From the Wards
Leave a comment

The Cost of Hope

They’re out of place in dirty Crocs and wrinkled sweatpants. More notably, she’s wiping tears from puffy cheeks. It’s a sharp contrast to the nurses, who are too casual. One makes a remark to the other about a tangled tube. They always get that way. The other chuckles.

I can’t take my eyes off the patient. One black eye, so sharply defined that it looks inked in. He moves like a robot. One second he’s perfectly still, the next he’s drawing a breath through the mechanical ventilator in his throat. Sharp, precise movements. The machine beeps; chest up. Another beep; chest down. Frozen. Beat; up. Beat; down. The screen to his left can fit three breaths: identical curves on the scrolling graph. Then it resets. Three more breaths. Beat; up. Beat; down. Like a robot.

The father looks uncomfortable but unfazed, as if his sympathy took effort. He looks like he came to see someone else’s son. He nods to the chaplain, gives me a friendly look. “Isn’t this tragic?” his eyes say. He returns his attention to the mechanical body. He knows we’re not there for him.

“How are you?” the chaplain asks, kneeling down by the mother. She and the father have the room’s only two chairs, so I stand motionlessly to the side. The chaplain shifts to find balance. “Has anyone come to see you yet?”

“No,” she manages to eke out. “No one.” And then she’s sobbing. Thick, heavy sobs. She’s trying to keep quiet; in the ICU there’s a hush that suggests that no one’s allowed to be louder than the softly beeping machines. But she can’t control it, and for a moment we all sit silently by, drowned in a mother’s grief. Then she collects herself, just enough to whisper, “I’m so scared.”

I’m scared too. I think we’re all scared. He’s my age. This room destroys the illusion that anyone is safe. It was a car accident, yesterday. He was alert when he came in and then things went downhill after surgery. What can you say to his mother?

The chaplain chooses to say nothing. He nods affirmingly and settles into position.

“Everyone says to be positive, but I can’t. They say it can always be worse.” She’s sniffling between sentences. There are no tissues in this room and her tears soak into her frayed collar. “I couldn’t live with him being a vegetable.”

It’s hard for me to understand that this a real person here. There’s a cognitive disconnect. This body is a medical project, I’m sure the nurses would agree. But this is also a son and a happy-go-lucky friend and a student. There isn’t room in my head for all of that. It’s too heavy.

She continues, “I was trying to be strong yesterday, when he was awake. But I had to move away sometimes. I didn’t want him to see me cry.”

“Now is the time to not be strong,” says the chaplain with all the tenderness of a father. He’s poised to reach out an encouraging touch, a hand on the shoulder, but he doesn’t. Maybe there’s a rule.

We linger for almost half an hour. I can’t hear much of the conversation as it escapes in whispers between choked sobs, but she’s sharing everything. “I’ve never opened up like this to a stranger,” she says.

“Most people here haven’t,” the chaplain agrees. “Can I pray for you?”


It’s a short prayer, but it gets right to the heart of her fears. He doesn’t have the family recorded in his patient list so I don’t know what her faith is, but she seems grateful. He stands when he finishes. “Don’t give up hope yet,” he says. “He could come off the ventilator and surprise us. You never know. He could be moving and talking before you know it.” She gives us a wan smile and we exit the room. My heart sinks. That feels cruel.

What if he doesn’t come off the ventilator? What if three days from now they ask her to decide whether or not to let her son die? What if there is no hope? I voice my concern.

“I don’t want to take away the disaster,” the chaplain says. “There’s still disaster, I don’t deny that. But I want to plant hope, just to open up the possibility that things could turn out okay. Everyone needs hope.”

I can’t argue with that, but I still feel discontent. Maybe that’s because I don’t have hope right now. I can’t see him waking up and returning to normal. In my mind, he’s going to die — soon. And his mother needs to deal with her grief. How could you be insensitive enough to offer hope?

“This way,” the chaplain says, starting off toward the next room. “They’re about to take this woman off life support.”

I’m not a chaplain. I don’t see this every day. And so I’m left with the inner turmoil. Did we make things better or worse? What did the mother really need?

The chaplain is already talking to a doctor, asking about the next room — if the family is in yet. His mind is two steps ahead, anticipating the next conversation, the next patient’s needs. I can’t move that fast, and so his motion feels almost casual. I wander along behind him, feeling suddenly out of place in my white coat and naïveté.

Nolan Adams Nolan Adams (1 Posts)

Contributing Writer

Loyola Stritch School of Medicine

Nolan is a first year medical student at the Loyola Stritch School of Medicine. He enjoys learning about global health, inventing holidays, and playing Spikeball when the bleak Chicago weather permits.