By Chaplain Ruth Diones
This time of pandemic reminds me of scenes from the movie Inception. I enter a dream world of empty streets. No people can be seen. I think I’m in the Bronx. Where is everyone? What is everyone doing? Where are the children?
Shift scene. I have now left the streets and am in a science fiction world which requires the use of special gear. People are in white suits; many are in scrubs. There’s a variety of head gear – some sophisticated, some a simple scarf. I think I could be in outer space in a stratified world of haves and have nots. This makes it hard to recognize people. The halls are much emptier and quiet. People almost seem to be gliding. Should we have had a fashion show?
What can spiritual care bring to this mix? As chaplaincy is about spiritual care at a time of crisis, my skills are/were appropriate for this time. It has been a time of crisis! However, it has also been a very different time. No visitors have been permitted. I was to avoid entering patient rooms. Each day I felt like I had to refigure out my ministry. How was I to serve at this time? It was frustrating but had to be done.
The emotional aura in the hospital has been changeable over this extended time. In March and the beginning of April, people were fearful of working with COVID-19 patients. It seemed people were hardly breathing. COVID was new. Much was unknown. People were afraid for themselves and their families. The stress level was palpable. We could see many people losing their precious lives. An unusually large number of patients
were under critical care.
At times, I circulated through the hospital. I looked into patient rooms through the new windows on 5 North. I saw patients lying inert, tethered to machines and tubes. These people seemed to me perfect icons of helplessness and aloneness. The windows meant that it was easier to see problems, and that fewer entries and exits from the rooms were necessary.
Now, at the beginning of June, I sense much less fear in the air. I think people have learned that infection control really works! There is an air of determination, and a need to take advantage of the easing of things. Staff is recovering from the intensity of the spike, taking a breather. The ED is much less occupied and there are far fewer patients on vents overall. Thank goodness there have always been vents available for all patients! During the height of COVID, there had been much fewer trauma codes and fewer psychiatric and detox patients; that’s now changing – almost back to normal. One staff member was remembering how nice the quiet had been.
Despite the futuristic images described above, I am reminded that humans have been through many plagues. The Bible has Revelations, which is often interpreted as a time of purging, cleansing and punishment. I have heard comments echoing these sentiments – that this pandemic can be seen as punishment for evil ways and sinful behavior and thoughts. Now, with the brutal, senseless death of George Floyd, and the attendant riots and looting, so many people asking, what were/are they thinking?
Yet, this has also been, here in the hospital, a time of witnessing enormous generosity and even plentitude. We are almost getting spoiled with free meals and parking! In addition, many resources have been posted on Workplace. Help has been offered for those not coping well. People are being cheered on. It has been a time of celebrating and recognition for courage. My impression is that every person has been touched by the pandemic – whether frontline or in isolation. Like many growing up I have seen myself as an individual, responsible for only for myself and free to seek my destiny. As Dr. Seuss said:
“You have brains in your head. You have feet in your shoes. You can steer yourself any direction you choose. You’re on your own. And you know what you know. And YOU are the one who’ll decide where to go …”
— Dr. Seuss, Oh, the Places You’ll Go!
I am realizing more and more how much we are connected. A plane was passing overhead and one of my spiritual teachers pointed it out. It had impinged on us. That helped me to some awareness. Mosquitos bring awareness. However, this time of pandemic has made the centrality of the ways we are interconnected so much more clear. Look what we have to do to prevent the spread of disease! Normally, we are always breathing air breathed by others. Now we are seeking to prevent this. Normally we touch and hug, and enjoy meals together. Now we social distance. The streets have been so noisy and busy at all hours. Now they are quieter.
Another spiritual practice is to pause before each meal and reflect on the source of our meal. So many people have been part of this meal’s journey. First, without seeds nothing happens. Such a miracle! The farmers’ efforts and knowledge drench the food. The earth, sun and rain are integral. There’s harvesting and transport. The marketplace. All those handling and preparing the food. This is multiplied by the number of ingredients. The cooks and servers deliver it to us. These people have been keeping the engines of our lives going! What would happen if these numerous people weren’t doing their parts? And, of course, everything we eat has been alive. We are ingesting others’ lives; they are becoming part of us in a very literal, physical way.
Since we are connected, then helping another is a way of helping ourselves. We can open to compassion for everyone. We can be in the presence of suffering. Another one of my teachers was saying that we are all all of the parts: the observer, victim and perpetrator; we are the healthy and sick. We are all made from the stars. Nonetheless, our bodies are always changing so the physical me that I was seven years ago is now gone. I’m made of new cells and bones. Yet the essence of me is still there. Constant change; eternal possibilities.
The Stay at Home rule has strained family systems. It has put coping mechanisms on overload. For a couple of months there were seven people under one roof at my in-laws. My 91-year-old father-in-law needed to be protected like all of the elderly. Further, his chronic, acute health issues required attention by a visiting nurse. The young people in the house have found quarantine very difficult often needing to vent. This tale can be told 1,000 fold in infinite ways. Yet there is so much to be grateful for! They have food. They have a home. Several are employed and can work remotely. A practice of gratitude is so important.
My own family unit has been troubled by the fact that I’ve been on the frontline. Most of my ministry was on the phone. I phoned inpatient rooms, but it was hard to reach people. Therefore, I called the families of patients who had died. I reached most families. Many had experienced difficulties making final arrangements for their loved one. The funeral parlors were overwhelmed. They were worried that their loved one’s body might be sent to Hart Island before they could finalize things. Most were grateful for the call and the acknowledgement of their loss. Many were in shock. So many expressed the knowing that they were part of something much bigger than themselves. This put a perspective on their grief and loss. It seemed to ease things. We are part of History.
One daughter of a patient who had died of COVID-19 lost both of her fathers in 48 hours (one was a stepfather). She has kids and is terrified for them. This disease spreads and can takes an enormous toll even on just one family! Another child of a patient who had died stated, “My mother had never been alone in her life. She wouldn’t have died if she hadn’t been alone.” Another patient’s family wanted someone to go to the bedside to pray. When she learned that I had done this she told me her whole family will now be praying for me. This touched me. Another daughter wanted me to keep calling her. Her mother was gone. She was dealing with her grief and was isolated in her house. She was so alone! Time hung so heavy. Other relatives wanted to know what had happened to their loved ones at the end of life. Did they suffer? What was really wrong? They seemed to need information for understanding and closure.
However, when I was directly exposed to COVID-19, which of course happened, and I shared this at home, I saw my family’s panic and alarm. My son left for his girlfriend’s house for a month. After his return, he still distances from me in the house. My daughter left to spend time with her grandfather. I think they, like me, slowly learned that if precautions were taken, it is possible to avoid the virus. I too had “freak out” moments. Once I decided I just had to be tested. Negative. Phew.
I have come to enjoy my weekends of complete isolation with my family in my home. On Friday evening the car has been going into the garage until Monday morning. I love the quiet, the opportunity to deepen my spiritual practice, reading, cleaning and gardening. Watching the approach of spring was a delight. The explosion of leaves, birds and flowers thrilled me. The air smelled so fresh. The weekends ended quickly. How can this joy co-exist with the co-existent dire events?
I asked one of our nurses how it was to be so sick – he did get the virus. I had observed him many times in the thick of activity. I knew he was at risk because he always went towards approached. I witnessed his caring and courage as well as his weariness. Then he got the virus. Now, he was willing to tell me about the moments when he came close to being intubated, and even death. He refused intubation because of the high mortality rate. He hung on through it. He struggled to breathe. He sat up hunched over. He took all the therapies. He kept saying to me, “It was interesting.” It seemed that it was hard for him to articulate what it was like to be in that place of facing mortality. While having withdrawn from formal religious practice, his spirituality was part of hanging on. Once the emergent moments passed there followed a lengthy recovery. I asked him how it has impacted his life now. He said that it has changed his perspective on how to live now. He has been tempted to go into a midlife crisis and get a convertible, but his fiancé is keeping him real, focused on his responsibilities. I also asked if he would do things differently if another spike came. He said he would like to think he wouldn’t. Providing full-hearted care is what he wants to do as a nurse.
I spoke at length with a security officer frequently posted in the ED. This guy keeps his cool. He said the most important thing about doing security was being observant and responding early. If voices are getting raised, address it immediately. He went on to share that during the spike he noticed a common pattern in COVID-19 patients. There would be a stillness about the patient. Typically, patients fidget; not these patients. They didn’t move. Then, they would sit up in the bed and struggle to breathe. Next they would lay down and soon code. Once, in a 16-hour shift, four people died this way. Another time, four people coded at the same time and a fifth patient was heading in that direction. All of these patients were brought back from the brink. I asked him if he had gotten sick. He said, no. He wore his mask. If he had to tackle someone, he sanitized his clothes thoroughly with wipes afterwards. Now, he still takes the risks of COVID seriously. It’s upsetting to him that people seem to be getting so lax about social distancing and wearing masks.
This is a time … and we are still going through it. I think more feelings and reflections will bubble up. What is bubbling up for you?