trauma chaplain – This Chaplain's Journey

Not Feeling Hopeful

Things seem really dark this year. I realized that this week as I have been thinking about “Good’” Friday” and “Holy Saturday”. Don’t even get me started on my frustration with it being called “Good” Friday. In Christian tradition, the Friday and Saturday between Maundy Thursday and Easter Sunday are days of darkness and grief as we mourn the death of Jesus. I admirably respect the traditions that acknowledge the death as much as the resurrection. In order for there to be a resurrection, there had to be a death. When I took Old Testament during seminary, I had to write a paper on what Holy Saturday would be like for the followers of Jesus, in the Gospels. It was one of my best works. Sadly, I can’t find it. But I wrote about the darkness of the death and how the people navigated between the darkness and the hope. I imagined there was an internal struggle, wondering if Jesus would actually come back. The people walked around in mourning, reviewing the images of the crucifixion that were forever etched in their hearts. While reviewing the images, Jesus’s voice could be overheard, with his promise, a promise he made himself; that hey would return. And just like any other individual in mourning, they wondered if he actually would.

It is Friday, April 7, 2023 and I feel like we are in that darkness. I know I feel that way. I feel like as a country, as a world really; we’ve been going through the darkness for quite some time. As I walk through the hallways of my work, I have seen a lot of darkness. As I think about what I’ve seen in the hospital, there is a lot of darkness and the overcast of clouds are only making it worse.

It’s not Covid this time. It is gun violence. It’s always been gun violence. There has been a steady increase. There has been a rapid increase in violence and what’s worse, the victims and the shooters are getting younger. They are teenagers, some barely out of their tweens. Their bodies look like red stained Swiss cheese and their faces look like children who had no way of knowing how to maneuver through their lives. Their bandages can’t stop the blood seeping from their heads. Their heads are suffering not only from penetrating gun shot wounds but also from a lack of minds that are mature enough to face what they have to face every day. The families are at bedside, crying in the darkness of their grief that they are too scared to acknowledge.

When i leave work for the day, i try hard to keep my promise of not watching the local news. I see the news every day in the hospital, so i don’t need to see it on tv or internet. Sadly, the news from around the country manages to enter my doors that i’ve tried hard to lock. The children i stood next to today were not the only children shot. Gun violence is the number one killer of children in the United States. When I leave work, i know i am not the only trauma chaplain holding the hands of grief stricken families. There are parents in other parts of the state and in other parts of the country, sitting at the bedside of their children. They are thinking about the last thing they did together, the last words they exchanged, the last time they heard their child laugh and wondering if they can afford the child size coffin they are too afraid to consider.

It’s incredibly dark right now and I am walking around in a bit of a haze. There are images playing in my head about the events i’ve seen on the news from Tennessee, Sandy Hook, and Columbine, just to name a few. The images of children i’ve seen in the hospital are running through my mind, too. I wonder what i will see tomorrow. I am not exactly sure but i am not feeling very hopeful that the promise of a resurrection will come true.

A Different Perspective

Walking through these halls, you have absolutely no idea
Exactly what you will encounter after each corner you turn
You know, one split second will turn it all upside down
And in a blink of an eye, your perspective will never be the same
A different perspective

Over the last few years, many stories have been shared
Each chapter played out in unexpected, unscripted dramas
If you didn’t know any better, none of this would be true
Your experience tells you, that every second is all too real
A different perspective

Standing by the trauma bay, you watch it unfold, a story all too common
In a matter of seconds, the patient arrives, having been shot multiple times
Trauma Attendings on both sides and ED Doctors at the head
If they do the impossible, this patient might actually survive
Days later, the chaplain sits at bedside, as this miracle talks about his faith
A different perspective

Family called and requested prayer as their patriarch with covid, was to be intubated
After they talked and prayed together the chaplain held the patient’s hand through his sedation
The chaplain called family and shared the visit; with gratitude they cried “how did he look?”
That prayer was the last he ever heard and “amen” was the last word he ever said.
A different perspective

Making rounds on the units, to check on the staff with intentionality
On one side of the unit, the chaplain comforts a nurse through tears
After family expressed their emotions in unfortunate, belligerent ways
On the other side of the unit, a family embraces a nurse with gratitude
As they expressed their appreciation for taking care of one of their own
A different perspective

You’re paged to the MICU for a covid patient that is about to pass
Due to visitor restrictions, two family members watch from outside of the room
The chaplain stands beside them, providing a gentle touch and sacred silence
The nurse strokes his forehead and respiratory cradles his hand, as the last breath is taken
A different perspective

A driver, with full term pregnancy, arrived, after having been in a car collision
ED Team, Trauma Team, OB Team, and one chaplain; 46 people already there
This child had seconds to be delivered but mother requested prayer before entry
An understanding scalpel paused; a prayer was said and this precious one was finally free
A different perspective

When you walk around, you’ll measure this and quantify that
Take a moment to see what is happening around you
It’s always good to look at things from a different point of view
In a matter of seconds, your perspective may never be the same
A different perspective

An ED and Trauma Chaplain Blessing

Blessed are you, the ones who enter into the unknown every day, as you cross the thresholds of the department of emergency. May you be the sacred voice needed for all that you will encounter.

Blessed are you, the ones who witness the unimaginable, where one split second can change a life forever, including yours. May you find your spirit of peace in the midst of sudden change.

Blessed are you, the ones who beg the parents not to see their deceased son who was a passenger, because the injuries made him unrecognizable. May your strength carry you, knowing that you need to comfort families of the other teens involved, too.

Blessed are you, the ones who support those who tried with everything they had to save that little girl’s life, only to be assaulted by that intoxicated voice in the next room. May you hold them with the promise that they are not alone.

Blessed are you, the ones who holds the mother as she walks into the bay, where her son, shot to death, laid breathless. May your strength hold her up long enough to say goodbye.

Blessed are you, the ones who caress the foreheads of those gone by their own hands, when they couldn’t take the darkness anymore. May your understanding resilience see the light of hope that is tomorrow.

Blessed are you, the ones who maneuvered through the chaos of care, as you held the hands of those who had no support at all. May your compassionate presence carry you through.

Blessed are you, the ones who absorb the blood curdling screams from devastated families when they hear what nobody wants to hear. May the words of your mindful spirit, erase the sounds that linger.

Blessed are you, the ones watching the staff who have continued CPR well beyond death because family is frozen in shock and can’t say “stop”. May you find comfort in one another, as the pain and exhaustion take hold of all of you.

Blessed are you, the ones who face day in and day out, not only the emergencies that come to the bay but also the traumas that continue on. May you seek those moments of renewal, when the quiet moments rarely come along.

Blessed are you, the ones who come face to face with those who are traumatized as well as those who caused their pain. May your faith be assured that your conflicted care for all who enter this space won’t go unnoticed.

Blessed are you, the ones who protect one another through strange humor, compartmentalizing, denial, built up walls, and unvoiced pain. May you see the tiniest crack in each other, with a light that shines through, that you will survive.

Blessed are you, the ones who are called to do this work. May you be blessed in the ways you are a blessing to many.

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.