That’s right, it is time for me to attempt a 365 project again. One day, One Picture, One Year. Last time, I got to 269. Let’s see how far I get this time.
The Gang in a picture. Alas, the lighting was poor so it’s not as clear as I hoped for.
Today was my graduation day at CPE. I AM FINISHED. My first unit of CPE is now OVER. Woohoo!
I began today like most days – hanging out in the PICU. I wanted to say goodbye to the few patients who seemed to live in the PICu with me. Most were alone as their parents were at work and I did what I usually do – I chatted with them, made some faces, and then said a short prayer. My goodbyes with some of the staff occurred during the week so this was just a few hours for patients. The sun was shinning bright, the medical rounds were already over, and there was a calmness through the whole place that gave me permission to walk around (and jokingly absolve a nurse by telling him to say half-a-dozen Hail Marys). But one thing I wanted to do was say goodbye to that child I met last Thursday.
I looked up her charts and saw that she was going to be discharged this morning. I entered her room and saw her mom and a friend talking to the little baby. The last time I saw the little one, she was waiting to be extubated. Today, she was resting comfortably. She was breathing easily, grabbing at hands like babies will do, and a pink blanket held her tight. She looked like every baby should. I chatted with the mom and she was less nervous than last week. She couldn’t wait to go home. She said thanks again for my being there on Thursday and for all I did for them. The visit was short but sweet and, with that, I found it to be a fitting ending to my first unit of CPE.
With that done, all the summer interns gathered in the chapel for our graduation ceremony. The staff of the department and the residents came to support us. We said words, we sung songs, we received our certificates, and then we finished with hugs and goodbyes. The certificates looked grand (except for the minor typo where they said we had completed Unit II rather than Unit I) and we then went, with our supervisor, out to lunch. It was bittersweet. We chatted and had a good time but I don’t think it has really sunk in that I won’t have to get up tomorrow and go to the hospital; that I won’t see my new friends tomorrow either. We really were a good and joyous group. I’m really gonna miss seeing some of them as often as I have. I’m gonna miss going onto the floors, writing verbatims, and all that. I’m honestly thinking I might do another unit of CPE before I graduate. I never would believe that before I started but I guess that’s how it works. I found out I’m actually good at this. Who would have thought.
On Wednesday, my colleagues and I had a “self care” day. Sure, we only have a week left in the program but, hey, we needed the day. We went and grabbed a drink (it was noon somewhere in the world), ate some Indian food, and then went and saw Crazy, Stupid Love. It was a great day and I took a couple of pictures. Enjoy!
I’d like to talk about babies for a minute.
During my round in the PICU, I tend to avoid crying babies. I’m not sure why but I do. If a baby is crying, I assume that the parents are with them and that it really isn’t a good time to stop by and say hello. Crying babies also tend to not respond to my funny faces, my “oohs ho ho ho,” my attempts at “where’s the baby” and all the other things I do to try and provide spiritual support to those who are ten months and younger. It’s a skill I’ve been developing and I have a good time with it. But crying babies, well, they’re crying. And usually they have good reasons to be crying. A baby in the hospital with ivs, tubes, and other such things – you’d cry too I bet. I know I’m not suppose to avoid them but I do.
But, for some reason today, I didn’t.
The social worker in the PICU referred me to a family who were Catholic and were open for a visit. They were busy yesterday so I planned to stop by this morning. I walked around and could hear their baby crying. I avoided it at first, saw a couple of other patients, but then decided to buck up and see the kid. I said hi to the nurse, suited up (the child was under isolation), and walked on over. The kid was squirming and crying. The kid had just had surgery the afternoon before and, from the chart at least, everyone said the kid was doing great. The docs had seen her fifteen minutes prior and were already trying to get her moved out of the PICU. The parents were so happy, they even felt comfortable enough to go home for a few hours. Things were looking up for this kid.
So I started my routine. I talked to the kid, made faces, told it I understood, and tried to get her to calm down. But it wasn’t working. I thought that maybe I was scaring her and I made the motions to walk away but that didn’t seem to be it. And the more she cried, the more I went into the typical “baby-crying-I-don’t-know-what-to-do-because-I-am-a-man” routine. But then she made a face I thought I recognized. She’s just struggling to poop, I told myself. The baby seemed to be calming down. But something was off. I asked the baby, “Are you alright? What are you doing? What’s wrong?” And then the crying stopped. So did the squirming. The alarms started going off and her heart rate dropped like a rock. I turned quickly to see that the nurse had stepped out. I looked back, and the baby was doing one final squirm and I saw it’s face starting to turn blue. I went “oh shit!” and ran from the room. I ran into the next room, told the nurses that something was wrong – that “there’s a baby that doesn’t look right.” My face said more than my words and two nurses quickly followed me into the room and got to work. The baby, in the words over the intercom, “coded” or “destated”. She stopped breathing. The nurses started to give her air and do chest compressions. More nurses came. Then doctors showed up. Soon, the entire staff was in the room working as a well oiled machine. They were doing their darnest with the kid. The communication was fluid. The movements precise. They knew what they were doing. But there was a panic in the air. The air was filled with suspense. And as they worked, I pulled back. I walked backwards until I ran into the far wall and the entire time, I did the only thing I could do – I prayed. I prayed hard. Over and over again, like a broken record, I prayed “Dear God, not her. Not her. Not her. Not again. You better save her God. You better fucking save her.”
It wasn’t long before the baby started to cry again. I saw her arms flail. She didn’t really like the air mask on her but she required it. She was back. She was breathing. And her heart rate returned to normal. She cried some more while the doctors kept working on her. The social worker came and chatted with me. So did the PCD. They told me she would be okay. And then, once the situation stabilized, the nurses started saying to me “Thank God you were here” and “This was divine intervention” and “You saved her life.” I took off my isolation gear, said if they needed me anymore, and when they said no, I stepped out. I needed to get out of there. I was freaked.
I went back to the office and called my wife. I talked to a couple of my colleagues and I told them what happened. I tried to calm down and get back to work. Several folks in the PICU reached out to me and asked if I was okay. My colleagues did a great job supporting me. My supervisor told me that I now have the best CPE story to share when I go back to school in the fall. But what was running through my mind was when I was going back to the floor, what was I going to see, what was I going to say, and “did I wait to long to get the nurses?” In the meantime, I attended a funeral, ate lunch, and had a class on group dynamics. It was near the end of the day before I finally had a chance to head back to the PICU. I checked the charts and read what happened. I gathered my things and went back up to the unit. I met the nurse of the room and we chatted. She was still traumatized by the event and so was I but I provided some pastoral counseling to her even though I was suffering from the same event she was. I don’t think I said all the right things to her but I think she was just happy to see me come back to the floor and to talk with her and say that it’s okay. I met the mom and she had been told what happened. She seemed rather calm and was grateful that I had been there. And I left feeling pretty good – still in shock but doing better.
But right before I met the nurse and the mom, I ran into the mother of a patient who’s child, who had been improving, had just taken a turn for the worse. She was frantic. She wasn’t ready to talk so I said I’d come back tomorrow. So when I walked back to the subway after work, and as I entered the stairs and into the artificially lit tunnels that led to the over-heated platforms, my heart sunk. Even though some good had happened today, it’s not over. In the next bed over, a family is heart broken and is suffering. Another child might die. As much as I am enjoying being a chaplain, I’m not really sure I could handle this every day. I joked at lunch that I have “won” CPE but I’m not so sure. I haven’t even properly processed what happened last Friday and then this happened. I’m not sure I could do this all the time (though I know this doesn’t happen all the time). This was a rather heavy baptism by fire.