Time To Grieve & Hope: When Patients Die, In All Of Life

Jesus Wept

Image by Pro-Zak via Flickr

Passed down from generation to generation of providers, it’s nearly a mantra among medical trainees:

“Don’t get too involved with your patients.  If you do, you’ll burnout and you won’t make good, objective clinical decisions.”

There’s real truth in this, of course, which is what gives the mantra its power.  I don’t want to dismiss that; it matters, and needs to be dealt with wisely.  But is that the end of it?  Should providers just “move on” fully and immediately from their patient interactions?

Dr. Pauline Chen, it seems, is among those who would say “no.”  In this short article for the BBC, she suggests instituting a five-minute pause for silence in the event of a patient’s death would be very beneficial for medical teams:

I believe that instituting the five-minute pause for silence after a patient dies will change the way doctors, nurses and other caregivers approach death.

First, it will give closure, as well as respect, to the relationship between that patient and his or her caregivers.

Second, the conscious pause, the act of taking time out, will establish a ritual. And rituals, consistently practised, offer great comfort at difficult moments.

Finally, the five-minute silence will allow caregivers to acknowledge their own feelings.

I agree with her.

More importantly, as Christians, we have the example of the Great Physician, who visibly cared – even cried – over his patients on several occasions.  He wept before raising Lazarus from the dead (John 11:35), and then again when he realized that Jerusalem’s destruction was a done deal because of its refusal to acknowledge Him as Savior and King (Luke 19:41-44).

It’s striking that, in both cases, Jesus gets “emotionally involved” even when the outcome is a foregone conclusion.  In the first case, the patient would be resurrected(!) just moments later.  In the other case, the patients were terminal with no hope of recovery.  Why bother caring?  Why not just move on and do something more productive?

You might be thinking, “I like this idea of the five-minute pause.  Healthcare providers get so hardened and we (or “they”) need to reconnect with our emotions.”  You might think this is mainly a medical thing.

In reality, though, this is an all-of-life thing.  If we dig deeper, we resist real emotional involvement and vulnerability in everyday moments that have nothing to do with healthcare.  A family member pokes fun of us and says they’re “just joking”, but we let it go and tell ourselves we don’t care.  We see a homeless person on the street, but don’t allow ourselves to be sad or consider helping.  We want to speak up in class or at the party, but don’t because we’re afraid – on some level – of rejection.

The same heart that leads nurses and doctors to race away after a patient dies lives in all of us.  However much we’d like to bury it, the fact is that we live in a broken world, and, we ourselves are broken.  In ways that are sometimes obvious, sometimes obscure, we like to distance ourselves from that reality.  Myself included.

Don’t get me wrong.  I like the idea of the five-minute pause.  A lot.  One physician I know held a thirty-second moment of silence after one patient’s death in his ER.  When he looked up at its end, nearly everyone was in tears.  Later, they confided in him that it was so powerful and he had many profound discussions about things that really mattered.  I hope that, if you have the opportunity, you’ll implement something like this in your setting.

At the same time, my heart is to see us, as Christians, go deeper.  And not just in moments of high drama, but in the mundane moments that make up the real story of our lives.  We need the courage to feel and acknowledge the brokenness and sadness – however large or small – that comes at us each day.  When we do that, as Dr. Chen suggests at the end of her article, that frees us up to care for others who are hurting.

But where does that courage come from?

The bible sketches out the answer, especially in the Gospels.  When Jesus entered our world and died on the cross in our place, he fully acknowledged just how bad it really is.  No sugar-coating, no pretending.  He had to leave heaven and perish at the hands of his creation!  But that wasn’t the end – he rose again in three days and promised that everyone who believes in him will join him someday in a world where everything that’s wrong will be made right.

So, following his example, I can admit just how messed up things are.  How wrong it is that the patient I was working on just died.  How wrong it is that my friend didn’t come through for me again.  And how wrong it is that I don’t care much about the people all around me.

But that’s not where we stop.  Even though I can’t fix so much of what I see around or in me, I don’t have to despair.  I can do my best, but at the end of the day God has to do the fixing.  And he’s promised to.  Without a doubt.  When we look at the cross and empty tomb, we can face the suffering in our lives with both honesty and hope.

Let me close by asking you to join me in reflecting on two questions:

First, what are those areas in your life where you’re not dealing with brokenness?

Second, what would it look like for you to start being more honest and hopeful?

If we ask him, God will show us what to do and give us the help we need to do it.

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