“Two are better than one, for if one falls, the other can help their companion up again; but how tragic it is for the solitary person who when down has no partner to help them up.” (Ecclesiastes 4: 9-10)

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A nurse called to request a chaplain; her patient, Eleanor, in her early 70s, was quite withdrawn, and she thought a chaplain might be able to engage her.  Reviewing her chart, I learned that Eleanor had fallen in her apartment and had remained down for three days, until a neighbor noticed her absence and called 911.  After two days in the hospital she was emerging from delirium, but she had other underlying health issues.  No personal contacts had been identified.

As Eleanor had tested positive for MRSA, an antibiotic-resistant infection, I first don a protective gown and gloves, then knock and enter her room.

“Greetings, Eleanor, my name’s Greg, I’m one of the chaplains here.”

She turns slowly toward me, squints, and says, “You’re a what?”  As I draw closer, I note her ashen complexion and several open sores on her arms.

“I’m a chaplain.  I’ve come by to offer to spend a little time with you.  Is that something you would like?”

She smiles gently and closes her eyes.  “A chaplain!  That’s so nice.  Yes, please stay.”  I pull up a chair by her bedside.

“It seems you’ve had a rough few days.  I’m glad you are here now so we can help you get better.”

“Oh, if you only knew the stories I have to tell …”

“I’m here to listen, and I have the time.  It’s really up to you to say whatever you want to say—or not.”

“It’s too hard, and I’m too tired to talk.  But would you stay here for a bit?”

“Of course!”  We sit quietly for a time, then I ask, “Would you like me to hold your hand?”  I place my hand a few inches above hers.  Wordlessly, she reaches up and clasps my hand, then brings our hands down together beside the bedrail.  I quickly sense the coldness of her hand through my glove.

“Ohhh …” Eleanor sighs and smiles.  “Your hand is so warm!”  I lay my other hand on top of hers.  “Even better!” she responds.  We sit in silence, gently squeezing each other’s hands every once in a while.

Gradually, Eleanor offers a few details.  She was raised Catholic but left the Church while still young, retaining only a sense of a God who loves her.  She has a brother but they fell out several years back and she’s lost touch.  She’s grateful to have an apartment—she hasn’t always been so fortunate—but she keeps very much to herself.

“If you only knew the stories I have to tell …” she repeats more than once but never continues.  It appears those will have to wait for another time …

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In preparing to visit a patient, I always look to see who is listed as a contact—and I make a special note to myself when that section is blank.  As with any patient, I listen for them to mention other people who are involved in their lives; if no one surfaces after a few minutes, I will ask directly:  “Who are the most important people in your life?”  More often than I wish, they answer, “I have no one.”  It never fails to break my heart.

Decades ago, before our current housing affordability crisis, I took a training class on root causes of chronic poverty and homelessness.  One instructor said something that stuck with me:  Homelessness is less about running out of money than running out of relationships, for if one is rich in relationships then help—even if just a sofa—is often available.  However, behavioral problems—including substance use—have a way of burning through relationships and wearing out one’s welcome, and the street becomes the only remaining option.  While this risks oversimplifying a complex problem, it captures an important dimension of the interconnectedness between mental health, substance use, and homelessness.  It’s a story I have heard many times at a patient’s bedside.

Of course, the problem of loneliness extends far beyond those living on the streets.  Loneliness has been declared a public health epidemic by the US Surgeon General,^[1],[2] and it is estimated to afflict up to half of the US population.  Studies have documented the health impacts of loneliness, including increased risks for heart disease, stroke, type 2 diabetes, and premature mortality.  None of this surprises anyone who spends significant time with patients in a hospital.

What can a chaplain (or friend) do?  As is often the case, not much and yet maybe a great deal.  The simple act of showing interest can open the door a crack for a lonely person unaccustomed to attention, as it appears to have done for Eleanor.  As I held her hand while we sat, I wondered how long it had been since she’d felt any kind of meaningful touch.  We humans are hard-wired for loving touch, as anyone spending time with young children can’t help but observe.  While prolonged isolation or trauma can make touch uncomfortable or even unbearable—and therefore it can only be offered, never presumed—we do not come into the world that way.  We all need connection.

In Eleanor’s case, our time together appears to have been therapeutic.  I never had a chance to hear her stories, but she began to open up and trust other caregivers and staff.  She engaged with a social worker who was able to track down her long-lost brother, and after some reticence, they agreed to a call.  It turned out to be a bittersweet reunion, as both were on their deathbeds in hospitals many miles apart, but afterwards Eleanor expressed appreciation for this chance to bring closure to that relationship.  She did not die alone.

When I retired from my full-time consulting career 11 years ago, I, like many new retirees, feared the loss of the relationships that had made my work life meaningful.  I decided to create a simple spreadsheet I call “Friends for Lunch,” which lists the relationships—business and personal—that I don’t want to let stagnate, along with the date when we’ve last been in touch.  It’s had many additions and deletions over the years, but the friendships this tool helps me keep alive are among my greatest treasures in life.

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[1] “Surgeon General: We Have Become a Lonely Nation. It’s Time to Fix That.”  NY Times, April 30, 2023.

[2] “Our Epidemic of Loneliness and Isolation: Key takeaways from the U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community.”  US Department of Health and Human Services.