The privilege of catching little plops of love

Another family I picked up through my regular wanderings on ICU were with a man who was told he would die 25 years ago. Back then he’d had a massive heart attack and as a result some of his bowel was deprived of oxygen and died. The man ended up with most of his bowel being removed. His wife was determined that he would get better and used to crush up small spoonfuls of biscuit to get something in to him. Much to the doctors amazement he pulled through. He then managed to live cheerfully with chronic diarrhoea for the next 25 years. However, this admission was different and he was not to pull through. The family were distraught because he had always been such a fighter. I was privileged to be asked to take his funeral. It was the first time that someone said to me they wanted a fairly traditional service but they didn’t want the words ashes to ashes, dust to dust.

I remember that day being really bitterly cold. I was shivering as I stood at the graveside. When it came to lowering the coffin, the man’s wife walked away. She just couldn’t face it and didn’t want to see it go in the ground. She wanted to come back once it was all covered up.

A few months after her husband died the woman’s elderly mother also died. This opened up her husband’s bereavement all over again. We sometimes complain about how life is hard but I am constantly humbled by the life experiences that people have and choose to share with me. I was also asked to take the mother’s funeral. It’s hard when the only times you see people are at the sad events in their lives. I often bump into people who burst into tears because I remind them of some bereavement or another. I don’t take it personally and just give them a hug until the little plops of love that are falling for their loved ones dry up.

A cultural divide that needed bridging

One day as I made one of my regular visits to the ICU I was told of the very sad situation of a 38 year old woman who collapsed in the street. Her breathing and heart stopped during the collapse. The paramedics managed to resuscitate her but once in hospital they realised that she had massive brain damage and was unlikely to survive. She was not married and her parents were on their way from abroad. Once the parents arrived I met with them on several occasions. They were obviously distraught and I spent lots of time just listening to the mum sob. It was an awful situation for everyone.

The young woman was moved from ICU to a ward and everyone knew it was only a matter of time. The palliative care team had become involved and had written up medication to help with the fitting that was occurring as well as the usual end of life medications.

The young woman’s dad was a very contained man and didn’t say much. The mum opened up to me more. They were always very polite and appreciative of my visits to them and their daughter.

The young woman died in the early hours one day. I became aware of this when I bumped into one of my palliative care colleagues in the hall. She told me that the parents had been unhappy the last day about medication and it seems there was a problem with the ward not necessarily following the instructions given by the palliative care team. I am well aware of the difficulties that can arise due to communication not being carried out effectively and kind of inwardly sighed at this added difficulty. I said I would ring the parents the next day to give them a bit of space from the awful immediacy of their daughter’s death.

Much later that day after most people had gone home my palliative care colleague phoned me. She said “Thank God you are still there” She sounded really shaken up. The woman’s mother had phoned her and screamed and shouted and sworn at her almost hysterically for half and hour. It seems she was holding my colleague responsible for her daughter not having a peaceful death. The mother would not accept from my colleague that she had written up all the medication that her daughter might possibly need and that there was nothing further that could have been done.

I really felt for my colleague. It is extremely hard to have all that raw emotion aimed and thrown at you and still keep a professional view of the situation. My colleague had started to doubt herself. I was able to reassure her that she had done everything possible. We then talked about this being an extreme grief reaction and then did a debrief. I told my colleague that I would ring the family and do any follow up needed. She warned me not to ring that night. I told her not to worry and to go home and have a nice glass of wine and that I would ring her and the family the next morning.

When I spoke to the family they were obviously distressed but were calm and coherent. It seems my colleague had born the brunt of it and they were now able to be rational again. I offered the family on-going support and said that if they needed any advice to let me know. I was acutely aware that they were not in their own culture or familiar surrounding. I also know the death is a bureaucratic nightmare. I encouraged them to ring me at anytime and said I would also ring them from time to time.

I didn’t hear from them for a few days and by the time I got to ring about a week had gone by. They told me they had arranged their daughter’s funeral for the next day and said I was welcome to come if I wanted. I asked them who was taking the service for them. They said no-one that they had just invited all her friends and hoped they would all say a few words. My stomached flipped as they said this. British funerals just don’t work that way. I said I would come to the funeral and that I’d see them in the morning. I then desperately searched for a few meaningful poems before I had to dash from the office for a meeting.

The next morning the woman’s friends gathered at the crematorium. The parents said a few words about their daughter at the beginning and thanked everyone for coming. Her dad then told us about the kind of child this young woman had been and how proud he was of his daughter’s achievements. He then said if anyone else wanted to say anything he’d like to hear from them. There was an uncomfortable silence. I got up and explained who I was. I read a poem and then said that we weren’t used to getting up and talking at a funeral but it’s good to have the opportunity to say a few words about the person who had died and what they meant to us and share memories. I sat down then a man got up and spoke about his debates with the young woman and how they always laughed together. He sat down and then there was the uncomfortable silence again. Eventually the dad got up and said he didn’t know what else he could say but that his daughter was the best person she could be. He started to choke on his tears so I went and stood beside him. He gratefully glanced at me and went and sat down. I read another poem and said people might like to share their thoughts with those around them. Again there was an uncomfortable silence. This time the mum got up and thanked everyone for coming and asked me if I would say a prayer and finish the service.

I normally think about what I am going to say for a week at a funeral. I take longer to prepare for funerals than for sermons because I think it is so important to give someone a good send off. Here I was, standing in front of everyone, with no notes and only a few moments notice of having to say something. I think what I eventually said was appreciated and I was fortunate to be able to recall words that I have used in similar circumstances but I didn’t like it and the experience left me exhausted.

The family came to see me a few days later. They left me a card which had these words inside; “We’d like to thank you for all of your help and support – it was a real comfort to us. While we thought we could ‘go it alone’ your presence at our daughter’s funeral aided us so much in getting through a most difficult time. We wish you a happy and fulfilling future. We’re sure that your compassion and understanding will continue to help many people. We hope that you derive much personal fulfilment and satisfaction for all do for others. You are a truly special and compassionate person.

The enclosed is for you to do with as you wish – charities, etc. it is a very small token of our appreciation”

Inside the card was £100. Sometimes it is impossible to gauge the impact of an interaction and what different people take away from these tragic situations. I will treasure this families comments and feedback. The money I gave to our chaplaincy fund from which we do an annual memorial service for all those who have died in the hospital. I wrote to the family and thanked them and said I would remember their daughter at the memorial service even though by then they would have returned to their home country.

The things they don't tell you in ordination training

An important role of a hospital chaplain is to take Holy Communion to patient’s who would normally either go to church and receive communion or have communion brought to them at home by their local church.

The service used in most churches now is in modern language. At the hospital we have books with a shortened version of this service in fairly large print so that it is easy to use at a patients bedside. These books are given to the patient so that there is no trouble with infection control.

Before I was ordained and came to work at this Hospital, I did some voluntary work at another local hospital. I had been helping the chaplain there with his communion round and he felt I could go off and do a bedside communion on my own. It was to be fairly straightforward with a young woman who regularly attended church and was used to being in hospital with a long-term condition. When I arrived at her bedside she explained that the elderly patient next to her wanted to receive communion too. I said this wasn’t a problem and that I had enough with me. We all moved over to the elderly woman’s bedside and were having a lovely service. The problem came when I gave the elderly woman the wafer. She started to choke on it. I cupped my hands under her mouth and she coughed the wafer into my hands along with her false teeth! I couldn’t believe this was happening to me the first time I was let loose on my own in the hospital. I rinsed the woman’s teeth and gave them back to her but didn’t know what to do with the wafer. 

Once consecrated, wafer’s are meant to be consumed. There was no way I was going to eat this masticated blob. I carefully wrapped it up in a tissue, finished the service and made my way back to the chaplain’s office. When I got there I gave the chaplain the tissue and said “I don’t care about the rules, I’m not eating it!” I explained what had happened and the chaplain really laughed and said it should be written up in a trainee’s handbook. He said not to worry and he would burn it. In fact he did burn it and placed it with the ashes of the palm cross used to anoint people on Ash Weds. Truly incarnational theology!

Getting back to the present day, I have come to really appreciate the time I have with patients when they receive communion. I have become adept at creating sacred space in the midst of the noise and smells of busy hospital wards. What I always find moving is being alongside a confused elderly patient. When this is the case I often use the traditional words service. I find time and time again that the familiar rhythm of the words and prayers stirs a memory held dear by these patients and they find themselves joining in with the old words. They are sometimes word perfect and do all the right things in the right places as they receive communion. Afterwards they go back to their imaginary cleaning or conversations with people who aren’t there.

There was one patient who used to cry the whole time her husband wasn’t with her. The poor husband was exhausted by trying to be with his wife as much as possible. The patient hadn’t been much of a churchgoer recently but I found out she liked to sing. When I visited her the only way I could get her to be calm was to just sit with her and sing the old hymns. She would always join in. As soon as I stopped singing she would start to cry out for her husband again but if I started singing she would join in once more.

In my time as a hospital chaplain I have learned the importance of communication and that most of the time this is done without words in the order of a conversation.