Part of my hospital chaplaincy duties is to write a reflection on how it’s going. Identities may be altered for privacy. All the writings are here.
The patient, Jerome, had a trapezoid-shaped hole in his head, and he told me it was from his son.
Jerome’s son had waited in his father’s home until he came back from work, and then he robbed him. Jerome fought back. In the struggle, his son had picked up one of those bright and shiny geode rocks the size of a torso, lifted it to the sky, and wham, in a sick, slicing arc, brought it down into his father’s head. The son was still at large. The father, after six months in physical therapy, still could not get the blood stain out of the carpet in his house. Jerome had lost his job at the oil rig; his wife had left him; his other son took two jobs to pay off the hospital bills, but one evening after dropping off his dad for PT, had been struck by a sixteen-wheeler and died on impact.
“Chaplain, I had this dream,” Jerome said, scratching his old wound, “that in another world, I was someone else, I was someone better, that I have two sons who love me, my wife never left, I was still at the rig with the boys … I had a dream that I was someone not me. It was extraordinary. It was wo—”
He fell asleep, which he told me would happen. His brain needed to shut down when it overworked itself. A few seconds later, he woke up and apologized.
“I had this dream, chaplain. Do you ever dream that you are someone in another world, a different you?”
I visited another patient, Donnie, who weighed about 1400 pounds. His legs had been amputated and he was nearly blind. He had a neurological deficiency in which he couldn’t stop eating; he had become diabetic and was recovering from Takotsubo cardiomyopathy, or as it’s also known, broken heart syndrome.
“Chaplain, I just think,” he said, eating his third plate of pasta, “I was meant to do … something, anything. Anything. Not this. Everyone tells you that your life is meant to help people, but how the hell can I do that here? Look at me.”
In our chaplain training, we call this intrapsychic grief, the pain of losing what could’ve been and will never be. It is the loss of future, the theft of invested time. It’s not a tangible, physical loss, but an internal shipwreck, the imperceptible emotional shriek in our chest when the picture of life we had planned for so long simply dies.
Donnie, the blind, obese, bedridden man with no legs, ordered pizza for the whole floor. That was, he felt, the best he could do. I told him it was even better than that.
Another patient, Lorenzo, had been in a car accident a few days before, and he suffered anterograde amnesia. He was having trouble remembering the words he had just spoken.
“Chap—you the chap, right?” He rocked back and forth in his bed, nearly clapping his hands in frustration. “My girlfriend is real worried about me, man, she real worried. I think I’ll be fine though, but my girlfriend, she real worried about me. I’m not worried, I think I’ll be fine, chap. You the chap, right?”
He repeated himself, perhaps, to find security in the canvas of his own assurances. His brain had resorted to a safe mode, to grip onto the word-balloons which were floating away, by constantly making new ones.
I was astounded and bewildered by how much a mass of gray pulp between our ears can determine the course of a life, and how inside the soul-box of our neurology is the possibility of a hundred lifetimes. I was angry that the tiniest neuron could so effectively demolish an entire world.
What separated me from someone else not me, except by the tiniest shred of a neuron, one misfired synapse, one slender thread of chance?
Another patient, Tony, was telling me that he had gotten weaker and weaker in his legs until one day, on the way home, he had collapsed at the ATM and there were floating heads around him asking what was wrong, but they looked like demon faces, and he tried to kick them off but he couldn’t move anymore. Tony had some sort of encephalopathy that had caused brain lesions and he was seeing things that weren’t there.
“But you know, chap,” he said, breaking into tears, “I got this long-lost brother up in Boston, he’s my half-brother but he loves me like a full one, Mikey, this guy’s made of money and he offered me a room at his place, his house is on this fifty acre property, it’s a mansion. Can you believe it?”
I spoke with Tony’s sister, who told me that no such brother existed, and there was no room, no mansion, no fifty acres. It was a story that Tony had been telling himself for months now, when his legs began failing him. It’s all he wanted to talk about, this promised land.
Oliver Sacks, in his book The Man Who Mistook His Wife for a Hat, writes about disturbed patients who “confabulate,” who spin tales all day long in a constant stream of chatter. They cannot help but conjure completely made-up yarns about meeting celebrities or devising inventions or discovering something remarkable, as if the widening chasms in their brain need a desperate momentum to thrive. Or, worse, such activity drowns out the long fall of personality into the abyss, into the unrecoverable ether. One story after another tumbles over the cliff so they don’t have to.
I don’t correct them. Placebos work because they are medicine given power; who am I to revoke a fiction made canon?
It is my role to honor the burial of what can never be done. It is my role to remember what will never become. It’s not just my role; you and I need this more than we think. At every turn, every choice, we die a million deaths each day. How can we stand such a thing, except to tell those stories that never had a shot?
I had this dream …
Suddenly, Jerome, the man with the trapezoid hole in his head, nodded off again, but his eyes fluttered, like someone was still home.
… that in another world …
He spoke, but a voice that sounded thicker, more weight, more verve. He sat up taller, his eyes closed but working. I took a small step back.
… I was someone else …
Jerome’s eyes quivered and he said, “I am the man from the other world.” He smiled, just for a second. “I am a hundred lifetimes, I am one of many. I am not who I could be.”
… someone not me.
“I am a life never had. I am the man in the dream. The dream wishes he could be the man in the other. We all wish to be awake in someone else. There is no perfect dre—”
And he woke up. Jerome blinked, saw me, and he apologized for sleeping again. I wasn’t sure if I should tell him about the other voice.
He said to me, “Chaplain, thank you.” He held my hands, his eyes alive and fiery, wet and fierce. “Thank you for listening. I have to believe my son didn’t mean it. He did the best he could with who he was. I still love my son, in this world or the next.”
I left the room shaking. I questioned if I had really seen what I thought I saw. I repeated his words in my head, I replayed the eerie twitch of his eyes, the way his body slipped into another skin, another dimension.
I wondered if I had glimpsed, even for a second, a keyhole into other possibilities, like dipping a toe into the stream of the infinite, where a son did not ruin his father, where a man missed a car by inches, where a promised land of endless acres was waiting at the other end.
I thought about how we’re always dreaming of being someone else, and the others are dreaming of each other, wishing for a world they couldn’t have.
We survive the nightmare, I think, by dreaming. To dream is to cope. It is the brain’s essential defense against itself. We create new dreams all the time, a new canvas of assurances, to wake against the intolerable. It feels like a lie: but what is hope, really, except a story we tell ourselves in the dark to light the way? If it works, who is to say otherwise? The world continues to be cruel and unfair, but we do the best we can with who we are, to dream amidst the wreckage of what no longer is, to bend with the merciless wind. To even share pizza with the whole floor.