patient stories

The Face of Christ

One of my continuous prayers is to see the face of Christ in my patients. St. Mother Teresa is my model for this. She was particularly fond of “the least of these” (Matthew 25), saying of the people she encountered that “each one of them is Jesus in disguise.”

Who could be more vulnerable, more overlooked, and more needy than some of the patients I encounter? The poor? The suicidal? The addicted? The homeless? The lost? My job sounds like it is so incredibly holy. But, oh, boy! Let me tell you something: sometimes Jesus is disguised real well in my patients.

The psychotic patient calling me horrible names. The creepy older man hitting on me. The opioid-addicted person who comes in with a fake complaint to try to secure narcotics. The poor person on disability for a disease I don’t even think they really have who asks me for juice, crackers, footies, blankets, and anything else they can get. The young person who is more into his or her phone than getting medical care. Alllllllll the dental pains and stubbed toes!

(No joke. I once saw a page from Emergency Medical Services (EMS) that they were bringing in a toe pain with a mechanism of injury of a brick 3 days ago. Cue eye roll.)

Man, I wish the Gospel message were easier. The Gospels are chock full of examples of Jesus telling His disciples to care for the needy as they would Him. But, have you taken care of some of these “needy” people out there? Like a needy patient that’s on the call light every minute? Sometimes, I literally think as I’m taking care of a particularly difficult patient and holding back so much anger, frustration, and even hatred: “Man, you’re lucky I believe in Jesus and have to love you.”

It is difficult to find Jesus in the faces of some of my most frustrating patients. Thus, my usual prayer to find Jesus in my patients. Sometimes, however, it’s painfully easy to see Him. As I’ve been entering into the Passion of Christ in Fr. Kevin O’Brien’s book The Ignatian Adventure as well as entering into the Passion as Holy Week has started, I keep returning to one particular patient who was the face of Christ for me.

I remember the room well. My Emergency Department has four rooms without curtains. Instead, they have a metal retractable wall and metal curtains. These rooms are reserved for psychotic patients to help protect them from themselves. Often, however, these rooms are utilized for non-psych patients, as it was in the case of a man we’ll call Jay.*

I did not even know I was receiving a patient until I came out of an adjacent room and saw multiple police officers outside my assigned bed. “Is he going to live?” a female officer asked me. I was confused. Most police officers I encounter at work are annoyed at being there, assume everyone is going to live, and more interested in their phone and/or radio than the patient. Who was this patient?

“Let me figure out what’s going on first,” I told her as I entered the room. With one glance at my new patient, I knew why she had asked. The once-white gauze wrapped around his head were varying shades of red: from bright red rose to a dark garnet. His clothes were spotted with dried blood. His face was marred with lacerations and abrasions. His left eye was swollen shut. His breathing was shallow. My patient looked  dead.

“Hi. I’m Marissa. I’ll be the nurse talking care of him,” I stated as I squirmed my way through the crowd of EMS and police officers to grab a pair of gloves. “What’s going on?”

The senior paramedic with salt and pepper cleared his throat. He told Jay’s story as I hooked up monitoring equipment. “This is Jay. He’s a 81 year-old male coming from home who sustained multiple abrasions and lacerations to his face. He has a history of Parkinson’s.”

Jay’s heart rate was elevated, likely due to obvious blood loss. “What’s the EBL?” I asked. EBL means estimated blood loss, an important factor in resuscitating trauma patients.

“About half a liter,” he answered.

“How’d this happen?” I asked as I glanced at the other vital signs on monitor. Jay was breathing well enough to have adequate oxygen saturations on room air, despite obvious dried blood in his nares. I placed a blood pressure cuff on his right arm and heard the monitor whir as it puffed up.

“His son,” one of the officers in the back right corner of the room said softly. My heart dropped.

I grabbed one of the scopes – the ophthalmoscope – to exam his eyes. “Jay, can you hear me?” He opened his right eye. The sclera was stained red, making his blue iris all the brighter. “Look at my nose,” I said as I shined the light on his pupil. 4mm. Reactive. “Can you open the other one?” The left lid weakly opened. I could not see a thing. “That’s Ok.” I replaced the ophthalmoscope with a thermometer probe. “Open for a temperature.” Jay obliged. “Under the tongue.”

As the thermometer read, I looked at Jay’s face. He had a deep laceration on his nose and countless superficial ones all over his face. Looking more closely at the head bandage, I saw bright red blood slowly oozing from his right temple. His son did this to him? I thought to myself.

“Jay, do you know where you are?”

“Hospital,” he said softly.

“Do you know what happened to you?” He remained silent. I did not have the courage to ask again for the sake of orientation questions.

I moved to the computer in the room to chart. “How bad is that cut under the bandage?” I asked the paramedic.

“Good couple inches. Couple others in there too. No squirters.”

“Blood thinners?” I asked. The paramedic shook his head. “He’s got a lot of lacerations. Any idea what he was assaulted with?”

“We found a piece of wood with nails in it, covered in blood,” the officer next to me said. “We think it’s that.” What the hell, I thought, as I clicked through all the mandatory triage tabs. Who could do this to their father?

The doctor – a third year Emergency Medical resident – soon entered the room. She asked similar questions, and the police officers with the patient told the story. They were called for a wellness check by a family member when the son of the patient had not heard from his brother or father in half a day. His brother struggled with mental illness, and his father had Parkinson’s with a touch of dementia. The police arrived, finding Jay on a couch downstairs, coated in blood. Next to him was a wooden stake with nails driven into it. Their partners had found Jay’s son and arrested him. So far, he admitted to assaulting his father and making the wooden stake to do it. He reportedly had been off of his medications for several days. I chimed in and reiterated what I knew: 500cc blood loss, multiple abrasions and lacerations, tachycardic, normotensive.

“Let’s take this thing off,” the resident said, motioning toward the bandage. She and I worked to take off his head wrapping, occasionally spraying saline so it came off easily. As the paramedic described, Jay had a particularly deep laceration on his right temple.

“Want an IV?” I asked, as I saw Jay grimace as we continued. She nodded. Wordlessly, the resident continued to evaluate his head as I worked on an IV. I drew all the usual rainbow of labs, pulling two extra lavender top tubes, the necessary ones for crossmatching blood types for giving blood.

“Scissors?” the resident asked as she moved down his body to his chest. I handed over my trauma shears. “I’m going to cut your clothes off,” she told him.

“I’ll get evidence bags,” I said. Working in a Level I trauma center, we are fairly used to collecting clothes as evidence for the police in paper bags.

“You can get him 25 of fentanyl while you’re out,” the resident said softly as she continued to cut. I looked at where she was cutting on his left arm, and saw another deep laceration on his left wrist.

I saw my ED technician at the desk and asked for evidence bags. “What’s going on?” he asked.

“Old man got assaulted by his son,” I said softly. “He’s going to need a major wound prep later.”

I went to the medication machine, overriding for the narcotic the resident had asked for. Who could do this to their father? I asked myself again. I could not help but think of Jesus. Picturing Jesus at the Crucifixion, I pictured what Jay looked like. But Jay was worse than I had ever imagined, even worse than I had seen in the movie The Passion of the Christ:

The resident finished her assessment while I medicated Jay and started some IV fluids. I gave him a couple of warm blankets before moving onto other rooms. I was deeply disturbed and kept picturing him as I was with my other patients.

After a while, the resident tracked me down to tell me he was ready to be washed. She did not see other large cuts that would need to be stitched aside from the one on his head and wrist. In that time, my team had gotten a psychotic patient, and my tech was busy sitting bedside. I would need to be the one to wash his wounds.

I came bedside with a tub of warm water and soap. Jay had been fully exposed, covered only by a hospital gown and a few blankets. I glanced at the monitor, and his heart rate decreased a little. His other vitals were stable. “Jay,” I called. He opened his good eye. “I’m here to wash you up. How’s your pain.”

“Fine,” he said softly. I went to work, starting with his wrist. It was hard for me to look at his face, so I started as far away from it as I could. The resident had numbed him well. Jay did not even flinch when I washed out his laceration. His hand were caked in dried blood, and after finishing his other hand, the water had a distinct red hue. I washed out the basin before beginning to clean his face.

I looked at Jay’s face: the dried blood, the deep and superficial lacerations, the swelling, the bruising, all of it. I looked at him, and  it was impossible not to picture Christ.

When I was a travel nurse in Connecticut, I would often go to the  Yale University Art Gallery on my off days. It was free and close by. In the permanent gallery, there’s a painting by Bendetto Bonfigli that literally stopped people in their tracks. It was a painting of the face of Christ, a crown of thorns on his head, dripping blood on his face, staring straight ahead, brows furrowed with concern and eyes fill with compassion. No one painting of the face of Christ had moved me as much as that painting.

But now, I had no need for paintings. I had His face right before me. Cleaning Jay’s face, I felt like Veronica wiping the face of Jesus or like Mary anointing his body at Bethany (Matthew 26:6-13, Mark 14:3-9, John 12:1-11). I used to wonder what the point was of cleansing him, but I experienced it and learned how both actions were an act of mercy and love.

Jay winced occasionally as I scrubbed particularly hard sections with dried blood and deep punctures. The worst was his left eyelid. I worked in silence, interrupted only by monitoring equipment and the intermittent call. I could think of nothing to say. Usually, when doing a task for an extended period in a room, I’ll ask about a patient’s family. This circumstance seemed like hardly the time.

After a while, Jay was as clean as I could get him and left. At the nurses station, I updated the resident. My relief asked me for report, and I ran down my list of patients. When we got to Jay, she asked what I had been thinking all night, “Who could do that to their father?”

Before leaving, I stopped in Jay’s room one more time. I updated the police officers before standing next to him. “I’m going home, Jay,” I told him as I touched his right hand. “My relief is going to take great care of you. You’re in good hands.” He gave my hand a squeeze, and I said good-bye.

I heard several days later when I asked the resident about him that Jay ended up being hospitalized. His CT revealed some facial fractures. Beyond that, I’ve never learned of what happened to him or his son.

But his face and his story have never left me. How could anyone do that to their father? I asked that day and into the next several weeks. How could that father continue to love his son? But I think of the time when my nephews have hurt me, either physically or emotionally. I still love them, but the hurt is even deeper because of how much I love them.

(And yes, we can say that my nephews (2 and 4) as well as Jay’s son didn’t know what they were doing. Jesus Himself said in Luke 23:34: “Father, forgive them, they know not what they do.” But I hate using mental illness or mental capacity or any other excuses for hurtful behavior. Yes, people have it rough, but people are not just a product of their environment. People have freedom and in having freedom, have a choice when they act a particular way. We are not machines. We can override our desires all the time.

Therefore, people do know what they are doing and choose sin to a certain extent. Forgiveness is not condoning or excusing a behavior, pretending we are not hurt, or just calming down. Forgiveness is more than that, as Robert Enright explains in his book Forgiveness is a Choice.  I think many people cannot forgive merely because they are never been told they can hold other people 100% accountable for their actions and are allowed to be angry that they have been wronged. Anyway.)

When reading through the Passion in The Ignatian Adventure, it is easy to ask the question of How could anyone do that to Jesus?  While the disbelief is a natural reaction to witnessing a trauma, I am finding Christ calls me deeper, past the initial disbelief and into the shadowy depths of my own heart. As He said to his disciples at the Mount of Olives, “All of you will have your faith shaken” (Mark 14:27). Though I may deny it and think nothing can shake me, it does not take long for me to find places where I have strayed.

When I think about going to a co-worker’s bachelorette party, the thing I dread most is having to explain how I need to go off and pray. Am I all that different from Peter who wants to deny that he knows Jesus?

When I think about tithing, I think about how much more comfortable I could be if I didn’t give money away. Am I all that different from the disciples who were indignant that Mary of Bethany spent a large sum of money on perfume to anoint Jesus?

When I think about my heart, I cannot help but notice its pockets of hypocrisy. Am I all that different from Judas who said he was close with Christ but when given the opportunity betrayed him?

When I think about the crosses in my life, I know I pray constantly for them to be taken from me. Am I all that different from the passerby, bystanders, and thief who taunted Jesus to come down from His cross.

When I think about the times were God appears to be absent in my life and I am overwhelmed, I tend to question His power. Am I all that different from the soldiers who mocked his might?

When I think about walking in faith in my future, I am scared and want proof. Am I all that different from Herod, chief priests, and scribes who asked for a sign to believe?

Surely, I have strayed and my faith has been shaken. Walking to Calvary with Jesus is frightening. It means loving my enemy, wanting good for those who hurt me. It means forgiveness. It means laying down my will and accepting the cup of the Father. It means giving up my desire to be self-sufficient and elect to be reliant on Christ. It means nailing myself to my cross instead of running away from it. It means trusting over doubt. In essence, it means dying to myself, and I know I fail to do that daily.

But this is why I know Jesus blesses me with moments with certain people who so clearly remind me of Him. Just as Jay needed me to take care of him, I needed Jay to remind me that indeed my vocation of nursing is a ministry. It is a place where I can encounter the children of God, broken and hurting, and offer them the comfort, care, and compassion that Christ Himself has given me.

As St. Teresa of Avila wrote:

Christ has no body but yours,
No hands, no feet on earth but yours,
Yours are the eyes with which he looks
Compassion on this world,
Yours are the feet with which he walks to do good,
Yours are the hands, with which he blesses all the world.
Yours are the hands, yours are the feet,
Yours are the eyes, you are his body.
Christ has no body now but yours,
No hands, no feet on earth but yours,
Yours are the eyes with which he looks
compassion on this world.
Christ has no body now on earth but yours.

What a gift it is to tend to the body of Christ.

*Please remember details (such as and ESPECIALLY names and other personal health information) have been altered or omitted to protect patient privacy. See about page for more information!

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