(This is the fifth in the series ABCs of Hospital Chaplaincy.)

It is the beating heart of the hospital. It’s also the only place I’ve ever seen a human heart beating (or struggling to beat) inside someone’s chest, up close and personal. I never know quite what I’m walking into when I get a call to the ER. Chaplains are part of the trauma team, automatically paged in the event of a trauma call. (More on that when we get to the letter T.) But there are many other reasons we get requests to come to the emergency room. It’s one of the units where I spend the most time. My closest friends on staff at the hospital are those who work the ER. (Incidentally, it is more appropriately called the emergency department, since it comprises many rooms. But thanks to those pharmaceutical commercials, when I hear ED I can only think of erectile dysfunction, so it remains the ER for me.)

Here, it’s all about crisis. Almost nobody wakes up in the morning planning on being in the ER later that day. The things that bring people here are sudden and surprising. I do my best to emanate calm, not to show shock or surprise no matter what I might see or hear. If I ever see you in the ER (and I sure hope I don’t), I will maintain a non-anxious demeanor, even if you tell me you just brought your young daughter in because she’s having seizures, or that your wife just attempted suicide, or that your father is in cardiac arrest, or if you have a wound open all the way to the bone, or if you were just sexually assaulted, or if you survived a shootout at your family reunion. Allowing myself to get pulled into your anxiety is tempting, almost reflexive, but it won’t help. Taking slow, deep breaths, and encouraging you to do the same just might.

I used to feel a surge of terror every time I got a page from the emergency room. There is still some anxiety, the fear of the unknown, but more than anything there is the anticipation of being useful. Most of the time when I walk out of the ER, I leave feeling that I was helpful, even in some small way, that my being there made a difference. That’s a really good feeling. It wasn’t always that way, but after six years on staff at this hospital and countless calls to the ER, I know the territory well. I know the shortcuts to the waiting room and how to steer family members through the maze to a private consult room where medical staff can update them. I know where to get ice water and boxes of tissues for upset loved ones.

I know many of the nurses, doctors, and techs well enough that we can communicate to each other with just a look, working together organically to care for patients and family members in the midst of seeming chaos. I know that some of them can tell when a particular situation is wearing on me, and that when they ask, “How are you doing?” they really want an honest answer. I know that when they lose a patient, they may not want to talk about it right away, but it’s hard and sad and it’s good for them to know the chaplain is there. And I am there, as often as I can be. It’s one of the places I most feel the presence of God, and I hope to help others feel the same. With over two dozen rooms that are sometimes full to overflowing, and at least that many staff members working one of the most stressful jobs I can imagine, there is always ministry to be done in the ER. Even if it’s hard, I love when I get to be the one to do it.