Just as I am

Herr, ich komme zu Dir, 

und ich steh' vor Dir, so wie ich bin

(Transl.) Lord, I come to You, 

And I stand before you just as I am

The security guard and I walk together through the dark night; silent and concentrated on the task on hand. The outdoor corridor which links the main building of our hospital to the morgue is long, but we eventually make it to our destination. All the way I can hear the shuffling of feet behind us as a family member of the deceased follows us. Out of compassion, I give him a "job" helping me push the gurney, so as to give him a sense of being a part of it all. Death is funny that way. It's scary and we want to run away from it. But when it's a loved one being wheeled away, we ironically stay put. 

****

(Earlier)

My shift is almost over and I'm taking shift-end vitals of my post-op patients. I'm about the retrieve the glass thermometer from under the arm of my patient when I hear the sirens. My co-worker shouts for me, "Hurry! It's an emergency!" I barely don't break the thermometer or totally drop my instruments tray as I maneuver myself out of the room. I rush into the Nurses' station, toss my tray to the side, grab my cell and don a pair of gloves. 

I can see the ambulance pull up, with its siren blaring and lights flashing. 

"Do I call the doctor?" I ask the other nurse.

"Yes!"

As I pull out my phone and dial, the back door to the ambulance is opened. It like a scene from Greys when I see two white, blond men practically straddling the patient, performing CPR. 

The doctor picks up the phone and for a nano-second I panic. I'm new. This is my first call-in for an incoming trauma. How do I explain to the doctor all he needs to know as quickly as possible? In the end my brain farts and fragments all forms of intelligent conversation: 

"Doctor! Emergency! Come quick!" 

He hangs up. 

I'm already in the ER when the man is rolled in by the paramedic and the two blonde men. I slip the oxygen mask on the patient and ask for a report. One of the blonde men tells me in learned Spanish that he isn't a doctor and points at the paramedic.

"English?" I ask him in English.

"Yes." He replies and continues to detail the sequence of events which led to the man's arrival at our hospital. 

The paramedic informs that the man was on a motorbike, drunk and crashed with a car. His apparent injuries prove this. I ask for a stethoscope and try to listen to his heart. Nothing. I reach to feel a pulse at his neck. Nothing. I open his eyes and check his pupils. Dilated. His lips are already turning purple. The doctor isn't present yet, but pending his confirmation, I call it: "Time of death: 18:34." The doctor arrives and checks the patient again, confirming his death. Instinctively and respectfully, I make the sign of the cross over the man's body. 

***

I concentrate hard on keeping the wheels of the gurney on the sidewalk. Off and on I hear them squeaking. Their rotation, along with the pounding of my feet on the pavement, form a rhythm in my mind. The rhythm translates into silent song as I recall the words to a popular German church song: 

            

               Herr, Ich komme zu dir und ich steh' vor Dir so wie ich bin. 

I can't stop my imagination as it visualizes this man literally standing before God "just as he is." What does God see? Unsolicited, I see the memory of the young volunteer from a couple of weeks ago (the young man from my previous entry) joining my jumbled Judgement Day thoughts. They stand side by side, two completely different people from totally contrasting lives. Yet similar... in death. 

Inevitably, the looking glass turns directions and I find myself looking at myself. What do I look like? Do I like what I see? Just as I am now, does He like was He sees?

Dad says that the moments of crises in life are the times when we are most malleable - most open to change. Trauma and death are definitely crises. I hate to wish anything unfortunate on anyone, but I do hope that experiences others have had or ones that you have observed from the periphery will impact your life enough to open yourself up to self-examination.

Because life is short. 

One more thought: 

What do YOU look like just as you are? 

(Lifetime) Endings

The ER on the day of the accident

It's been 9 days. 

216 hours. 

12960 minutes. 

Just a short memory ago, really. 

Yet, literally… a lifetime ago. 

Dressed in my hospital scrubs I rush over to the Emergency room at our hospital. There's been an accident. A crash. A motorcycle. A young man… one of ours! I am pretty sure I won't be of much help, but I feel compelled to see it with my own eyes. My pace slows down as I arrive at the door. My eyes glance at the door handle. I know, instinctively, that on the other side is a scene that will shock me and touch the depths of my heart. But I am a nurse. I need to see the clinical facts and absorb it all to understand. I open the door and am received by silence. The young man is lying on a gurney in the middle of the room. I take in the obvious procedures done on him and the demeanor of those present and inconspicuously take my leave. 

With a heavy heart, I return to my work station and am quickly immersed in my duties. An ambulance pulls up and through the window I see the gurney pass by, surrounded by our doctors, nurses and the newly arrived paramedics. The hospital chaplain flits back and forth between the staff and worried spectators, offering what I can imagine are words of comfort and hope. It's not an easy day on the job for any of us! The ambulance drives off, its bright lights reflecting off the glass from my window. People are still milling around - still looking out in the distance in the direction where the ambulance drove off to. It's like time has stood still and no one knows what to do. No one can believe that something like this has happened here… to one of us. 

An hour or two later we receive the news that the young man barely made it to the hospital in the city, and died. A part of me recognizes that this was an obvious possibility, but the reality of it all is that I (along with all the others) had been hoping for a miracle. There is a sense of finality and resignation in the air. 

The thing about tragedies in life is that they don't always happen "for a reason." That's just what they are: events that cause great suffering, destruction and distress. There aren't always lessons to be learned which neatly make everything whole again. Our lives are definitely not Hollywood or Disney movies with "happily ever afters." It's probably more accurate (if we continue to follow film analogies) to consider our lives an independent film; like those on Sundance that don't always have a good ending. 

But, human and naïve as I am, I stubbornly and almost desperately seek out my healing in the form of at least a decent ending. 

These are the short scenes of my ending: 

***

I walk out to the breezeway and am stopped by a lady waiting her turn for a doctor's appointment. 

"I was watching. Is the boy going to be all right?"she asks. 

I am momentarily confused. Who is this? I see the hunched-over and frail body of the elderly stranger and I am struck by her profound concern. It amazes me the compassion we innately have towards those around us. So great is its force that even strangers are pulled in. 

***

I observe from afar as the hospital administrator and foreman receive the family of the young man and physically guide them through the events of the terrible day. They are patient and obliging in their time of need. Meetings are set up with the young man's roommates and friends so that the relatives can rescue remnants of their loved one's life in the form of friendships, memories, items, etc. I can't help but feel proud of the compassion of our people. 

***

The ambulance returns from its trip to the city and I rush out to help unload it. Our nurse steps out of its side door, her movements slow and heavy. I stand in front of her and look her straight in the eye. 

"How are you?" I ask her. 

There is deep, deep sorrow in the pools of her eyes. I hear her sigh and can almost physically feel the weight on her shoulders. It clutches at my soul and I can feel my heart rising in my throat. 

"I kept him alive until we got there," was her answer. 

I knew that this minute success would indubitably be a balm to her soul. Although the young man had not survived, she would be comforted by the fact that he hadn't died on her watch. Tiny comforts. 

I pull her in for a hug and hold her for a long time. She doesn't cry, being so exhausted as she is. But she clings to me and I know that this is exactly what she needs. I thank Jesus that I am allowed to hold her up in her time of need. I, myself, feel unexplainably lifted up. 

***

A memory returns to me as I remember the previous Sunday services, just 3 days before the accident. I am sitting in the last pew and in front of me is this young man sitting next to a beautiful blonde with gorgeous hair (bc her hair is all I see from behind). The person leading services asks if there are guests among us and the young man stands up, proudly introducing his girlfriend to the congregation. They are planning on getting married soon and she has come to visit him. 

As I reflect on this memory, I am wowed by the timing of it all… It was an unknown final goodbye between the almost-engaged couple. A final weekend in which they most likely made lovely memories drinking tereré together, going for walks, talking, hugging, etc. A gift of sorts, if you will. 

***

There are so many more short scenes that I could add, but then I would never get to the end of this entry. 

Endings are hard. They aren't neat or simple. They are horrible and unfair. 

Dear Reader, I don't have a good ending for you this time. It really is a Sundance film. The drapes fall and signal the end of the show on a cast of confused and hurting actors. The only silver lining I could find was... each other. In every single one of my scenes, there are no lone actors. I dare to presume that real life is much the same. We don't act alone. There are others in the cast. 

Even though I still can't make heads or tails of it all, as I look back on the scenes… no one was ever alone. Perhaps our greatest challenge in times of grief is to remember this. There are others around us grieving along, also uncertain of how things should or will end. 

That's it for today. Perhaps a more cheerful entry will come soon :) 

Waiting…

It's 5:00pm on a Sunday afternoon and I am on the floor. I have at my charge 2 clinical patients and 1 post-surgical. One of the three is giving me a run for my money. His O2Sat keeps dipping and I am forced to check on him every 15 minutes to make sure nothing worse happens. I have tried taking him off of oxygen two times, but apparently he literally can't live without it. By 5pm he has started to stabilize and I finally have a moment to breathe.

As is my custom, I move over to the side window of the Nurse's station from which I can see out into the main courtyard of the hospital. I see people arriving. I keenly observe them, trying to figure out what their emergency could be - because I am also in charge of the ER during my shift. They are carrying brimming feed sacks, like those 25kg ones filled with chicken feed, and travel bags. At this point it's only two of them and they don't seem to be in a hurry to get medical attention. In fact, they head over the the waiting area, put down their bags, and proceed to prepare tereré (a national communal tea prepared with loose-leaf herbs and drunk through a metal, filtered straw). I am about to go out to them to see if there is anything I can help them with, when the hospital guard walks into my Station. I simply ask him about the new arrivals.

"They are here for tomorrow. They've taken a number and are going to wait their turn for the morning consultation hours. Some of them have been traveling all day to get here."

I had heard about patients such as these, but hadn't had the opportunity to see them for myself.  For some reason, I had stored these stories in a mental box of ancient history. It's one of those stories that is told in churches about how things were in the "old days" when people would walk for kilometers and travel cross-country to make it to the mission hospital; arriving bedraggled and exhausted. But this was just yesterday evening, May 25, 2015. The "old days" were staring me in the eye.

Lost in thought, I don't immediately notice the on-call Doctor walk in. He walks up behind me next to the window to see what I am looking at and looks at me quizzically.

"Why do they come so early?" I ask him. The question is basic, but my interest drives deeper. He doesn't disappoint me with his straightforward answer. I insist.

"It costs 60.000 ($12US) for an ER consult at the hospital and 40.000 ($8US) for normal hours. Why would they go through all this inconvenience and discomfort just for 20.000 ($4US)? Why not just pay the extra and go home?"

I can see the doctor's gaze glaze over and can sense a long answer is being processed. Thus, I take a seat.

"This hospital is well-known to a lot of people. The efforts of those who came before us, going out deep into the interior of the country, seeking out patients and offering them hope and healing has poured over into today. These simple people have heard the success stories from their neighbors, uncles, aunts, friends, friends of friends of how they came to km81 and were healed. Many of them have been screwed over so many times by their local health services and are tired of it all. They are willing to travel for days just to get treated fairly and by good doctors who will fix them up. I have heard it said by humble people (el campesino) that the eucalyptus trees that line the entrance of this hospital filter the evil and sickness. Just by entering this place, your healing begins. Then they get here to us and are received with such enthusiasm and love and care, and another part of them feels healed. All this happens even before they speak a single word to a doctor! Sometimes we are able to fix their problems, sometimes we aren't. But, nonetheless, we take the time to listen to them and to appreciate them as a whole. Sometimes the patient just wants someone to listen to them. And thus the legacy continues… Getting back to your question: They come because they know that there is hope, blessing and healing at this hospital. And they want that."

I was speechless and so moved by his words. I could literally feel God's invisible presence stroking my arm encouragingly as if saying, "I am here. These are my people. This is MY work."

I didn't want to forget this moment and so I stood up, left the Station and inconspicuously put my cell phone on camera mode.

There they are. 

Some of them are sleeping already, while others sit around chatting. All of them waiting... to receive hope, blessing and healing. 

I just gotta say that I love being a part of it all  <3 p="">