Dead Bodies and Lamentations

What do you do with a dead body in the room?

My first dead patient arrived that way. He was half naked, pupils blown, head bashed in from a car accident in which he was thrown through the windshield. It was my first week on the wards as a medical student and though I had been through enough trauma alerts with the surgical team to know the drill, the brutality of it all still took me by surprise. The trauma bay was chaotic for all of twenty minutes as the team performed what they already knew would be an exercise in futility: chest compressions, central lines, bags of saline, etc. Someone had asked me to get warm blankets so I scurried around retrieving them but primarily tried to stay out of the way. Once the twenty minutes of resuscitation were over, the chief resident called the time of death and everyone simply stopped what they were doing and awkwardly shuffled out of the room. I remember standing there under the bright spotlights alone with the dead body, blankets still warm in my hands, watching as blood suddenly decided to gush out of the man’s skull and onto the tiled floor. I remember staring at the growing puddle and feeling like the most helpless and useless person in the world.

In the years since, I have been in the room with a dead body more times than I can count. I have been the one to warn the family of what was coming, whether they were prepared or willing to hear it or not. I have begged them for permission to stop CPR, to acknowledge the death as final and irreversible. I have had to make the pronouncement of death. I have watched family weep with silent tears and have had them scream at me from down the hall. I have done CPR on babies and adults. I have helped zip up the body bag. Even as I write this, my memory relives the hearing of those noises, faces, voices, lamentations.

Whether I want to or not, whether it is fair or reasonable or not, my job puts me in a position to listen to a wide range of hurt and anger and grief. It has become reflexive to absorb these narratives, in part because it makes me better at my job but also because the plainness of the suffering voice is compelling. That said, some days I come home both thoughtful and irritable, resentful of my role as a dustbin for the sorrows and troubles of others. I grouse and pour myself some seltzer over ice and sort through the emotions of others that have been laid on me.

But in some odd way, I have also come to appreciate such experiences even if I cannot bring myself to be thankful for them. In thinking about that helpless experience of watching blood spill out of a man’s head, of pushing a baby’s chest in perfunctory CPR, of shocking a dead body into convulsions over and over again, I am forced to acknowledge the brutality of death and visualize how easily the sacred becomes desecrated.

I recently heard seminary professor Dr. Soong Chan Rah talk about the Book of Lamentations, how it begins with a funeral dirge for a nation humiliated, raped, and obliterated into exile. He talks about how the book speaks about the dead body in the room, the death of the nation of Israel. It is composed in broken meter, styled to imitate a limp, written from the voices of the beaten and wounded.

How lonely sits the city
that was full of people!
How like a widow has she become,
she who was great among the nations!
She who was a princess among the provinces
has become a slave…

My eyes are spent with weeping;

my stomach churns;
my bile is poured out to the ground
because of the destruction of the daughter of my people,
because infants and babies faint
in the streets of the city.

They cry to their mothers,
“Where is bread and wine?”
as they faint like a wounded man
in the streets of the city,
as their life is poured out
on their mothers’ bosom.

- Lamentations 1:1; 2:11–12

There has been a lot of talk in the post-election season about “understanding one another” and “coming together” and “moving on.” There has been a lot of wondering about “why can’t we all just get along?”, a question that would seem honest and harmless if not for its implicit favoritism towards the dominant culture.

There are many things to lament, as there are many things that are broken, and this is legitimately true in most shades of American politics. But racism is a particular sort of devastation in our history that merits its own dirge, one that the American church has been too reluctant to sing. Think for a moment about the white nationalist conference in DC and resurgences of the KKK, then think about these words from the book, “The Cross and the Lynching Tree”:

No historical situation was more challenging than the lynching era, when God the liberator seemed nowhere to be found. “De courts er dis land is not for niggers,” a black man from South Carolina reflected cynically. “It seems to me that when it comes to trouble, de law an’ a nigger is de white man’s sport, an’ justice is a stranger in them precincts, an’ mercy is unknown. An’ de Bible say we must pray for we enemy. Drop down on you’ knee, brothers, an’ pray to God for all de crackers, an’ judges, an’ de courts, an’ solicitors, sheriffs, an’ police in de land.” Whether one was lynched on a tree or in court, the results were the same. “Lord, how come me here,” they sang, “I wish I never was born!” (page 27)

The language of lament has helped me understand what has been so bothersome about the “evangelical” Christian voice in the national politic. We talk about how the church is the cure to American culture without acknowledging its complicity in a long history of corruption and tainted ambition. We talk about our entitlements to freedom without mentioning the offal nature of slavery and oppression. We demand forgiveness and reconciliation without recalling our viciousness of speech and deed. We talk about God’s sovereignty as resurrection without mourning the abused and defiled body of Christ. We have skipped ahead to resurrection songs when the bleeding body is still naked on the stretcher.

What do you do with a dead body in the room?

What can I say for you, to what compare you,
O daughter of Jerusalem?
What can I liken to you, that I may comfort you,
O virgin daughter of Zion?
For your ruin is vast as the sea;
who can heal you?

Your prophets have seen for you
false and deceptive visions;
they have not exposed your iniquity
to restore your fortunes,
but have seen for you oracles
that are false and misleading.

All who pass along the way
clap their hands at you;
they hiss and wag their heads
at the daughter of Jerusalem:
“Is this the city that was called
the perfection of beauty,
the joy of all the earth?”

- Lamentations 2:13–15

Dead Bodies and Lamentations

Scum of the World

I could hear the cussing from inside the room and noted the awkward glances of nearby nurses and staff who turned to look and gawk. Even though I only sat a few feet outside the door, I ignored the increasingly loud litany of expletives and deliberately focused on the screen in front of me. He was my patient and I was doing my best to concentrate on his rapidly evolving list of medical problems, the electronic progress note already ballooning in front of me as I tried to prioritize multiple terminal conditions competing for attention. I scrolled through pages of old notes that were littered with repeating instances of phrases such as “lost to follow up,” “did not comply with therapy,” “uncooperative,” and the ever favored, “signed out against medical advice.” I paused and watched as a freshly berated specialist walked out of the room, sat down at a nearby computer, and dictated into his own note the word “belligerent.” The diction snob inside me was pleasantly surprised to hear a new and applicable word and so I inserted it into my note as well.

Last week my pastor asked me, “How do you keep from becoming cynical?” The question caught me off guard; it occurred in the context of a series of conversations on the struggles of caring for people in both spiritual as well as physical matters. My reply was somewhat flippant as I didn’t have a good response. The question was unintentionally pointed; Pastor Tom is a quick-witted man and one of the many reasons why I respect him so much is that even though he appreciates a dry and sardonic sense of humor, he intentionally suppresses it. By contrast, I relish in lengthy conversations about all things dark and cynical. In college I would rant about the evils of systems of poverty, child slave labor, sex trafficking. Nowadays I rant about urban violence, health disparities, child abuse, racism, Donald Trump. I am not shy about these views and justify vocalizing them as a mechanism for challenging injustice, but the genuine and curious nature of Pastor Tom’s question left me unexpectedly exposed to scrutiny. After all, what is justice and how does that apply in medicine? What is the root of cynicism and why are criticism and sarcasm so satisfying?

Continue reading “Scum of the World”

Scum of the World

Trauma: What Freud Learned About Rape

In medical school we glossed over Freud because psychoanalysis had largely become outdated. Popular culture has turned his method into a mockery; we chuckle to think of the bearded psychiatrist listening intently to some dude reclining on a sofa talking at length about the hidden sexual meaning underlying his bedwetting dreams. In the new era of cognitive behavioral therapy and evidence based medicine, the realm of the subconscious seems better studied by functional MRI scans, neurobiological theories, and data-driven analysis & interventions. To see medical professionals chasing fanciful interpretations of dreams or inkblots would now seem quaint at best and like quackery at worst. Do we really esteem Freud’s preoccupation with the psychosexual stages of children with anything but puzzlement? Unsurprisingly, I was taught to have a low opinion of Freud and consequently rarely thought about him or his theories through the rest of my clinical training.

And yet I’ve recently come to a new appreciation for Freud from an unexpected source. Continue reading “Trauma: What Freud Learned About Rape”

Trauma: What Freud Learned About Rape

Segregation

It has been about a year since we moved out of the “inner city.” It’s an experience we are still processing with many mixed feelings, among them relief, disappointment, and shame. It is a relief to be able to walk around the block without fear of hearing gunshots, to sleep at night with working heat and running water in the winter (since the pipes don’t freeze here), to not wake to banging noises wondering if we are being broken into. It is disappointing to feel isolated in our rented apartment, that even though our neighbors are friendly and engaging, our interactions tend to be brief and largely disconnected. And shame… I am still not sure why we feel that but we do.

Continue reading “Segregation”

Segregation

Anniversary of Theft

My wife reminded me that it has now been one year since we were last broken into. She was partly reminded of this because our car was broken into last week, an incident in which only a cheap phone charger and several quarters were taken. This occurred despite having moved to a “nicer” area of the city, one in which we easily enjoy walks in the park and Greek festivals and fancy burritos. It is a neighborhood where we can walk freely, a stark contrast to our old one where I whimsically described myself as sticking out like a Chinese thumb on a black man.

Continue reading “Anniversary of Theft”

Anniversary of Theft

Failing Faithfully: Created, Fallen, and Waiting

[This is an advance post in a series from the ESN blog. You can find the first part here or here.]

In the first post of this series, I was ruminating about a patient who had a rapid decline in health and social circumstances, culminating in a recent scan that showed the possibility of cancer even while he was struggling with homelessness. It was a bleak situation that caught me off guard because I was not expecting it and was grieved to think of what it would be like for him to die alone.

He has since died.

Continue reading “Failing Faithfully: Created, Fallen, and Waiting”

Failing Faithfully: Created, Fallen, and Waiting