trauma – This Chaplain's Journey

Gone Too Soon

Hello. How are you doing today?

Yes, I know. I don’t look familiar to you right now. Yes, it’s been a while since I’ve written. I’ve got a multitude of reasons that have kept me from writing. If you’re not in healthcare, you just won’t understand.

It’s been a long time since July 18th and so much has happened since then. The one thing that has been consistent is Covid. Numbers were going down but that certainly didn’t mean that Covid was gone. People still died. People still died without their families present at bedside. People still spent a lifetime in the hospital, weak enough to be scared; wondering if they would ever make it home. Gone too soon.

That’s not all that happened. Life continued on with other challenges that kept me away from my laptop.

Since the last time we sat together, I’ve had to officiate 2 funerals for young people, far too young to be buried. The promise of a baby girl that ended a few months too soon. Such a sweet family that had to deal with a loss familiar to millions of other parents. Losing a child before they had a chance to develop is difficult. Losing a child who you’ve wished and prayed for, the one you invested so much in, is gone. Not only that, but the emotional and financial savings accounts were depleted, along with the promises and hope of a new family. I stood in front of this family, witnessing the grief in their faces and her devastated parents. I saw the face of this precious angel. There have been so many gone before they should have been, including this sweet little girl. Gone too soon.

After the funeral, I made a promise to myself not to do any more. The work I do at the hospital is heavy. Sometimes, it weighs on me in ways I don’t see coming. When I officiated this sweet girl’s graveside service, that took some of my reserve. I needed time to recover. There is a reason I do weddings and not funerals.

Well, not three weeks later, I received a text message. It was September, which happens to be Suicide Prevention Month. I received a text about a young 16 year old teenager, a boy really, who died by suicide. He was the son of someone very dear to me. She asked that I do the funeral. Of course I said yes.

As a trauma chaplain, I see too much. I see a lot of young pain coming into the trauma center on a daily basis: young people who died from ATV or motocross collisions; young people that were killed out of revenge; and young people who thought they were invincible as they traveled in their cars.

I have learned to manage through the distress when it comes to these situations. They are hard and I feel for the families. Sadly, I’ve seen enough of them to know I can appropriately manage my emotions and strength (most of the time). I can’t say the same for other traumas. The situation that is most difficult for me to manage, is when a young person takes their own life. This happens all too often. ALL TOO OFTEN. I’ve seen children as young as 8 years old, come into the hospital after having shot themselves. There have been teens coming in with marks on their necks. Some of them overdosed on something they find at home. Rarely do they survive and even when they do, a part of their spirit died in the process. Gone too soon.

I did not see the young 16 year old. He never made it to the hospital. But I saw his younger siblings when I went to their house. I saw his family. On the day of his funeral, I stood behind the pulpit and saw his friends. I saw the faces of his teammates, classmates and the friends he grew up with.

What makes it hard for me is I get it. I understandably how things can get so terribly dark that the only thing they think will take away the pain is to hurt themselves. Those young minds aren’t mature enough to comprehend what will happen after attempting suicide. They can’t manage the darkness and how to find some sort of light to guide them through. The pain has to be so much, with a darkness that blinds any feeling of hope, that suicide is the only possible solution. I understand it all too well.

I’ve seen the results of suicide, too many times. They ranged from ages 8 to 93. It’s so hard. For several reasons, my heart hurts for young teens. The word “young” means everything. Even though this young boy was surrounded by abundant love, he felt alone. He felt a pain that he just couldn’t take any more. His darkness blocked out the love of his family and friends. The darkness masked his pain from being seen by his friends and family. HIs youthfulness didn’t know what to do and it couldn’t be healed. This resulted in a family and community in so much pain, only time will be able to help. Gone too soon.

This year has been a difficult year. After his funeral, I crashed. A part of my spirit died, after carrying so much during this year. His death and connecting circumstances were too much to carry and recover 100%. What helped is I did get to celebrate several weddings I officiated. I also get to work with phenomenal people but things are just not the same. Sadly, the young ones still get brought to the hospital. Infants are still dying before they are born and teens are still hurting themselves. Healthcare workers are leaving.

Trauma is real. Suicide is real. Infant loss is real. Covid is real. Please don’t forget that. Please do what you can to help and support one another, including the healthcare workers. We hear so much about Covid but as you can see, the virus is not the only thing going on within these walls. There is so much more than you can ever imagine and no matter the age, many spirits have been impacted. Healthcare workers have been severely hit. Our spirits have taken a beating. Several have died. Many have been hurt. Too many have left healthcare all together. They are gone too soon as well. Sometimes it’s all too much to sit down and write about and when you do, it still doesn’t make sense.

When You Know What the Outcome is Going to Be

Have you ever been asked to pray for a family, to pray for a miracle because they are certain that everything is going to be ok? Have you ever prayed at the request of family, although you already know the outcome will not be what they want you to pray for?

It’s been a while since i’ve posted a chaplain blog entry. I have definitely been writing. Between my work computer and my personal laptop, there are about 6-8 unfinished entries. I’ve got a lot to say, just not really sure how to say it.

That brings me back to the original questions. Have you ever prayed for a family, as they ask you to pray for a miracle? They are certain that God will do the right thing and save their loved one. Once they’ve been admitted to the hospital, that prayer request comes a little easier to fulfill, carefully worded in comfort. When the family is the family of a trauma patient, who lies in the trauma bay, being resuscitated by the ED and Trauma Teams, it’s a little more difficult to pray what they are calling out for. It’s even more difficult, when you already know that the outcome will not be what they are praying for.

The other day, at work, I was tired. When I am tired, i tend to get punchy. Most of the time, it’s a silly kind of punchy; filled with laughter, goofy comments, and jokes. That’s how the morning started. I was feeling great, hanging out with one of my teams and having a good day of support and camaraderie. We had no idea that was about to change.

When you work in a level 1 trauma center, your day can change in a matter of seconds, when there are traumas headed in your direction. Our traumas can be any age, gender and mechanism. Gun shot wounds, car collisions, assaults, stabbings, suicides, water accidents, falls, head injuries, animal attacks and depending on where you are located, even shark attacks. The list is endless. We’ve had infants to the elderly and we’ve had multiple traumas at the same time. Each trauma will impact a team member differently. We’ve worked hard to not allow the impact to maneuver it’s way into our emotions, but every once in a while, one does get to you.

When traumas come in, the ED and Trauma teams are prepared for whatever is coming. Sometimes, the teams have no idea what they are about to face but they are prepared. They get the Trauma Bay stacked with appropriate supplies and medication. The operating rooms are ready to take on whatever trauma enters their facilities. Experienced doctors, surgeons, nurses, respiratory therapists, care partners, and other healthcare clinicians (including us chaplains) are present with the expertise to do all that can possibly be done.

The unique thing about traumas is the split second it takes for one to happen and that one second changes someone’s life forever. There is no discrimination of age, skin color, gender, wealth, or gene pool. The life of this particular trauma that we were about to receive, was changed in a split second, too. There were already fatalities at the scene and this one would become another one. Despite the heroic efforts that were attempted by all the teams this day, the life of this trauma patient ended all too soon.

I was with the families. They asked me to pray for their loved ones. They wanted me to pray that God will save them and to pray with the assurance that God already has. What they didn’t know, I already knew. The prayer they were requesting would not be answered in the way they had hoped.

In my role as a chaplain, there are two scenarios that are difficult to accept. One is, no matter how hard the clinical teams work to save a patient, their resuscitation efforts may not be enough to bring the patient back. The second scenario is this, no matter how hard I pray, the outcome may not be what the family had hoped for. Either scenario is painful to accept, and even more difficult to accept when you already know how it’s going to end.

I pray that never happens to you.

Do You Love Your Job?

No.

I’m often asked that question or some variation of it: “Do you love your job” or “I bet you really enjoy your work”. The first few times I was asked, I, of course, said yes. But after some time, I realized that I was wrong. I don’t love my job.

Some people get chaplaincy mixed up with being a pastor or minister. Maybe they thought I did the same thing as a pastor of a church. Well, I don’t. A minister/pastor and chaplain are completely different things but that’s a post for another day.

Chaplaincy is an entirely different calling. It’s an experience that I don’t “love” taking part in. I am a chaplain for a level 1 trauma center and what I see day in and day out would normally make you want to turn away from this job.

Chaplaincy is a difficult role to carry on a regular basis. I see the results of car collisions. I’ve sat with guilt ridden drunk drivers who I’ve had to comfort as they found out they caused a fatality; yet don’t remember a thing about that day. There have been teenage texters in the emergency room, who had no idea the death was their responsibility. Sweet children who were not properly restrained and I’m begging to hear them cry in the trauma bay. I’ve met motorcyclists who had to have a leg amputated because the car didn’t see the motorcycle entering the intersection. I stood next to a father and husband, who lost his daughter at the scene of a car collision and his wife who later died in the ICU. Then the next day, I consoled the driver of the other car, after the officers informed him of the fatalities he caused. With these experiences, I’ve come to the conclusion that there is no such thing as a car “accident”. There is always something that caused the collision to happen, that could have been prevented.

I met 30 to 40 year old individuals who were having fun at the lake and after diving head first, became quadraplegic. Hunters who were anticipating their first 8 point buck for the season, only to have broken legs or ankles after the tree stand collapsed. There have been farm workers who were working with broken equipment, who were injured when the equipment fell on them; arms that were crushed when they slipped. I’ve met 80+ year old independent individuals who fell when going to get the mail that morning and that evening, were surrounded by family at the hospital as they passed away. Families and patients, who one minute were doing normal, everyday things, and in one split second, their lives were completely changed.

It is difficult to love a job when I am sitting next to a mother and i have to tell her she can’t see her son because his body is now evidence in a murder investigation. It’s hard when I can still hear the blood curdling screams of 30+ family members who found out their loved one died after a vicious attack. I’ve sat with families who replay their lives over and over, wondering if they could have seen the signs and been able to stop their 21 year old from shooting herself in the head. I’ve asked the police to allow the father to hear how his 3 year old son is doing in surgery before they arrest him, because the three year old found his dad’s gun and accidentally shot himself. I’ve stood next to a 93 year old man, who shot himself to try and end his pain. He removed his oxygen mask and begged me to let him die.

I don’t love my job but it is truly a gift to watch the teams I work with do the work that they do. It is humbling to watch them maneuvering through unexpected events and making split second decisions they have no time to think about. They save lives every single day, from doing CPR at bedside to opening a chest cavity in the trauma bay. I’ve stood with the surgeons whom after surgery were able to inform families that their loved one was still alive, despite the multiple gun shot wounds. I’ve stood with those same surgeons when they had to tell the families they did all they could do but it wasn’t enough to save them. You will never be able to understand what it is like to be there, unless you have been there. I am honored to be there with them, standing side by side. I am a part of these teams. I am in the trenches with them. I am honored to be in their vulnerable moments, just as they are in mine.

I don’t love my job. I will never be able to say that. However, I can say with full certainty, that I am humbled and honored to do the work that I do. To sit with all of those I’ve mentioned and not be touched by their grief, pain, uncertainty and life; I would be inhuman. What an honor it is to be present with a patient or a family member, in their most vulnerable state, in their weakest moments. Every day, I am placed in situations I’ve never been. I’ve seen things that I never imagined I would see in a lifetime. I’ve heard sounds that I cannot get out of my head. There have been many times that I finished my shift and called out to God, “Lord, I have no idea how I got through this time but somehow you carried me through, with the words to say and the space in which to say them. Thank you.”

I am only one chaplain. There are many others, across the country and around the world, who do this incredibly difficult work. October is Pastoral Care Month and next week, October 25-31, is Spiritual Care Week. If you know a chaplain or work with one, please thank them for the services they provide. We certainly don’t do this work for recognition but it does help to know we are respected and recognized as an integral part of an extraordinary team of clinicians, committed to the holistic care of patients and families.

I don’t love my job but I am incredibly humbled and honored to do this work, with these people, at every opportunity provided.

Suicide and Faith

Being a chaplain for trauma patients and families is not easy. I meet them in the emergency department and then continue to follow them in the ICU to keep a continuity of care flowing as much as possible. Trauma is a different beast all together and it takes a certain spirit and heart to work with this community.

Those of us who work in trauma have a unique gift of strength and resilience. Trauma is not for wimps. A former chaplain resident I mentored called me “hardcore”. You see things you never imagined you would ever see. You hear pain that you’ve never experienced in your life. It’s challenging all the time. It’s difficult most of the time. And it’s heartbreaking a lot of the time. It’s deeply humbling to walk along side each patient and family member I meet. I am incredibly grateful to work beside the ED and Trauma Teams as we walk in the trenches together.

There is one particular population that I am quite sensitive to; a population I see all too often – patients who’ve attempted to die by suicide. When I say I see them a lot, I am not exaggerating. I’ve seen patients as young as 12 to as old as 93. This year alone, i’ve faced a 12 year old child and 78 year old adult and plenty of ages in-between. There are too many. Unfortunately, many accomplish their goal but not without our team trying everything humanly possible to save them. They die while hearing the screams of their family members crying out for answers as their loved ones take their last breaths. There are many things I can’t do and on top of that list is responding their “why” question. I will never be able to answer them.

The question “why” is more complicated than you think, especially for people of faith. When a family is dealing with the trauma of their loved one (any kind of trauma), I often hear, “I don’t know how people who don’t know God, get through this.” Their faith allows them to cope and survive through the challenges of trauma. However, faith and suicide have a different relationship. For families of suicide patients, faith is another dimension of struggle and pain. There is a level of unwarrented shame and misunderstanding. I met a family deeply devoted in their faith, who lost a loved one to suicide. Their faith caused more pain because the older generation in this family could not acknowledge the suicide. “We went to church. We prayed. We were happy. There has to be something else that caused this. We are not going to tell anyone what happened.” The pain and anger within their broken hearts kept them from seeing beyond their faith.

Faith becomes a struggle when the pastor tells the family, “Are you going to believe the doctors or are you going to trust God?” They demand the families to “pray harder…call out to God..repent for your lack of trust…God will save him..you’ve just got to believe harder.” Those are actual statements I heard from a “pastor”. I cried after that individual poured the salt of shame and guilt into the open wounds of the family. I could see the pain in their faces. They were already grieving the anticipated death of their child. This pastor’s rant made them grieve a loss of their faith, at least what the pastor thought was lost. The patient died that night, after shooting himself through the side of his head with the bullet hitting both hemispheres of the brain. The metal escaped through the other side of the brain but not before causing irreparable damage, a “non-survivable injury”. The only reason I share the specifics of the injury is to help you understand that a patient will NOT come back from this. There will not be the miracle of complete healing. They will die. Even if the body survives, they are already gone. The pastor would not accept that but instead of being the pastor the family needed, he was so much worse. He caused irreparable damage, too. I can only imagine what he said at the funeral service. Why do pastors do that to their flock? How can they inflict so much pain and guilt into the families that trust the pastor with their faith? I will never be able to understand.

There is another level of shame that needs healing. Suicide comes from a deep, dark pain from within the souls of those who are hurting. The pain is so dark that they are willing to do just about anything to stop the pain. It’s a pain so deep they can’t carry it anymore. The pain is nothing to be ashamed of. This darkness is a cancer, it’s a disease, just like heart disease, diabetes, high blood pressure, etc..that needs to be treated. It is depression and anxiety. It is loneliness and grief. It is aloneness and a loss of control. God knows it’s real. God gets that. God feels our pain. There is no god i know that would brush away the pain of one of his children. God would not shame or sentence their child to hell. No earthly parent should feel that way either.

There is nothing shameful in regards to suicide. Painful, yes. Shameful, no. A patient who shot himself in the chest, removed his oxygen mask and cried out to me, “Just let me die.” The pain in his voice was heartbreaking and painstakingly real. I spoke with his sister who would not accept that this was a suicide attempt. She told the family they were not allowed to share what really happened. She was ashamed of it; likely because of the stigma she grew up with as well as some struggle with her faith. I talked with her about that shame and explained what I shared above. She listened but did not verbally respond. I could tell she was thinking. A couple of months after her brother’s death, she returned to the hospital. She thanked me for explaining the pain that he brother felt. I suspect she knew the pain was there all along. Our conversation helped to free her brother and ultimately, herself, from the shame of depression, pain and suicide. She was able to learn more about her brother’s tragedy and pain and help others understand it, too.

Suicide is real. Depression and anxiety are real. Loneliness is real. Pain is real. People struggle every single day with the darkness that has taken control of their lives. The one way they can gain back any control is to do the only thing that will take away all the pain. I get it. I get it more than you can imagine. If you feel that pain, please reach out. Call the Suicide hotline, meet with your doctor. Request a counselor. If your pastor is a safe person to talk to, meet with him or her. find someone to help carry the yoke with you. Don’t be ashamed.

Life is a continuous struggle for someone in immense pain. Faith should never be a conduit of that darkness. Faith should be the one constant place where you can find a glimpse of light that will guide you through the wilderness and the valley, where you can fight to live another day.