way out of it. And then I’d find myself carrying their sorrow afterward, after I’d left them, into the light of morning, into the next day. Even now I have only to close my eyes and I can still see case after case…
I would be called to Code Blues, invariably in the middle of the night. I have observed CPR now so many times, I know how it goes. It is nothing like TV. They pound on the chest, they inject chemicals; if there are electrical charges they are like stickers that attach to the chest. The old-fashioned kind they like on TV are no longer used–but TV is not big on verisimilitude when it comes to medicine, I have found.
Even if the person was revived by the Code Blue, they were not necessarily out of the woods. More than once I would be summoned for a Code Blue only to be summoned later for a death call–the family had decided to ‘pull the plug.’ But nine times out of ten, CPR does not revive the patient. They all work really hard, sometimes for the better part of an hour, and the person does not respond. Sometimes I have gotten there just after a code has been called and that person is simply the wrong color…that is never a good sign.
By ‘death call’ I mean a call in which the person was either dying or had already died. They constituted the majority of my calls when I was on call.
As far as ‘pulling the plug,’ I have come to hate that term. The very first death I ever saw at the hospital–way back last June–was a lady who died on the ventilator. The staff had to inform her family that her chest moving up and down was because of the machine, not because she was alive. I was horrified. I had three death calls that night–my second night on call ever–and the last one, when they took that poor man off all the machinery and let him die in peace, it was a relief. He just sighed and departed. Ventilators don’t stop people from dying. They might slow it down a little and make it more uncomfortable. The same goes for all those other machines. They might slow it, but they won’t stop it if the elevator is going to the top floor…
I saw people who had died of cancer, heart disease, kidney failure, stroke…all kinds of things. I saw so many people in that hospital, mostly African-American, in their fifties who looked to be in their seventies, ill with kidney failure, heart disease, and diabetes. It’s an epidemic. I wonder why there isn’t more news coverage of this. Honestly, it’s an outrage.
It is one thing, hearing about shooting deaths on the news, or hearing about some tragedy or other in the news, and another thing entirely to be the point person for that crisis. When it’s on you…And when I was on call, it was all on me. Nobody else. I was the spiritual care/emotional care person for the hospital. Having a crisis? Need a hug? Need a prayer? That’s me.
Or at least, it has been, since last June, when I started my first unit. My second CPE (clinical pastoral education) unit ends tomorrow. I have two units to go. I’m not sure when I’m going to tackle them. I want to deal with some of this PTSD first. The flashbacks. I still jump every time I hear an ambulance go by or hear a pager go off. I have to remind myself that the pager isn’t for me, that I’m not on duty. That trauma code? That’s not for me.
I haven’t gotten an entire week’s sleep, uninterrupted, without a night of on-call to disrupt it, in nearly a year. I vaguely remember what that was like. I would kind of like to rediscover it.