Sunday at the Children’s Hospital -The Toast

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It is early Sunday morning and my cat has just pounced on my quilt-covered ankles to inform me her dish is empty: our weekly waking ritual on my faith’s holy day. If I don’t oblige right away she will start in on her most mournful arias, so I stumble through the dark of my basement apartment, scoop some kibble into her dish, and stare into the bathroom mirror at my badly lit face as I arrange it into the composed, non-reactive, open, listening face I was taught to assume in my first unit of clinical pastoral education. I am a conduit, not a vessel. God, drain the dead out of me at the end of the day. I haven’t been to church in six months. My cat leaps up next to the sink and bends her head to the trickle of water I’ve turned on for her, her quick tongue scattering the stream into little shining drops.

Since I began spending my Sundays at work in the hospital, walking the quiet corridors from 8 to 5, I’ve tried just about every liberal Protestant evening worship service within a 20-mile radius. Most Reverends I know will tell you that after three years of seminary and however many years in the field, they don’t go to church for the sermons, and I’m no different. I’m there for the bread and wine, not the one sermon that everyone in this town seems to preach every Sunday about how we should all try not to be so busy all the time. Everyone around here uses wafers for communion, too; every time the celebrant lifts that thin glossy cracker up toward the ceiling and invites the congregation to the “feast,” my heart sinks as I remember tearing off giant chunks of the grainy homemade bread of my childhood.

But the worst part of church is coffee time, which some churches, full of hope and good feelings, call “fellowship time” — those twenty minutes after the service when everyone mills around outside the sanctuary and strenuously tries to embody Christian hospitality toward each other over powdered-sugar-covered donut holes. It really is a valiant effort, and it’s right to try. As an introvert I know how hard it is, and I know that when I’m not at work I don’t always make it easy for others to be friendly to me, either. But since I am a thirty-something no-longer-in-school ordained single woman without any children, my fellow congregants usually struggle to find something in common with me, so we end up having some version of The Conversation — a Conversation familiar to pretty much every pediatric chaplain I’ve met:

FRIENDLY PERSON [after determining that I have no husband or wife or significant other or children we can talk about]: So what do you do?

ME: I work at the hospital–been there about three years now.

FP: Oh! What do you do there?

ME: I’m a chaplain.

FP: Oh my goodness. [a story about FP’s personal experience with chaplains, which I find genuinely interesting but always seems to end with] Do you work all over the hospital?

ME, giving up: Yes, but almost all of my work is on the pediatric units.

FP: Oh my God that must be horrible. Oh, I could never do that. Oh, you must be a saint.

And the conversation is over, because sick or dying children is a place no one wants to visit, a big black ocean of fear and grief that you can’t allow yourself to cross without risking some deep psychological or emotional shit. I don’t blame them at all; that fear is real, and it is pretty basic to human experience. It’s one of the things I try to help people through at work. The tired chaplain self-congratulatory quasi-joke is that chaplains are the ones who run toward the burning building when everyone with sense is running away. But I always want to say something like, You could do it. Lots of people could. It takes a lot of training and a lot of education, yes, but if you had that, you could do it, too. Some mean and unreasonable part of me sometimes wants to add, and you should.

The hospital chapel is quiet in the mornings. Often the cleaning staff have left the bright overhead lights on so the room looks like someone’s about to give a presentation, and every inch of the industrial tan carpet that I hate glares aggressively back at me. Today I dim the lights back down to a comfortable warmth, with shadows in the corners, so that the outside light can paint the floor through the squares of stained glass in the window. I check the wall of prayers, where patients and their families and friends have clipped up prayers they’ve written on the little squares of paper we leave by the door. The wall is heartbreaking, always, and theologically complex.

After six years of working in hospitals, four years of which have been in pediatric settings, my faith has been stripped down from the fullness of those creeds and confessions I joyfully recited before my ordination (What do you understand by the providence of God? The almighty and ever present power of God by which God upholds, as with his hand, heaven and earth and all creatures, and so rules them that leaf and blade, rain and drought, fruitful and lean years, food and drink, health and sickness, prosperity and poverty — all things, in fact, come to us not by chance but by his fatherly hand [Heidelberg Catechism Q&A27]). There aren’t a whole lot of rock-solid assertions I feel comfortable making anymore, and on bad days I feel myself bloom with envy when a parent or patient tells me about the peace their faith in God has brought them in the midst of their or their child’s cancer treatment or miscarriage or difficult recovery from surgery. I don’t doubt that they feel that peace, and I feel certain that peace is a holy gift to be nurtured and cherished, but times when I feel that peace myself are few and far between.

On the hospital’s pediatric oncology floor is a wall of faces, pictures of children who have passed through our care either to remission and healing or to a death no one could prevent. The families of these children chose the pictures, and they are beautiful. Some of them were taken before the kids’ treatment, and they glow with health, holding fishing poles, playing musical instruments, grinning at the lens. Some of them were taken mid-treatment, and they glow with hope, petting a therapy dog, waving at the camera, showing off their chemo hats. Only we who work on the floor know which of these children are no longer alive, which makes this wall both incredibly moving and incredibly difficult to walk past without a few tears escaping.

Would I rather not know? Would I rather pretend that each one of these beautiful children grew up healthy and happy and cancer-free? Oh, sometimes, yes. Oh, yes. To go back to the time when I didn’t know the difference between a neuroblastoma and an astrocytoma, when childhood illness and death was an amorphous horror that happened to people I didn’t know. Back when God was good, and in charge of everything. I remember that peace. But it is not what happened. That horror was not amorphous to the individual children and families who experienced it. It was horribly specific, detailed, immediate. I know that now because I was there.

Lots of people have heard that the shortest verse in the Christian Bible is the succinct “Jesus wept” (John 11:35), when he was approaching the tomb of his friend Lazarus. That’s how the King James version translates the original Greek word for “wept,” which is in the aorist tense. But the aorist tense is slippery sometimes; it can also refer to the beginning of a more continuous action, which is why the New Revised Standard version translates this verse as “Jesus began to weep”–no one was quite sure when it ended, or if it really ever ended at all.

On this Sunday I head upstairs to the pediatric cardiac intensive care unit, where there is a baby who had open-heart surgery the previous Friday. Her chest is still open, the gap covered by a clear dressing, the dressing covered by a clean white hospital sheet covered by a bright pink crocheted blanket. Her chest will stay open until her body’s swelling goes down enough so that the heart won’t be constricted when they close it. Her parents have taken a much-needed break for sleep, so I stand at her bedside while the nurse adjusts her medication pumps. Twenty years ago there would have been no help for this child. Though there is help for her now, there’s also no guarantee that she will make it through this recovery unscathed. All I can do is hope, and if hope becomes impossible, look for the small graces that allow a person to put one foot in front of the other each day after something so terrible happens. The graces do come, though they don’t make up for the grief. Through the window behind the baby’s bed I see fog shrouding the highest floors of the hospital, but I can still make out the dark outline of the river below, the trees, turning. What kind of people are we if we don’t allow our hearts to be broken?

I don’t go to church this Sunday evening. It’ll be waiting for me when I’m ready, the bread, the wine, the well-meaning people. Tonight I trudge down the stairs to my apartment in my heavy hospital clogs and hear the tiny high sound of my cat meowing behind the door, ready for me to fill her bowl, scratch her ears, and set a thin trickle of cool water running so she can drink, and scatter the drops into stars. It’s enough for today.

*

Descriptions of patients are generalized from many experiences and fictionalized for privacy.

Rachel Brownson is a hospital chaplain and earnest writer of poems who lives in Michigan. She tweets at @rkbrownson.

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This is heartrending and wonderful. Thank you for the work you do.

ETA: I was one of those kids, in one of those families, trying to figure out the random cruelty of the world, experiencing that "specific, detailed, immediate" horror (as you so wonderfully say). Years later and no longer in immediate danger, I don't have an answer for why what happened to me did happen. I remember and cherish, though, the people who were simply there; the chaplains and ministers and priests who didn't try to explain away the pain and anger, but sat and gave me and mine a safe space to grieve. So I say thank you with every grateful little part of my soul. Now I'm going to conclude this comment before I start tearing up at my desk.
What kind of people are we if we don’t allow our hearts to be broken?

Thank you, thank you, thank you.
Gorgeous, beautiful, so sad. Thank you.
Thank you for your work, and for sharing this beautiful, heartbreaking story.
What kind of people are we if we don't allow our hearts to be broken?

This line really got me. So beautiful. Thank you, Rachel, for writing this.
You could do it. Lots of people could. It takes a lot of training and a lot of education, yes, but if you had that, you could do it, too. Some mean and unreasonable part of me sometimes wants to add, and you should.

I appreciate this. I'm sure I've said it myself to other people in other circumstances out of unstoppable reflex and unwillingness to tell them my real opinion about what it is they do, but I never mean it and I don't think anybody does. "I could never do that" means "I don't want to do that, and as long as other people do it for me, I'll never have to." The truth, which upsets people, is that anybody can do almost anything and everybody can do what they have to.

never mind that anyway. This piece is really good.
1 reply · active 538 weeks ago
I agree- it's super frustrating when people dismiss someone who's dealing with something terrible with "oh I couldn't do it" because they kind of imply that people who DO do it choose to because they decided to take on a challenge. And that's not what happens. You don't have to look for awful stuff, it comes to you, or you realise it exists. And once it's there, you're handling it in some way, every second you keep breathing after the thing happened. It's literally impossible to die from not being able to cope, feeling horrible or not wanting to experience the horrible thing, as long as you keep feeding your body some meals now and then. People who are alive stay alive (and thus, living with the bad thing) unless illness, age or physical trauma actively causes them to die. Sometimes people don't really realise that - they can't imagine what a life beyond the point of the terrible event would look like, so they say stuff like "I don't know how you keep going", as if the person does "know" how to keep going, as if continuing to be alive means that they have decided that the horrible thing (whatever it is) is okay. Like there's a special kind of person out there, who don't feel bad when bad stuff happens.

But, not everybody can cope well with everything. Having an awful thing happen to you, or entering an awful situation, doesn't give you the ability to handle it. It doesn't cause you to be different in any way - you are exactly who you were, in an awful situation. You don't transform into a new or special kind of person who knows how to be okay with horrible things. You're just as not-okay with having awful things happen to you as the people who tell you that they couldn't do it. The difference is that you don't have the option of not experiencing the thing. People act irrationally in the face of danger or horror all the time. They cope in sub-optimal ways. Some learn to cope well, some don't.

But yes, as long as they don't die, they cope with it some way, be it good or bad. So I get what you mean and I definitely wish this kind of dismissal would stop.
I wish I had never encountered a pediatric (specifically, a neonatal one) chaplain. I wish i was still ignorant that such people exist and are there, in part, to oversee events that I wish I didn't know occur. But I remember the chaplain who baptized my nephew in the minutes after it became clear that he would leave the little body only just delivered from my sister. I remember how he sang "Amazing Grace." I can't lie and say that he brought solace to the hideousness of what was happening, but I also don't think that was his job. He was just there because my sister requested him and because he had decided somewhere in his life to be the sort of person who would choose to be in a room where a baby is dying, maybe so that the other people in that room feel that much less alone. For his (and your) willingness to place himself in a space that a thousand other sane adults would flee, to be there voluntarily, I am endlessly thankful.
There's this book on the shelf below the record player in my parents' house. It's part of a Time/Life series* and this one's on animal behaviour. One of the pictures shows a chimp reaching out to touch the back of another chimp. It's simply labelled, "Comfort." 30 years after reading it, there are still times when I can't think of anything to say when I heard stories like this so, if I can, *reaches out and puts his hand on your back*

Ook.

* Ask your parents, kids.
Your insight into the specificity of the work and the attendant grief rings very true to me (and my experience in chaplaincy and congregational ministry).

It's not the death of a child that is hard to endure. It's the death of this child.
fromthelandwithlove's avatar

fromthelandwithlove · 538 weeks ago

I'm saving this for the summer that I know is coming, when I'll be doing CPE myself. Hopefully I will be strong enough to hold the fullness of the suffering of others.
Katharine's avatar

Katharine · 538 weeks ago

My brother died of neuroblastoma when I was 8 and he was 5. Thank you for your very clear writing. It's good to find people who understand that world.
Thank you
Thank you so much for your work. I'm a not very religious nurse, and one of the most touching moments I've seen was a chaplain telling a patient who had just gone through an emergency situation, "I was outside the room praying for you."
lyricalikons's avatar

lyricalikons · 538 weeks ago

My son was in cancer treatment from age 3 to age 6 1/2. We spent a lot of time in the oncology ward. I have never read a piece that I have relayed to more than this one, especially how it is to be having those same conversations over and over. Thank you for this.

Also, we started attending a church that uses handmade, dark, sweet, grainy bread for Eucharist. Thank God.
1 reply · active 538 weeks ago
Perhaps that is how churches should advertise themselves. We will walk with you when the going gets tough because of the Eucharist. Also the Eucharist bread.
Thank you for the work that you do, and for sharing your story with us. My job isn't quite as recoil-inducing as yours, but I've definitely had moments when people have been quick to exclaim they could never do my job and instantly create an uncomfortable, and unnecessary chasm between us, rendering further conversion all but impossible.
I had an older brother who died when I was an infant. My parents' minister and church were instrumental - but so were several hospital staff. When they met a nurse - this was years and years later - they remembered her, because, after realizing that she and my parents were Christian, asked if she could pray for my brother. Now, as an adult who has experienced the tangible love of a Christian community but struggles very hard to believe in anything, much less in a deeply flawed institution... it's more complicated. Love your last line.
Your work is really important. Thank you for doing it. My partner was in seminary and died a little over a year ago (ovarian cancer), and the hospital chaplains -- a few of whom were her classmates and our neighbors -- were wonderful. Hospital chaplains are incredibly important. <3
It may not have been my imagination then, those times when I felt it was my faith shoring up that of the chaplain on duty as I attended the twice-weekly services in the hospital chapel the last 2 1/2 months of his short life.
If we met at coffee hour I would thank you on behalf of the parents too deep in grief to do so, then I would ask you what sort of things our faith community could do to bless you and strengthen you. After that we'd probably talk cats.

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