Our Father in heaven, hallowed be your name.
When I found myself alone with a family and their dying son, the familiarity and dependability of the Lord’s Prayer was the best I could muster. Not yet a family doc, I was a fresh seminary graduate, struggling as a chaplain to bring comfort in the face of impending grief. Familiar words, with which we could together come before the Almighty, seemed the best place to start.
She hadn’t been able to talk for several days. I don’t know what robbed my mom of her speech. Was morphine the culprit, with its ability to dull both mind and body? Did sheer exhaustion from laboring over each breath leave her too tired to talk? Or maybe her pain was so severe that she could not give voice to its intensity. But what she couldn’t speak with words, she spoke with groanings.
In nursing school, to learn about human anatomy, we dissected stray cats. The tiny blobs and structures inside them looked more like toys than organs; at times I had difficulty telling one part from another.
When our instructor got us invited to the medical school’s Anatomy Lab that studied real people, I was excited to finally see a complete human body. Maybe there would be straight pins with little flags for each section of the heart and brain. I expected the experience to be like our Cat Lab: clinical and unemotional.
In 1983, the community hospital where I worked did not yet use the acronym AIDS. We used another one–FUO, for fever of unknown origin–which was emblazoned in marker on a red card on the doorjambs of certain private rooms. These rooms each had an anteroom with a sink and a hamper. This is where the donning and removal of protective suits took place. In this 4-foot-by-6-foot space between the hall and the patient’s room, the garbage cans bore biohazard symbols, and the red bags inside them were doubled and then encased in a third, clear garbage bag–to protect us, we were told.
“There are some unusual spots on my feet that I want to have examined,” says the fifty-something woman with a friendly smile.
She is wearing an al amira, a two-piece veil consisting of a close-fitting cap and an accompanying tube-like scarf. The rest of her body is covered by her loose-fitting abaya, despite Philadelphia’s sweltering July heat. I have learned that these garments are traditionally worn by Muslim women as an expression of modesty when they’re in the presence of males not in their immediate family.
When I joined the surgical team, she was already a fixture, having languished there on the fourth floor for over two months. Attractive, in her early thirties, she wore little but skimpy lingerie–garb that seemed at odds with her belly, criss-crossed as it was with surgical scars and small holes that weeped gastric juices and intestinal fluids. On the team’s daily rounds, the surgeons would don gloves, avoid eye contact with her, hem and haw their way through a cursory exam, then quickly move on.
Only a medical student, and feeling awkward in her presence, I would trail behind, tapping out a note before hurrying off to catch up with the team.
Two daughters bring their severely demented mother into the clinic. The mother is no longer able to speak, but over the last few days she has groaned more during diaper changes. Her nursing home is worried she might have a bladder or vaginal infection. To check her urine, we undress her and catheterize her. To check her vagina, we take a swab using a speculum. We spin the urine and look for sediment under the microscope. Nothing. We look at the vaginal smear under the microscope, using both a saline prep and potassium hydroxide. Nothing. We treat her for bacterial vaginosis, because it’s a condition that’s easy to miss.
We were best friends, but we always respected each other’s physical privacy. All of this changed when I became Dad’s caregiver.
There are many ways to be naked. There’s physical nakedness, and there’s also the nakedness of feeling vulnerable. When my body and hence my life have been out of control, it has felt like nakedness. When I have had no covering against the elements, whether physical or psychological, I have felt naked.
I was in a large supermarket in the late afternoon. At the busy cheese counter, I took a number and stood waiting in the large crowd. When my number was called, I pushed through the customers to the counter and gave my order. After I’d finished, I took a half-step backward and collided with someone.
As I turned around to apologize, I found myself facing a young woman who towered over me. I am white; she was African-American and wore the uniform of a meter maid. I said that I was sorry, that I hadn’t seen her.
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