To the End — A Christmas Story

I’m beginning my time at Nemours Children’s Hospital. Moving into chaplaincy again, this story came to mind. I wrote it about my first experience of death in the hospital one December many years ago. It’s almost all true, but none of the names are. May what needs to be unmade in you die this winter, and may Jesus be born  in its place.

To the End

I had gotten to the cave-like accommodations of the on-call room right next to the emergency room at about 10:30, after blundering my way about trying to figure out how to do rounds and forgetting to do two referrals that my supervisor had given me. It was my first overnight shift at the Hospital as a chaplain intern.  During rounding, my experience with the nursing staff in the ICUs made me feel like an outsider.  Obviously I was new.  Obviously I didn’t know what I was doing. Plus, an encounter with a family whose mother had aspirated earlier that evening had made me feel like an intruder.  They didn’t want me there.  They just wanted their mom to be okay.  But she was not okay.  She was being transferred to the ICU.  I remember her chin was turned up and her mouth was wide open and shrunken closed at the same time (no teeth).  She died that week, I learned later. i also learned later that a chin turned toward what would be the sky if she could stand is a death omen.

“What’s the point of being a chaplain if they don’t want me?”  I thought.    “How do I wiggle my way into this system?  Do I want to?  How does one provide comfort to people in such circumstances?  Can I pretend to provide comfort?”

“Whatever.”  I said aloud as I turned off the light next to the bed.  Sleep wasn’t hard.

I was awakened by the beeping pager at about 12:30.  It was only my second page and I didn’t know what the numbers on the pager meant.  Somewhat drowsily, I called the page operator and she helped me call the number.  It was a nurse from the Neonatal Intensive Care Unit.  They were preparing to take a baby off his ventilator.  Less than shock at this horrible news I felt my sense of obligation.  I wanted to “do it right.”  As I scrubbed up at the entrance to the NICU the thought crossed my mind that it could be a baby I had visited with another intern whom I had shadowed a few weeks earlier.  When I entered the room I discovered that indeed, it was Frankie.  Distracted by this coincidence, I met the nurses, residents and doctors.  I didn’t remember the face of Steph, the nurse who paged me, but I had met her earlier that evening on my seemingly ineffectual rounds.

Steph greeted me, “Hi, thanks for coming.  We thought that you should be here.  To like… say a prayer or something.”  She shook my hand with a child’s wrist.  She was such a tiny woman.

This NICU room was shared by three other babies.  It was dimly lit with fluorescent lighting at the desk.  The parents were not there.  His mother, Sandra, did not want to be there.  Maybe she could not be there.  When I met her the day after Frankie was born, a few weeks earlier, she was a mess.  This was her fifth child.  Her oldest had Down’s syndrome.  She didn’t know why God would do all this to her.  I didn’t either.  She wanted us to pray for a miracle.  I was so glad that on that day my role was to shadow the chaplain.  I half-wished I could be a shadow now.

I walked into the room and a crowd was gathering to witness the death.  Frankie was in a crib, not like Sharod, Madelynne and “Baby Herrison” who shared his room who were all in incubators.  He was a full term baby boy, wearing a blue hat and covered in a hand knit afghan.  He looked like a giant compared to his roommates, but he was less than one month old.  He was motionless except for the rhythmic and oddly mechanical rise and fall of his tiny chest.  Machines were pumping his heart and filling his lungs with air.  On November 6th, he had been born brain dead from lack of oxygen during birth complications.  His brain had never told his body to live.

But the doctors had given his newborn synapses the chance to start firing by keeping him alive artificially.

They hadn’t fired.

Medical arrangements were being made and it seemed like we were waiting for as many people to be present as possible.  Shelly, a resident, gave Frankie some morphine though an IV.  Steph sat in the chair and another nurse named Barb wrapped Frankie up and made it so all his cords could reach her waiting arms.  This was Steph’s room and she would be the loving arms for this child as she had been for much of his life.  The weight of this burden seemed like it should crush her tiny frame.  Once in Steph’s arm, the Doctor; a stern, South Asian man, very much maintaining his scientific objectivity; gave the go ahead and said “Make sure to note the time.”

I noted the time.

It was 1:06 am on December 2nd.  Twenty-six days after he was born. They removed the tubes and everyone stood back.  Steph and a few others were already crying.  I asked Shelly, “Would you like me to say a prayer now?”  She nodded.

I prayed aloud, “Dear One, we’re gathered here at the end of Frankie’s life because we want to honor it and acknowledge it.  We know that you are here with us.  You are with us always and even more so at this moment between life and death.  We thank you for the short time that Frankie was with us.  We praise you for life and the opportunity to know this child.  Frankie’s life was so hard and it’s been hard for us to watch him struggle.  Take him now.  We trust that your love will surround him as it already has.  We pray that you be with us in this time of darkness.  We pray especially for his mother.  Be with her as she grieves.  You know suffering.  You know death.  We know you know Frankie and we know that you are with him.  Be with us now.  Amen.”

After the prayer, most were crying.  My eyes welled but barely teared.  I stood by as we continued to wait for Frankie to die.  Thankfully, Shelly had turned off the monitor and we didn’t have to listen to his heart beat slowly fade.  The room seems so still and silent in memory, but I know that the three living babies probably gurgled, and their machines definitely beeped and whirred.  Yet in those long minutes before Frankie died, my senses were empty save the sight of that dying babe.   Because she had turned off his machines, Shelly had to keep checking his heart with her stethoscope to see when it stopped beating.  It kept beating until 1:19am.

13 minutes of silence.

After Frankie was dead, most people filtered out, and the intricate death ritual began.  Steph and Barb set themselves to filling out paperwork and assembling Frankie’s memory box, a nice padded box with places for pictures and all of the things that Frankie accumulated in his short life—hats, blankets, an Elmo stuffed animal.  I stood in a corner and watched.  As they worked, Steph talked with Barb about how another baby had died in her room on her watch the week before.  “I’m not sure how much of this I can take.”

I said, “This isn’t exactly what you signed up for, huh?”

“No, it is,” she replied.

I responded “Well, for what it’s worth, what you are doing is really something beautiful and so ancient, you know?  I mean, there’s a lot of paperwork but the way you take care of the dead is really beautiful.”

“Thanks,” she squeaked as she took off her glasses and wiped her eyes.

They continued to work and I stood by and commented on a few mundane things, like the quality of the pictures they were taking for his memory box.  Mostly I just stood and watched as they professionally loved the dead body and the absent family through their work.

When they cleaned him I almost had to leave. His naked body was already changing color.  I had a physical reaction to this.  I had been stifling a cough from the moment I walked into the room and I think that sensation coupled with the sight of his decaying body, made me slightly nauseous.  But soon the sweet smell of the baby shampoo and soap filled the room and I stayed by their side—by his side until they finished and he was again covered.

I asked Steph, “Can I touch him.”

“Of course,” she said, feeling better—the safety of routine soothing her some.

It was the first dead body I had ever touched. I brushed his cheek with the top of my index and middle finger, whispering his name, and then I attempted to secretly cross him, but Steph saw me.  She quickly turned away but couldn’t help herself.  She collapsed in the chair and cried.  Barb kneeled beside her and hugged her.

“It’s okay, Steph.  I know,” she said.

I didn’t have that luxury.  I didn’t know.  My experience with death was little.  That was why I had signed up to be an intern as a chaplain.  I wanted to know suffering and death more intimately because in my head I knew it was inevitable for all of us.  I’m not sure I knew it in my heart, but I was learning.

Steph’s ready-to-be-brokenness was killing something in me—something worthy of death.  Her physical and yet living frailty sobbing next to the now dead frailty of Frankie’s body was teaching me the cross.  Touching the dead one with the sign of the cross and seeing her being broken by it was breaking me.  I thought of all the babies I was proud to say that I held on their first day of life.  It was strange to say that I had been with a baby and touched him on his last day of life.

“I touched a dead baby.”  I told my wife the next day.

And he touched me with the holy hand of a once born in a manger, now crucified and resurrected Christ.

I stood by silently and watched the women embrace.  They might as well have been Salome and Mary.

When Steph recovered, they wrapped Frankie in his death shroud and put him in a bag for transport to the morgue.

“I’ll go down with you,” Barb said.

I didn’t go down with them.  I left them at the elevator.  I was exhausted so I went back to the on-call room cave and slept.

I emerged from the hospital that morning, bought a cup of coffee and went to the plaza at 10th and Locust to sit and watch the morning being born.  As I sat on a bench, the people that walked by were so much more alive than usual.  I loved them so much more than I had before.  I loved them because they were all so frail, so easily dead.  I was too.  I was baptized in Frankie’s death.  I died with a dying baby.  I died to the myth of immortality and invulnerability that still lived deep in my heart though denounced in my head.  The Incarnation made a new kind of sense.

God chose the Incarnation and a breakable body to be Emmanuel.  In the failure, death and brokenness of several human bodies at the Hospital in the early morning of December 2, 2009, my reliance on God’s self-revelation in our darkest darkness was not so much reinforced but realized.  It was felt in my heart and it felt like knowing God.  I guess I was poised to be laid low, poised to see us all as the delicate creatures we are.  Who better to show me than a brain-dead baby, a month old, alone, his parents incapable of dealing with his death?

When I finished my coffee sitting on the bench in the plaza, I walked to the trolley underground at 13th and Market.  I descended the steps and heard route 11’s arrival being announced.  I ran to catch it, jumped between the closing doors and found a seat underneath the twinkling lights of the elusive Christmas Trolley.  The driver had decked his halls with Christmas lights and he was playing Christmas music from a boom box on his dash.

Bing Crosby sung in error, “Someday soon our troubles will be out of sight…”

A little boy sat across from me.  He asked his young mother, “Are we getting off here?”

“No,” she said. “We go all the way to the end.”

She was right.

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