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In Kansas City hospital rooms, telephones are ringing again.
Between the onset of the cellphone era and the start of the pandemic, bedside phones for patients didn't get much use. But with COVID hospitalizations as high as they've ever been, medical teams are once again keeping in-person contact to a minimum.
Now these obsolete relics have become important instruments for patient care.
Jonathan Rudnick is a rabbi and community chaplain at Jewish Family Services who visits patients at hospitals all over the metro. He says those phones are his only hope now for reaching patients.
"We know what room they're in and the phone number to that room," and that's it, Rudnick explains.
These days, it's not uncommon for Rudnick to make patient calls, only to hear that telephone ringing and ringing and ringing — no answer.
"People are not used to the phone in their hospital room ringing," Rudnick explains. "It may not even be within reach of them because again, no one's thinking about, 'Well, this is something you'll need.'"
In pre-COVID times, Rudnick would find out pretty quickly, in person, if a patient wanted company, if they were sleeping or busy — or if they didn't want him there at all.
But a phone that just rings? It brings no such clarity. It offers no useful information. For Rudnick, that's hard.
Rudnick doesn't do patient visits out of some personal need to pray for strangers. In fact, he jokes that the fastest way to get a chaplain to go away is to ask for a prayer.
His goal is something much more basic.
"People come to hospitals, almost always, for the physical," Rudnick explains. "They've got a problem and they need/want to have it fixed. And this place has concentrated all these resources, right? Technology, medications, human experts to do that. So that makes sense.
"The unintended consequence is: Things get very imbalanced with all this focus on the physical. Something needs to heal physically. At the same time, it's like, 'What about the rest of me?' We are multidimensional creatures and when one dimension is being related to so intensively, the other ones can get lost."
The art, he says, is figuring out what any given patient needs.
"I kind of tend to look at it as connecting to themselves, connecting to other people and then connecting, you know, beyond themselves," Rudnick says. "So that could be God, it could be nature. It could be a lot of different things."
When no one picks up the phone, there is quite literally no way to make any of that happen, no matter how profound the need may be for the unreached patient.
That haunts him.
Those of us who go about our lives outside hospital walls are trying to process a lot of news from inside that world. It's difficult to comprehend stories of caseloads pushing health care workers past the brink of exhaustion. We shake our heads reading stories of delayed care or lack of access to beds causing non-COVID conditions to worsen rather than heal.
Working in this environment, chaplains still try to recognize the humanity of each person they encounter, to understand what their condition means to them. A chaplain can be someone to talk to, someone to cry with, someone who knows how hospitals work and can help you figure out what to do when you're stressed and confused.
Trying to do all that over the phone, Rudnick says, is like working with his hands tied behind his back.
For Ramona Winfield, this is the challenge right now.
What inspires her is "recognizing God in places and situations and circumstances that most folks don't see." A nurse's hard work. A patient's release from pain.
As a chaplain on the palliative care team at University Health (formerly Truman Medical Center), Winfield still does patient visits in person — unless they're COVID patients. Even as a hospital staffer, she doesn't enter COVID patients' rooms.
"We couldn't have a conversation with them a lot of the time because they're intubated," she explains.
For COVID patients who aren't intubated, Winfield also calls that bedside phone, trying to reach them. When that doesn't work, she looks up their relatives.
"If they have a church family and they want the church family contacted, I would do that," she says. "If they want a priest to say a prayer over them, I can get the priest."
Visiting priests say prayers and anoint the sick from outside the COVID patient's room, looking in.
But that's not quite the same as presence.
Once, Winfield got called to a room where a non-COVID patient had died. A grieving relative had climbed into bed beside the patient, and wasn't responding to the nurse, who stood bedside. Winfield arrived and stepped into the grief-stricken person's line of vision, allowing the nurse to move aside.
After a couple of attempts to start a conversation, Winfield changed her approach. She stood quietly for a moment, taking in the scene before her, and then started singing.
"I began to sing this song," Winfield explains, "and the family member began to cry. He just lay there and cried. And I got some tissue and I wiped the tears away as I was singing. And then the family member began to talk."
He spoke not to Winfield, but to the deceased relative, expressing love, saying goodbyes.
"And then I told the family member, 'Pretty soon security's gonna have to come up to take the body to the morgue. And so we're gonna give you just a few minutes to be with the patient.' And the family member was like, 'OK.'"
Winfield stood in the background and continued to hum while the family member took a towel and used it to wipe the patient's face, hands and feet.
"As he was doing this, the family member would say, 'You've done so much with these hands, taking care of your family. You worked hard,'" Winfield recalls. "And as he wiped the feet, he would say, 'Those feet have walked so many miles just to make sure that your children had all that they needed.'"
After being immobilized with grief when Winfield arrived, the relative left the room in peace, on his own terms.
Winfield is trying her best. Sometimes that means ministering to the hospital staff.
"I'm a people watcher," she says.
It's a trait she uses to identify family members who need a little extra help, and the family members who want to be in charge — a matriarch or patriarch, who needs to be addressed directly from the get-go.
It also allows her to see signs that a health care provider is struggling. When a patient dies, she says, "they naturally go through a process of grief. It's important for someone to be able to recognize that, especially in times of COVID."
Sometimes Winfield and the other chaplains will try to find a moment to check in with their teammates. "Just to pay little attention to what's going on and say, 'Hey, we're here for you.'"
For those who don't want to talk, Winfield often writes "thank you" notes after observing their hard work on behalf of a patient. "I may send them a letter and say, 'We appreciate all that you've done. Your work here is very valuable. The family said this about you.' Just so they know that we see what they're doing."
Rudnick's situation is different. He isn't at a single hospital day-in and day-out. He has less information about what's happening in a room where a patient isn't picking up the phone.
Not long ago, one of the volunteers on Rudnick's team learned that a patient was on a ventilator, having attempted — to no avail — to reach them for two weeks. The volunteer felt helpless.
Checking in with a nurse, Rudnick found out a spouse sometimes came to visit this particular patient.
"I said, 'So how about this? Could you give the spouse my name and cell number and let the spouse know that this is available?'" he recalls. "'No pressure, you know?'"
Rudnick doesn't know if that family will end up reaching out to him or not. At the very least, they will know he is here for them.
It's not the kind of connection that Rudnick and his team are used to. But it's something more than the uncertainty of a ringing telephone.
