The worst day of your life

“I suppose you’re going to tell me that this will be the worst day of my life?”

Coming from the mouth of a 10-year-old girl whose mother had just succumbed to an opiate overdose, the child’s words carried unspoken impact.

The priest who was telling me this story said he wasn’t sure how to respond.

This was back in the day when one of his duties was to serve as chaplain for the city fire department. The firemen would call him in on those sorts of impossible cases where no one had any idea what to do; cases like this one: a 10-year-old girl unexpectedly orphaned on the spot with no apparent next-of-kin.

By the time he arrived at the sparse apartment, other tenants in the public housing complex had started to filter in, each attempting in his or her own inept way to offer condolences and comfort.

“It was like something out of a Tennessee Williams play,” the priest said. “Everyone was concerned. No one knew what to do.”

“What did you say to her?” I asked.

Momentarily, the priest’s eyes regarded an infinite point in the distance; then he collected himself.

“I thought of all the bad things that this little girl would be facing in the coming hours, days, and weeks ahead. I thought of all the not-so-good things she might be facing for the remainder of her formative years, maybe even for the rest of her adult life.”

He lapsed into silence. Then the words came again. “Suddenly, I remembered that I had just lost my own mother. I knew how it felt. It felt like the worst day of my life. That gave me the courage to tell her: yes, this would be the worst day of her life; but there was always hope that somehow things would work out for the better.”

The hint of a tear glistened in the corner of his eye.

“Those are the ones that you always remember,” I said.

“Yes,” he said. “They are.”

Sometimes in our struggle to care for others, we must first learn how to care for ourselves, how to lay down our own burdens. In facing our own suffering and accepting our own wounds, we learn how to help others heal.

Humane Medicine — When difficult decisions must be made

Moral distress: when clinicians feel they cannot do the ethically appropriate thing. Midnight medicine: when difficult decisions must be made with no time for consultation and critique. more»

Interested readers can now access my latest Humane Medicine column — Midnight Medicine: A time when difficult decisions must be made — recently published in the Journal of the American Academy of Physician Assistants.

A Wounded Healer

A November 2, 2006, New York Times article, “Tending a Fallen Marine, With Skill, Prayer and Fury,” documented the story of Petty Officer Third Class Dustin E. Kirby, age 22, a trauma medic assigned to the Second Mobile Assault Platoon of Weapons Company, Second Battalion, Eighth Marines, as he tended to Lance Cpl. Colin Smith, age 19, a fellow soldier who had been shot in the head by an Iraqi sniper just outside Karma, a city near Falluja in Anbar Province, Iraq. “Doc” Kirby stabilized the wounded marine, who was transported to the nearest medical facility by helicopter within 12 minutes of being shot.

The Times reporter described Kirby’s emotional response: “He held his bloody hands before his face to examine them. They were shaking. He made fists so tight his veins bulged. His forearms started to bounce.… ‘In situations and times like this, I am bound to start yelling and shouting furiously,’ he said.”

Kirby himself was later wounded by another Iraqi sniper eight weeks later, on an otherwise quiet Christmas afternoon. His jaw and upper palate were damaged extensively by the sniper’s bullet that struck the left side of his face. Sometime later, after several operations and on ventilator support, Kirby was still alive, although he could not speak. He subsequently returned stateside to Bethesda Naval Medical Center in Maryland for further care.

In his book, The Living Reminder, Henri J. M. Nouwen states that those who minister are called to heal by reminding people of their wounded past and by connecting their wounds with the wounds of all humanity.

Petty Officer Dustin E. Kirby, a trauma medic, is now a wounded healer. As such, his wounds are connected with the wounds of Lance Cpl. Colin Smith, and with the wounds of all humanity.

In his novel, A Farewell to Arms, Ernest Hemingway, commenting on those wounded in war, notes that “finally only the names of places had dignity. Certain numbers were the same way and certain dates and these with the names of the places were all you could say and have them mean anything. Abstract words such as glory, honor, courage, or hallow were obscene beside the concrete names of villages, the number of roads, the names of rivers, the number of regiments and the dates.”

A rural settlement on the western edge of Karma, a city near Falluja in Anbar Province, Iraq. Second Mobile Assault Platoon of Weapons Company, Second Battalion, Eighth Marines. October 30th, 2006; December 25th, 2006.