They Sat on the Ground with Him.

When my father had his heart attack, the family rushed to Cleveland to sit by his bed and congregate in the waiting room outside of the cardiac wing of the Clinic. We waited for two days: through his stabilization in the emergency room, the initial assessment and first battery of tests, the consults with specialists, and finally the intervention. His surgery was actually delayed by a few hours because Robin William's cardiac surgery was taking longer than expected and they shared the same doctor. In spite of that, Dad made it home safe and sound and a few years have gone by in relative cardiac heath, minus the salt and extra gravy.

From that, the Vega family learned to appreciate the phrase, "as serious as a heart attack." As bad as it could have been, it's amazing how far medical technology and treatments have advanced in the last few years, let alone the last twenty. They now not only stop your heart and divert all blood from your chest to a machine, they cool your body down to morgue temperatures only to revive you after the surgery with a slow thaw. All that in the name of progress and a few extra saved brain cells. 

Despite all the progress and advances made in medicine, things that were unthinkable even a few years in every field of science, nothing still spells terror like the diagnosis of cancer... and, at Grace Fellowship Church (and in my own life), we have had more than our fair share or cancer cases; some of them very recent and still ongoing. What do you say to someone who is actively suffering the diagnosis, treatment, and uncertainty of cancer? For that matter, what do you say or do for anyone who is suffering real anguish and pain?

In the first few chapter's of the Biblical book of Job, the writer describes an ongoing bet between God and Satan regarding the namesake of the book and the horrible series of events that befall him. "But stretch out your hand and strike everything he has, and he will surely curse you to your face."

Consequently, all of his belongings are stolen, his children die in horrible accidents, and his own body is stricken with "painful sores from the soles of his feet to the top of his head." Nothing is left except his life, but even his quality of life is destroyed. His friends could hardly even recognize him when they see him for the first time after all of this had happened. If you've seen anyone who has undergone chemotherapy, has been slowly wasting away, or has an advanced liver disease, you may have a better understanding of how Job looked to his friends, shocking.

For all of the commentary indicting the three friends (Eliphaz, Bildad, and Zophar) for their presumptuous commentary in later chapters, I think the final paragraph of chapter two (had it been all they did) is the most beautiful example of friends offering solidarity in regards to the suffering of a friend and loved one:

"When Job’s three friends, Eliphaz the Temanite, Bildad the Shuhite and Zophar the Naamathite, heard about all the troubles that had come upon him, they set out from their homes and met together by agreement to go and sympathize with him and comfort him. When they saw him from a distance, they could hardly recognize him;they began to weep aloud, and they tore their robes and sprinkled dust on their heads. Then they sat on the ground with him for seven days and seven nights. No one said a word to him, because they saw how great his suffering was."

What do they do? Nothing that seems heroic, but it is amazing.

1. When they hear about Job's suffering, they gather together and go to check on him. 
2. When they see his suffering, they show genuine emotion and concern.
3. Without explanation or rationalization, they share in what they can of his suffering. They sit with him. 

How often do we make the later mistake of the friends and open our mouths to pontificate... when what we should be doing is the simplest of acts, just being with the one who is suffering?

Let them speak if they choose. Let them ask if needed. If they do, then speak or act. Be patient, open, and available. That's the amazing part we all too often forget and, because of that, end up doing more harm than good.     

I may never know or fully understand the true magnitude of anyone's suffering, but I can share in it and sit on the ground with them. 

Dying, But No Faster Than the Rest

I've done it before, but it never seems to get easier: They ask, "How is my [loved one] doing?"

I reply, "How much do you know?... They're dying."

Some of them know it, but can't say it. Some of them get blind-sided. Some of them just cry. None of them react the same, but they all get that look on their face when the light-bulb goes off in their mind. That tears me apart, the moment they see the expiration date on their loved one peaking out from the blanket at the foot of the bed.

I've given up giving false hope, agreeing with the thousand excuses and miraculous scenarios the person asking is hoping I'll tell them. Yes, I believe, but I've seen death more than miracles and the signs are often clear... if you choose to see them. The trick is in how you show them, prepare them, bring them together and help them navigate the inner (and sometimes outer) fights.

They think I'm the expert, not the loved one who's ready to let go and be with their long dead spouse. Sometimes, the patient just knows they can't hold on and is looking for permission from the loved one. In the midst of that, I'm supposed to be the sign post or the weather channel, the portent that signals life or death, the one to tell the family (often) what they already know.

I have to be the first to say it, to make it real or banish all the fears. What's more, the family never wants to ask it in the room or in ear-shot of the patient. They seem to think it's escaped the patient, the one lying in bed. They say things like, "Let's not talk too loud just in case they're listening."

Who? The patient, angels, death?

Even if family never shows up, I know. I mourn. I carry it with me. Each one sticks with me. Each one makes me remember my own mortality and the ones I'll leave behind.

Some nurses get drunk, some get mean, and (worst) some go numb. Personally, I write and always cry, not in front of the family, the lover, the friend, the rest of whoever, but I do cry. I've cried in the stairwell, the break room, the locker room, in bed, or at the solitary bedside of the comatose patient while doing my assessment or hanging medication. I've struggled with God. I've yelled at God in the car before going in the house late at night to go to bed. I've lost faith and gone down dark roads.

But I come back. So far, I've always come back. Sometimes all I can do is put one foot in front of the other until I can look up again, but I look up again. That's what I tell them: the patients and their loved ones. Not all of it, but enough to let them see I care and know a bit of what they feel. Forget the tag you see hanging off the patient's toe or the one you infer on your own toe.

We ask, "Will I ever see this person again, or do I lose them forever? What about my other loved ones? What is the point? What am I doing with my life? When will I die?"

When we're honest with ourselves, we answer, "Yes. We will die. Maybe no faster than the rest, but we are all going to die."

The moments before imminent death, that infinitesimal point in eternal history, make us question life and after. It can rip your psychological well being from its roots. It happens to the patient. I'm sure it's happening to the loved ones I interact with at the hospital. It happens to me, but experience lets me weather the storm with a strong face. At some level, we're all going through the same questions, anxiety, and angst.

What can you do? What can I do?

So far, nothing I can do as a nurse providing care, administering medications, observing what is happening and trying to anticipate what will happen can do anything more than delay the inevitable. Nothing the doctor can do as a physician can stop the end. No amount of family bickering, anger, bargaining, or finger-pointing can affect the past, but we can affect the present.

Discuss what's bothering you, be open, enjoy the moment. Spend now with who you can, when you can. Tell the air if you have to. That's all you can do, but you can miss the opportunity to do it.

Nurses know. Doctor's know. Your loved one who's dying probably knows better than all of us. Do you?