Daily Archives: October 20, 2014

The Enduring Mystery of an Encounter with an AIDS Patient

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Last night I wrote about my early experience dealing with AIDS while serving as an Army Medical Service Corps personnel officer in 1987. In the 1990s that experience changed as I began to deal with men and women who were dying of the effects of full blown AIDS while serving as a hospital chaplain. The experiences of being with those men and women, and in some cases with their families, or loved ones was another chapter in my acceptance of Gays as well as other people marginalized and abandoned by my fellow Christians.

This is an account of one of those encounters at Parkland Hospital in Dallas where I was doing my Clinical Pastoral Education residency, it is not about the politics of AIDS, instead it is about humanity, connection, faith, mystery and things that I cannot explain. Those who know me or have followed my writings on this site know my struggles with faith and God, belief and unbelief.

Even today thinking about this encounter brings tears to my eyes and makes me wonder about faith, life, reason and mystery. Frankly, it is something that I cannot explain, nor do I care to. I am content to live with the mystery of something that I cannot explain, but then at the same time, I am not.

As Anais Nin wrote: “The possession of knowledge does not kill the sense of wonder and mystery. There is always more mystery.”

Peace

Padre Steve+

Sometimes death comes unannounced but other times it sounds a warning.  Most of the time we think of such warnings as what our body is saying to us, maybe someone is having chest pains or that we know of a terminal condition which is getting worse and the doctors say that there is nothing else that they can do.  Other times it appears that some people almost have a sixth sense about their impending death and leave notes or say “goodbye” to loved ones in a different way than they would normally do.

When I see or hear about the sixth sense kind of incident I find that I am intrigued.  As a student of history I have read countless accounts where soldiers know that they will not survive a particular battle and leave things or messages for their friends to give to loved ones.

There have been times when I have had a sixth sense about what was going to happen to someone and the feeling is like you are watching something unfold in slow motion but can do nothing to stop it.

This story is a bit different and took place during an overnight as the “on call” chaplain at Parkland Memorial Hospital in Dallas during my Clinical Pastoral Education Residency. Parkland is a rather large, at the time of my residency a 940 bed county hospital and Level One Trauma center.  The “on call” chaplain after normal hours was the only chaplain in the hospital to cover all emergencies in the house.  Usually I stationed myself in the ER area as that was the “hottest” place for ministry at any given time.  I would always take a spin around our 9 ICUs sometime in the evening to make sure that nothing was brewing; but unless something was going bad on one of them would always end up back in the ER.

One night I had just finished with a situation involving a violent death in the ER when about Nine PM I got a page from “9 South” our General Medicine Step-Down ward. This was a ward that not much usually happened on, in fact as a critical care and trauma type I considered it and other wards like it as a bit boring as nothing much usually happened there.

The nurse that I talked to when I returned the page told me that I needed to come up right away. She said that she had a patient who was convinced that she was going to die that night.  Intrigued, I told the nurse, that I would be right up and made my way up to the ward.

I got to the ward about 9:15 PM and met the nurse who further explained the situation to me while I reviewed the chart.  The nurse was an RN who had come to the United States from India and she was obviously unnerved by what was going on. She told me about the patient, I reviewed the chart as is my normal procedure and then went in to visit the lady. There was nothing in the chart to indicate any problems, in fact she was listed as improving enough to go home the next day, discharge orders were already in the chart.

The lady was in her mid-30s and she was HIV positive. She was married, and her husband who was also HIV positive and in a more advanced stage of the disease had been discharged from the hospital the day before. She had come in for a few day stay as she had been spiking a fever but that was under control, and she had no other medical issues. She was not at the point of having any of the major opportunistic infections or diseases associated with full blown AIDS, her T-Cell count was good.  Clinically she was stable and expected to do well for a number of years to come.

But despite all the good numbers, stable condition and good prognosis the woman was convinced that she was going to die, this very evening.

Just after the evening shift change the patient had told the nurse that “the Lord was going to take her home tonight.”  This troubled the nurse as it would any normal rational person, so she called the duty Internal Medicine resident physician to come and speak with the lady. The resident could not convince here that she was going to be okay and that she told both of them that she was going to die that evening and “go home and be with Jesus.”

Now for those who have never lived in the south “going home” is not like leaving the office at the end of the day.  Elvis “went home” wherever that was (see “Men in Black”) and if you are talking with someone raised in the South and they start talking about “going home” you better stop and clarify to make sure that they are going home to watch the Braves on television and drink a beer, or if they are planning on dying.

I had a grandmother who told me from the time that I was 5 years old that she was either “going home” or “wasn’t going to be around much longer.” Of course she was convinced that she was going to die, and once I stirred up a hornet’s nest when after she told me that “she wast going to be around much longer  So I asked her “where are you moving to?” Granny was not impressed and gave me an earful. Granny lived to be almost 90 years old when she finally “went home”  when I was 40 after giving me 35 years worth of warning, but I digress…

Now patently I am of the mind that if the numbers say that you will live I believe the numbers.  I’m a baseball guy, God speaks to me through baseball and I play the percentages. It is the rational thing to do, which means that while I believe that God can intervene in situations I don’t bet on that happening. I read the chart. I talk to the nursing staff, and I talk with the physicians.

After talking with the resident and nurse I was convinced that this lady would walk out of the hospital in the morning and probably outlive her husband. Then I met the lady.

I walked into her room. She was sitting up in bed with her Bible open beside her on her mattress. She appeared to be very calm and there was a peaceful sense about her.  She was from Jamaica and very polite and when I introduced myself to her she greeted me warmly with the accent characteristic of that island nation.

“So you are the pastor?” she asked.

I replied that I was the Chaplain and that the nurse and doctor had asked me to spend some time with her.

She then said “Ah yes, they do not believe me because I told them that Jesus told me that he will take me home tonight.”

So I asked her what she believed was going on with her. She then described to me what had occurred that evening to make her think that she was going to die. “You see pastor, the doctors say that I will go to my house tomorrow but I will not.”

She paused and even more curious I nodded for her to go on and said “really? Tell me more.”

She continued “Pastor you see this evening Jesus came to me, he visit me and tell me that I will go and be with him tonight.”

Now I have to admit that I was skeptical. However, she was not acting emotional or even bothered about what she just said. Normally I might ask for a psychiatric consult, but she seemed to be completely rational, and her chart made no mention of any mental illness or psychological issues.

I was fascinated and asked her to tell me more. She then went on a fairly long recitation of her faith journey from the time that she was a young girl. She told me how she frequently would sense God’s presence and hear his voice at different points in her life. She told me how she had gotten HIV from her husband, who had been a drug abuser and how much it meant for her to be right with others and God.

So I asked her about the specifics of “why she thought that she would die tonight?”

Calmly she explained. “The doctors tell me that I will be well and go home tomorrow. They tell me that I am in good condition and that I will live a long time, but that does not matter to me because Jesus told me today that he will take me home to be with him….tonight.” 

The word tonight was said with a confidence that stunned me. She talked as if this was a regular every day occurrence and her face was radiant.  She continued “I love Jesus and know that he will not lie to me so I know that I will be with him tonight.”

Her faith was touching and powerful in its simplicity and the amount of trust that she showed even to a message that she believed to be from Jesus that was completely different than the news of the doctors. After our conversation, which lasted about 30 minutes involved me probing her faith, asking what she understood about her condition and talking about her family. It seemed to me that our visit was a time for her to tie up the loose ends of her life and that I was the person that she was taking the time to share them with.

As we closed she asked me if I would pray with her and give her a blessing which I did.  She thanked me, reached out and asked for a hug. She embraced me weakly and then let go, and she thanked me again.  I was moved by this, still not convinced that Jesus would take her home. I didn’t she was going to die but there was a certain finality in her words and actions that gave me a bit of doubt about the facts and numbers that I trusted in.

When I left her room, I charted my visit, wrapped things up with the resident and the nurse and went back down to ER where more carnage was waiting, shootings, motor vehicle accidents and drug overdoses.

About 2:30 AM my pager went off. It was the nurse’s station on Nine South. I returned the call and the nurse that I had talked with earlier was on the line.

She was nearly frantic and said: “Chaplain, please come quick, I went in to check her vitals and she is dead!”  I put on my best calm voice and said “Who is dead?” 

The nurse nearly in a panic said “The lady that said that God was going to take her home, she died!”  I looked up from the Trauma ER nurses’ station and realized that there was nothing immediate and told the nurse  “Okay I’ll be right up” and went up to the ward as quickly as I could.

When I got to the ward to find the nurse pacing anxiously outside the door of the patient’s room.  I asked if the nurse if she was okay, meaning her and not the now deceased patient. The poor nurse replied that she was upset by the death because the lady should not be dead. She was frightened and that she didn’t understand how the patient could calmly know that she was going to die.  Now the nurse was not a southerner unless it was the south part of the Indian subcontinent.  She was relatively new to Texas and the American South she was not as attuned to some of the religious and cultural aspects of either the South or some of the Caribbean islands, where the lady had come.

After helping the nurse calm down I met the resident who was in the room looking perplexed, when I walked in he said “This women shouldn’t be dead.” 

I couldn’t think of much else to say so I just said to him “sometimes it’s just someone’s time even if the numbers don’t say so.” 

He said: “Yeah, I know, but this was really freaky because she told me that she was going to die tonight and she did.”

I did concur with this young doctor that what had happened was a bit on the unusual side but that we couldn’t discount what she believed especially since she had been correct. As the resident went to finish up paperwork I looked at the woman. It looked like she had simply fallen asleep. Her Bible was on her lap and opened to the book of Revelation, the 21st chapter. Although I cannot be sure exactly what she was reading can only imagine that it was this verse “See, the home of God is among mortals. He will dwell with them as their God; they will be his peoples, and God himself will be with them; he will wipe every tear from their eyes. Death will be no more; mourning and crying and pain will be no more, for the first things have passed away.” (Revelation 21:3b-5 NRSV)

This dear woman had passed away, gone home looking forward to a place where whatever tears or sorrows she had experienced would be wiped away. I closed her Bible, gently placed her hands together over it and prayed a prayer of commendation before pulling the bed sheet over her face and body.

On leaving the room I spent a bit more time with the nurse who was beginning to gather herself after this unusual death.  A couple of hours later I would escort the body of this woman to our morgue accompanied by the nurse and a LVN.

If you have never made the walk to a morgue it is always the longest walk you will ever make. At Parkland it seemed that no matter where you were coming from the walk took forever as it is a massive facility, and in the wee hours of the morning while most of the world sleeps, that walk is an eternity.

As we rode the elevator down to the basement where the morgue was located we continued to talk a bit more. When we got to the basement and commenced the walk down the long and empty corridor to the morgue we did so in silence. I unlocked the door and then the door to the walk in refrigerator, which could hold up to eight adult bodies on cold stainless steel gurneys at any given time. Dimly lit and damp the morgue has a truly macabre ambiance which is magnified by the sight of bodies of the deceased wrapped in body bags and covered by white sheets.

Once I had admitted the body and locked the door to the morgue the two nurses left to head back to the 9th floor. I took the chart and other paperwork up to our office where our decedent affairs clerk would complete the death certificate. The daytime duty chaplain would have the responsibility of discharging the woman’s body after an autopsy was conducted and a funeral home came to take her body to her final resting place.

I thought how unusual this case was as I sat for a while in the office. I had heard of similar things but had never seen something like this before where the person in question made such a claim and was right defying the numbers that said she would walk out of the hospital. After a the rest of the evening, or rather the early morning was relatively uneventful and my shift came to an end as the rest of the staff came in for the day. I briefed the chaplain who was taking the pager, did my debriefing with my fellow Pastoral Care residents and went home, wondering what had happened.

Physicist Max Planck who originated Quantum Theory said: “Science cannot solve the ultimate mystery of nature. And that is because, in the last analysis, we ourselves are a part of the mystery that we are trying to solve.”

It is a mystery, so I guess I should leave it there…

Peace

Padre Steve+

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