During my clinical internships, a patient request came in to the chaplain’s office, where several of us were gathered.

“It’s for Willy,” one of the chaplains announces to the room. The others nod.

“Hey, Greg, this would be a good one for you,” she continues. “Willy’s in and out of the hospital a lot, we all know him. He’s a nice guy and loves chaplain visits, but he can be demanding so we try to share the load. Your turn today.”

I review Willy’s chart, which reveals a history of IV drug use and homelessness, though he is now clean, sober, and housed. He has several chronic medical conditions, including a heart condition I’m not familiar with: endocarditis. I mention this to one of the chaplains.

“Ah, yes, we see a lot of that, especially with patients like Willy. You’ll want to read up on it at some point. But you don’t need to know anything about it for your visit.”

So I head off, and Willy is just as advertised: Grumpy to see yet another new chaplain, but softening slowly as we engage. Grateful for company, happy to share about his religious upbringing and the twists and turns of his life, and appreciative of prayer. While difficult to disengage from, he leaves me hoping I will see him again—which I do. A beautiful, complicated human.

◊

Endocarditis is an inflammation of the lining of the heart, characterized by lesions, called vegetations, that are as strange as anything I’ve seen in medicine. Visualized via echocardiogram, they remind me of strands of kelp floating in a sea bed. Needless to say, that’s not a good thing for one’s heart valves or overall health, and it can be difficult to treat.

Endocarditis is usually caused by bacterial or fungal infections, and there are many risk factors that make people susceptible to it. The most prevalent, at least in the population served by my hospital, is IV drug use. That’s one of the reasons my chaplain colleague thought a visit with Willy would be a valuable part of my training experience.

◊

A year later I am called to a “rapid response” for Vivian, a patient on the floor where I’d visited Willy. This term means there has been an unexplained change in a patient’s condition. While often not serious, chaplains always respond in case visitors are present who may be distressed by the change in the patient or by the flurry of responders. This time there are no visitors, but it’s clear Vivian’s situation is not good. I stand aside as she is whisked down the hall on a gurney to the ICU. I check with her bedside nurse and learn that Vivian is visited daily by her husband as well as other family and friends.

I return to the chaplain’s office to scan Vivian’s chart, where I learn that, in addition to cancer, she’d been receiving treatment for endocarditis, possibly caused by an infection in her chemo port. I then head to the ICU, where providers of all kinds are rushing in and out of her room. The charge nurse spots me quickly and says, “We need you to take point with the husband, who’s on his way.” She paused to get an update from another nurse, then turns back to me. “He just arrived in the waiting room.”

What follows is some of the most difficult work I’ve done as a chaplain: Conveying the gravity of Vivian’s condition without prematurely extinguishing hope. Accompanying her husband through shock and grief while helping him spread the news of Vivian’s situation to loved ones. Welcoming family members to the ICU waiting room and gathering them for updates from doctors working to save Vivian’s life. Steadying them through new waves of grief as they receive the news that nothing more can be done. Keeping vigil with them in the waiting room as the staff prepare Vivian’s room for all to gather to say their good-byes, then accompanying them back to see her. Through it all, we share many tears and prayers.

In the agonizing waits between updates, I ask her loved ones what they would like me to know about Vivian. I learn that she is a committed life partner, a hard worker, a person of bedrock faith, a loyal friend, the life of a good party. All I can say in response is that she sounds like someone I would like to know. Yes, they say, everyone loves Vivian.

◊

I step outside of Vivian’s room to speak with Dr. Weiss, who’s been leading the charge to save Vivian’s life. He is busily charting the care that had been provided to Vivian.

“This might take me a while,” he says tersely, without looking up.

“I understand, I will wait,” I reply as calmly as I can manage.

After 30 seconds or so he stops typing, hangs his head for a moment, then turns toward me. “I’m sorry. What’s your question?”

“I’m trying to prepare the family for the next step, which I suspect is you explaining the process of disconnecting life support.”

He nods. “I need a few minutes, but I don’t want to wait too long, either. What do you think?”

“Five minutes is probably about right. Give me a couple of minutes, then come in whenever you feel ready.”

He nods again, then pauses. “You know, when I saw she had endocarditis, I just assumed she was a drug user, though I realize now that she’s not. I’m sitting here feeling like a complete asshole that this thought even crossed my mind, because it shouldn’t—and didn’t—change the care we gave her. Still, I feel terrible that I thought it anyway.”

“Well, if it’s any consolation to you … I went through the same thought process. I don’t think that makes us assholes, I think it just means we’re human.”

We share a brief nod and smile, then resume our duties.

◊

The Trappist spiritual leader Thomas Merton urges us “to resolutely put away our attachment to natural appearance and our habit of judging according to the outward face of things … Our job is to love others without stopping to inquire whether or not they are worthy.”¹

Like many spiritual teachings, I hold this as an ideal to which I fervently aspire, but most days I fall short. I’m only human, and this habit of judging has usually run its course before I even recognize it happening. Dr. Weiss is only human, too. Same for Willy, for that matter. I know we’ll all keep trying, but we’ll also keep failing. We’re all human, and that’s the best we humans can do.

I’m just grateful we have each other to look to for support when we do fail, and a Creator with infinite compassion for our limitations.

1. For the full context of this quote please see: Thomas Merton on Loving Others ↩︎