A Chaplain’s Motto: Do No Harm.

All nursing home medical charts begin with what is called the “face page.” I flip through the binder to a photo of my newly-admitted hospice patient. It could pass for a mug shot: the stoic-looking woman stares out beyond the page, her strong jaw set in subtle defiance. Thin, white strands of hair are pulled snug to the nape of her neck. Wire rims barely contain the bulging glass framing her milky blue eyes. Her brows furrow and the dusky complexion is speckled with a few prominent moles that sprout black, wiry tufts of hair at her chin. She portrays the assemblage of an elegiac soul and a “been-around-the-block-one-too-many-times” type of toughness.

The woman’s name is inscribed in bold, blackcaps beneath her admission photograph: MARTHA ELIZABETH MCCURDY, age 82 – white female. Widow. Next of kin: deceased – husband Harold James McCurdy, and daughter Sarah Elizabeth McCurdy. I hate it when children die before their parents.

            Next, I peruse the medical and social work notes deposited earlier by my colleagues: a granddaughter is listed – Katherine Louise Browne.  I punch the numbers into my cell. She answers after a few rings. “Katherine, I’m the hospice Chaplain. Would it be alright for me to visit your grandmother today?”

      She launches in without preamble: “No offense, but I don’t think she will get much out of your visit. In fact, if you tell her who you are, she may not let you in. Maddy and God are not exactly on the best of terms. Oh . . . and by the way, please call me Kat.” 

“Who’s Maddy?“ I inquire.

That’s what they called Martha at the precinct. She was a cop. The nickname stuck.”

“Did she display a faith tradition as an adult?”

“It’s complicated. When Maddy left home at eighteen, she was pregnant. From what I was told, her boyfriend had been home on leave and when he returned to Europe, they lost touch. Poor Bacia.” Kat clarifies: “My grandmother is Polish.”

“So to answer your question, yes . . . my mother said they went to church together when she was a kid. But I’ve never seen my grandmother so much as pick up a rosary. Losing my mom broke her heart. They were close.”

  “When did your mother die, Kat?”

 “When I was seventeen, fifteen years ago . . . of cancer.”

A tough age for a girl to lose a mother. “Were you close to your father and grandmother?” 

 “Close enough. I’m doing well: married my college sweetheart and have a career that I mostly enjoy. The light of our life right now is Liza, our three-year-old. We call her Ladybug. Maddy thinks Ladybug looks a lot like her own childhood photos.”

“How often do you see your grandmother?”

“I manage to get there once a week or so.”

“How does she seem to you?”

“Well, it’s difficult to get a smile out of her these days. She’s tired of course, so our visits are shorter. But she’s withdrawn even when she says she’s not tired. Liza barely draws a light-hearted response anymore.”

 “You inferred that your grandmother and God had a falling out of sorts. What happened?”

“I’d rather have her explain.”

“Will she?”

“Well, if not . . . then I guess we won’t need a Chaplain.” The dismissive comment goads me into wanting to really succeed with this patient.

 “Is there a specific reason you requested a Chaplain when you signed on to the Medicare benefit?” 

There’s silence at the other end of the line for a moment. “She’s so melancholic. And it’s not just because she knows that she’s dying,” Kat responds. “There’s more to it than that. She seems preoccupied . . . distant. She was always a bit reserved, but this feels different. I’m worried. She’s endured some rough stuff along the way, but there are still so many things I don’t know about her. Maybe there are a few more family skeletons hanging in the shadows.”

            “If that turns out to be the case, maybe I can help dislodge a few.”

“I guess I checked the box for chaplain because I don’t know what to do. She reminds me of those tigers at the zoo pacing the perimeter of their cages – back and forth. So restless. Watching. Waiting. It must be a soul thing.”

 “Kat, is there anything she might be waiting for?”

“I wouldn’t know. Isn’t that your job . . . to figure that out?” I chuckle to myself. Kat might just be a ‘chip off the old maternal block’: blunt, brief, and bold. It would make sense that the “acorn” wouldn’t fall too far from the formidable, “Matriarchal Oak.” I’ll soon find out.

“I’ll give it my best shot, Kat. Thanks for your help. I’ll be in touch.”         

I inform the nurse’s station that I will be visiting Martha. I shove my credentials into my jacket pocket, set my phone on vibrate, and head off down the narrow hall. It is littered with peeling wallpaper and paint chips glitter at the baseboards. The forlorn-looking carpet and drab-beige walls make everyone and everything seem older in this place. At the elevator, I key in the correct floor and navigate my way to Room 246A.

The smell of industrial-strength cleaning supplies, urine, and the remnants of lunch mingle in the air. I have to admit, I have yet to adjust to the distinct smell of a neglected old nursing home. The odors of illness and dying permeate my clothing and follow me home. Riotous cacophony spills into the hallway from the iconic TV game show, “The Price Is Right” . . . a staple of every long-term care facility in the country.

I glance in: heads hang . . . chins-to-chest, drool pooling, boredom, and fatigue sitting sentry in rows of wheelchairs. Many former teachers, salesmen, homemakers, tradesmen, and veterans occupy this stuffy room of the mediocre facility; while physicians, lawyers, politicians, engineers, and executives inhabit the upscale facility across town.  

            “There before the grace of God, go I.”  In this ministry, my own mortality is always staring me down. Sometimes I feel like Ebenezer Scrooge, being forced to envision the stark reality of a future that hasn’t yet arrived. So I‘ve learned to enjoy each day and be grateful for every speck of health I currently possess – like the ability to thread each leg into a pair of pants without having to hold onto a dresser. I observe my patients and take note: all of their elderly woes seem just around the corner and down the road a short stretch from my vantage point.

            Replaying the comments of Martha’s granddaughter, I pray that I can be of help. Even as a Chaplain, my motto is: Do no harm. I’m referring to injury to the patient’s soul. Serious business, that. Could I make matters more convoluted than Kat has described? A voice deep within me whispersyes, you actually could.”  I push the thought aside and muster courage.

            I position myself before Martha’s door and tap . . . gingerly.  No greeting is forthcoming. Maybe she is napping. I tap again with a bit more resolve. Silence. I check my notes: hearing deficit, aids in both ears. I knock louder. An eerie stillness continues to protrude from the other side of the door, like the calm before a tornado touches down. 

            I check my watch (a nervous habit); then push the door ajar . . . ever so slightly . . . “Mrs. McCurdy?” 

“Who are you and what do you want?” 

            My head cautiously peeks around the door. I see her. Responding quickly to her own query, she adds impatiently: “I’m tired, go away.’’

I decide to disobey.

            I approach as if greeting the Great and Terrible Wizard of Oz.  Martha is seated in a high-backed chair that is covered in floral chintz with a walker positioned at her feet. The patient who usually occupies Bed B at this hour is in rehab. I introduce myself and out of habit, I automatically tack on my professional title (as her granddaughter had precisely instructed me not to do). The exact second it spills from my lips, I regret my mistake. Damn. Her seasoned always-on-the-lookout-for-trouble-cop mentality immediately catches my misstep and pounces.

Martha uncoils like a snake swaying to the melodious vibration of the snake charmer’s pungi. She rises in stages to her full height – all five, stocky feet of her and propels herself awkwardly onto the sturdy frame of the walker; pendulous bosoms swinging at her mid-section. Instinctively, I move closer in case she wobbles. Her beady little eyes never leave my face. Her spectacles are perched like a sharp-eyed eagle situated at the edge of a towering snag, its attention riveted upon some unsuspecting prey. Bony-knuckled hands with gnarled veins encircle the metal bars like talons.

            “I have some questions for you . . . chaplain,” she snorts out the moniker emphasizing the first two letters with sarcastic delight and a teaspoon of spittle. According to her granddaughter, Martha has been mulling life’s insults and allowing them free reign to marinate and fester since her daughter died, like a kid who can’t stop picking at a scab. I understand. I inherited that tendency from my own mother. It’s probably genetic. Prayer, counseling, meditation, and just plain old fatigue over it all helped me to finally take leave of cohabitation with regret.

            “I have a good one for you,” she taunts. She doesn’t waste any time warming up but launches right in by hurling years of accumulating venom into one compact lob. As veins protrude and throb from the region around her neck and her face flushes red, she gets right to the jugular: “What kind of God allows children to suffer?”  She pauses just long enough to allow the question to register and then rattle round in my brain, like the small metal ball that bounces from target to target inside a pinball machine.

            In reality, my brain is downloading pastoral care remedies to dispense as quickly as possible.

            Her initial question puzzles me. It is so broad; leaving me no clues. I’m suspicious it camouflages a serious injury or trauma. But for whom? Herself. A relative. Children she stumbled across in her law enforcement career?

Martha continues in dogged pursuit of God’s dereliction of duty safeguarding innocence: “Those kids did nothing wrong. Nothing. Such torment of children is sinful. If God is so powerful and perfect, he should’ve done something. Kids can’t make sense of belts and booze and hunger. They have no wisdom from which to draw, nor perspective from which to give their predicament some sensibility, or a menu of salvific options to pursue. They’re just stuck. Bewildered. Frightened. Miserable.”

Her evidence against God seems airtight and ironclad. 

            Her God is on trial. Therefore, I am on trial for what I represent.   

Perhaps, without realizing it, she has unveiled snippets of a childhood agony: flinging inflamed remnants of a turbulent youth into this tiny space she shares with a random roommate. Space where eighty-two years of life’s possessions have been winnowed into the four drawers of an aunt’s antique dresser.

            She shifts her stance for what appears to be another round of determined inquisition.  

            “Prayer is useless,” she asserts. “A waste of time. Believe me, no one is listening. For months, I searched. I called out night after night. I begged . . . nothing. For years, I pleaded. What could be more precious for God’s priorities than children?” She looks down at the floor, a bit of saliva gathering at the corner of her mouth, but then looks up to set her gaze upon me like a heat-seeking missile. Martha inches the walker forward, repositions her portly frame, and opens her lungs full bore – spraying pellets of indignation at close range: “If there is a so-called Savior, he never rescued me.”

           She presents a convincing case. If we get to it, “Maddie the Cop” will demand from me every pastoral skill I possess. I’m concerned about the toll that this final emotional barrage will have on her condition. In my mind, I’m already retrieving the blood pressure cuff, oxygen oximeter, and alerting the RN on our hospice team. As far as I’m concerned, we’re finished for today.

But then one final undaunted declaration slices through the momentary silence: “THERE IS NO GOD.”

Upon the pronouncement, I imagine a judge gaveling a vehement protest from the courtroom gallery.

And similar to a withering balloon as the final vestiges of air escapes its strangulated neck, she releases an anemic afterthought, “don’t you get it, there never was.”

We sit. The room radiates hopelessness. The lingering residue of the fiery interrogation continues to beat down like the unrelenting heat of an August day. I search for water.

            Dear God, what happened to this woman?  I feel the weight of responsibility for years of someone’s suffering slide upon me like a boulder jarred free from its mooring during a spring mudslide.

            The room is still except for the cheap plastic clock marking time on the bedside table. The older I get . . . well, I hate the sound of clocks ticking. In particular, I detest the boastful carillon emanating from the patriarch of the clock kingdom . . . the stately Grandfather. I envision the face of “him” as a wizened old soul with a white, well-groomed goatee. And he, having reached the stage of elderly statesman in the age-old craft of time-keeping, holds court in every foyer encased in the finest cherry cabinetry. When my mother lay dying, the antique French Morbier Grandfather stood politely just outside her door . . . tracking and proclaiming on the quarter-hour just what little time remained for her.

I ease Martha backward and she is slowly swallowed up by the wing-backed chair, pale and fragile once again . . . drained, looking all of her eighty-two years and more.

            I settle myself onto a folding chair, feeling somewhat refreshed by the coolness of the hard metal. She is battle-weary. I’ve yet to utter a word. My role was to listen and observe today. It’s amazing how exhausting that can be.

The room is stifling. A sliver of light escapes a small cleft in the drawn curtain. I glance at my watch to actually gauge the time. Surprisingly, only blocks of minutes have elapsed since I first rapped at her portal; yet, I feel as if we’ve been entertaining these stoic walls for hours. An aid enters to dispense morphine and attend to Martha’s personal needs. I think that we’re both desperate for a recess.

            I escape to the hall and close the door on the smoldering pile of emotional rubble. I slump against its grainy wood and release every ounce of the air from my lungs in one swift exhale. During the brief reprieve, I pace and pray for wisdom. A plan begins to form. 

            The aid leaves; my cue to return. I tap on the door once again. An impatient tone beckons, “Come in.” In a perfect world, Martha would be waving a little white flag side-to-side in acquiescence. On the contrary, she remains defiant, but less so – still, her chin juts forward – characteristic of the rigid profile of her facility photo.   

            “You pose reasonable questions, Martha,” I offer as I lower myself next to her. “I’ve fretted over the same contradictions.” We sit quietly for a few minutes mulling my overture of understanding and concession. My intention to offer a small token of reconciliation in God’s stead is received with detachment. Her steely composure has been restored since my interlude out in the hall.

            “Maybe tomorrow you could tell me the stories of your life that have brought you to these questions.” There is a slight softening of her facial muscles and a twinge of her lip. I tentatively reach to cover her hand with my own. She doesn’t repel my advance. Progress. A blessing.

           “Martha, you look drained.” Confessing confidences is taxing. The release of these pent-up emotions are crucial to my work with her; but at her age, the emotional and physical toll of such intense revelations must feel similar to a knock-out in round six with a superior boxing opponent.

            “Could we continue our visit in a few days?” She doesn’t decline. I’m hopeful.

            I press the call button next to her bed for the staff to come. She needs assistance to get back into bed and I need to write my notes. I offer to pray with her before I depart, but she declines. So I pray. Incidentally, I interpret her outbursts of anger and anguish to be prayer. She is crying out from the deepest parts of herself: poignant laments and soul monologues. My favorite psalms.

            I thank her for the visit, heave the six lb. chart to my chest, and grab the handle of my rolling briefcase. As I head for the door, I notice a large thread-bare-one-eyed dog plopped on Martha’s bed. I’m curious. She doesn’t seem the sentimental type to cling to a ratty remnant of her childhood. A gift from Ladybug, Martha’s great-granddaughter? Nope, it looks too flea-bitten. I’d definitely place it as an item from a by-gone era.              

Before I exit, I’m inspired to ask Martha about the stuffed toy. She doesn’t respond to my query. Maybe she didn’t hear me, so I ask again. She looks toward her neatly-made bed with a look of surprise and embarrassment, as if caught as an accomplice to a crime.

“His name is Koda,” she asserts in a pragmatic tone. “I got him one Christmas when I was twelve . . . he resembled my pet, a German Shepherd.”

And then she throws in a crucial tidbit of information: “a peace offering from my parents, I suspect.” I can see the muscles in her jaw tighten. Her gaze seems gripped by something beyond this room.

“A peace offering?” I’m confused.

“Yeah, ‘the bury the hatchet’ type of peace offering . . . you know, a compensatory gift.”

I can see by her body language that the curtain has dropped on this line of questioning.

Is this mistaken disclosure a betrayal of her closely-kept confidences? Will she come to believe that she misplayed her hand in this round of visits?

Perhaps, but this avowal is an important harbinger to me.

Our hospice CNA strides through the door just as I’m off. I share some observations with her and trudge down the hall. I finish documenting our visit in the pastoral care section of the chart and retrieve paperwork for my office. The shelf for Martha’s medical history is still occupied by the unwieldy binders of other patients. Thankfully, a social worker from a competing hospice muscles out a chart she needs. I quickly stuff “Martha” into the appropriate vacancy.

            Heading to the elevator, I retrieve my credentials from my pocket, fling them around my neck, and turn on my phone. I grab an apple and a bottle of water out of my satchel and prepare to drive to my next facility; three lovely ladies to go.  

            The temperature lowers at least fifteen degrees as I step away from the building and out into the crisp day. The fragrance of burning leaves and freshly cut lawn is pungent. Snippets of crimson color against a cobalt-blue sky greet me: vibrant and beckoning. The polar opposite of what I leave in my wake: infirmity and reticence. A gusty breeze animates the American flag in the courtyard. Maple leaves swirl at my feet. I inhale gulps of crisp air as if starved for oxygen.

As I turn back to glance at Martha’s second-floor window, I pray for her to live a few more months. She has questions conceived in suffering that deserve a hearing; if not outright answers.

            Her heart is aflame in search of the truth. I remember an adage that I thought profound from a clinical pastoral education class: “The heart, like the grape, is prone to delivering its harvest in the same moment that it appears to be crushed.”

            Just like Dorothy and her friends learned in the Frank Baum classic, “The Wizard of Oz:” Martha does not yet understand that the answers she seeks will be uncovered deep within herself. The journey always leads back home. Her soul’s primordial lover is patient. Perhaps, Martha is not waiting for anyone, but the Divine One waits for Maddie.

The harvest is near. We will begin again another day.

This story is about an actual patient. It is an excerpt from my book: “Surviving Hospice: A Chaplain’s Journey Into the Business-Side of Death.” (Names and details have been altered).

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