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Listen – Then Respond

The buzz on my belt brought an adrenalin rush.  The ER was paging and that meant trouble because they don’t call the chaplain when an 11-year-old boy breaks his arm or an elderly woman falls.  They call when death is in the house.

I arrived to find Stephen, a middle-aged man, lying on a gurney surrounded by the experienced and efficient ER staff.  A CPR tag-team circulated blood through his lifeless body while others placed tubes and IVs and called out regular progress reports.  After some time, the lead physician said, ‘I’m calling it.  Time of death:  2:14 pm.’ 

And that was that.  A life that at 1:14 seemed vital and endless had ended.

The lead physician brought Stephen’s wife Mary into the room and explained that they had done all they could, but he was sorry.  The ER staff, now stripped of their life-saving usefulness, expressed their regrets and left the room until only the chaplain, the dead man, and his shocked wife remained. 

Mary fell across her husband’s bare, cooling torso and began to sob.  After a few moments, I stepped forward and placed my hand on her back in order to witness and join her grief.  There was nothing else to do.  A chaplains’ words could only trivialize and intrude on the overwhelming reality of her loss.  How could words meet the shock of having your husband, the man you kissed and cuddled and fed and fought just hours ago, now lie naked and lifeless in a cold white room? 

I knew little about Mary and her just-dead husband.  We both spoke English but that didn’t mean we spoke the same language.  Was she religious? Resilient? Resistive?  Did she prefer connection and kindness, or solitude and straight talk?  Was my presence a bother or a comfort?  This was not the time for an interview.  I’d have to listen and find out.

So we stood side by side as tears moistened her husband’s chest.  When the grief storm calmed, I’d sit quietly in the corner.  When new waves rose to weaken her legs, I’d rise with those waves and lend her my strength.  We didn’t talk.  We didn’t need to.  Ours was a language that responded to the moment.

To offer contemplative care means to offer listening.  We put aside our canned professional and cultural responses and listen.  We listen with our ears, but more importantly with our hearts, trusting that the open-hearted compassion we offer will guide us more precisely than any memorized checklist of skills. 

Contemplative caregivers don’t lead with skills:  We lead with listening.  We hold our hearts open long enough to hear, even when that means feeling temporarily uncomfortable and incompetent.  We wait in that uncomfortable space until we understand the needs of this particular person deeply enough to meet them where they need to be met. 

Contemplative caregivers must be brave.  We must have the courage to not know because certainty is often a facade that renders us unable to learn.  When we hide behind certainty, we risk protecting ourselves instead of those we serve; we risk treating our fear instead of treating our patient. 

But not knowing isn’t the same as ignorance:  Our patients need our expertise.  They have come to us to utilize our skill and experience.  But they don’t need us to draw their blood to treat their toothache or x-ray their arm to treat their depression.  They need us to remain open long enough to understand what’s happening.  They need us to listen.  They need us to observe.  They need us to put aside our needs so we can understand theirs.  Only after listening are we qualified to respond.

Mary remained with her husband’s body for several hours, draped across Stephen’s chest as when she first arrived.  I could see that she was stuck.  The shock of his sudden death was more than she could accept, yet the ER needed to move his body to the morgue.  So even though we’d hardly spoken during our hours together, I asked Mary if she’d be willing to speak directly to Stephen and tell him of her love and memories, of her regrets and disappointments.  And she did.  Her love and anger and fear flowed out in waves.  She cried and raged and offered forgiveness.  She tenderly touched his face and held his hand.  And when she was done, she said goodbye.  Mary was finally able to leave her husband’s body behind and trust that he would be taken care of. 

From the perspective of a busy ER, the hospital needed to move Stephen’s body and make room for others.  From Mary’s perspective, she needed time to accept Stephen’s death and an invitation to say goodbye.  Listening to Mary was the key to resolving these conflicting needs.  Her actions told us what she needed:  She needed us to keep listening until, together, we learned what to do. 

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