The look of concern on the faces of the nurses was close to the expression of fear. These three nurses were well acquainted with life threatening and crisis situations, they were used to responding quickly, they responded to emergency C-sections, they held full term babies who died after birth, they held babies who were not ready to come out of the womb but came early and they held babies who died in the womb. These were Labor and Delivery nurses. I had never before seen this look of alarm on their faces when I arrived at the nurses’ station answering a page from them.
What was going on?
What were they fearful about?
Being a chaplain in the hospital is different every day, punctuated with unexpected visits in my regular rounds of seeing patients. I routinely see patients who are recovering, mothers at risk of an early delivery, neonatal patients and mothers of neonatal patients. This day I was called to an unexpected visit; I received a page with no message except to come to Labor and Delivery.
I wondered what was going on.
When I got there, I saw the expressions on the nurses’ faces and again I was puzzled at what caused the nurses to be so concerned. They explained that they had a woman who they could not help. One of the nurses clarified that a young mother appeared to be depressed. Now I understood some; nurses in Labor and Delivery are used to caring for the physical health of mothers and babies. The physical complications were not the concern of these physical healers, it was the patient’s apparent sadness that they could not heal. So, they called a chaplain, since this presented differently. It was emotional pain that they were uncomfortable handling.
The charge nurse explained that a mother had been readmitted after discharge with complications from birth. It was odd to be readmitted. This particular woman had a baby six days ago and was discharged to go home. Then she was admitted to our hospital with a serious health concern on the sixth day after having her baby. When she was readmitted to the hospital she was unable to have her baby with her. The medical part of this woman’s stay was not the alarm but that the nurses could not mend this woman’s mood.
As the worried nurse related her story, I prayed silently for wisdom, to be fully present and to be able to know what to say to this patient. I did not know where she was emotionally or what her need was.
I prayed silently.
I entered a darkened room where the patient was on her side looking very much like a child with her face in the sheets. Let’s call her Leticia. She appeared sullen and withdrawn as I introduced myself. I asked about her story, pulling up a chair next to the bed so that she knew I wanted to attentively listen. She told her story in a soft voice and barely looked at me when she spoke.
A few weeks before her delivery date she had an auto accident, which caused her to be taken to the hospital. The doctor checked her and determined that she needed immediate surgery because the placenta was in a dangerous place, causing both her and the baby to be in danger. This young African-American woman continued recounting that she had an emergency C-section delivery, a necessary hysterectomy and needed bladder surgery.
I listened closely and asked some clarifying questions. As we talked about how serious this situation had been, she started to turn toward me saying that she thanked God that the baby was fine in spite of the accident. I acknowledged Leticia said and affirmed that God was with her through this experience.
She thanked God that the baby was fine.
The baby was in NICU for a few days while Leticia was recovering in the hospital. Both baby and Leticia went home together. Now she was readmitted into the hospital with complications, but the newborn was not with her. She communicated to me that she missed her baby and the four other children at home.
Her gaze shifted away from me again. I sat with her in her pain because at times there are no words relieve pain. I verbally named her lonesomeness for her children and the sadness of being separated from them. Leticia shared that her husband was helping with the children at home.
Leticia’s gaze shifted.
I started to address Leticia’s sadness of not being with the children – of being separated from her newborn and her other children. But, instead, I decided to talk about the possibility of grief of a hysterectomy at 23 years old.
“You have been through so much in such a short time. Wow!”
She nodded in recognition.
“In addition to the separation from your children, you have had a loss. You lost your uterus and the possibility of having more biological children.”
Turning her head toward me, Leticia considered what I said. I paused to give her time to process this. I knew that grieving the loss of the ability to bear children is much like a death for some women.
A loss like this brings grief.
“I have seen women in their 40’s tell me that they grieved when they lost their uterus. They shared that there was a sense of sadness and grief because their childbearing was over – a chapter in their life was over. How much harder it must be for someone in their 20’s! I wonder if grief is some of what you are feeling?”
She nodded and I could tell that this resonated with her. (I remembered my own grief when I knew I could not have any more children.)
A chapter in her life closed.
“Did you plan to have more children?” I asked.
“I think so, because I always wanted a big family,” she answered.
We stayed in the moment for a while because I hoped that naming grief and validating what she was experiencing emotionally would help her be aware of some of things she was feeling. Her position changed from a semi- fetal position facing away from me to looking toward me engaged in the conversation.
We stayed in the moment.
We also talked about processing all the things she had been through. I could only guess that this was extremely difficult for her with the trauma of the events and it had to be a whirlwind of emotions for her. I expressed empathy and asked if she had anyone to help her.
“What about family? Your mother?”
“No, my mother is not really around,” she stated.
I inquired more about Leticia’s family and she told that she was in foster care from the time she was 13 years old. Before that, when she lived with her mother they were sometimes homeless. Consequently, she shared that she did not trust many people or have many people in her life. Leticia said that she was afraid to let people in her life, choosing rather to stay to herself and with her children.
My hope was that I could develop a trust with her. My heart went out to her, realizing that her children and her husband were her only family. She wanted to be home with them and she told me a few times and that is why she was so sad.
I asked about how she met her husband, which led to a grin on her face as she recapped their love story. Her husband married her as a single mother of two children. (I had been a single mother with two children, so I knew some of the insecurity; I also remarried a man who was willing to take on two children.) She expressed thankfulness for her husband and his care even though they had been through rough financial times. In all this she talked about God in her life and that she prayed but said that she did not attend church right now.
“You are a survivor with all you have been through. You are going to get through this and make it!”
Leticia’s eyes widened and I could sense a empowerment coming back into her. It was as if a spark flickered in her spirit. This was a moment for me when I had the opportunity to see God work in her – a moment of seeing the sacred in this dear one.
“You have accomplished so much as a child out of foster care and now as a mother.”
A spark flickered in her spirit.
I wanted Leticia to know that I admired her ability to get through homelessness, foster care, being a single mother, a life-threatening emergency surgery and now this. I wanted her to know that she was strong. I wanted her to know that she was very courageous. Courage is not the absence of fear; it is managing that fear.
Leticia’s face expressed that she was proud of what she had accomplished. At that point, I knew that I connected with her. This was an unanticipated moment for me both to connect with her, but also see new strength in her. It was the twinkling of reverential awe for me – to see God coming close. How could acknowledging her strengths give her hope? Her countenance changed. Maybe, expressing faith in someone gives hope.
Courage is not the absence of fear – it is managing that fear.
Since Leticia had mentioned God, I encouraged her that God was with her in all that she was going through. I encouraged her to find a church that could support her, her children and love her. I prayed with her before I left asking God to take care of her family, bring healing to her body and return her home soon.
After the visit, I hoped that our conversations and my joining her in her anguish had helped her. I was thankful for the opportunity to give this young woman a chance to process her feelings. I was also thankful that I let her know that I believed in her. Using emotions from my own story enabled me to be fully present with her. I stayed and was present with Leticia in her time of pain – the valley of the shadow of death.
The next day, the nurses in the unit were quick to tell me that her children came in to see her, that she had been released and that Leticia had for home left smiling. Not only did the patient have a smile but the nurses were grinning, too!
A dear friend and mentor, Rev Sue White, would say that all we have to do is be available and willing, “God will show up.”
“God will show up.”
