32 Navigating hope and despair in ER conversations.
Finding helpful answers to direct questionsIf you’ve sat with a family in an emergency room, you’ve faced hard questions. And you’ve struggled to figure out the way to navigate hope and despair. It doesn’t matter if you are a chaplain or a pastor or a friend that showed up in a hard time. You get questions and you have to answer. Sometimes it sounds like this: +++ “Dad will be all right, right? He’s tough.” I hate that question. Dad may be tough, but dad’s in the middle of a cardiac arrest. Dad’s heart stopped three times in the last 30 minutes. Dad’s been smoking for the last fifty years. Dad hasn’t been to the doctor for a couple decades. Dad’s blood pressure is already high. Dad’s in trouble. And his daughter is watching me think. I’m not medical, I’m spiritual. I’m the chaplain. I should offer hope and encouragement. She wants me to say, “I’m sure he’ll be fine.” She wants me to say, “Of course!” She wants me to say, “You can’t keep a good man down.” She wants me to say something. She’s been waiting for 2 seconds. In a couple minutes, the doctor will walk through that door and say, “Has your dad ever talked about how far he wants to go with life-saving measures? If his heart stops again, would he want us to do everything we can to get it started again?” And his daughter will say, “Of course, do everything.” And the doctor and I will be thinking, “For a man his age and in his condition, with the amount of CPR he’s already received, his chances of leaving the hospital alive are less than 10%.” She’s been waiting for 4 seconds. And yet, I know there are miracles and I know that she’s wearing a cross and I know that there are actual people in that 10% and I know that he’s tough and I know that she lost her mother in this same hospital a decade ago and she doesn’t want to have that conversation here now. She’s been waiting for 6 seconds. I am fearful of offering false hope. But I’m also reticent to offer false despair. I don’t want to give up on what could happen. I don’t want to watch her heart stop before her dad’s does. She’s been waiting for 9 seconds. And this is no time for a lecture on lifestyle, reminding her that he has made choices about health that led to this moment. This is no time for a meditation on how much he has contributed to her life up til now. She’s been waiting for 12 seconds. It’s time to answer her question: “I’m glad he’s tough. But his fighting spirit might be stronger than his body right now. He’s in critical condition. I just saw the team with your dad. They are working as hard and carefully as they can. There’s more family on the way? Good. We’ll get them back here as soon as we can. And I’ll go check on your dad, to see what’s happening right now. Would you like a prayer? ‘God. We know that there are people working hard on Dad. We ask you to give them wisdom that goes beyond their training. We know that our days have limits. But we know that we can ask you things and you don’t judge us for asking, and right now what we most would like is that he will wake up. Through Christ our Lord, Amen.’” She blows her nose. And I repeat my offer to go check on her dad, knowing that she could use a minute alone to breathe. As I walk out of the consult room, I pray that I’ve found the balance, for her, between false hope and false despair for the next four minutes.