My first night as chaplain. Paramedics rush a gurney through the automatic doors of the ER, the patient’s body flying like a luger down an icy track. A trail of blood splatters onto the ground behind the paramedics as they press into his plushy chest—up, down, up, down. A head full of thick, ropey dreadlocks lolls to the side.
My pager shakes in my purse: “Level 1 Trauma: 17-year-old male, GSW [gunshot wound] to chin, ETA 10 minutes.”
Then another page: “Level 1 Trauma: 21-year-old male, GSW to chest, ETA 10 minutes.”
When the pager vibrates again, I can’t tell if my hands are shaking or it’s an actual page. It is.
“Level 2 Trauma: 23-year-old male, GSW to abdomen, ETA 20 minutes.”
I lean against the counter at the nurse’s station and try to breathe. The charge nurse, Woody, plants herself in the middle of the ER entrance and yells out locations: “Abdomen to Trauma A! Chin to C29! Chest to Trauma B!” until the nurses have shoved all four men—bleeding from their various wounds—into separate trauma bays and exam rooms.
I squeeze my notebook to my chest and stare as a nurse kicks the gurney brake when the first victim arrives in the trauma bay, and the team swarms around his body.
“On my count,” says a brunette nurse. “1, 2, 3.” Four people grasp the edges of the body board and hoist the man onto the bed in one fluid movement. One young nurse clasps her hands together and presses them outward, punching them into the man’s sternum, again and again and again, forcing the blood to keep flowing.
“Get me two rounds of epinephrine,” says the trauma doctor. He slips on his paper mask and gloves, then he reaches around the nurse performing CPR and looks at the wound. A tech weaves the man’s IV between them, connecting it to the bag of fluids on the metal stand.
“Has anyone contacted the blood bank?” yells the doctor. “What’s his type?”
A phlebotomist in maroon scrubs rolls in a tray full of vials and inserts himself into the huddle. As the nurses around him sanitize and scan for other injuries, his gloved fingers graze the man’s skin, his face still with concentration. His fingers stop somewhere in the crook of the man’s elbow, and he slides in the needle like he’s fastening the clasp of his wife’s necklace.
“All right, the OR is ready for Trauma B,” yells Woody, slamming down the phone at the nurse’s station next to me, making me jump.
Two minutes later, the team, decked out in hairnets and disposable shoe covers, emerges from the trauma bay. One nurse leans into the gurney as if pushing it up a large mountain. A tech in green scrubs follows, rolling the IV pole and monitor, which beeps and dings its dismay at the patient’s dropping oxygen level, heart rate, and blood pressure. Another nurse hustles the ventilator along, its thick accordion tube scrunching and stretching as they run through the halls.
A lone tech follows in the wake of this patient, gathering trash from Trauma B. It’s spread around the room as if from a whirlwind: scissored clothing, sterile packaging for needles, a lone half-spooled roll of gauze.
Woody leans in asking, “Hey, Dewayne. Did that patient have any tattoos? Gang-related?”
Dewayne drops a sneaker stained with something dark into a drawstring bag for the family. “Yep. Right on his stomach. He was a Blood.”
Woody turns to me. “You the new chaplain?” She glances at my tight-cropped pants and leopard-print shoes.
“Yeah. First night,” I say.
“Well, stick around. There’s gonna be a lot of angry people here.”
I loiter around the nurse’s station, blink up at the monitor with the heart rates of the three trauma patients still in the ER. I open my notebook and write down the names of the victims. I try to look like someone who belongs here. A cluster of policemen stand beside me, decked out with walkie-talkies, batons, ToughBook laptops.
“Chaplain!” yells Woody, jogging by. I flip my notebook closed and trot to catch up with her, my ballerina flats make a squishing noise on the tile.
She gathers the social worker, another nurse, and me into a huddle. She looks us each in the eye. “I don’t know who shot who. I don’t know if these guys were enemies or friends. But the crowd out there is starting to get angry.” A stray strand of ginger ponytail trembles as she makes each point. “We need to split them up.”
“But they’re all gunshot victims,” says the social worker. “Aren’t we on code grey? Isn’t the ED already sealed off to all visitors?”
“Technically yes, but I don’t want these families to kill each other.”
Woody gives us each a name and tells us to find the corresponding family and then to bring each one back to a different consultation room. As she reaches the last name, her hazel eyes give me the once-over. I’m not ready, I want to say. I’m really not. She looks down at her notepad.
“Tyrel Brown,” she says, each word weighted, slow. I scribble it in my notebook.
In the lobby, a crowd of men and women stand scattered and scowling. They watch each one of us as we enter. The social worker speaks the first name into the ether and then lets her eyes drift around the room. A section near the Coke machine starts to jostle and stir.
“Tyrel Brown,” I say, lifting my shaky voice. I look to the snack machines, toward the spinning glass doors to the outside. No one responds.
I tear out the piece of paper and hand it to the registrar. She gives me a bald glance, and then nods toward a group circled around one of the tan pleather couches. When I walk toward them, I can feel their sidelong glances at my outfit.
“I’m Caroline. I’m the chaplain on duty—” I begin. Their eyes go wide.
“Chaplain?” says a girl with braids and pink sweat pants.
“Fuck this,” says a man leaning back in a knee-length t-shirt.
“Is he dead?” asks the girl, her face contracting with the last syllable.
“I—I can’t give out medical information.”
“You can’t even tell us if he dead,” she says, her chin dropping in disbelief.
“I don’t even know. I haven’t seen the patient yet.”
“Jesus,” she says, crossing her arms. “Chaplain ain’t never good news.”
I take a deep breath. I step forward and something sticky pulls at the bottom of my shoes. “If you’ll follow me, I’ll take you back to a family room. Then you can get some information.”
“We can’t even see Tyrel?”
“Not right now,” I say, bracing for her next comment.
“Jesus,” she says, not moving from her folding chair.
“Come on, Sharita,” says the man, rising to his full height. “Let’s go.”
They don’t speak or make eye contact as I lead them through the labyrinth of the emergency department, or ED.
When we arrive at the small, hidden family room I let say, “I’ll find a doctor to update you as soon as they’re free.”
They slink down into the chairs. “Is there,” I pause with my hand on the doorknob, “anything I can get for you?”
Sharita gives a small exhale, almost a laugh.
“Okay,” I say, turning to leave. “I’ll be back.”
While the family I’ve left in the consultation room waits for answers, I receive another page.
“For shit’s sake,” I mumble to myself, expecting another gunshot wound, but it’s just a phone number.
I walk to the back of the ED, where a psych patient with matted bed hair wanders. I find a seat and a computer. I exit out of an indecipherable line graph on the monitor. When I call the number, I hear the whistley, grandfather voice of Ray, our senior chaplain. “Did you page me?”
“Hey, Ray. No, I didn’t. What’s up?”
“I got a page from the hospital. It wasn’t you who paged me?”
“Nope, sorry,” I say.
“Everything going okay?”
“Well,” I push my fingers in between the curls of the phone cord. “We have four GSWs right now.”
“Four?” I hear his breath on the receiver. “I’m on my way.”
Twenty minutes later, Ray stands in the ER, his nostrils flaring as he scans the ED, and I give him the lowdown.
“So the families are already back here?” he asks, cocking his head.
“Yeah,” I say. “Well, we split them up and put them in the family rooms.”
“But the ED is still under code grey?” he asks, referring to an ER status involving a security threat, such as a combative patient or severe weather.
“I guess so, yes.”
He snaps his head to the side, puts his hands on his hips, and takes a breath. “All right, we’ve got to get this here sorted out now.”
We start walking toward one of the nurses to consult when a doctor comes by and says to us, “Death notification.”
“All right, we’re right behind you,” says Ray.
The room we enter is bare except for a circle of chairs, a cheap coffee table, and a poster declaring patients’ rights in English and Spanish. A man wearing a wife-beater flexes his bicep and clenches his teeth, stares at the floor. A woman paces with hands covering her mouth, her whole body vibrating like a tuning fork that’s been just been struck. An older lady sits with her hands grasping the plastic arms of her chair, as if she’s going to spill out.
The doctor sits and leans in. “I’m Dr. Peters, I was the doctor working on Demarcus when he came in.” He rolls back his shoulder, almost a tick. “What do you know so far?”
The man in the wife-beater rolls his head toward the doctor. “We just know he got shot.” He fixes a cool stare on Dr. Peters.
The doctor’s shoulder spasms again. He looks down at his notes. “So Demarcus came into the ER with three gunshot wounds. One to the abdomen,” he grabs his own loose scrubs around the midsection. “One in his leg, and one to . . . one to his chest.”
A woman gasps.
“The EMTs did a good job with CPR on the way here. But they’d still lost a pulse by the time he got here.”
A wail escapes the grandmotherly woman. The younger lady grabs her hand.
“It’s okay, mama.”
Dr. Peters hunches over like he’s ducking some imagined blow. He glances up from under his glasses. “We continued chest compressions for twenty minutes, but we were not able to get a pulse back.”
“And he died.”
A woman hurls herself on to the floor and stomps her thick-soled, perfectly white shoes, screaming “Oh Jesus! Oh Jee-sus!” A young man whimpers and holds his head in his hands, revealing a maze of braided black spirals on his scalp. The room roils and rolls.
I stay one step behind Ray as the grandmother falls apart in his arms. I can’t tell if I stay in his shadow to learn or to block myself from the chaos.
I watch the doctor say he’s sorry, place an awkward hand on the shoulder of the closest family member, the sister. She stomps and cries, shakes off his paw in one convulsive sob. But I still envy the doctor. He gets to leave.
We stay in the room longer than I thought possible. One man punches a hole in the wall. Another kicks the chairs. The women scream and shake.
When the pager finally buzzes again, I step into the hall. I’m so relieved to be out of the room that I don’t even think about what this page could be about.
“Hi, this is the chaplain,” I say when someone answers the phone.
“This is Connie in the OR. We had a death.”
“The GSW victim?”
I feel my body go slack. Ray says he’ll handle it if I’ll stay with Demarcus’s family.
“I–,” I shift on my feet. “Okay.”
I look at the thick door to the family room, hear the gasping sobs and wailing, brace myself. Before I enter, though, two nurses approach, arguing over whether the family should be allowed to see the body.
“It’s not allowed,” says Woody. “Already been ruled a medical examiner case.”
“As long as they don’t touch anything,” says Angie, a brunette with fawn-like features and a saccharin voice. “I think we should give them at least this.”
Woody sighs, taps her foot and narrows her eyes. “Just the mother.”
Angie nods and turns to me. “How about you stay with her so she won’t touch the body?”
My mouth drops open.
“It’s her first night, don’t go too hard on her,” says Woody.
Angie looks me in the face, square but not unkind. “Break her in.”
As we inch down the hall together, Angie holds the elbow of Demarcus’s mother. She is short and solid and lets herself be led like a blind lamb.
“Now,” she says, “you can talk to him, you can sing to him, you can blow him kisses,” she pauses. “But you can’t touch him, okay?”
She nods blankly, her eyes red and unfocused.
Angie turns and leans her face toward the mother, “Caroline’s going to go with you from here.”
The mother doesn’t react as Angie walks away and I step closer. Tears stream down her dark-freckled face as I take her arm, the skin loose and warm.
“Are you ready, Mrs. Jones?”
Her eyes are fixed. She raises her chin and blinks slowly.
I rein in the impulse to knock on the door, and we push into the room into the dark, cool room. When we step inside the exam room, Mrs. Jones whimpers, and goes limp in my arms.
“Hold on, hold on,” I say, trying to shore up her soft body while grabbing a chair and sliding it across the room, the metal legs scraping across the tile as I move it under her. She makes a low, tremulous moan as I lean her into the chair.
“I know,” I say. I kneel and move my hand toward her back, hesitate. She lets out broken, wrenching sobs. I rub between her shoulders, the sound of my hand against her windbreaker oceanic and familiar. “I know.”
I stay like that, huddled against her, as her back rises and falls.
It’s only then that I steel myself to look at Demarcus. Crouched on the floor, I’m eye-level with the white sheet that covers his body, the one pale sole of his foot that protrudes. My eyes trace from his foot, up his body, to his eyes that stare blankly at the ceiling. His mouth gapes open, lips chapped and bluish.
Demarcus’s mother sniffles.
“I know,” I say again.
An hour later, Mrs. Jones gropes for the handbag on the floor, without taking her eyes off Demarcus.
“Oh, it’s here,” I say, picking up a large, floppy bag with peeling fake leather.
She gathers it into her lap, collects the wadded up tissues in one hand, and inhales. And then she rises, wobbly, beleaguered. I stand, too, a wave of blood rushing to my burning, tired thighs.
“Do you want me to walk with you out to the lobby?” I ask, shielding my eyes from the fluorescent lights that accost us in the hall.
She shakes her head.
“Okay,” I say and touch her back.
She reaches for my other hand and gives it a quick, tight squeeze. For the first time that night, Mrs. Jones looks me full in the face, and nods, demure and final.
I let go of her hand and watch her walk down the hall, her gait labored and listing to the right.
I find a free computer in the emptiest part of the ED and log in to the charting system to try to appear busy. I stare at the names and ages and admitting diagnoses. My gaze wanders to the clock on the wall, and I calculate that I have roughly 10 hours left on my shift. I sigh and hunch over the screen.
“Chaplain provided emotional support and ministry of presence to family of deceased patient,” I write in Demarcus’s chart. “Facilitated viewing of body.” I pause and stare at the cursor blinking. “Patient’s mother tearful.”
Later that night, Ray and I go looking for Demarcus’s family again because I failed to obtain next-of-kin and funeral home information. When we exit the building in an automatic swish of the doors, a wave of heat and humidity hits me, and I realize I’ve been freezing the whole night. We find his mother who is now surrounded by three thick women, making her look even smaller.
“But we have no money,” argues one of the aunts when Ray asks her about funeral home arrangements. She squares shoulders with him and frowns.
“All right, all right,” he says, pulling out his little black notepad. “Do y’all know Thompson’s? It’s down on East Wendover.” He scribbles down a number and rips it out. “Now, they’ll help you out with the financing and all that. You just give them a call, now.”
A girl in a McDonald’s uniform flails around under the ED awning, shouting, “Someone shot my boyfriend! Somebody shot him!” Her face is splotchy with weeping. “Can somebody tell me if he dead?”
I am watching her when I notice that one of the women in the group is staring at me. As I turn, she says in a low, restrained growl, “You didn’t even pray for my grandson.”
I realize that this is Demarcus’s grandmother, the mother of the woman I accompanied to see the body. She’s right.
I feel my face burn and my stomach clench.
“Hold on, now. We’re going to have a prayer, now,” says Ray, tilting his head and holding up one palm. He gathers us all in a circle and lifts his voice above the idling pick-up truck, the clatter of someone unfolding a wheelchair from a trunk, and the girlfriend weeping.
Ray finally goes home, and I walk to the cafeteria to buy an ice cream Snicker’s bar from the vending machine. My footsteps and the crinkle of the packaging are the only sound in the long, still hallways. I want to open it so badly, but I don’t want to be seen eating it. After what I’ve witnessed, people probably expect me to have more spiritual things on my mind than a snack. I finally arrive back in the chaplain’s on-call room, throw my pager on to the bed, unbutton my slacks. I watch myself eat the ice cream bar in front of the large mirror. My blazer seems cheap and flimsy under the fluorescent lights. I look gaunt and pale. I stare at the narrow bed that so many of my co-workers have slept on. The housekeepers have forgotten to change the bedding, so it’s messy and sprinkled with crumbs from some other chaplain’s midnight snack.
Before that, this room belonged to the patients of the hospital. I stare at the bed and wonder who slept there, if anyone died on its hard plastic surface. In seminary, we learned about the thin places. Celtic monks believed that there are places on the earth where heaven and earth kiss, where we can feel and taste God’s presence in a palpable way. One professor said that thin places exist in hospitals, in the room of the dying patient.
I wonder exactly what he pictured when he taught us that. A loving family holding hands and singing gospel songs around a beautiful elderly woman. A nurse brushing a gentle hand against the forehead of her favorite patient as he drifts away in peace. I doubt he envisioned what I saw in the trauma bay, in the family room, in the strange twilight area between the operating room and the morgue. I doubt he knew about Mrs. Jones whimpering, forbidden to touch her only son, with only me to comfort her.
The next morning I arrive wrinkled and bleary-eyed to morning report. I shuffle the stack of documentation I’ve printed off, one for each pastoral encounter.
“So,” I say, looking at my neatly pressed and sleep-dewy co-workers. “I had four GSWs at the same time. Gang shooting.” I watch panic play across their faces. I’m the first new resident who’s completed an on-call night at the hospital on my own.
“Two of them died,” I add. “And, oh yeah. Ray came, and he was very helpful.” I look at my shoes, bracing myself for whatever he will add.
“What happened was,” he rubs his goatee. “Chaos. Nobody knew where each family was. The staff totally ignored the code grey.”
I wait for him to say that it was my fault, that I let the families back to the ED too quickly. That I basically just followed him around all night. That I failed to pray for a woman who was sobbing over the body of her dead son.
“But Caroline,” he says, eyebrows raised. “She did very well.”
I look up at him. He taps his dress shoe on the floor and looks me in the eye over his glasses, smiling. I flush.