Sometimes I feel like I blog about all the hard parts of medicine, the stories that wrench my heart and my struggles to know what to offer in the face of suffering. Those people stay vividly with me, certainly, but they are not the sum total of my life in medicine. It includes glimpses of loveliness and light as well as grief and regret. This is a post to recount one of the former stories.
One particularly hard afternoon when I was on the inpatient (hospital) service a few months ago, I found myself in the ICU. I had just been seeing one of the sadder patients on our service in the ICU, who was essentially paralyzed but totally conscious. Our best medical treatments had done little for him, and he had little family or friends nearby and so had been paralyzed, awake, and on the ventilator alone without any visitors and unable to communicate for weeks. I was feeling the weight of the sadness of his whole situation as I finished my note on his condition and began walking to the stairs to go see my next patient.
As I walked, I started hearing the strains of music. I listened for a moment, thinking initially that someone had a radio running in a patient's room. It sounded more like a hymn, however, so I moved towards it in curiosity and found an Amish family gathered around an ICU bed. It appeared they had made the decision to withdraw care from a patient, although I don't know any of the story. But as they stood with their community member in the patient's last hours or minutes, they were singing the old hymn, "Nearer, my God, to Thee," the notes of which I had heard.
That stately old hymn always reminds me of the Titanic, where the ship's orchestra courageously played it as one last musical effort to bring comfort and hope to the ship's doomed passengers and crew in an irremediable situation as the ship sank. Hearing the Amish family sing it with the understated beauty of a cappella harmony with their quiet dignity aroused much the same feeling of steadfast resolve and persistent faith. This was especially true when sung surrounded by all the high-tech ICU interventions that often feel futile, the lonely suffering of the patient I had just left, the impending grief of their own family, and my own sense of helplessness. I left the ICU and went to cry in the privacy of the stairwell with a sense of having been given a gift, a glimpse of the hope and faith when I most needed the reminder, a sense of being embraced and held.
I moved from the stairwell on to the next floor where I encountered a friend who graduated from this residency program last year and is now doing a fellowship. She asked me how I was with some concern since I think the juxtaposition of the disparate experiences I had just had was written on my face. I rarely see other residents or fellows/attendings in the hospital, so I stopped to process a bit, sharing with her the sense of darkness and hopelessness over my first patient and the shimmering light that felt like a candle in the darkness from the peace of the Amish family's faith. She nodded and shared some of her own patient experiences and finally gave me a hug before we moved our separate ways.
Hugs are big in my family, I think an inheritance from my nana who believed everyone needs one (and probably more than one). We give them when we first greet and when we say goodbye. Many of my friends know me as the one who gives them hugs. They are important to me, a needed source of support and a frequent gesture of affection.
http://pocketcultures.com/2010/07/14/kiss-hug-or-shake-hands/
As I processed this experience with my spiritual director, I realized that I received two hugs that day. When asked how I felt after the beauty of the hymn in the ICU, the word that came to mind was "embraced." I think God knew, though, that I still needed human arms on the hug, so he put my path in line with that of my friend, and I had flesh-and-blood arms to offer me affection and sustenance as well.
I said at the beginning of the post that I sometimes feel like I post about all the hard things. The same can sometimes be true of my life; I can focus too much on the painful things, neglecting or taking for granted the shafts of light and glimpses of beauty that cross my path in the midst of the suffering. I have started seeing a spiritual director, and I think part of the purpose of spiritual direction is to help me pay attention to the beauty.
God is always at work - in my life as much as in the lives of my patients and others for whom I long to see his transforming power. It's just a matter of learning to see, remembering to look, recognizing his voice. Spiritual direction is setting time aside to look and listen.
Blogging performs much the same function for me, forcing me to look again at the stories of the people I encounter, to reflect on what the meaning of this sadness or that soaring hope is, and to look for where God is involved in it. And in both, I have found, I am met. Unobtrusively, quietly, usually unexpectedly, God shows up and is present and who I am and what I know and what I have learned at the end of the process is not the same as at the beginning. In this, too, I am caught up and held, and I give thanks. God is good. E'en though it be a cross that raiseth me, still all my song shall be, nearer, my God, to thee.
One particularly hard afternoon when I was on the inpatient (hospital) service a few months ago, I found myself in the ICU. I had just been seeing one of the sadder patients on our service in the ICU, who was essentially paralyzed but totally conscious. Our best medical treatments had done little for him, and he had little family or friends nearby and so had been paralyzed, awake, and on the ventilator alone without any visitors and unable to communicate for weeks. I was feeling the weight of the sadness of his whole situation as I finished my note on his condition and began walking to the stairs to go see my next patient.
As I walked, I started hearing the strains of music. I listened for a moment, thinking initially that someone had a radio running in a patient's room. It sounded more like a hymn, however, so I moved towards it in curiosity and found an Amish family gathered around an ICU bed. It appeared they had made the decision to withdraw care from a patient, although I don't know any of the story. But as they stood with their community member in the patient's last hours or minutes, they were singing the old hymn, "Nearer, my God, to Thee," the notes of which I had heard.
That stately old hymn always reminds me of the Titanic, where the ship's orchestra courageously played it as one last musical effort to bring comfort and hope to the ship's doomed passengers and crew in an irremediable situation as the ship sank. Hearing the Amish family sing it with the understated beauty of a cappella harmony with their quiet dignity aroused much the same feeling of steadfast resolve and persistent faith. This was especially true when sung surrounded by all the high-tech ICU interventions that often feel futile, the lonely suffering of the patient I had just left, the impending grief of their own family, and my own sense of helplessness. I left the ICU and went to cry in the privacy of the stairwell with a sense of having been given a gift, a glimpse of the hope and faith when I most needed the reminder, a sense of being embraced and held.
I moved from the stairwell on to the next floor where I encountered a friend who graduated from this residency program last year and is now doing a fellowship. She asked me how I was with some concern since I think the juxtaposition of the disparate experiences I had just had was written on my face. I rarely see other residents or fellows/attendings in the hospital, so I stopped to process a bit, sharing with her the sense of darkness and hopelessness over my first patient and the shimmering light that felt like a candle in the darkness from the peace of the Amish family's faith. She nodded and shared some of her own patient experiences and finally gave me a hug before we moved our separate ways.
Hugs are big in my family, I think an inheritance from my nana who believed everyone needs one (and probably more than one). We give them when we first greet and when we say goodbye. Many of my friends know me as the one who gives them hugs. They are important to me, a needed source of support and a frequent gesture of affection.
As I processed this experience with my spiritual director, I realized that I received two hugs that day. When asked how I felt after the beauty of the hymn in the ICU, the word that came to mind was "embraced." I think God knew, though, that I still needed human arms on the hug, so he put my path in line with that of my friend, and I had flesh-and-blood arms to offer me affection and sustenance as well.
I said at the beginning of the post that I sometimes feel like I post about all the hard things. The same can sometimes be true of my life; I can focus too much on the painful things, neglecting or taking for granted the shafts of light and glimpses of beauty that cross my path in the midst of the suffering. I have started seeing a spiritual director, and I think part of the purpose of spiritual direction is to help me pay attention to the beauty.
God is always at work - in my life as much as in the lives of my patients and others for whom I long to see his transforming power. It's just a matter of learning to see, remembering to look, recognizing his voice. Spiritual direction is setting time aside to look and listen.
Blogging performs much the same function for me, forcing me to look again at the stories of the people I encounter, to reflect on what the meaning of this sadness or that soaring hope is, and to look for where God is involved in it. And in both, I have found, I am met. Unobtrusively, quietly, usually unexpectedly, God shows up and is present and who I am and what I know and what I have learned at the end of the process is not the same as at the beginning. In this, too, I am caught up and held, and I give thanks. God is good. E'en though it be a cross that raiseth me, still all my song shall be, nearer, my God, to thee.
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