Sometimes as
human beings, despite all the layers we consciously build upon the shell of our
souls to shelter us, define us, and project an image to others of what we hope
we are, our basic inherent quality of goodness emerges on its own free will. A
kind word, a gentle touch, a hint of a smile, an understanding patience--these
are all things that escape uncontrollably in moments where our consciousness is
left behind, running to catch up to our spontaneous reaction in a moment of crisis
for another.
Of all of these
unconscious acts of inherent kindness and compassion, though, none ranks higher
than a heartfelt hug. Not a light tap on the back, or the fake kiss of a cheek,
but rather a hug that emerges from the tightened embrace from one to another
that, for the briefest of moments, conveys the wordless caring that we all
crave to receive. Like cake batter in waxed pleated cupcake sheaths, these hugs
are ready to emerge, when fed warmth, to spill out of us into the want of
another.
It was one of
these moments, of private hugs and hushed whispers, that I was recently privy
to witness in the trauma hallway of our department. Suprisingly, however, it
was given from the most unlikely of persons.
Trauma patients
are typically the most complex of all our patients, with a wide spectrum of
issues ranging from life-threatening physical injuries to the endless abyss of psychological
and social tolls from the unexpected event. Like trauma patients before her and
trauma patients since, Room 18 held an unfortunate patient (in her early
twenties) who presented via helicopter from a car-accident scene. She had been
a front-seat passenger who, due to a multi-car collision and the twisted
secrets of fate, sustained both severe physical injuries and, more importantly,
powerful psychological injuries that would be life-long. Sadly, her mother, the
driver of their car, had died at the scene of the accident.
Although I
wasn’t the primary ER attending treating this unfortunate patient, I poked my
head into the room to see if I could help in any way with her treatment. The
mood of the room was somber, an understandable heaviness weighing down any
spirit of knowing our quick actions might help this patient recover fully from
her physical injuries. The bright lighting that reflected off shiny metal cots
and posts and equipment could do nothing to deflect the pain and misery of this
patient’s future. Of her impending misery. Of a future life where her mother
would not be available to share a secret ingredient to a recipe, to consult
over whether to serve ham or turkey on Christmas day, or to call “just because.”
Nor did the room’s sterility help clean our own pain for this patient’s tragic
loss. Adding to the senselessness, we later learned that the mother’s unselfish
reaction in the crash had been to swerve their car in a direction that would
protect her daughter from being directly hit, or t-boned. This patient’s mother
had given her own life so that her daughter might keep hers.
After this
patient was stabilized, it was shared with her that her mother had not survived
the crash. Her mournful wails and cries after learning her cruel truth could be
heard the hallway through. As tragedy’s effect usually does to each of us in
the emergency department, we paused in this moment, recognizing the
profoundness of change in one of our patient’s lives.
Eventually,
family members trickled in and supported this patient as further emergency
treatment was provided to her. Occasionally, I would pass by a pair or group of
family standing in the hallway, outside of the patient’s curtained room,
hugging and whispering to one another, trying their best to simultaneously provide
and receive support. With each pass, I would slow down just a bit and nod my
sympathies, wishing I could sponge even just a tad of despair from their
shoulders.
It was soon
after that Amelia, one of our “regulars,” was placed in the only available room,
Room 17, next to the unfolding trauma tragedy. Ms. Amelia was an elderly woman
with an extensive mental health history who had signed into our ER, yet again,
for a multitude of miniscule complaints. Although she was well-known to much of
our staff, I had only met Amelia one prior time a few years earlier.
I walked into
Room 17 to introduce myself to Amelia, only to find the room empty. Reentering
the hallway, I couldn’t help but notice two younger people fully embraced by
the strong, steady arms of their slight, grey-haired grandmother. It was a
breathtaking scene—the younger boy and older teen-aged girl leaning their heads
into the gathering arms of this strong woman. I walked slowly by, looking for
the nurse to ask her where our patient had disappeared. Not finding the nurse,
I ran to the lounge for a quick bathroom break.
Returning down
the hallway, I happened upon the same scene playing out that I had just passed
by, the shorter older woman still embracing the younger two people while
turning her head and softly taking turns whispering into each’s ear. It was a
touching scene, one that struck me as both comforting and tragic.
Suddenly,
though, I heard the hallway nurse yell out, and turned my attention to the
young, blonde nurse who was doing the yelling. “Amelia,” the nurse scolded as
she approached the same group of three from the opposite direction as me,
“leave this family alone.” I was confused. I looked to the group of three. I
looked at the nurse. And I looked back to the group of three just as the nurse
touched the older woman on the shoulder and spoke again. “Please, Amelia,” she
pleaded, “you need to go back into your room and leave this family to
themselves.” The nurse’s voice cracked, begging of Amelia to not put up any
resistance.
I stood still,
staring at the scene. I looked at the group of three breaking apart, the older
woman lingering to release the younger people from her arms, being urged on by
the nurse. I looked at her pained face, watching as she whispered her last
words to the young family members, releasing them hesitantly from her grip as
the nurse coaxed her towards Room 17. And suddenly, with amazing clarity, the
truth of the scenario smacked me in the face. Amelia, my next patient with the
psychiatric history, was the “grandmother” who had been embracing two of the
family members of the trauma patient.
“Well, I’ll be,”
I whispered to myself while approaching Room 17’s doorway. The beauty of
Amelia’s gestures were not lost on me, but I readied myself to have a serious
discussion with her about privacy issues and respect and all of that stuff. Any
family such as this trauma patient’s deserved their privacy in the depths of
such crisis. Before entering the room, however, while I was putting a pair of latex
gloves on in the hallway, I overheard the two recipients of Amelia’s hugs
speak.
“She was a nice
lady, wasn’t she?”
“Yes, she was,”
the other responded simply. “I wonder what she is here for?”
“I don’t know,”
the first answered, “but I hope she is alright.”
I paused to
absorb the enormity of the moment, realizing that kindnesses can come from the
most unexpected people in the most unexpected places at the most unexpected
times. Despite Amelia’s personal struggles, most of which I could only imagine
in her daily dealings with mental illness, she gave of herself that which she could,
some heartfelt hugs. Hugs that appeared to be received with the intent for
which they were given. Those hugs of Amelia’s, well, that was a darn-special
privilege of mine to get to witness—one stranger comforting others in their
moment of crisis.
Maybe all of
this stuff the nurses warned me about Amelia were a thing of the past.
I walked into
Room 17, extending my hand in greeting. “Hello, Amelia,” I said with renewed faith
in our patient, “I’m Dr. Jim. What can I do to help you today?”
She mumbled
something as she paced beside her cot. “Pardon me?” I asked her. The medical
student accompanying me gave me a look that he, too, did not make out her
words.
She wasted no
time in speaking up. “What the hell is wrong with you people I should be out
there with those people they need me don’t make me come back in here.” She
spoke quickly, hauntingly, in one long exasperated breath.
Even though I
knew Amelia wouldn’t like my explanation, I quietly explained to her that,
although her hugs were welcomed and appreciated and quite nice, actually, we
all had to respect the trauma family’s privacy at such a profound moment of
sadness. I reassured her, though, that her actions were a privilege for me to
watch and that the family appeared to appreciate her gesture.
“Now,” I
continued, “what can I do to help you today?”
“Get me the hell
out of here,” she said, glaring at me. “I don’t need to be in no room next to
where bad stuff happens.”
I offered to try
to find her another room, but she turned the offer down. When I asked her what
her complaints were that I could help her with in the emergency room, she
ignored me. “I want to leave,” she said with conviction. I made her assure me
that she had no pains anywhere. I was reassured by her words that she was
having no feelings of despair or urges to hurt herself. Thankfully, she had
also assured several of the staff that she was not depressed or having any ideations
to harm herself. And judging by her hugs, it appeared that all she wanted to do
at this very moment was to help others in need.
“Amelia,” I said
calmly and kindly, “are you sure you are going to be alright?” She nodded her
head yes. After her hallway hugs, I think she truly forgot what reasons she had
that had brought her to our ER that day. I discharged her from our ER without
any workup after she passed my screening exam and a consultation with our case
managers.
I can’t forget,
though, why I think Amelia was there. I think that sometimes, in some
mysterious ways, things happen in our daily lives that defy explanation. For
unexplained reasons and circumstances, Amelia chose to visit our ER on a day
when a few others were in need of a heartfelt hug.
And from Amelia,
that got just that.
As always, big thanks for reading. I hope
this finds you well. And to those of you who have continued urging me to write,
I thank you. Your kindness has been felt…Jim
