Wednesday, October 29, 2008

Sleeping in a Lonely Bed

I mentioned in my previous blog that I’m not married. I’ve only ever been serious about one man, over a decade ago. I used to joke to people who asked that I thought he was Mr. Right, but he turned out to be Mr. Jerk. It’s true that he was something of a jerk, but in his defense I have to add that the real reason we split up was simply that we weren’t right for each other: he was an emotionally needy Scorpio and I’m a freedom-loving Sagittarian. Not that I believe astrology much (although, I have to admit that the Chinese are on to something – I really do seem to have all the behavior traits attributed to the Dragon!) but it’s undeniable that he pushed for an emotional closeness that I simply was not able to offer him. Part of me is saddened by that, because when he wasn’t being a jerk, he was a great guy. Also because in the years since I’ve managed to work a little on alleviating that need for independence, and would really welcome emotional closeness with someone. First, I need to approach the issue of physical closeness with someone. Hell, I grew up in a house with my own bedroom, and I’ve never even shared a room with someone, so aside from the rare instances like that brief stay with my sister in a horrid motel on Lake Huron (thank God we can laugh about that now!), I have always slept alone. Could I learn to share with someone who hogs the covers? Would he be able to tolerate my constant tossing and turning, due to RLS? What if he snores? What if I do? (I’ve been told I do, but it was my father who said this, so the source is rather dubious – and definitely a case of the pot and kettle meeting in a black place) For someone who enjoys sleeping and resting as much as I do, this is not a small issue. On the other hand, it’s been damned cold this week, and I can’t help but think how much I’d love to have someone else sharing my bed, even if like the majority of men he’s not really into cuddling. Just the extra body heat would be a good thing – right now, my roommate’s 6-month-old tabby cat Bobby sleeps on my bed, and though he’s cute and purrs a lot, it’s just not the same thing (although, just like a guy, he butts his head in my face when he’s ready to go downstairs and be fed; that’s his way of saying, “Hey? You up yet?”). The more I meet with people who haven’t avoided physical and emotional closeness, the more I yearn for it, and envy them.

Yesterday morning, I was in the ICU to which I’m assigned, checking the patients who are intubated as part of my daily rounds. Three doors down the hall, I saw a room with about 15 medical staff inside, which I immediately realized meant only one thing: CODE BLUE. Before I could go ask for clarification, I heard that unmistakable sound: EEEEEEEEEEEEEE echoing down the hall. A nurse came out from the room, and in a rare moment of team synchronicity, we briefly communicated: Is he?....Yes; just now. That was my introduction to Steve, who was thought to be going home today, but instead died unexpectedly yesterday after emergency surgery. I spent nearly three hours with his widow and two of his children; I love to hear stories about great people, and Steve was definitely somebody I wish I’d known. His wife Sally told me about how he’d been her best friend for almost her entire life; they were married for over 50 years and spent only two or three nights apart. Now she wonders how she’ll sleep alone. A friend who has already been widowed said that she had to sleep on the couch for over six months after her own husband died; she couldn’t get herself accustomed to sleeping alone.

That afternoon, while making normal rounds on a different floor, I met Vivian, who was standing at the bedside of her husband Frank. He is over 90 already, and they’ve been married 60 years. The sheer numbers are almost incomprehensible to me; I can’t imagine being with one person for so long. She, too, expressed her fear of losing him, so I told Frank (who was sleeping fitfully) in a joking tone, “hey, you heard her – you have to get better ‘cause she can’t be without you!”. Humor is something I often resort to when I discuss issues surrounding emotional neediness, and this blog is a perfect example. I guess using humor is a good defense when you find it hard to understand the language. I’ve never shared a bed with someone; how the HELL can I try to offer support for someone who has done so for nearly twice my lifetime?!? The one thing that stands out to me is something Sally said twice, both times in a heartbroken voice: “Who will I talk to now?”

When I sit back and try to process this all, I realize that there IS no way I can understand what it’s like to spend 60 years with one person. At the same time, it makes me yearn all the more to find someone with whom I can share even 60 months. I’ll take that over being alone any night. I’m at last beginning to realize that sleeping in a lonely bed is only good for those who can’t open up to others emotionally. Now that I can, and am, I’m ready to find a man with whom I actually can pursue emotional closeness. I guess I’d better try to find another Scorpio, though, or things might be even worse this time :) Thank you, Steve, for being such a wonderful husband to Sally. And thank you, Frank, for being so indispensable to Vivian. I was privileged to be present in the lives of both of you, and your ladies.

Keeping It Relative

Sometimes it’s tough to find a support outlet to help me cope with the emotions raised in me by the tragedies I witness. My single state was never seen as a handicap until now; at least if I had a husband I could discuss things one-on-one with him, in confidence. Though my family and friends offer wonderful support, I find myself stymied by the need to talk to them about what I’ve been through and at the same time being cautious about divulging too much information through the less-than-perfect media of telephone or email. This was a lesson well learned during my first unit of CPE, during which a well-known actor was a patient in the ICU. During a previous stay, he had been visited so often by staff singing his praises and asking for autographs that it tired him. He made it clear to his doctor that this time he wanted to have no visitors beyond family and medical staff who were necessary. I personally can’t imagine anything more horrible than to have people constantly going in and out of my room, like Grand Central Station, even if it IS with well-meaning intentions. When I’m sick, I don’t want anyone around. Aside from that, I’m very private – I don’t want the details of my situation bandied about. So when a situation hits so close to my heart that I find it difficult to move on, as I must, how can I share it while respecting the privacy of those involved? The dilemma simmers inside me until the lid is ready to blow off, and in the meanwhile it affects my caregiving with other patients. It’s at that point I realize that if I don’t somehow find release, then I’ll flounder about for an indefinite period of time. Is that what the family of this patient would want? Given my very brief period of contact with them, I don’t think so. As a family of strong faith, I think they firmly believe she is still with them in some way, watching over them like the cherubim and seraphim we read of in the Bible.


She did look like a tiny angel lying there, so small that I’d have guessed she was no older than five. She was, in fact, several years older, having celebrated a birthday this summer (little things like this come to mind in prayer after I attend a death; I’m sad that she was unable to enjoy another Halloween, but at least she got to celebrate her last birthday). Sometimes you think maybe it would be easier for the family if she’d had a disease, if there’d been some inanimate thing like a cancer to blame for her death. This was mentioned by a nurse who has extensive experience working in pediatric intensive care wards; undoubtedly she’s seen her share of children with leukemia or something similar. On the other hand, death is death, and no matter the circumstances, you can’t change the truth that this little girl will not only never enjoy another Halloween, but also will never graduate school, be given away by her daddy at her wedding or have grandchildren for her parents to spoil. That is tragic enough, but exacerbated by the circumstances surrounding her hospitalization. Sometimes it’s just a freak accident that takes a child from us, and this freak accident was caused by her older brother. It’s been only a handful of times in my function as a pastoral caregiver that I have no words of comfort for a family; this was one of those times. As it was, the parents did not need anything from me; they had somehow reached a place of acceptance within themselves before I arrived in her room. They even packaged up all her toys, which had filled half the room, and graciously asked the nursing staff that the toys be donated to the playroom for patients and siblings of patients. I watched other family members –uncles, grandparents and adult cousins – come in and say their last goodbyes to her; regardless of a patient’s age, it’s heartwrenching to be a part of this ritual. But the worst thing about it was what I did not see: her brother was not present that morning when she was taken off life support, nor during the ritual of goodbye. The staff familiar with the case expressed grave concern for him; my prayers both bedside and in the chapel afterward focused mainly on him. During all the time I attempted to function as a chaplain, offering support to the staff, filling out the death notes and preparing the death certificate, I struggled with my personal feelings. You see, the little girl looked so much like my younger niece that it was hard not to imagine myself in a similar situation, as the aunt going through the ritual of goodbye. I managed to hold it together most of the day, but when I spoke with my parents on the phone late that evening, I broke down and cried when describing how much she looked like my sister’s daughter. My parents relayed this news to my sister, who often doesn’t have the time to talk with me, but made a special effort to do so the following day. It helped immeasurably, and made me realize all over again that very simple truth which I write about extensively in my theology but have a tough time putting into practice: I can’t function well without a community of support surrounding me. I spent so many years trying to be self-sufficient, and all I got for it was a stilted way of expressing myself and difficulty in building and maintaining friendships. Family means everything to me, and without them I wouldn’t be where I am now. I pray that in future years, this boy can say the same thing. And that his sister will somehow communicate this to him, watching over him until the day they see each other again.

Friday, October 17, 2008

What's in a Number?

I’m slowly increasing the amount of time I spend with people, and the number of times that we pray together. My results-oriented mind keeps telling me that my numbers HAVE to be high, but I’ve had a cold for over a week and am just now getting back on track. I’m also wearing new shoes, and my feet hurt (I know it was dumb, but they’re tennis shoes! I thought those were supposed to be comfortable from the get-go!!). Quality over quantity is something I’m still working on. I’m learning more now than I ever have, even though I still haven’t “hit the max” with my visits. Taking notes from things other residents say helps; I realized on Wednesday, for example, that I’m missing an enormous opportunity for ministry when I simply go directly into my assigned units and bypass the peripherals.

I was on my way into the ICU to which I was assigned, and saw a group of four people sitting by the window in the enormous family waiting room outside the unit. Something compelled me to stop and ask how things are, and the patient’s mother gratefully opened up to me. She said prayer was what they needed most. He’s a young man in his mid-30s and they’d been up all night waiting for news. On my way through the unit, I stopped by his room, where his wife was communicating with him as best she could (he’s been intubated). His chart did not list a religious preference, and I thought to check with the wife because based on the name, I suspected that he was Catholic. She told me that he was, and when I asked if they would like the priest to visit, she was happy to say yes. After I made my rounds, I paged the priest and asked him to visit, and late in the day when I was leaving the unit from yet another visit, the mother told me how much they appreciated the priest having stopped by, and I relayed the news to him. None of this would have occurred if I hadn’t observed others, listened and altered my own behavior habits.

Late in the morning, I visited a patient in the postoperative ward to which I’m assigned; I like to see people who’ve not yet had a visit and this gentleman had been hospitalized nearly two weeks without seeing anyone from pastoral care. He asked me outright to pray with him, and we gripped hands tightly while we gave thanks. I’m getting more accustomed to opening up and admitting my unease over certain things; afterward I admitted that I’m hesitant to pray in public, and he said that for a non-prayer, I sure do a great job J At one point, a staff member came in to ask him some routine questions and he invited her to join us in prayer. Without hesitation, she said yes, and we all held hands in a prayer circle. Afterward, she addressed me by his wife’s name, having mistakenly assumed that I was the patient’s spouse rather than the chaplain. It was cause for a laugh among us, but I was made grateful again for being in a hospital where the staff is unafraid to express their spirituality.

The patient was unafraid as well; he referred to himself as a “dedicated Christian”. He’s in the hospital because someone attacked him, but he didn’t even want to discuss that. Instead, he spoke about life choices – specifically, the fact that after several false tries, he’s finally ceased smoking at age 65. He was able to get his 90-something mom to stop smoking as well, but too late: she’s been diagnosed with lung cancer and given a bleak outlook. Instead of being angry or despairing over that, he has an optimistic outlook that would put Little Orphan Annie to shame. He told me how grateful he was that I’d stopped by, and how much he’d needed to pray with someone – how much it mattered that someone cared enough to come in, talk with him and pray with him. In turn, I think that inspired him to ask a staff member for the first time to join us in prayer. He, too, observed others, listened and altered his behavior.

In total, I met with 13 people yesterday. The ideal daily goal is 20-25, but when I consider how much I’m learning from each encounter, taking the time to reflect on it in this manner, and taking the time to pray for the people I’ve met, I think I have to accept the reality that if I want to learn as best I can, the sheer numbers will be lower during this unit. The more I open up and feel comfortable sharing with people, the more I’ll be able to approach and the more opportunities I’ll have to learn, teach and help heal. Given the content of my visits yesterday, I’m more than satisfied with my numbers so far. The rest will come in its time.

Thursday, October 9, 2008

A Sweet Pain

The day after we shared our first verbatims in group, I took stock of the notes I’d made during the feedback session before I began rounds. O had said that as a seminary-trained chaplain I shouldn’t feel as if I’m imposing on patients, while Q reminded me that I should be meeting around 20 people daily. B had picked up on my subconscious habit of directing the visit, and J talked about the double bind of wanting closeness but fearing it. I resolved to work on all these things simultaneously, so with these things in mind, I went visiting in the postoperative unit, choosing those patients who had been here longest without a chaplain visit.

Mr. C looks remarkably healthy for a hospital patient, my age and a strapping man. He was out of bed, standing by the window while I introduced myself and explained that as a chaplain, I’m here to help in ways that are spiritual rather than medical, and that includes procuring religious materials and praying with patients. I sensed the same hesitation in Mr. C that I myself have felt in expressing my spirituality to others; he seemed uncomfortable at first sharing that part of himself with a stranger. He hesitated for a long minute, but I waited patiently (rather than seize the opportunity to retreat, as has been my habit in the past). Then he stepped forward and asked if I would pray with him. We held hands while I prayed aloud, naturally, from the heart, without a script. I gave thanks for God’s presence in the room, asked for God’s guidance with the medical staff, invoked the Spirit’s presence during healing and then fell silent, offering space for Mr. C to add his own words to our prayer. He chose to pray silently, for a markedly long time. I stood immobile for so long that my legs began to hurt, but I welcomed that hurt. His giant hands engulfed mine completely, and he gripped me so tightly that my left arm grew numb all the way up to my elbow.

During our mutual prayer, while this man silently prayed so fervently for things unknown to me, I prayed just as fervently that I would always remember this moment when I am tempted to retreat from closeness. I wanted that pain seared into my memory, so that I would never forget what occurs when I ignore my fear of closeness and share my spirituality with another: a joining of souls that is impossible to express in words, but which underscores the very reason I return continuously to the joy found in pastoral care.

Monday, October 6, 2008

With the eyes of the heart enlightened

It may sound more than a little strange, but I have a confession to make: I’m a chaplain, and I’m uncomfortable admitting what I do. Automatically expecting skepticism or even dismissal from others, I often simply say that I’m in residency at a large hospital. This is true, of course, but I don’t clarify that I’m a resident CHAPLAIN. Now it’s not necessarily that I want people to think highly of me, because I generally don’t get the “whoa- you’re a doctor!” reactions that one might expect. It’s simply that I’ve realized, only three weeks into this residency, that my spirituality is equivalent with who I am as a person, and expressing either to other people is something I’ve found extremely difficult to do for a very long time. Like the saying goes, if you get burned often enough, you stop going near the fire. Starting now, my fear of going near the fire has to change.

Now there’s an interesting metaphor, considering the fact that fire is the medium most often used by God to appear to the prophets in the Hebrew scriptures (admission #1 about my spirituality: though I’m not a Jew, I find it insulting to Jews to refer to their holy scriptures as the Old Testament, because to me it implies that their law is obsolete). For those less familiar with those books, I’ll refresh your memories: the book of Exodus tells how Moses was out in the desert one day and witnessed a bush that was burning. The fire burned but did not consume the bush, and it was from this medium he was told that he would go to Pharoah to tell the ruler of Egypt to release the Israelites from slavery. When I consider this story in light of what I wrote above, the phrase that stands out to me is that the bush burned but was not consumed. I might be badly hurt, but I remain strong in who I am, and no amount of hurt will change that. What sparked this reflection is what should always spark it: continuous, deliberate interaction with others on a spiritual plane.

I had a remarkable visit today with a woman whose doctors cannot figure out what is wrong with her. As a woman of faith, she is convinced that the answers will come when it’s time. I told her that I’m the chaplain assigned to her floor, but unlike my previous visits, I didn’t bother explaining what it is a chaplain does. I could see a Bible open to the book of Ephesians on her bedside table, next to the box of Kleenex she used at an alarming rate to clear copious amounts of phlegm from her mouth. She invited me to sit, and once we maneuvered the IV stand out of the way, she asked about my beliefs. For some reason, I found it easy to admit to her that I’m uncomfortable sharing my beliefs, acknowledging that that’s pretty ironic considering my vocation. She didn’t judge me; instead, she asked me, “and what is your spirituality?” I think it’s the first time anyone has asked me that directly. In my attempt to answer, I realized how much my beliefs have changed over the past few years, due largely to those with whom I came in contact at McCormick Theological Seminary in South Chicago. Most of them are unaware of this, since I found it all but impossible to share my true self with my fellow seminarians. Nevertheless, the members of the graduating classes 2004-2008 have profoundly affected my life, and my beliefs, as a Christian and as a pastoral care provider (admission #2: I’ve left behind the ultrarational portion of my Presbyterian heritage, and now firmly embrace the Pentecostal understanding of the Spirit’s movement in us and among us). During the visit, our roles changed; she became the chaplain and I the person to whom she ministered, though neither of us found this situation objectionable. Speaking passionately of her experience in prayer, she told me that I should be ever mindful of the enemy’s camp….the evil one who would attempt to keep me from doing the work that I was called to do. Never lose sight of the fact that you were called, she said. You were CALLED, for God’s sake, BY God. I didn’t choose this hospital and this residency; God chose me for it. I cannot be faithful to what I believe if I allow the hurts of the past to hold me back from connection with others. It was such a simple lesson, but it was like I was hearing it for the first time. I did not hesitate to tell this woman that I felt she’d been the chaplain this day, the messenger, and I the recipient. She was somewhat dubious at first, but when I explained my theological standpoint further (that in itself is a change of huge proportions), she smiled in understanding and agreed with me.

Part of the process of clinical pastoral education is creating a set of learning goals, and strategies to pursue in achieving them. One of my goals is to begin opening up and sharing my spirituality with others, while another is to learn to stop being results-oriented and enjoy the rich learning process. It’s richly rewarding when more than one of my goals comes into play during a visit, as it did today. Fittingly, I can address both those goals in this blog, by sharing what I learned, and how it was informed by my theology. This is who I am, without apology.