Dr. Saul Ebema

In 2008, I got accepted into the Clinical Pastoral Education (CPE) program at Elmhurst Hospital in Elmhurst, IL. That summer, I had graduated with my MDiv and was looking for a ministry opportunity that did not involve church work.

I had enjoyed my CPE unit experience at the Adventist LaGrange Hospital and wanted to pursue chaplaincy. During my unit of CPE, I was placed in the detox unit at the hospital and I enjoyed my experience of walking alongside and counseling patients struggling with addictions and their families. Some of those interactions were special.

I was excited about exploring chaplaincy further through the CPE residency program. There were five of us accepted into the program. After the usual orientation routine, our supervisor Fr. Mike assigned us to hospital units where we would spend our entire year long residency.

Fr. Mike was a progressive Catholic priest that loved his cigarette and would often be found outside at the corner of the hospital with a lit cigarette in hand. But do not let that exterior fool you, he was everything you would want a CPE supervisor to be. He was humble and respectful; devout to his faith and always encouraged us to have an open mind during patient visits. He was never harsh but often challenged us where we needed to be challenged.

Everyone got assigned different units within the hospital, but I was assigned to the Hospice department to work closely with the hospice chaplain.

I was happy with my placement in hospice care because a year before this, I had worked as a volunteer chaplain at the Family Centered Hospice in Addison. I had enjoyed driving around the neighborhood, visiting patients in homes, nursing homes and hospitals. So, being placed with the hospice department was a natural fit.

After two weeks of orientation with the hospice chaplain and making visits with her, I was assigned my own patients to visit on a regular basis and that was when I met Nancy B. (not her real name)

Nancy B. was a 95-year-old woman and was one of the nicest residents in that nursing home. Her hair was grey, short, and lush. Sometimes her eyes appeared milky when she was tired but usually, they were gleaming with energy. Her face was weary at times but always loved having visitors. She had outlived her friends and family therefore, did not have any family left. She was married at some point but never had children.

As a chaplain in training, I enjoyed my visits with her. She was admitted to hospice care with a diagnosis of end stage Alzheimer’s disease. As such, she never remembered me, and each week was a fresh start. After about three months of weekly visits, I became somewhat a familiar face to her.

Perhaps because of that sense of familiarity, she began to assume different personalities upon me every time I visited her.

Like she would say, “I know you, you are my brother.” The next time, “I know you; you are my husband.” On another visit, she would say, “I know you; you are the mail man or the milk man.”

Initially, I would try to correct her saying “no, I am the chaplain.” Those attempts to correcting her often led to unpleasant visits because she would get agitated and angry with me.

After a number of agitation episodes, I decided to seek for wisdom from my CPE supervisor, Fr. Mike. After listening to my story of struggle with providing comfort for Nancy B, he went straight to the point.

He said, “Saul, why do you try to correct her? When she assumes a personality upon you-like calling you her husband, her brother, the mail man, etc., just accept that role and play along. By accepting the role that she assumes upon you during the visit, you will be able to provide the best care for her and she will benefit greatly from your visits.“

In my next visit, I was ready to play along. The moment she saw me, she immediately said, ‘I was looking for you?”

I said, “really? Do you know me.”

“Yes, I know you, you are my husband.” She replied with confidence.

So instead of correcting her this time, I played along, and we had a great visit.

Then one day she shocked me.

She said, “I’ve been stuck at the train station for a while but will be boarding the train soon to go home. To be with my mother.”

Now this is a woman who is 95 years old, so I did not take that seriously. I figured that it was just the delusion caused by the Alzheimer’s disease and decided to play along.

“How long have you been at the train station?” I asked

“About two weeks now. It’s been a long line, but I am getting closer.” Then she continued, “If I board the train, I will leave you note.”

I thanked her for her kindness but did not think much of it.

The following week, I took off for vacation.

When I returned after vacation, without reading the hospice notes, I went to visit her. Only to be told by the nursing home secretary that she had died that week I was off.

Then I remembered her story of being at the train station and about to board the train. It then donned on me that in her own way, she was telling me about her death. I have now learned to take such communication seriously.