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  • Writer's pictureJohn Lantos

Parents prayers in the PICU

Two stories.

In one, Trondheim, by Cormac James, a young man collapses at a bus stop.  In another, A Small Good Thing, by Raymond Carver, a schoolboy is hit by a car.  In both, the boys fall into a coma. In both, the parents hover at the bedside, hanging onto hope and onto the doctors every word. In both, the doctors are cagey, enigmatic, unable to explain exactly what is happening or what to expect. “’It might be a day, a week, a month, who knows,’ the doctor said. Like some canny garage mechanic, she managed to make the uncertainty sound predictable, and the delay a point of pride. We won’t really know anything until we try to wake him up.” (Trondheim). “’We’ll know more in a couple of hours.’ The doctor looked at the boy again. ‘Sometimes you see this in shock cases, this sleeping. I don’t want to call it a coma. He’s just in a very deep sleep. It’s just a question of a little more time.’  Then he left the room.” (Small Good Thing)            

In both stories, a mother begins to pray.  One says, “I almost thought I’d forgotten how, but it came back to me. All I had to do was close my eyes and say, ‘Please God, help us – help Scotty,’ and the rest was easy. The words were right there.”

The other prays by her son’s bedside. “If what has to happen is he dies, she prayed, give me the strength to accept that.”  Later, her bargains with God become more complex, “If you save him, if you give him back to us, no matter what his state, I will accept – no, too mean – I will love him as he is, no matter what. I will love them all, with all their faults, just as You love me with mine.  That was the highest price she could think of just then.”

Then she has second thoughts, “Even if ghosted (the mother’s) every hope.  Even if they managed to get the tube out.  Even if they managed to wake him.  What would she be satisfied with? Awareness?  Recognition?  Motor skills? Or what that too greedy? What would she give, for instance, for him at least to be able to talk?”

In one story, the child dies. The doctor tries to comfort the parents. He puts his arms around them both. The mother thinks, “He seemed full of some goodness she didn’t understand.”

In the other, the boy wakes up. Nobody expected it. “During her five years in the ICU, the ward nurse had seen all kinds of sorrow and never once cried, but she was crying now, at the end of Pierre’s bed.  Within minutes, the rumor had spread, and from all over the ward, the scrubs began to gather at the doorway to catch a glimpse of the miracle.”  The doctor celebrates with them, “Most of my patients leave here on a gurney or in a wheelchair. If I didn’t celebrate things like this, I’d never celebrate at all.”

As the stories are written, the child's survival or death is not the climax of the story. What happens will happen. Both are about the ways that the parents try to understand, cope, and heal.

After he wakes up, the mother goes to the cathedral, thinking to offer prayers of gratitude. At the altar, she begins to cry.  “She had expected Pierre’s salvation to be remedy, redress, or spur, but now she understood it would be none of those things. As the first thrill failed, the disappointment it revealed had no obvious name or target, and at the altar, under the cross, her prayer was the opposite of appreciation.  “So be it,” she said, nodding in concession to a contract of her own devising. Danger had dug a hole that deliverance had not filled, and now when needed to learn how to live in it.”

In the other, the parents begin to accept their loss, “She sat on the sofa with her hands in her coat pockets.  He found an empty box and thought to pick up some of the child’s things that were scattered around the living room. But instead, he sat down beside her on the sofa. He began to weep.  She pulled his head over into her lap and patted his shoulder. ‘He’s gone,’ she said, ‘he’s gone and now we’ll have to get used to that. To being alone.” 

These stories, written 40 years apart, explore the pain and prayers of parents in the PICU. Together, they show how much has changed, medically and technologically, and how those changes have had little effect on the spiritual experiences of PICU parents.

Both stories connect the parents’ prayers to questions about what we hope for from medicine and the ambiguity of hopes and prayers at the edges of life.  Both subtly connect the parents’ inner struggles to those larger questions about the purposes and consequences of intensive care.




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