'Til Death Do Us Part

Getting married in the ICU

Photo by Sandy Millar on Unsplash

I have married a lot of people. Officiating weddings was my side hustle when I was living in NYC and training to become a chaplaincy educator. I took pride in creating personalized ceremonies that were both lighthearted and reverent. In my premarital counseling sessions, I would remind couples that marriage is a major change and ergo, there was going to be some loss and grief. They never liked hearing this and didn’t want to believe me because they were all so rosy-eyed and in love.

Most clergy prefer doing funerals over weddings. This surprises people since they would rather attend a wedding than a funeral. But from the clergy’s perspective, funerals are more straightforward and the family is generally more appreciative and less demanding. Funerals don’t have the same “wedding industrial complex” pressure for perfection. There are no bridezillas at funerals.

I am a rarity in that I actually prefer doing weddings. Maybe it’s because I am surrounded by suffering all the time so I welcome the opportunity to bask in love, fancy dresses and cake.

Yours truly officiating at my sister and brother in law’s wedding several years ago. I may have turned it into more of a roast than a homily.

I am more conflicted about officiating weddings in the hospital. I have done a few dozen and had requests for at least triple that. My policy is that someone needs to be at the end of life for me to consider officiating and not just because they are bored, have time off work and realized they could get it over and done with for free. (Really, I’ve had that request.)

The strangest hospital wedding request I received was in the Labor & Delivery unit. I met the soon-to-be first time father in the hallway. “I want to hold a surprise engagement and wedding as soon as my baby is delivered” he told me. “I’m planning on putting the diamond ring on the baby’s finger and then my girlfriend will see it the first time she holds him. I’ll ask and then I’ll open the door and have you there waiting to marry us.” 

I tried not to look as shocked as I felt. I asked if his girlfriend had talked about what kind of wedding she wanted. He admitted she dreamt of a fancy affair with her big family present. I then asked if he attended the childbirth classes. Did he understand what his girlfriend was about to go through? He had not considered this part, but did not think it would be a big deal. I gently explained this could not happen, as surprise weddings aren’t legal. He was still mad at me when I left the unit (as were the nurses, since I robbed them of a party). I later found out the new dad fainted during the delivery.

The weddings that I have done in the hospital are both sad and sacred affairs. The wedding is happening because someone is dying. Sometimes the patient is the new spouse. Sometimes the patient is a relative of the engaged couple who wants to bear witness to their union before they leave this world. It is always bittersweet. Moments of joy alongside sorrow. When it comes to emotions, lavish, big city, champagne-soaked weddings have nothing on the intimate, tear-filled, ICU ceremonies.

The bride was Anna. She was about to die.

It had been unexpected. She hadn’t been sick for long, but the ICU doctors knew she only had a few days left. Her last request was to marry her fiancé, Dan. The wedding they had originally planned was a few months away, on a date she would not live to see.

Dan was surprisingly calm as I walked him through the process. I gave him a list of vows and readings to choose from. He asked if during the ceremony we could play “Your Song” from Moulin Rouge. It seemed almost too appropriate.

To prepare for the wedding reception, I commandeered the medical residents’ break room. My interns transformed the space with decorations I keep in my office for just these occasions. The hospital provided a cake and sparkling cider. Dan’s aunt made a bouquet of fake flowers (real flowers are not permitted on the ICU). The guests used a marker to draw pictures of ties and jewelry on the blue plastic gowns they had to wear in the room. Anna was upset that she had to be on the breathing machine during the ceremony. Her sister suggested it could be her “something new.”

Anna was lying in the bed, with her head propped up and Dan stood next to her, holding her hand. I stood on Anna’s other side and their family crowded around the foot of her bed.

Anna’s nurse was by the door watching Anna’s vitals. She had made sure Anna’s IV medications were full to prevent any chance that an “empty” alarm might interrupt the ceremony.

I took a deep breath and began the ceremony. When Anna’s father read the poem “I Carry Your Heart” he got so choked up that he motioned for me to take over. Tissues were passed back and forth among the guests and the sobbing was audible, but the bride and groom didn’t notice. They gazed only upon each other.

They said their vows. Those classic lines have been recited so many times, but were even more somber in this space.

I promise to be your loving and faithful wife/husband,

In plenty and want,

In joy and sorrow

In sickness and health,

As long as we both shall live.

I pronounced them husband and wife. The nurse removed the breathing machine briefly so they could kiss. After applause, hugs, and sniffles, Dan asked us to depart for the break room so he could steal a moment alone with his new bride. It was then that he broke down crying for the first time.

Anna died the next morning with her husband by her side.

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The same poem read by Anna’s father at her wedding was read at her funeral by her husband.

As you read it, may you think of those whose hearts you carry in this world, or beyond.