Last year was my first New Year’s Eve spent in New Orleans. I celebrated with my group of new friends in a fascinating way – a jubilee was held at one’s house, and amid good food, great wine and stimulating conversation we bonded into one. Then, at the appointed hour, we all sat and shared slices of a single King Cake. A New Orleans communion involves more than remembering Who is responsible for our existence and why. Each one of us, as we ate, shared his or her best memories about 2008 and what made it unique, and our hopes for the coming year. Every share and hope was toasted with fervor by the entire group. After three months in residency, I had learned to open up to the extent that I shared how grateful I was for the new friends I had, how I felt as if my life were truly beginning after being on hold for many years, and that I looked forward to more learning in 2009.
Unfortunately, I am present in spirit only at tonight’s Jubilee because every other chaplain had plans for this year’s end and I was asked if I would please work this night. I accepted before remembering what a joyous experience we’d had last year. Initially I felt extreme disappointment over missing this evening, and if I'm being totally honest maybe even a little resentful (I realize that that makes no sense, but when do emotions ever make sense?) but I have to say now that I think it better that I was here. Once again God called me to put others first, to be part of someone else’s life experience, and to learn from it a lesson for my own existence.
When I arrived this afternoon, I was told about the two patients at highest risk: Tom, who was quite elderly, and Paul, who was only 25 but had a very weak heart. They were to try something experimental on Paul that would help his heart to function at the rate of a normal, healthy heart for as many as 8 consecutive hours. I’m guessing that this would save him the tremendous sacrifices that heart transplant recipients go through, because his nurse told me that he absolutely refused a transplant. He chose to live life on his own terms, which meant he would not allow his immune system to be destroyed and then replaced with steroid therapy and someone else’s heart. The doctors wanted Paul to reach a slightly higher level of good health function before they tried the experiment, but it wasn’t to happen. Three hours after I arrived, he coded and died. His mom told me afterward that he couldn’t bring himself to live a life that was less than what he considered normal for a 25-year-old, so he did many things that a person with heart problems really shouldn’t even be able to do. As is usual, the medical professionals were frustrated and confused by this. His nurse told me that he had ignored medical advice, did what he wanted, and now he was paying for it - not in an unkind tone, but in a manner that made it plain she couldn't quite understand that decision. But what stuck out to me was that he’d asked his nurse early this afternoon if the two could talk in private, without his mother present (so she wouldn’t be upset). The nurse closed the door behind them, and he said to her point blank, “I’m going to die, aren’t I?” She skirted the truth a little, as every doctor usually does (I understand this; how can we truly know?), and replied, “There’s a very strong possibility that you will, yes.” And he told her that he wanted to sign a DNR order while he still had the capacity.
His nurse was very puzzled by his refusal to consider organ transplant, to live a life too full of restrictions and too void of natural activities. His mother understood perfectly, though, as she explained to me after he died that Paul had always understood that he would not live to be an old man. What was important to him was quality, not quantity. Looking down at Paul, I thought of all the things I’ve learned this past year, all the changes I’ve made for the better, and how very much every patient visit now is filled with quality words – and not a quantity of words. I’ve become the open-hearted minister I so longed to become when I first searched for a residency in CPE, and so I said a prayer asking that God welcome him home and that the good memories his family and friends have remain alive to keep their hearts warm until they are one day reunited. Simple, short and heartfelt – that’s what authentic ministry is for me.
The Spanish have a New Year’s Eve tradition of downing twelve grapes to the twelve chimes on the clock as it strikes midnight, followed by a toast. Tradition holds that if this is done, the following year will be prosperous. Yet I have no grapes here in the office, no chiming clock that will give me twelve bells of renewal, and – alas! – no Cava to drink in toast afterward. Nevertheless, I celebrate Jubilee with my friends in absentia, I down las doce uvas de la suerte in principle if not in deed, just as I believe Paul does with his family and friends in their memories, by thinking of all those quality things that have entered and enriched my life, and now make me a more complete person. 2009 has been the finest year of my life so far. On the stroke of midnight in the EST, where I was raised, I offer up the final salud! to this year and say that I fully expect even more quality in 2010. God welcome you home, Paul, and thank you for reminding me that quality over quantity is what matters in life.
Thursday, December 31, 2009
Tuesday, September 8, 2009
Who I Am
I mentioned in a previous blog that the first time I functioned as a chaplain was during an interview for a residency, at a large hospital a few hours outside San Diego. I was touring the facilities with the on-call chaplain when a Code Blue was called over the loudspeaker. Code Blue is universal medical language: someone is in imminent danger of dying, and the Code Blue team – which includes the chaplain – is to report immediately to the scene. In this case, it was the ICU, where a 70-something woman was struggling with pancreatic cancer. Her two daughters were clinging to each other in the waiting room and upon seeing us arrive, one gasped, “Oh God, it’s the chaplain….she must have died!!”. That was the first time I realized that nobody seems to have a good idea of who I am. I was surprised, to tell you the truth, to be equated with the Grim Reaper, but if I myself had been asked at that very moment to define who I am as a chaplain, I don’t think I would have known what to say. It took a year’s residency in this role to define my identity as a chaplain. Yes, I show up when people die. But there’s so much more to it than that.
I talk with staff nurses about their lives; that’s how I found out one of them married the sister of one of his patients (the romantic in me still sighs at this). I hear them complain about everything from the lousy weather to the crappy economy to some ridiculous thing their spouse said, and even if I think the spouse’s words sound reasonable, I give neutral listen to the complainer. They don’t want to hear what I think; they want me to hear, period. I hear them vent their frustration about patients who are ‘frequent fliers’ [those who rotate in and out of the hospital due to poor lifestyle choices] or the fact that somebody on the previous shift didn’t make something clear in a note. We talk about local attractions, like JazzFest, and they share their personal experiences with Mardi Gras over the years. It’s like we become a family of sorts.
I also spend time with families, in both death and the struggle for life. Oddly, it’s when I’m facing death that my role seems easier to define – comfort, prayer, presence, grief facilitation. I hate using intellectual terms for such an emotional process (now that alone is an indication of how much I’ve grown!) especially because they don’t give even a hint as to what comfort and presence imply, or how they differ from family to family. Sometimes I’m present during the dying process; sometimes I’m present when a doctor tells a family nothing else can be done and that the medical team suggests withdrawing support. Watching the family tearfully telling a loved one that it’s okay to ‘go home’ is not the same as watching a family argue over whether or not a miracle will occur and Mom/Aunt/Sister/Beloved Wife will abruptly improve. Sometimes the support is to medical staff, as it was when a young resident had to tell a family that there was nothing else she could do. It was the first time she’d had to have this conversation with a family and the patient herself made the decision to have support withdrawn. After she died, the doctor burst into tears outside her room. I gave comfort in the form of a long, strong hug and the admission that if I ever reach this stage I want a doctor like her, who cares enough to cry. I wonder now if she was crying partly because she knew this was only the first of many such conversations she would have, but we never got into that – she was on call all that night, and had to leave and see somebody else. Shelving the emotion and learning to function in the present is something both doctor AND chaplain must learn to do well. It bonded me to her in a way that few things do, but even then it was her feelings that were the focal point – not mine.
The tough part has been, of course, for me to open up and share myself with others. Who I am, what I want in life, why I’m here, how I feel when certain things happen. Before I earned my first unit of CPE, I would have said that it’s most important for me to listen to what others have to say, but now that I have completed four units I've realized how obvious it is that this is a two-way street; it’s also important for me to share with others, so that they can gain a sense of who I am and in turn build a sense of trust in me. I had a tough time doing that in the internal medicine unit because most visits there are one-time only, and the staff shows less of a need to connect in a familial way with the chaplain. The ICU was easiest to form connection, due to long term stays and because staff members there are so accustomed to spending those long periods of time with one patient and family. Though I struggled as the chaplain assigned to the Mother Baby Unit because I was defining a role nobody had ever filled, it leaves me with great pride this last week of my residency that it was in this unit I learned to define who I am, and share with others in the way that’s necessary.
When I was initially introduced, I think some of the staff nurses were puzzled; they, like the daughter of the woman in San Diego, thought a chaplain mostly appears when things go wrong. Why would we need one in a place where happy things occur? I could have said at the time in a flip manner that that’s precisely when a chaplain SHOULD appear! I didn’t understand at the time how complex the question is. Instead, I learned that having a happy atmosphere surround me was exactly what allowed me to open up and share with people the way I should. Little by little, I opened up to the new moms with whom I met, and they in turn began picking up on the openness in me and gained a sense of trust. It went beyond the tired but dismissive smile and nod and thanks for visiting me, to real talk. Some expressed fears about how they’ll raise this baby to be a good, responsible citizen in such a crazy world. Others were worried because their older children didn’t quite understand how the family dynamic would change so drastically. One told me that this baby was a gift from God and told me about her little angel, her 8-year-old son who died two years ago. Then she poured out her guilt over blaming God for the loss of her son, and how badly she wanted to find reconnection with God but wasn’t sure how. All of the new moms, over time, changed from puzzled by my presence to happy and grateful for the visit. It’s only now at year’s end that I realize that’s because of the way I myself changed because of my ministry in this unit. I obviously didn’t know at the start who I am as a chaplain; over the year, I learned – and it showed.
I am still a painfully private person; I have great difficulty sharing much of myself with others. For that reason, it was easier not to be offended when I got the door shut in my face by new dads or new grandmas because Mom ‘couldn’t see someone right now’. I’m a harsh self-judge and many times in the past I would take this personally, even though that sounds silly now. But because the whole concept of new motherhood seemed so surrounded by intimacy, I never took offense at this. Indeed, I understand all too well the intense need for privacy and solitude. I think it helped me to feel less like an interloper and focus more on what I could provide to the patient. As we spoke, and they asked questions about me, I began sharing stories about my own childhood, talking about the loneliness I felt because the oldest two children were closer to each other, and how I’ll always be the baby in the family. I related tales about my being an infant hippie, eating the garden flowers. Then there was the infamous time I crawled away from home and halfway into a farmer's field; two brothers who lived across the street found me in a rhubarb patch and my grateful mother gave them a copy of the Beatles' latest album (oh, how that dates me!). I spoke with great pride of my oldest sister’s two daughters, and how I see them as the epitome of the children I would most like to have should I ever reach that point. I told them that I’m not a mom and would welcome it but only if I find the right man whose children I’d want; that I’d never want a child just for the sake of having a child, because that seems to me a very weak reason to become a mother. It’s the most real I’ve been in this place, these meetings with new moms. That it took place in the one unit where none of us, least of all me, seemed to know who I am is very fitting to me. It appeals to my sense of learning as a thing that takes place in the least likely settings when you least expect it. Maybe there’s some mental dynamic going on here as well – the wounded child returning to the womb or some such psychobabble – but what stands out most is that in a place where nobody saw a need for me, I created a need for me. What's more, I served it well. This is who I am as a chaplain.
I talk with staff nurses about their lives; that’s how I found out one of them married the sister of one of his patients (the romantic in me still sighs at this). I hear them complain about everything from the lousy weather to the crappy economy to some ridiculous thing their spouse said, and even if I think the spouse’s words sound reasonable, I give neutral listen to the complainer. They don’t want to hear what I think; they want me to hear, period. I hear them vent their frustration about patients who are ‘frequent fliers’ [those who rotate in and out of the hospital due to poor lifestyle choices] or the fact that somebody on the previous shift didn’t make something clear in a note. We talk about local attractions, like JazzFest, and they share their personal experiences with Mardi Gras over the years. It’s like we become a family of sorts.
I also spend time with families, in both death and the struggle for life. Oddly, it’s when I’m facing death that my role seems easier to define – comfort, prayer, presence, grief facilitation. I hate using intellectual terms for such an emotional process (now that alone is an indication of how much I’ve grown!) especially because they don’t give even a hint as to what comfort and presence imply, or how they differ from family to family. Sometimes I’m present during the dying process; sometimes I’m present when a doctor tells a family nothing else can be done and that the medical team suggests withdrawing support. Watching the family tearfully telling a loved one that it’s okay to ‘go home’ is not the same as watching a family argue over whether or not a miracle will occur and Mom/Aunt/Sister/Beloved Wife will abruptly improve. Sometimes the support is to medical staff, as it was when a young resident had to tell a family that there was nothing else she could do. It was the first time she’d had to have this conversation with a family and the patient herself made the decision to have support withdrawn. After she died, the doctor burst into tears outside her room. I gave comfort in the form of a long, strong hug and the admission that if I ever reach this stage I want a doctor like her, who cares enough to cry. I wonder now if she was crying partly because she knew this was only the first of many such conversations she would have, but we never got into that – she was on call all that night, and had to leave and see somebody else. Shelving the emotion and learning to function in the present is something both doctor AND chaplain must learn to do well. It bonded me to her in a way that few things do, but even then it was her feelings that were the focal point – not mine.
The tough part has been, of course, for me to open up and share myself with others. Who I am, what I want in life, why I’m here, how I feel when certain things happen. Before I earned my first unit of CPE, I would have said that it’s most important for me to listen to what others have to say, but now that I have completed four units I've realized how obvious it is that this is a two-way street; it’s also important for me to share with others, so that they can gain a sense of who I am and in turn build a sense of trust in me. I had a tough time doing that in the internal medicine unit because most visits there are one-time only, and the staff shows less of a need to connect in a familial way with the chaplain. The ICU was easiest to form connection, due to long term stays and because staff members there are so accustomed to spending those long periods of time with one patient and family. Though I struggled as the chaplain assigned to the Mother Baby Unit because I was defining a role nobody had ever filled, it leaves me with great pride this last week of my residency that it was in this unit I learned to define who I am, and share with others in the way that’s necessary.
When I was initially introduced, I think some of the staff nurses were puzzled; they, like the daughter of the woman in San Diego, thought a chaplain mostly appears when things go wrong. Why would we need one in a place where happy things occur? I could have said at the time in a flip manner that that’s precisely when a chaplain SHOULD appear! I didn’t understand at the time how complex the question is. Instead, I learned that having a happy atmosphere surround me was exactly what allowed me to open up and share with people the way I should. Little by little, I opened up to the new moms with whom I met, and they in turn began picking up on the openness in me and gained a sense of trust. It went beyond the tired but dismissive smile and nod and thanks for visiting me, to real talk. Some expressed fears about how they’ll raise this baby to be a good, responsible citizen in such a crazy world. Others were worried because their older children didn’t quite understand how the family dynamic would change so drastically. One told me that this baby was a gift from God and told me about her little angel, her 8-year-old son who died two years ago. Then she poured out her guilt over blaming God for the loss of her son, and how badly she wanted to find reconnection with God but wasn’t sure how. All of the new moms, over time, changed from puzzled by my presence to happy and grateful for the visit. It’s only now at year’s end that I realize that’s because of the way I myself changed because of my ministry in this unit. I obviously didn’t know at the start who I am as a chaplain; over the year, I learned – and it showed.
I am still a painfully private person; I have great difficulty sharing much of myself with others. For that reason, it was easier not to be offended when I got the door shut in my face by new dads or new grandmas because Mom ‘couldn’t see someone right now’. I’m a harsh self-judge and many times in the past I would take this personally, even though that sounds silly now. But because the whole concept of new motherhood seemed so surrounded by intimacy, I never took offense at this. Indeed, I understand all too well the intense need for privacy and solitude. I think it helped me to feel less like an interloper and focus more on what I could provide to the patient. As we spoke, and they asked questions about me, I began sharing stories about my own childhood, talking about the loneliness I felt because the oldest two children were closer to each other, and how I’ll always be the baby in the family. I related tales about my being an infant hippie, eating the garden flowers. Then there was the infamous time I crawled away from home and halfway into a farmer's field; two brothers who lived across the street found me in a rhubarb patch and my grateful mother gave them a copy of the Beatles' latest album (oh, how that dates me!). I spoke with great pride of my oldest sister’s two daughters, and how I see them as the epitome of the children I would most like to have should I ever reach that point. I told them that I’m not a mom and would welcome it but only if I find the right man whose children I’d want; that I’d never want a child just for the sake of having a child, because that seems to me a very weak reason to become a mother. It’s the most real I’ve been in this place, these meetings with new moms. That it took place in the one unit where none of us, least of all me, seemed to know who I am is very fitting to me. It appeals to my sense of learning as a thing that takes place in the least likely settings when you least expect it. Maybe there’s some mental dynamic going on here as well – the wounded child returning to the womb or some such psychobabble – but what stands out most is that in a place where nobody saw a need for me, I created a need for me. What's more, I served it well. This is who I am as a chaplain.
Tuesday, September 1, 2009
The Big Fat Guy
Kenny is surprisingly lucid for a guy under the influence. He’s in his late 50s, and a Viet Nam vet, according to him. I guess that’s true, though he must have been extremely young at the time he served since we officially began pulling out of that mess just about the time he gained his legal right to vote. He has moments of extreme clarity in his speech – for example, his understanding of God and retribution surpasses that of many people with whom I studied at seminary. That makes it all the more sad when he reverts to form as a guy drying out from a severe overdose of hallucinogens. At that point, he sounds frightened and somewhat incoherent, repetitious and superstitious, and above all lonely. To make matters worse, the hospital has been unable to locate any family.
According to Kenny, his brother died three days ago in a motorcycle accident. He cried real tears when he spoke of losing his brother, and told me how the big fat guy in the corner was the monster who did it. Without inflection, he told me that if he got a chance, he would kill that big fat guy and even pointed to a particular spot as if expecting me to see the same thing he did. What I saw was a machine that was not hooked up to anything, and the bathroom set up solely for the patient’s use. It’s a struggle at times to engage with people who clearly aren’t on the same plane I’m traveling, but after a year as a chaplain I’m learning to stay and face the unknown rather than retreat from it out of fear, so I acted as if I knew exactly what he was talking about and nodded neutrally.
Kenny understands the devil well, too – at least he understands what the concepts of temptation and evil mean to the human psyche, and how trust in God helps when one is faced with these things. As if sharing a secret, he told me conspiratorially that when the devil comes at you with all sorts of promises, you need to look toward God. ‘God knows these things happen to us,’ he whispered. Then he stopped abruptly and advised me where to put the needle and I explained that I am not a nurse, but a chaplain. At this point he asked my name (which I’d mentioned when I first walked into his room, beckoned by him from the hall). When I told him, he said, ‘you look just like my mother.’ A little uncomfortable with this, I said jokingly, “when she was younger, I hope!” but he didn’t even crack a smile when he affirmed that he did indeed mean when she was younger. He explained that she had been a nurse’s aide and I told him that that’s a good helping profession and was sure that she had helped many people. When he mentioned the big fat guy again, it was with remorse as he talked about the bad feelings and how he doesn’t want to give in to them. He knew it was wrong to want to kill the big fat guy, so he tried to listen to what God told him to do.
It’s heartbreaking to hear somebody who is so clear minded and at the same time so muddled mentally. Kenny seems to have an understanding on some level of the dangers inherent in drugs. He repeatedly complained about the staff’s attempts to give him morphine, explaining that because he was in Viet Nam he knows that morphine hardens the veins. Though I did not say so aloud, internally I wondered about the metaphors present in this situation. Did the drugs he’d been in the habit of taking harden his veins, deaden him to the pain he’d already experienced and continued to feel? Did the fact that he retreated from reality shame him? Who or what is the big fat guy who bothers Kenny so? Why does he want to kill the big fat guy, yet a few minutes later express remorse over the idea? Do we all have those thoughts?
When I reflected on this, what came to mind – absurd as it might sound – was the climax of the classic film “Ghostbusters”, in which a giant version of the Sta-Puft Marshmallow Man is sent by an evil god to destroy New York City. The evil god tells the ghost busters that the city will be destroyed by the vehicle of their choosing, based on the first thought that comes to mind, so they advise each other not to think of anything. Of course, Dan Aykroyd’s character immediately thinks of the one thing he thought could never hurt him – in essence, a big fat guy. In the movie, the ghost busters stand their ground and do battle, and eventually vanquish the big fat guy, though not without massive globs of melted, burned marshmallow falling all over Manhattan. It made me realize that it’s what I am beginning to do with my big fat guy, which for me means my biggest fears in this chaplaincy. Instead of running away, or doing something to harden my veins or deaden the feelings, I face them. At times I feel those metaphorical gobs of marshmallow splattering against me, but talking with Kenny made me realize that even though we all want to annihilate those big fat guys that cause us so much pain, sometimes just the fact that we can stand up to them is enough.
According to Kenny, his brother died three days ago in a motorcycle accident. He cried real tears when he spoke of losing his brother, and told me how the big fat guy in the corner was the monster who did it. Without inflection, he told me that if he got a chance, he would kill that big fat guy and even pointed to a particular spot as if expecting me to see the same thing he did. What I saw was a machine that was not hooked up to anything, and the bathroom set up solely for the patient’s use. It’s a struggle at times to engage with people who clearly aren’t on the same plane I’m traveling, but after a year as a chaplain I’m learning to stay and face the unknown rather than retreat from it out of fear, so I acted as if I knew exactly what he was talking about and nodded neutrally.
Kenny understands the devil well, too – at least he understands what the concepts of temptation and evil mean to the human psyche, and how trust in God helps when one is faced with these things. As if sharing a secret, he told me conspiratorially that when the devil comes at you with all sorts of promises, you need to look toward God. ‘God knows these things happen to us,’ he whispered. Then he stopped abruptly and advised me where to put the needle and I explained that I am not a nurse, but a chaplain. At this point he asked my name (which I’d mentioned when I first walked into his room, beckoned by him from the hall). When I told him, he said, ‘you look just like my mother.’ A little uncomfortable with this, I said jokingly, “when she was younger, I hope!” but he didn’t even crack a smile when he affirmed that he did indeed mean when she was younger. He explained that she had been a nurse’s aide and I told him that that’s a good helping profession and was sure that she had helped many people. When he mentioned the big fat guy again, it was with remorse as he talked about the bad feelings and how he doesn’t want to give in to them. He knew it was wrong to want to kill the big fat guy, so he tried to listen to what God told him to do.
It’s heartbreaking to hear somebody who is so clear minded and at the same time so muddled mentally. Kenny seems to have an understanding on some level of the dangers inherent in drugs. He repeatedly complained about the staff’s attempts to give him morphine, explaining that because he was in Viet Nam he knows that morphine hardens the veins. Though I did not say so aloud, internally I wondered about the metaphors present in this situation. Did the drugs he’d been in the habit of taking harden his veins, deaden him to the pain he’d already experienced and continued to feel? Did the fact that he retreated from reality shame him? Who or what is the big fat guy who bothers Kenny so? Why does he want to kill the big fat guy, yet a few minutes later express remorse over the idea? Do we all have those thoughts?
When I reflected on this, what came to mind – absurd as it might sound – was the climax of the classic film “Ghostbusters”, in which a giant version of the Sta-Puft Marshmallow Man is sent by an evil god to destroy New York City. The evil god tells the ghost busters that the city will be destroyed by the vehicle of their choosing, based on the first thought that comes to mind, so they advise each other not to think of anything. Of course, Dan Aykroyd’s character immediately thinks of the one thing he thought could never hurt him – in essence, a big fat guy. In the movie, the ghost busters stand their ground and do battle, and eventually vanquish the big fat guy, though not without massive globs of melted, burned marshmallow falling all over Manhattan. It made me realize that it’s what I am beginning to do with my big fat guy, which for me means my biggest fears in this chaplaincy. Instead of running away, or doing something to harden my veins or deaden the feelings, I face them. At times I feel those metaphorical gobs of marshmallow splattering against me, but talking with Kenny made me realize that even though we all want to annihilate those big fat guys that cause us so much pain, sometimes just the fact that we can stand up to them is enough.
Monday, August 17, 2009
A Visit from Forrest Gump
There’s a lot I like about the film “Forrest Gump”, largely because I love the study of history and the film showcases so much of the past half century of my country and how we’ve been affected by it. My favorite line, hokey though it sounds, is the one everyone thinks of when you mention this film: “Life is like a box of chocolates. You never know what you’re gonna get.” It brings to mind the stories I’ve heard about my Aunt Patricia, the eldest of four children, and a great connoisseur of fine quality chocolate like See’s Candies. Every time her parents splurged on a box of candy, she would poke her finger through the bottom of a piece to make sure it wasn’t something she hated, like coconut or cherry. If she didn’t like it, she left it in the box – hole side down. I’ve always been put off by the selfishness apparent in this behavior, but looking at it through the lens of pastoral care what disturbs me is the idea of leaving the undesirable as is; hiding it rather than facing up to it and finding that you might not only NOT find a chocolate covered cherry inedible, but might even find it enjoyable. Forrest saw a silver lining in every cloud – heck, Forrest didn’t even SEE the clouds that filtered the light over him. I want to be like that when I face the things I don’t like and have ignored which now come back to haunt me.
When I went to see my internist in March for a full physical, my exact words to him were that I had felt ‘off it’ for a while. It wasn’t something I could put my finger on, but I knew instinctively that something wasn’t quite right. He ordered a full workup and found two problems: my blood pressure was too high, and something was wrong with one of my kidneys. I made a deal with him: give me six months to implement a cardio program to improve the blood pressure rather than put me on medication right away. He agreed, and in only four months I brought it down from 150/90 to 122/80. The kidney, however, continued to remain an issue. After a failed communication that resulted in a missed appointment with a urologist, I saw one on Thursday afternoon, expecting to hear what I’d heard twice in the past two years from two other doctors, one at an ER in Phoenix and the other right here at our Urgent Care Clinic: that I had an infection, and here’s some antibiotics to clear it up. Instead, she told me that the tests they’ve run already are not conclusive, but they can tell that the kidney isn’t functioning at an acceptable level. They want to run another test later this week, which will result in one of two things: either I have some sort of surgery to address an ongoing problem, or I may have to have my right kidney removed altogether.
To say I was blindsided by this is a vast understatement. I truly wasn’t expecting to hear something that serious, even though I’ve had problems with this kidney for the past eighteen months. If I’d still been at the job I had before I went to seminary, I probably would have seen to it much sooner, but I had no health insurance for over two years, and medical issues took a back seat to things like paying rent and putting food in my mouth. Not that I’m whining; don’t get me wrong. I remember talking to two different people years ago in Tucson, both of them homeless because they chose to buy the medication necessary for their health issues over having a roof over their heads. They made their choices, I made mine, and I don’t regret it. But too many years of ignoring stuff I didn’t want to deal with have got me in a tough spot now. The doctor was very frank with me; I was told that if the kidney is functioning at a very low level, it would actually be far more harmful to leave it in, and may even be fatal. She also underlined the fact that many people function perfectly fine with only one kidney. After I left her office, I went back to the chaplains’ office and poured out my concerns on two fellow chaplains, and the office secretary. We sat and discussed things for a while, and one of them asked if the doctor had mentioned cancer. I replied in the negative, to which he responded, “Did you ask her?” I’d been so shocked that it never occurred to me to ask, but given her forthright manner with me I think she’d have said something if she had that suspicion. I sat there for a while, rolling around in a ball of numbness, until that little voice inside me told me that it was unhealthy to wallow in this. I gathered my things and made a concerted effort to visit several more patients in the last hour of the day. Initially I was afraid that I’d not be engaged, that my concern over my health would overshadow any pastoral care I could offer. That was before I met Tommy.
Tommy’s mother is in the hospital, and he doesn’t quite understand why. He was sitting on the window seat in her room (which happened to be the For Every Season There is a Miracle Room) while she lay intubated and unconscious. I asked what was going on, and he got a little agitated and explained that he didn’t understand all the things the doctors had said. It was at that point I realized that Tommy has a lower IQ than many people, but it didn’t stop him from talking animatedly about his Baptist church right down the road. He proudly told me that it’s his job to cut the grass because he’s the only person who is qualified to do it, and just like that I thought of Forrest Gump, the ‘gozillionaire’ who offered to cut the massive town hall lawn for free. Tommy takes great pride in what he does, as if it were the most important thing in the world – and to him, it is. He also said to me that God is his special friend. I was envious of his ability to focus only on what’s right in front of him and be happy about it, until I realized that one needn’t be Forrest Gump to do that. Worrying about what might be is pointless. Of course, God told us that, but hey, I’m only human. I worry, and I imagine the worst, which nets me nothing more than unwanted stress. I think God sent Tommy to me, and me to Tommy, so that we could offer each other the support that each of us needs. For Tommy, it was prayer about his mother’s situation. For me, it was the lesson that I need to focus on what’s right in front of me, and put all my energy into that, instead of wasting it on the hypothetical. After all, you never know what you’re gonna get in that box of chocolates called life. When you get stuck with a coconut when you were really expecting caramel, instead of imagining where the caramel might be hiding, enjoying the chocolate that covers the coconut is what counts.
When I went to see my internist in March for a full physical, my exact words to him were that I had felt ‘off it’ for a while. It wasn’t something I could put my finger on, but I knew instinctively that something wasn’t quite right. He ordered a full workup and found two problems: my blood pressure was too high, and something was wrong with one of my kidneys. I made a deal with him: give me six months to implement a cardio program to improve the blood pressure rather than put me on medication right away. He agreed, and in only four months I brought it down from 150/90 to 122/80. The kidney, however, continued to remain an issue. After a failed communication that resulted in a missed appointment with a urologist, I saw one on Thursday afternoon, expecting to hear what I’d heard twice in the past two years from two other doctors, one at an ER in Phoenix and the other right here at our Urgent Care Clinic: that I had an infection, and here’s some antibiotics to clear it up. Instead, she told me that the tests they’ve run already are not conclusive, but they can tell that the kidney isn’t functioning at an acceptable level. They want to run another test later this week, which will result in one of two things: either I have some sort of surgery to address an ongoing problem, or I may have to have my right kidney removed altogether.
To say I was blindsided by this is a vast understatement. I truly wasn’t expecting to hear something that serious, even though I’ve had problems with this kidney for the past eighteen months. If I’d still been at the job I had before I went to seminary, I probably would have seen to it much sooner, but I had no health insurance for over two years, and medical issues took a back seat to things like paying rent and putting food in my mouth. Not that I’m whining; don’t get me wrong. I remember talking to two different people years ago in Tucson, both of them homeless because they chose to buy the medication necessary for their health issues over having a roof over their heads. They made their choices, I made mine, and I don’t regret it. But too many years of ignoring stuff I didn’t want to deal with have got me in a tough spot now. The doctor was very frank with me; I was told that if the kidney is functioning at a very low level, it would actually be far more harmful to leave it in, and may even be fatal. She also underlined the fact that many people function perfectly fine with only one kidney. After I left her office, I went back to the chaplains’ office and poured out my concerns on two fellow chaplains, and the office secretary. We sat and discussed things for a while, and one of them asked if the doctor had mentioned cancer. I replied in the negative, to which he responded, “Did you ask her?” I’d been so shocked that it never occurred to me to ask, but given her forthright manner with me I think she’d have said something if she had that suspicion. I sat there for a while, rolling around in a ball of numbness, until that little voice inside me told me that it was unhealthy to wallow in this. I gathered my things and made a concerted effort to visit several more patients in the last hour of the day. Initially I was afraid that I’d not be engaged, that my concern over my health would overshadow any pastoral care I could offer. That was before I met Tommy.
Tommy’s mother is in the hospital, and he doesn’t quite understand why. He was sitting on the window seat in her room (which happened to be the For Every Season There is a Miracle Room) while she lay intubated and unconscious. I asked what was going on, and he got a little agitated and explained that he didn’t understand all the things the doctors had said. It was at that point I realized that Tommy has a lower IQ than many people, but it didn’t stop him from talking animatedly about his Baptist church right down the road. He proudly told me that it’s his job to cut the grass because he’s the only person who is qualified to do it, and just like that I thought of Forrest Gump, the ‘gozillionaire’ who offered to cut the massive town hall lawn for free. Tommy takes great pride in what he does, as if it were the most important thing in the world – and to him, it is. He also said to me that God is his special friend. I was envious of his ability to focus only on what’s right in front of him and be happy about it, until I realized that one needn’t be Forrest Gump to do that. Worrying about what might be is pointless. Of course, God told us that, but hey, I’m only human. I worry, and I imagine the worst, which nets me nothing more than unwanted stress. I think God sent Tommy to me, and me to Tommy, so that we could offer each other the support that each of us needs. For Tommy, it was prayer about his mother’s situation. For me, it was the lesson that I need to focus on what’s right in front of me, and put all my energy into that, instead of wasting it on the hypothetical. After all, you never know what you’re gonna get in that box of chocolates called life. When you get stuck with a coconut when you were really expecting caramel, instead of imagining where the caramel might be hiding, enjoying the chocolate that covers the coconut is what counts.
Sunday, August 2, 2009
New Orleans: Proud to Crawl Home
I wish I could claim ownership of the witty title of this blog, but I’m afraid that honor goes to someone else. It’s a statement I’ve seen on dozens of bumper stickers over the past year in this city. La Nouvelle Orleans. Nueva Orleans. The Big Easy. My adopted home. On the day I first arrived, roughly 90% of its inhabitants had been evacuated for Hurricane Gustav, which they had been warned would make “The Storm” (that’s what the natives call Hurricane Katrina) look like child’s play. We know now, of course, that that didn’t happen; Gustav lost strength as he rolled through the Gulf of Mexico and slammed into the mainland, causing far more damage north of here in Baton Rouge and Shreveport. New Orleans lost power for some hours, but came through largely unscathed. Its inhabitants returned home as if nothing serious had taken place, and picked up life where’d they’d left off. This is the dominant attitude among the denizens of this tropical port city – put the bad behind you and move on, living life as if there’s no tomorrow, because there may NOT be a tomorrow. I think few people know this better than natives of New Orleans.
The Storm is still a dominant discussion with visitors, even four years after it struck. Three days after I arrived, having yet to find suitable housing, I used Craigslist to connect with the woman who would turn out to be my roommate for the next 11 months. On my way to her house, I stopped a 20something couple in a pickup truck at the corner of Claiborne and Jackson, asking how far it would be for me to walk to Carrolton Avenue. Without hesitation they said, “Oh, that’s too far to walk! Hop on in; we’ll give you a lift.” It shames me still to admit that my first reaction was to draw back and think, “are you NUTS?!? I don’t even KNOW you!!” Such is the mindset of a Yankee. We Northerners are a rather self-focused lot, and rarely express such open friendliness. But I’d already demonstrated courage when I moved here having no place to live, so I accepted their offer. I shared that I had literally just arrived in New Orleans and had yet to know much about it. The young woman looked out the window at the houses passing by and said sadly, “I just don’t think this city will ever be the same after The Storm.” I didn’t realize at the time just how deeply those words are felt by natives of NOLA (another local term). Of course I’d already heard and seen bits and pieces – a member of the Southern Louisiana Presbytery whose home was destroyed told me that if it had been built on ground just nine inches higher she would have been able to save it. The Garden District branch of the NOLA Public Library, a big beautiful home on St. Charles Avenue, is indefinitely closed for repairs, with a big sign about ‘recovery’ on the front lawn. Gradually I’ve learned more: my boss has food supplies stored in her office in case another relief effort is needed. After The Storm my roommate’s church had to borrow space from the oldest Protestant congregation in the city’s history, First Presbyterian of NOLA, because their own sanctuary was virtually destroyed (they are still rebuilding). My own church is a blended congregation: the oldest “White” UCC in NOLA (St. Matthew) has merged with the oldest “Black” UCC in NOLA (Central), because Central’s sanctuary was destroyed – and is still being rebuilt. During a small group meeting of several of my church members, one of them (who is a NOLA transplant, having lived here only 15 years) summed it up perfectly: even if New Orleans as a city exists for another thousand years, it will always and forever be divided into two phases: Before The Storm, and After The Storm.
Though The Storm dominates discussion, what stands out to me is the genuine friendliness of Southerners. My roommate’s next door neighbor is her closest friend, and I have warmly been welcomed into the fold. I am family by adoption, which never fails to amaze me. It’s not a generational thing, either – everyone considers me family. Yesterday, while walking down Carrollton Avenue eating some coffee flavored gelato from Gelato Pazzo, I passed by the neighbor’s son by adoption (because his mom is neighbor’s other best friend), who was on his way to Subway to buy a sandwich. He’s typical of guys in their early 20s – drooping jeans, goth design tshirt, and three metal studs in his lower lip outlining his goatee and making him look remarkably like a devil, or a latter day General Beauregard in hip hop attire. A smile stretched across his face as he greeted me and gave me a hug (that’s another thing unique to the South – you won’t find Yankees hugging or kissing each other’s cheek!). Such treatment never fails to warm my heart. In her final evaluation of me at the end of my first unit of CPE, my supervisor wrote of me: “community is what she most longs for, and simultaneously fears.” I thought of that today, as I reflected in this blog, and realized even more strongly why God chose to bring me to New Orleans. Here, my hunger is fed – and I in turn have gained the trust necessary to be part of the family. I didn’t have to make the effort from the start, because in NOLA, friendliness is always extended toward others. NOLA natives are the very definition of community.
My ex-roommate in Phoenix was very unexcited by the idea of my coming here. One of my bestest friends from high school recently signed on to Facebook, and asked me, “What the HELL are you doing in New ORLEANS???” as if it were something filthy. They don’t know the NOLA that I know, though, so I can only pity them. It’s not all about Bourbon Street and bare breasts (for the record, the genuine natives of this city, to a person, all stridently claim that it was drunken Yankee co-eds who began this tradition, not the locals), or the looting scenes that national TV just had to show repeatedly in the wake of The Storm. It’s about community. Heck, I’m even learning that making eye contact is the NORM here. In Chicago, if you do, you’re expected to look away instantly or it’s taken as a challenge. Here, if you don’t acknowledge someone it’s seen as a slight. More to the point, it goes beyond simple acknowledgement. One of my patients, a transplant from Ohio 19 years ago, put it perfectly when he explained why he loves this city: “because here, when people ask you how you’re doing, they actually want to know the answer.”
Sometimes I wonder if I’m crazy, loving this place….especially now that we’re into August. This is my first August here, which has inspired countless warnings of “Oh, just you wait – you haven’t felt humidity yet, ‘til you’ve survived a NOLA August!” (hint to the locals: it’s not exactly something to brag about). Sometimes it feels as if I’m swimming through the air. I open my front door and feel damp in less than 60 seconds. I have learned to disregard logic when it comes to direction, since from my house’s vantage point the sun rises in the south and sets in the east (that’s why they call this the Crescent City!). The diet is not exactly what one could call healthy, unless you eat mainly raw fruit. But the people have made me welcome in a way I’ve never felt. When my residency ends in six weeks, I’ll be staying here.
Yeah, the local phrases are a little different (I knew I was truly an adopted daughter of NOLA when I looked at some gathering clouds a few weeks ago and said, ‘looks like it’s fixin’ to rain’) and groceries are still far more expensive than they should be, but this gem of a city has been healing to me in so many ways that I can only turn around and offer to assist in its own healing from The Storm. After all, that’s what family does - and it’s a strong family. This afternoon on my way through the parking lot of Robert’s (pronounced Row-BEARS, since this is NOLA) Grocery, I saw a late model Toyota with the following bumper sticker: ‘drove my Chevy to the levee, but the levee was gone’ and laughed out loud – just like a good NOLA native would. We came through alright, and though a tremendous amount of recovery work STILL remains, we’ll continue to rebuild, while enjoying life to the fullest because you never know what lies around the corner – or how long the levee will hold. Laissez les bon temps rouler!
The Storm is still a dominant discussion with visitors, even four years after it struck. Three days after I arrived, having yet to find suitable housing, I used Craigslist to connect with the woman who would turn out to be my roommate for the next 11 months. On my way to her house, I stopped a 20something couple in a pickup truck at the corner of Claiborne and Jackson, asking how far it would be for me to walk to Carrolton Avenue. Without hesitation they said, “Oh, that’s too far to walk! Hop on in; we’ll give you a lift.” It shames me still to admit that my first reaction was to draw back and think, “are you NUTS?!? I don’t even KNOW you!!” Such is the mindset of a Yankee. We Northerners are a rather self-focused lot, and rarely express such open friendliness. But I’d already demonstrated courage when I moved here having no place to live, so I accepted their offer. I shared that I had literally just arrived in New Orleans and had yet to know much about it. The young woman looked out the window at the houses passing by and said sadly, “I just don’t think this city will ever be the same after The Storm.” I didn’t realize at the time just how deeply those words are felt by natives of NOLA (another local term). Of course I’d already heard and seen bits and pieces – a member of the Southern Louisiana Presbytery whose home was destroyed told me that if it had been built on ground just nine inches higher she would have been able to save it. The Garden District branch of the NOLA Public Library, a big beautiful home on St. Charles Avenue, is indefinitely closed for repairs, with a big sign about ‘recovery’ on the front lawn. Gradually I’ve learned more: my boss has food supplies stored in her office in case another relief effort is needed. After The Storm my roommate’s church had to borrow space from the oldest Protestant congregation in the city’s history, First Presbyterian of NOLA, because their own sanctuary was virtually destroyed (they are still rebuilding). My own church is a blended congregation: the oldest “White” UCC in NOLA (St. Matthew) has merged with the oldest “Black” UCC in NOLA (Central), because Central’s sanctuary was destroyed – and is still being rebuilt. During a small group meeting of several of my church members, one of them (who is a NOLA transplant, having lived here only 15 years) summed it up perfectly: even if New Orleans as a city exists for another thousand years, it will always and forever be divided into two phases: Before The Storm, and After The Storm.
Though The Storm dominates discussion, what stands out to me is the genuine friendliness of Southerners. My roommate’s next door neighbor is her closest friend, and I have warmly been welcomed into the fold. I am family by adoption, which never fails to amaze me. It’s not a generational thing, either – everyone considers me family. Yesterday, while walking down Carrollton Avenue eating some coffee flavored gelato from Gelato Pazzo, I passed by the neighbor’s son by adoption (because his mom is neighbor’s other best friend), who was on his way to Subway to buy a sandwich. He’s typical of guys in their early 20s – drooping jeans, goth design tshirt, and three metal studs in his lower lip outlining his goatee and making him look remarkably like a devil, or a latter day General Beauregard in hip hop attire. A smile stretched across his face as he greeted me and gave me a hug (that’s another thing unique to the South – you won’t find Yankees hugging or kissing each other’s cheek!). Such treatment never fails to warm my heart. In her final evaluation of me at the end of my first unit of CPE, my supervisor wrote of me: “community is what she most longs for, and simultaneously fears.” I thought of that today, as I reflected in this blog, and realized even more strongly why God chose to bring me to New Orleans. Here, my hunger is fed – and I in turn have gained the trust necessary to be part of the family. I didn’t have to make the effort from the start, because in NOLA, friendliness is always extended toward others. NOLA natives are the very definition of community.
My ex-roommate in Phoenix was very unexcited by the idea of my coming here. One of my bestest friends from high school recently signed on to Facebook, and asked me, “What the HELL are you doing in New ORLEANS???” as if it were something filthy. They don’t know the NOLA that I know, though, so I can only pity them. It’s not all about Bourbon Street and bare breasts (for the record, the genuine natives of this city, to a person, all stridently claim that it was drunken Yankee co-eds who began this tradition, not the locals), or the looting scenes that national TV just had to show repeatedly in the wake of The Storm. It’s about community. Heck, I’m even learning that making eye contact is the NORM here. In Chicago, if you do, you’re expected to look away instantly or it’s taken as a challenge. Here, if you don’t acknowledge someone it’s seen as a slight. More to the point, it goes beyond simple acknowledgement. One of my patients, a transplant from Ohio 19 years ago, put it perfectly when he explained why he loves this city: “because here, when people ask you how you’re doing, they actually want to know the answer.”
Sometimes I wonder if I’m crazy, loving this place….especially now that we’re into August. This is my first August here, which has inspired countless warnings of “Oh, just you wait – you haven’t felt humidity yet, ‘til you’ve survived a NOLA August!” (hint to the locals: it’s not exactly something to brag about). Sometimes it feels as if I’m swimming through the air. I open my front door and feel damp in less than 60 seconds. I have learned to disregard logic when it comes to direction, since from my house’s vantage point the sun rises in the south and sets in the east (that’s why they call this the Crescent City!). The diet is not exactly what one could call healthy, unless you eat mainly raw fruit. But the people have made me welcome in a way I’ve never felt. When my residency ends in six weeks, I’ll be staying here.
Yeah, the local phrases are a little different (I knew I was truly an adopted daughter of NOLA when I looked at some gathering clouds a few weeks ago and said, ‘looks like it’s fixin’ to rain’) and groceries are still far more expensive than they should be, but this gem of a city has been healing to me in so many ways that I can only turn around and offer to assist in its own healing from The Storm. After all, that’s what family does - and it’s a strong family. This afternoon on my way through the parking lot of Robert’s (pronounced Row-BEARS, since this is NOLA) Grocery, I saw a late model Toyota with the following bumper sticker: ‘drove my Chevy to the levee, but the levee was gone’ and laughed out loud – just like a good NOLA native would. We came through alright, and though a tremendous amount of recovery work STILL remains, we’ll continue to rebuild, while enjoying life to the fullest because you never know what lies around the corner – or how long the levee will hold. Laissez les bon temps rouler!
Saturday, July 4, 2009
Tears
During the year after I earned my first unit of CPE, I deliberately took some personal time away from my pastoral formation and worked at Macy’s in Phoenix’ illustrious Biltmore Plaza. One of my co-workers was a nursing student, and she told me she’d been taught that expressing emotion of any sort, especially crying, is absolutely verboten in her profession. I said bluntly that I think that’s nuts. Of course I expect my doctors and nurses to be competent in the face of tragedy – that’s partly why they go through such extensive training. But I think it’s ridiculous to forbid them to express ANY sorrow over the loss of a patient, or a hopeless diagnosis. Try as we might to deify them, they are human, too. Now, after a year as a chaplain, I’ve realized that they go through the same complex process I go through in separating the emotion from the facts. I think what happens is, they learn early on, as I did, to distance themselves from patients and situations so that they can function without expressing emotion in the present. Then they go home and deal with the frustration, anger and sorrow in private. Sometimes you might think that a doctor or nurse doesn’t feel it, but you couldn’t be more wrong. Oh, they feel it – and many times afterward, as a sort of venting, they’ll talk to the chaplain. It’s a tough process to learn how to keep emotion from affecting your behavior, but it’s absolutely necessary in this profession.
Unfortunately it can be tougher for a chaplain since emotion is largely what drives our visits, and because we ourselves must offer support to the medical staff. We’re also on hand for every death of every type, and the sad truth is that many people associate the chaplain solely with death. During an interview for a residency at a medium-sized hospital two years ago, I was touring the facilities with the on-call chaplain when a Code Blue was called. When we arrived in the ICU together to find two 40-something women clinging to each other while their mother fought cancer, one looked at us and gasped, “Oh God, it’s the chaplain….she must’ve died!” One time during this residency, I responded to a Code Blue called for a 20-something patient who’d passed out in her bathroom, and upon seeing my clerical collar, her mother cried, “MY DAUGHTER DOESN’T NEED A CHAPLAIN! SHE’S NOT DEAD!!!”. Part of a successful CPE program is learning, so instead of feeling affront, I learn to be more sensitive to people’s impressions – i.e., when I visit a new mom whose baby is in the NiCU, the first thing I say is that I’m here to greet ALL new moms and I’m so happy that she had a healthy birth. Unfortunately, when I respond to a death, no explanation of my presence is necessary. Everybody knows why I’m there.
I’ve been present for so many deaths now that I’m beginning to understand how the doctors do it – how they function professionally in the face of grief, without letting emotion even show, much less color what it is they say and do. It’s been a long time since I’ve cried after a death. I feel bad just admitting that on paper, but it’s true. After a while, you just don’t react in the same way. Yes, it’s always sorrowful, especially when it’s unexpected or due to some horrid disease instead of natural causes, but usually I compartmentalize my emotions and work out the sorrow in different ways, after I’m away from the hospital. This ability is especially helpful if I’m attending the death of a baby. I think if I were a mother who’d just lost a child, I might feel resentful seeing someone else cry tears over my child. That sense of ownership of emotion is part of the grief process. So if I cry when I attend a death, am I grieving for the death of someone I never knew? Or am I grieving for myself? What, exactly, have I lost that causes me to cry?
Chris was an extremely handsome man, though initially I couldn’t tell from all the tubes attached to him. He was rushed to the hospital yesterday after a drug overdose that led to cardiac arrest. One of his family members told me that he had fought addiction for so long, he’d been through rehab, he’d tried to clean up. In the end, though, the demon got the best of him. I’d been told ahead of time when I arrived tonight for the overnight on-call shift what the issue was, and in making rounds I commented to the charge nurse on duty in the NiCU, “I can’t imagine ever doing that”, and she said, quite seriously, “I can. Not that I’d do it, but I can understand needing that escape.” Chris' extended family was openly grieving when I arrived for the withdrawal of care. The tubes were removed, and he went almost immediately, as if he’d been just waiting for a release that heroin never provided. The family had done so much grieving already that they were past the point of needing extensive pastoral care; in fact, they left the room less than ten minutes after his heart stopped. They, too, had fought the demon, worked out the emotion, and now had release. I felt like a fifth wheel for the most part, though I tried to offer comfort, and also said a prayer shortly after he died. I had extensive paperwork to write afterward, and about 15 minutes later I looked up into the room where his nurse was taking away machines, removing tubes and restoring some semblance of humanity to his appearance. Observing Chris, I realized that without all the tubes, he looked like actor Leonardo DiCaprio, who is one of my favorites.
During his dying process, I had wondered about the demons that chased him, caused him to retreat from life and escape through drugs. Was I really any different, I wondered, though my method of escapism was social isolation? Had I not done the same thing myself far too long? It was almost as if through Chris's death I was being taught a lesson about escapism…I’d done it myself, just as the nurse claimed. I simply hadn’t used drugs as my means. Facing up to that was a very tough thing for me, and brought a lot of feelings to the fore. Sometimes the emotion is so strong that you can’t wait until you’re away from the hospital to deal with it; you need to right then. For that reason, I found myself crying after I left the unit and returned to my office shortly after midnight, tears of grief over what I myself had lost – and tears of gratitude that I’ve managed to best my own demon and am moving forward. Afterward, I googled the word ‘tears’ and on Wikipedia, found this quote about crying: an emotional reaction considered by many to be a uniquely human phenomenon, possibly due to humans' advanced self-awareness. So apparently, my advanced self-awareness led me to react emotionally over what I’ve lost and what Chris and his family have lost. That sounds too intellectual to me. The reality is that the last of my grief over what I’ve lost is being expressed, both right after the visit and right here. Like Chris, I, too, have finally found that release I sought. It’s a damn good feeling – and though he had to go to Heaven to get it himself, I am firmly convinced that Chris, too, finds it a damn good feeling. Rest in peace, brother.
Unfortunately it can be tougher for a chaplain since emotion is largely what drives our visits, and because we ourselves must offer support to the medical staff. We’re also on hand for every death of every type, and the sad truth is that many people associate the chaplain solely with death. During an interview for a residency at a medium-sized hospital two years ago, I was touring the facilities with the on-call chaplain when a Code Blue was called. When we arrived in the ICU together to find two 40-something women clinging to each other while their mother fought cancer, one looked at us and gasped, “Oh God, it’s the chaplain….she must’ve died!” One time during this residency, I responded to a Code Blue called for a 20-something patient who’d passed out in her bathroom, and upon seeing my clerical collar, her mother cried, “MY DAUGHTER DOESN’T NEED A CHAPLAIN! SHE’S NOT DEAD!!!”. Part of a successful CPE program is learning, so instead of feeling affront, I learn to be more sensitive to people’s impressions – i.e., when I visit a new mom whose baby is in the NiCU, the first thing I say is that I’m here to greet ALL new moms and I’m so happy that she had a healthy birth. Unfortunately, when I respond to a death, no explanation of my presence is necessary. Everybody knows why I’m there.
I’ve been present for so many deaths now that I’m beginning to understand how the doctors do it – how they function professionally in the face of grief, without letting emotion even show, much less color what it is they say and do. It’s been a long time since I’ve cried after a death. I feel bad just admitting that on paper, but it’s true. After a while, you just don’t react in the same way. Yes, it’s always sorrowful, especially when it’s unexpected or due to some horrid disease instead of natural causes, but usually I compartmentalize my emotions and work out the sorrow in different ways, after I’m away from the hospital. This ability is especially helpful if I’m attending the death of a baby. I think if I were a mother who’d just lost a child, I might feel resentful seeing someone else cry tears over my child. That sense of ownership of emotion is part of the grief process. So if I cry when I attend a death, am I grieving for the death of someone I never knew? Or am I grieving for myself? What, exactly, have I lost that causes me to cry?
Chris was an extremely handsome man, though initially I couldn’t tell from all the tubes attached to him. He was rushed to the hospital yesterday after a drug overdose that led to cardiac arrest. One of his family members told me that he had fought addiction for so long, he’d been through rehab, he’d tried to clean up. In the end, though, the demon got the best of him. I’d been told ahead of time when I arrived tonight for the overnight on-call shift what the issue was, and in making rounds I commented to the charge nurse on duty in the NiCU, “I can’t imagine ever doing that”, and she said, quite seriously, “I can. Not that I’d do it, but I can understand needing that escape.” Chris' extended family was openly grieving when I arrived for the withdrawal of care. The tubes were removed, and he went almost immediately, as if he’d been just waiting for a release that heroin never provided. The family had done so much grieving already that they were past the point of needing extensive pastoral care; in fact, they left the room less than ten minutes after his heart stopped. They, too, had fought the demon, worked out the emotion, and now had release. I felt like a fifth wheel for the most part, though I tried to offer comfort, and also said a prayer shortly after he died. I had extensive paperwork to write afterward, and about 15 minutes later I looked up into the room where his nurse was taking away machines, removing tubes and restoring some semblance of humanity to his appearance. Observing Chris, I realized that without all the tubes, he looked like actor Leonardo DiCaprio, who is one of my favorites.
During his dying process, I had wondered about the demons that chased him, caused him to retreat from life and escape through drugs. Was I really any different, I wondered, though my method of escapism was social isolation? Had I not done the same thing myself far too long? It was almost as if through Chris's death I was being taught a lesson about escapism…I’d done it myself, just as the nurse claimed. I simply hadn’t used drugs as my means. Facing up to that was a very tough thing for me, and brought a lot of feelings to the fore. Sometimes the emotion is so strong that you can’t wait until you’re away from the hospital to deal with it; you need to right then. For that reason, I found myself crying after I left the unit and returned to my office shortly after midnight, tears of grief over what I myself had lost – and tears of gratitude that I’ve managed to best my own demon and am moving forward. Afterward, I googled the word ‘tears’ and on Wikipedia, found this quote about crying: an emotional reaction considered by many to be a uniquely human phenomenon, possibly due to humans' advanced self-awareness. So apparently, my advanced self-awareness led me to react emotionally over what I’ve lost and what Chris and his family have lost. That sounds too intellectual to me. The reality is that the last of my grief over what I’ve lost is being expressed, both right after the visit and right here. Like Chris, I, too, have finally found that release I sought. It’s a damn good feeling – and though he had to go to Heaven to get it himself, I am firmly convinced that Chris, too, finds it a damn good feeling. Rest in peace, brother.
Monday, June 8, 2009
Great Expectations
This week’s weather forecast had predicted sunny, beautiful weather in New Orleans at least through Friday, which excited me – especially since I have Friday off (compensation for working overnight on Saturday). Here I thought it’d be beautiful all week, I could eat my lunch out in front of the hospital near the fountain while I people watched, and ride my bike to work. I was surprised to see storm clouds gather late this morning; surely I was mistaken? Nope. The rain started pouring just before I left work, necessitating my leaving my bike locked to the bike rack and riding the bus home. I hate it when things like that happen; when you expect something completely different and you get a big, fat slap in the face instead.
This morning I was checking intubated patients in my ICU, and came upon Wilbur, who is 80 years old and has been hospitalized for two weeks now. His wife called on Saturday morning & left a message asking to speak with the priest. When I got the message, I called her home and had to tell her voicemail that he wouldn’t be available until this morning. On my way by Wilbur’s room, I noticed a woman sitting on the window seat, chatting on a cell phone. She looked too young to be Wilbur’s wife, but confirmed for me when asked that she was indeed the lady who had called on Saturday. She’d sounded a little frantic on the phone, which concerned me. In person she explained that our staff priest had made a connection with her husband the likes of which she hadn’t experienced since she was a child, being educated by the nuns of Notre Dame. Apologetically, she told me that for years she’d experienced priests who seemed to pray by rote rather than emotion, so when our priest made such a big impact she wanted very much to feel it again. I agreed with her that Father is a very humble man, said I was glad that she’d found that connection and expressed my happiness that her husband’s numbers are looking better. At that point, her face crumpled and she began to cry. Looking at me woefully, she said, “I keep telling myself that he’s 80 already….I knew it would come eventually. But age doesn’t matter. It still hurts so much.” It was so painfully real to hear her grief, but unlike so many times in my past, I didn’t run from it. Instead, we spoke about love, which of course is what makes it hurt so much. She said that the opposite, indifference, would be far worse and that she’d never have preferred that over this, no matter how bad the pain gets.
Thirty minutes later, in the internal medicine unit to which I’m assigned, I met Michael, who requested a chaplain visit this morning. He’s a very tiny man, sitting with his legs drawn up against his chest, constantly rocking on the bed – not in nervousness, I surmised, but because he had a need to feel some motion. It was obvious to me that he’d had a stroke; his first few utterances were uh-uh-uh-uh-uh before he began speaking. At 57, he has never had long term employment (due to problems he clearly stated are his own doing), and feels in some way that he has failed his family and society. It’s heartbreaking to hear the hopelessness in some people’s words, especially because it was clear to me that this man’s intelligence level is near genius. He spoke of being stuck in a trap from which he couldn’t escape, and is frightened that this stroke means that God is punishing him for something. I told him that in the nine months I’ve been at this hospital, I’ve seen eight patients under age 60 who had strokes. For the first time, I saw a glimmer of hope in his eyes – really? It’s not unheard of? Maybe it was a wake-up call, not a punishment? The physical prognosis for Michael is excellent, according to his nurse. As for his emotional well-being, I am learning to work within my boundaries. I can’t fix the problems for him, only shed some light into the dark corners of his thoughts. Maybe what he considered a scary detour will turn out to be something good in the end.
That’s something I was told by a patient last Thursday morning during our first meeting. James had explained to me that he has difficulty taking pills ever since he was diagnosed with diabetes, because the disease takes away full control of the mouth’s muscles. That sounded scary to me, but he shrugged with the nonchalance that so many patients with cardiac problems demonstrate. It’s just one more thing you learn to deal with and live with, he said. Can’t let yourself get sidetracked to a standstill. Before our visit could end, the team of doctors came in to speak with him and I gave the family some privacy, saying I’d be back later. As it turned out, I wasn’t able to because I was asked to spend the afternoon visiting the Spanish-speaking patients in the transplant unit. Pedro was so grateful to speak in his native tongue that it had him in tears. His transplant was successful, as he had hoped, but he’s had a setback in the form of an infection in his leg. He’s missed the wedding of his daughter, and the birth of his son’s first child, because he’s been hospitalized here for nearly 3 months. It was humbling to see how a simple visit from someone who could listen – and understand – was so uplifting to him. When I finally went back to visit James today, I literally said no more than two sentences before a Code Blue was called. As attendant chaplain on-call, I had to excuse myself a second time and thus spent the next 90 minutes with Wilma’s family.
Wilma has a road map of heart problems, and a heart attack put her in the hospital last week. What caused the code, the cardiologists simply are not certain, but it didn’t matter to her family. Her granddaughter correctly guessed that her mother and aunt (Wilma’s two daughters) would be hysterical upon learning the news. Indeed they were; her eldest daughter literally collapsed to the floor outside the ICU and we had to rush for a wheelchair. She spent nearly 30 minutes hyperventilating, begging Jesus not to take her mommy when she could actually get a breath to speak. It was the most dramatic expression of grief I have ever witnessed. I asked one of the ICU nurses, who has been here 3 years, if he’s ever seen someone in a state like this, and he said that though he’s seen many people terribly grief-stricken, this was a first for him. He was very respectful of it, grabbing a can of Sprite and some ice for the daughter, and getting a few other things to help, though he was still taking care of two patients. The attendant who got the wheelchair, on the other hand, was unimpressed, and muttered under her breath, “they’re nuts!”
Initially, I was quite offended by her crass remark, but as I reflected later, I realized that it’s indicative of her lack of experience. It’s naïve – and remarkably sad, too. She’ll learn the hard way, as I did, as Wilbur’s wife has, as Michael has, as James has, as Pedro has, and as Wilma’s family now is: we can have all the great expectations we want. We can expect sunshine every day. But the bottom line is, life simply isn’t like that. There are no guarantees, and as I told Michael, who so badly wants a second chance, every day you wake up with breath in your body you’re given a second chance. What you do with it is up to you, but this much is a given: you can hope for great things, but they won’t always happen. The real test of who you are as a person is how you respond in the face of the setbacks.
This morning I was checking intubated patients in my ICU, and came upon Wilbur, who is 80 years old and has been hospitalized for two weeks now. His wife called on Saturday morning & left a message asking to speak with the priest. When I got the message, I called her home and had to tell her voicemail that he wouldn’t be available until this morning. On my way by Wilbur’s room, I noticed a woman sitting on the window seat, chatting on a cell phone. She looked too young to be Wilbur’s wife, but confirmed for me when asked that she was indeed the lady who had called on Saturday. She’d sounded a little frantic on the phone, which concerned me. In person she explained that our staff priest had made a connection with her husband the likes of which she hadn’t experienced since she was a child, being educated by the nuns of Notre Dame. Apologetically, she told me that for years she’d experienced priests who seemed to pray by rote rather than emotion, so when our priest made such a big impact she wanted very much to feel it again. I agreed with her that Father is a very humble man, said I was glad that she’d found that connection and expressed my happiness that her husband’s numbers are looking better. At that point, her face crumpled and she began to cry. Looking at me woefully, she said, “I keep telling myself that he’s 80 already….I knew it would come eventually. But age doesn’t matter. It still hurts so much.” It was so painfully real to hear her grief, but unlike so many times in my past, I didn’t run from it. Instead, we spoke about love, which of course is what makes it hurt so much. She said that the opposite, indifference, would be far worse and that she’d never have preferred that over this, no matter how bad the pain gets.
Thirty minutes later, in the internal medicine unit to which I’m assigned, I met Michael, who requested a chaplain visit this morning. He’s a very tiny man, sitting with his legs drawn up against his chest, constantly rocking on the bed – not in nervousness, I surmised, but because he had a need to feel some motion. It was obvious to me that he’d had a stroke; his first few utterances were uh-uh-uh-uh-uh before he began speaking. At 57, he has never had long term employment (due to problems he clearly stated are his own doing), and feels in some way that he has failed his family and society. It’s heartbreaking to hear the hopelessness in some people’s words, especially because it was clear to me that this man’s intelligence level is near genius. He spoke of being stuck in a trap from which he couldn’t escape, and is frightened that this stroke means that God is punishing him for something. I told him that in the nine months I’ve been at this hospital, I’ve seen eight patients under age 60 who had strokes. For the first time, I saw a glimmer of hope in his eyes – really? It’s not unheard of? Maybe it was a wake-up call, not a punishment? The physical prognosis for Michael is excellent, according to his nurse. As for his emotional well-being, I am learning to work within my boundaries. I can’t fix the problems for him, only shed some light into the dark corners of his thoughts. Maybe what he considered a scary detour will turn out to be something good in the end.
That’s something I was told by a patient last Thursday morning during our first meeting. James had explained to me that he has difficulty taking pills ever since he was diagnosed with diabetes, because the disease takes away full control of the mouth’s muscles. That sounded scary to me, but he shrugged with the nonchalance that so many patients with cardiac problems demonstrate. It’s just one more thing you learn to deal with and live with, he said. Can’t let yourself get sidetracked to a standstill. Before our visit could end, the team of doctors came in to speak with him and I gave the family some privacy, saying I’d be back later. As it turned out, I wasn’t able to because I was asked to spend the afternoon visiting the Spanish-speaking patients in the transplant unit. Pedro was so grateful to speak in his native tongue that it had him in tears. His transplant was successful, as he had hoped, but he’s had a setback in the form of an infection in his leg. He’s missed the wedding of his daughter, and the birth of his son’s first child, because he’s been hospitalized here for nearly 3 months. It was humbling to see how a simple visit from someone who could listen – and understand – was so uplifting to him. When I finally went back to visit James today, I literally said no more than two sentences before a Code Blue was called. As attendant chaplain on-call, I had to excuse myself a second time and thus spent the next 90 minutes with Wilma’s family.
Wilma has a road map of heart problems, and a heart attack put her in the hospital last week. What caused the code, the cardiologists simply are not certain, but it didn’t matter to her family. Her granddaughter correctly guessed that her mother and aunt (Wilma’s two daughters) would be hysterical upon learning the news. Indeed they were; her eldest daughter literally collapsed to the floor outside the ICU and we had to rush for a wheelchair. She spent nearly 30 minutes hyperventilating, begging Jesus not to take her mommy when she could actually get a breath to speak. It was the most dramatic expression of grief I have ever witnessed. I asked one of the ICU nurses, who has been here 3 years, if he’s ever seen someone in a state like this, and he said that though he’s seen many people terribly grief-stricken, this was a first for him. He was very respectful of it, grabbing a can of Sprite and some ice for the daughter, and getting a few other things to help, though he was still taking care of two patients. The attendant who got the wheelchair, on the other hand, was unimpressed, and muttered under her breath, “they’re nuts!”
Initially, I was quite offended by her crass remark, but as I reflected later, I realized that it’s indicative of her lack of experience. It’s naïve – and remarkably sad, too. She’ll learn the hard way, as I did, as Wilbur’s wife has, as Michael has, as James has, as Pedro has, and as Wilma’s family now is: we can have all the great expectations we want. We can expect sunshine every day. But the bottom line is, life simply isn’t like that. There are no guarantees, and as I told Michael, who so badly wants a second chance, every day you wake up with breath in your body you’re given a second chance. What you do with it is up to you, but this much is a given: you can hope for great things, but they won’t always happen. The real test of who you are as a person is how you respond in the face of the setbacks.
Friday, May 22, 2009
Language
I was never good at math and science. Or at least, they never came easily to me, like languages did. I remember how shocked I was when my sister failed first year Spanish, because it was SOOO easy for me (only that first year; once el subjuntivo entered the equation, it was a lot of hard work). Two years later, I struggled –with the help of a tutor, mind you – to get a C in geometry, a class in which my sister had earned an A, without much work, from the same teacher. That’s when I realized that maybe I should focus on the things that I understood well, improving on what I already knew. I spent all four years of high school studying Spanish & working as my teacher’s aide, and then I majored in Spanish at university, with the intention of teaching Spanish at the secondary level. After a year’s break, I pursued a masters’ degree in Spanish linguistics, an unusual area of focus since most graduate students in language focus on literature. My area of focus was on the skeleton, as it were: how and why the language evolves the way it does, based on society and its communication needs. One of my assignments, for example, was to translate four pages of the literary classic Cantar de Mio Cid, written in the 12th century, to modern Castilian, explaining why I made the choices I did. Among the things I learned was how heavily we humans are influenced by outside elements when we attempt to communicate. I also learned that teaching the language was far too boring for me; I’d rather use it in the work I do. My first job, post grad school, required native fluency in Spanish so that I could edit translated documents, side by side, comparing the Spanish and English together. For all the differences between the languages, some things are just as dry in one language as they are in another (for a great sleep aid, try reading income tax law in Spanish; I guarantee you’ll be asleep in less than ten minutes!). For the most part, though, things sound far more beautiful in Spanish than in English, in my opinion. At my graduation from seminary, I read the Scripture lesson from the book of Nehemiah in Spanish while my friend (& fellow graduate) Jorge read it in English. To my ears, there is absolutely no comparison between “I am doing a great work and I cannot come down. Why should the work stop while I leave it to come down to you?’” and “Estoy ocupado en una gran obra, y no puedo ir. Si bajara yo a reunirme con ustedes, la obra se verÃa interrumpida.”
At the time, I had not yet earned my first unit of clinical pastoral education, and so it had not occurred to me that sometimes the communication is just as beautiful and fluid without words. As fate would have it, I learned that lesson from a woman who was able to speak only Spanish - when she could speak aloud. Silvia was the first person whose death I attended; no chaplain ever forgets that. Five days into my first unit of CPE, I was paged to the ICU because a Spanish-speaking chaplain was requested by Silvia’s family to pray with her. Due to the nature of her illness, I was required to don a gown, gloves and a mask before entering her room. In the end, I must have looked like a giant ghost, hovering above her. The entire time I prayed, she squeezed my fingers, as if not only to be a participant in the prayer even if unable to speak, but also to bring some semblance of humanity back into the room, to reassure herself that it was God’s representative who hovered above her. Two days later, during my first ever on-call shift, I was paged from another unit to attend her death. Though it’s been two years now, I still recall her face when I arrived, how peaceful she looked in death.
One day a young man, here in the US illegally, was brought in with a gunshot wound. It was clear he was frightened of more than simply the medical care, but I hastened to reassure him, saying “No soy la migra” [I’m not from the INS], and explained that I was a chaplain. The word didn’t seem familiar to him, so I added, “Pues, es obvio que no soy padre [Well, it’s obvious that I’m not a priest] - this brought a huge grin to his boyish face, and drew a weak laugh - pero soy una mujer de Dios [I didn’t know how else to describe it, since I wasn’t yet ordained, so I said simply that I was a woman of God].” I doubt anyone ever uses this phrase in most Spanish-speaking countries, but the young man understood perfectly and was more than willing to pray with me. I still feel a little self-conscious when I speak with the Spanish-speaking patients here (I’m the only Spanish-speaking chaplain on a staff of seven, so I am called to meet with all Spanish-speaking patients); though I understand what they say perfectly, it’s when I myself speak that I feel as if I’m underneath a colossal spotlight. Gradually I’ve realized that it’s not about wanting to be perfect; it’s that I still want so badly to be able to FIX everything, both in English AND in Spanish. Sure that’s unrealistic, but it’s the truth. And I know deep down that the people with whom I meet couldn’t care less if I conjugate a verb wrong, or due to my self-consciousness teeter between the TU and USTED forms. Whether words are used or not, whether I use newly invented phrases to express myself, it’s always met with a smile and a genuine GRACIAS.
Ah, gracias….and its English cousin, gratitude. I thought of Silvia and the young man again yesterday, after I met with a patient rendered speechless after a stroke. Sharon is not Hispanic, she’s Black, but the lack of speech was strongly reminiscent of my meeting with Silvia, and our unorthodox way of communicating brought back my meeting with the young man. She was able to write on a notepad, shakily, and though some words were legible, I struggled to understand what she wrote about her family as I asked about them. Frustration caused her to grunt, shaking her head. Gradually, the grunts formed into a weak sound…BRUH…BRUH….BRUH….and I realized that she was saying the word BROTHER. Once we mounted that hurdle, she wrote the following about her mother: MOM IS R D. I thought it meant that her mother is dead, but when I asked she shook her head slightly and again tried to explain what she meant, holding up her hands with her fingers bent in various patterns. Tears came to her eyes, and she grunted again. Slowly, the grunts began to take shape until they sounded the same: AAAY…..AAAYT….AAAAYT….I jumped on it, exclaiming, “your mother is 80-something?” and she smiled in relief. Far from being frustrated over spending ten minutes to discover that she has 6 brothers and an 85-year-old mother, I was overjoyed that she had spoken to me. I said as much, and after a minute of pausing to reflect, I took her hand in mine and prayed a prayer of thanksgiving. I thanked God that the gift of speech was returning to her, that the staff members care about her, that she has family to be there for her during this time in the hospital. I also prayed paraphrasing Paul’s words from his letter to the church in Rome, insisting that God has a purpose for Sharon, that she is called, and that these things happening will work together for her good so that she may go and accomplish great works for God. By the time I was through praying, Sharon had drifted off to sleep like a trusting child. I whispered that I would return today to check on her, and left the room. Today, while making rounds through her unit, I was surprised to see from the door that her bed was empty. Imagine my shock when I moved further into the room and saw her sitting up in the chair next to her bed, talking with a friend, no less! She explained that the doctor told her that she’d not had a stroke, but something that strongly resembles one. She's already regaining her strength; the doctors had plans to reassess her late today and, if all is well, she will be released to go home. When I asked how all this happened in so short a time, she told me that what she remembers is waking up at 1:30am this morning. Gradually she realized that she was praying aloud, saying “praise God, thank you, Jesus!” repeatedly. I was so awestruck that I could say nothing. Some things simply can’t be expressed in the language of words, even by those of us who were gifted with it. Instead I thought of the prayer I had prayed the day before, focusing on gratitude and on having a purpose to accomplish great works for God. Apparently, Sharon is expected to begin work on hers immediately!
As for me, my great work is continuously in progress, and though sometimes I have setbacks, the last thing I want is my own self-doubts and fears to hinder it. Through the gift of words, I express here in this blog the things I am experiencing and how they affect me. In effect, part of my great works is what is written here, and those fears won’t become a tangible thing and hold me back from my purpose. Or, as I’d rather put it, estoy ocupada en una gran obra, y no puedo ir. Si bajara yo a reunirme con ustedes, la obra se verÃa interrumpida.
At the time, I had not yet earned my first unit of clinical pastoral education, and so it had not occurred to me that sometimes the communication is just as beautiful and fluid without words. As fate would have it, I learned that lesson from a woman who was able to speak only Spanish - when she could speak aloud. Silvia was the first person whose death I attended; no chaplain ever forgets that. Five days into my first unit of CPE, I was paged to the ICU because a Spanish-speaking chaplain was requested by Silvia’s family to pray with her. Due to the nature of her illness, I was required to don a gown, gloves and a mask before entering her room. In the end, I must have looked like a giant ghost, hovering above her. The entire time I prayed, she squeezed my fingers, as if not only to be a participant in the prayer even if unable to speak, but also to bring some semblance of humanity back into the room, to reassure herself that it was God’s representative who hovered above her. Two days later, during my first ever on-call shift, I was paged from another unit to attend her death. Though it’s been two years now, I still recall her face when I arrived, how peaceful she looked in death.
One day a young man, here in the US illegally, was brought in with a gunshot wound. It was clear he was frightened of more than simply the medical care, but I hastened to reassure him, saying “No soy la migra” [I’m not from the INS], and explained that I was a chaplain. The word didn’t seem familiar to him, so I added, “Pues, es obvio que no soy padre [Well, it’s obvious that I’m not a priest] - this brought a huge grin to his boyish face, and drew a weak laugh - pero soy una mujer de Dios [I didn’t know how else to describe it, since I wasn’t yet ordained, so I said simply that I was a woman of God].” I doubt anyone ever uses this phrase in most Spanish-speaking countries, but the young man understood perfectly and was more than willing to pray with me. I still feel a little self-conscious when I speak with the Spanish-speaking patients here (I’m the only Spanish-speaking chaplain on a staff of seven, so I am called to meet with all Spanish-speaking patients); though I understand what they say perfectly, it’s when I myself speak that I feel as if I’m underneath a colossal spotlight. Gradually I’ve realized that it’s not about wanting to be perfect; it’s that I still want so badly to be able to FIX everything, both in English AND in Spanish. Sure that’s unrealistic, but it’s the truth. And I know deep down that the people with whom I meet couldn’t care less if I conjugate a verb wrong, or due to my self-consciousness teeter between the TU and USTED forms. Whether words are used or not, whether I use newly invented phrases to express myself, it’s always met with a smile and a genuine GRACIAS.
Ah, gracias….and its English cousin, gratitude. I thought of Silvia and the young man again yesterday, after I met with a patient rendered speechless after a stroke. Sharon is not Hispanic, she’s Black, but the lack of speech was strongly reminiscent of my meeting with Silvia, and our unorthodox way of communicating brought back my meeting with the young man. She was able to write on a notepad, shakily, and though some words were legible, I struggled to understand what she wrote about her family as I asked about them. Frustration caused her to grunt, shaking her head. Gradually, the grunts formed into a weak sound…BRUH…BRUH….BRUH….and I realized that she was saying the word BROTHER. Once we mounted that hurdle, she wrote the following about her mother: MOM IS R D. I thought it meant that her mother is dead, but when I asked she shook her head slightly and again tried to explain what she meant, holding up her hands with her fingers bent in various patterns. Tears came to her eyes, and she grunted again. Slowly, the grunts began to take shape until they sounded the same: AAAY…..AAAYT….AAAAYT….I jumped on it, exclaiming, “your mother is 80-something?” and she smiled in relief. Far from being frustrated over spending ten minutes to discover that she has 6 brothers and an 85-year-old mother, I was overjoyed that she had spoken to me. I said as much, and after a minute of pausing to reflect, I took her hand in mine and prayed a prayer of thanksgiving. I thanked God that the gift of speech was returning to her, that the staff members care about her, that she has family to be there for her during this time in the hospital. I also prayed paraphrasing Paul’s words from his letter to the church in Rome, insisting that God has a purpose for Sharon, that she is called, and that these things happening will work together for her good so that she may go and accomplish great works for God. By the time I was through praying, Sharon had drifted off to sleep like a trusting child. I whispered that I would return today to check on her, and left the room. Today, while making rounds through her unit, I was surprised to see from the door that her bed was empty. Imagine my shock when I moved further into the room and saw her sitting up in the chair next to her bed, talking with a friend, no less! She explained that the doctor told her that she’d not had a stroke, but something that strongly resembles one. She's already regaining her strength; the doctors had plans to reassess her late today and, if all is well, she will be released to go home. When I asked how all this happened in so short a time, she told me that what she remembers is waking up at 1:30am this morning. Gradually she realized that she was praying aloud, saying “praise God, thank you, Jesus!” repeatedly. I was so awestruck that I could say nothing. Some things simply can’t be expressed in the language of words, even by those of us who were gifted with it. Instead I thought of the prayer I had prayed the day before, focusing on gratitude and on having a purpose to accomplish great works for God. Apparently, Sharon is expected to begin work on hers immediately!
As for me, my great work is continuously in progress, and though sometimes I have setbacks, the last thing I want is my own self-doubts and fears to hinder it. Through the gift of words, I express here in this blog the things I am experiencing and how they affect me. In effect, part of my great works is what is written here, and those fears won’t become a tangible thing and hold me back from my purpose. Or, as I’d rather put it, estoy ocupada en una gran obra, y no puedo ir. Si bajara yo a reunirme con ustedes, la obra se verÃa interrumpida.
Friday, May 8, 2009
Hail Mary, Full of Grace
Most people are aware that New Orleans is a heavily Roman Catholic city, but I never realized just how pervasive the presence is until I moved here. This is the only place I’ve ever lived where Black people are as likely to be Catholic as they are to be Baptist or Pentecostal. Many times it’s apparent from a person’s name: the Creole or Cajun names like Boudreaux and Thibodeaux (as common as Smith and Jones are in other places) are almost always indicative of somebody who is Catholic. So one day several months ago when I met Mary, whose surname is a Cajun one not mentioned here, I was a little surprised to see that her religion was listed as Protestant.
She was 72, and so tiny that at first I thought her room was empty until her nurse explained that she was sitting in the chair beside her bed, a sight obscured to me by the large curtain that was half drawn. Mary had been hospitalized for over a week by the time I met her, and it was plain that she was eager to have a visitor. Unlike some people, she didn’t talk about her own aches and pains, or complain about them. Instead, she spoke about her daughter, who lives in Minnesota and hikes mountains when she’s not busy writing books and teaching at university. She also talked about her son, who is in his early 40s and still unmarried, because – as she puts it – he is his mother’s caretaker first and foremost, and therefore he could not commit himself to another woman in the way he felt a husband should. Mary was proud of him for being such a devoted son, but she worried about this a lot; she wanted very much to see him happily married. We also spoke of religion; her surname was that of her husband, who himself had been Catholic. Mary was not, but allowed her children to be raised in the Catholic faith. Prayer was very important to her; that, too, sticks out from our first meeting. Prayer sustained her, and we had prayed a nice prayer together before I left. It’s only looking back that I realize Mary was the type who focused on everyone except herself. No talk about her heart problems, or if she was scared, or lonely as a widow of five or six years. Instead, she found strength through giving to others. She even gave me the advice that LSU’s dental school is a great place for inexpensive dental work, after I showed her the tooth I had chipped on a piece of Halloween candy.
I had not seen Mary since, though I was aware that she was what I call a “frequent flier” – the people who spend a great deal of time in and out of the hospital. She had not been in my unit so I didn’t get the chance to see her again until last week, when she was again hospitalized and this time given a room in my ICU unit. I went to visit her last Tuesday, and came in while she was discussing some things with her nurse. The nurse wrapped up and Mary looked up at me rather vaguely, asking, “is there something I can do for you?”
I was rather crestfallen that she did not remember me. I see so many people, and most are tough to remember though I try my best (especially after a patient said it was good to see me again, leaving me horrified because I had no clue who he was!). Mary was one who was easy to remember, if only in part because of her boldly Cajun surname. I explained who I was, without mentioning our previous visit, and asked how things were going. Mary told me that she had been in a rehab facility, and it was a nightmare. There was one nurse for 30 patients, and said RN worked 17 hour shifts. She rarely saw her nurse, her bedding was rarely changed, her doctor’s orders were not followed, and her special dietary needs were ignored. She deteriorated rapidly and had to be readmitted to our hospital as a result of the rehab facility’s negligence.
It was incredibly difficult for me to listen to all this, because it brought back strong memories of our first meeting in early November. At that time, my aunt had spent six weeks in a rehab facility like the one Mary told me about. The anger I felt over the lack of decent care for my aunt was strangling to me since I was 2000 miles away and could do nothing. It was very difficult at the time to focus on my patients instead of the injustice facing my aunt and my family in Tucson. I had to tamp down the anger I could feel rising in me again, this time on behalf of this sweet lady who seemed to spend all her time trying to make things better for others. I commented neutrally that it must have been a horribly frustrating experience for her, and she replied, “Well, I realized that God put me there for a reason. When I came into the hospital again, my doctor asked me about the facility and how it had gone. I told him every detail and told him not to recommend that place to any other patient, ever again. He said he wouldn’t.” How characteristic of Mary to say such a selfless thing, to state that there was a reason. She was not impotent with anger over the treatment she’d received, nor was she acting like a martyr. It was a straightforward, matter-of-fact statement. While I processed that, she cocked her head at me and asked, “so, did you ever go to LSU’s dental school and get that tooth looked at?” I stuttered to a halt as I realized that she indeed remembered our visit, had remembered all along – or perhaps her memory just needed a nudge. We spoke briefly about it, and then, in her characteristically blunt manner, which is so reminiscent of my aunt, she asked, “Well, are you gonna pray with me?” I smiled broadly and did so.
Earlier this week, Mary signed a DNR order, which means that if she reached code blue status that she was not to be revived. Then she and her son chose a hospice care facility to assist her as she went home; he signed the papers on Tuesday afternoon. Very early yesterday morning, though, her condition worsened dramatically. I was called by the doctor to pray with her at 10:30am, about 90 minutes before I was off duty after a full night on call. Mary’s every breath was labored, and it was difficult to understand what she tried to say. No family was present and based on the things she’d said about her relationship with her son, I explained my concern to her nurse. He was en route to the hospital from his job; his sister was flying in from the Midwest.
Mary’s daughter did not arrive in time to try to speak with her again, but her son was at her bedside when she died two hours after we’d prayed together. I never did ask her how she reconciled the Catholic and Protestant faiths (and believe me, in this city they are DIFFERENT faiths), but I learned from her how to demonstrate grace in the face of a challenging situation. It made me think of the teenage Mary in Luke 1, being told that she would be the mother of God’s only child. Instead of complaining or whining, she said, “Here am I, the servant of the Lord.” Maybe it’s a stretch to compare the two women, but for the first time I have a full understanding of the phrase spoken so reverently in the Catholic Church: Ave Maria, Gratia Plena. It means a whole lot more than just a mother’s love for her child.
She was 72, and so tiny that at first I thought her room was empty until her nurse explained that she was sitting in the chair beside her bed, a sight obscured to me by the large curtain that was half drawn. Mary had been hospitalized for over a week by the time I met her, and it was plain that she was eager to have a visitor. Unlike some people, she didn’t talk about her own aches and pains, or complain about them. Instead, she spoke about her daughter, who lives in Minnesota and hikes mountains when she’s not busy writing books and teaching at university. She also talked about her son, who is in his early 40s and still unmarried, because – as she puts it – he is his mother’s caretaker first and foremost, and therefore he could not commit himself to another woman in the way he felt a husband should. Mary was proud of him for being such a devoted son, but she worried about this a lot; she wanted very much to see him happily married. We also spoke of religion; her surname was that of her husband, who himself had been Catholic. Mary was not, but allowed her children to be raised in the Catholic faith. Prayer was very important to her; that, too, sticks out from our first meeting. Prayer sustained her, and we had prayed a nice prayer together before I left. It’s only looking back that I realize Mary was the type who focused on everyone except herself. No talk about her heart problems, or if she was scared, or lonely as a widow of five or six years. Instead, she found strength through giving to others. She even gave me the advice that LSU’s dental school is a great place for inexpensive dental work, after I showed her the tooth I had chipped on a piece of Halloween candy.
I had not seen Mary since, though I was aware that she was what I call a “frequent flier” – the people who spend a great deal of time in and out of the hospital. She had not been in my unit so I didn’t get the chance to see her again until last week, when she was again hospitalized and this time given a room in my ICU unit. I went to visit her last Tuesday, and came in while she was discussing some things with her nurse. The nurse wrapped up and Mary looked up at me rather vaguely, asking, “is there something I can do for you?”
I was rather crestfallen that she did not remember me. I see so many people, and most are tough to remember though I try my best (especially after a patient said it was good to see me again, leaving me horrified because I had no clue who he was!). Mary was one who was easy to remember, if only in part because of her boldly Cajun surname. I explained who I was, without mentioning our previous visit, and asked how things were going. Mary told me that she had been in a rehab facility, and it was a nightmare. There was one nurse for 30 patients, and said RN worked 17 hour shifts. She rarely saw her nurse, her bedding was rarely changed, her doctor’s orders were not followed, and her special dietary needs were ignored. She deteriorated rapidly and had to be readmitted to our hospital as a result of the rehab facility’s negligence.
It was incredibly difficult for me to listen to all this, because it brought back strong memories of our first meeting in early November. At that time, my aunt had spent six weeks in a rehab facility like the one Mary told me about. The anger I felt over the lack of decent care for my aunt was strangling to me since I was 2000 miles away and could do nothing. It was very difficult at the time to focus on my patients instead of the injustice facing my aunt and my family in Tucson. I had to tamp down the anger I could feel rising in me again, this time on behalf of this sweet lady who seemed to spend all her time trying to make things better for others. I commented neutrally that it must have been a horribly frustrating experience for her, and she replied, “Well, I realized that God put me there for a reason. When I came into the hospital again, my doctor asked me about the facility and how it had gone. I told him every detail and told him not to recommend that place to any other patient, ever again. He said he wouldn’t.” How characteristic of Mary to say such a selfless thing, to state that there was a reason. She was not impotent with anger over the treatment she’d received, nor was she acting like a martyr. It was a straightforward, matter-of-fact statement. While I processed that, she cocked her head at me and asked, “so, did you ever go to LSU’s dental school and get that tooth looked at?” I stuttered to a halt as I realized that she indeed remembered our visit, had remembered all along – or perhaps her memory just needed a nudge. We spoke briefly about it, and then, in her characteristically blunt manner, which is so reminiscent of my aunt, she asked, “Well, are you gonna pray with me?” I smiled broadly and did so.
Earlier this week, Mary signed a DNR order, which means that if she reached code blue status that she was not to be revived. Then she and her son chose a hospice care facility to assist her as she went home; he signed the papers on Tuesday afternoon. Very early yesterday morning, though, her condition worsened dramatically. I was called by the doctor to pray with her at 10:30am, about 90 minutes before I was off duty after a full night on call. Mary’s every breath was labored, and it was difficult to understand what she tried to say. No family was present and based on the things she’d said about her relationship with her son, I explained my concern to her nurse. He was en route to the hospital from his job; his sister was flying in from the Midwest.
Mary’s daughter did not arrive in time to try to speak with her again, but her son was at her bedside when she died two hours after we’d prayed together. I never did ask her how she reconciled the Catholic and Protestant faiths (and believe me, in this city they are DIFFERENT faiths), but I learned from her how to demonstrate grace in the face of a challenging situation. It made me think of the teenage Mary in Luke 1, being told that she would be the mother of God’s only child. Instead of complaining or whining, she said, “Here am I, the servant of the Lord.” Maybe it’s a stretch to compare the two women, but for the first time I have a full understanding of the phrase spoken so reverently in the Catholic Church: Ave Maria, Gratia Plena. It means a whole lot more than just a mother’s love for her child.
Tuesday, April 14, 2009
Practice What You Preach
In the Presbyterian Church, those who feel called to ordained ministry must pursue a process with their respective church sessions (that’s the governing board) and presbyteries (that’s the local governing body). They become “inquirers” upon the request of their session and the approval of the presbytery’s Committee on Preparation for Ministry; this phase lasts for an indefinite period of time, but at least one year. At some point, they pursue (with the session’s prior approval) candidacy for ordination with their presbyteries. I was approved for candidacy by my presbytery in April 2006, after 18 months as an Inquirer. I asked that the charge be given me by one of the members of my home presbytery, who had studied Hebrew with me at seminary and is now a campus chaplain at the University of Arizona. Ben told me I was crazy for studying advanced exegesis during my last semester at seminary, especially with a professor as notoriously meticulous as Dr. Theodore Hiebert (Francis A. McGaw Professor of Old Testament McCormick Theological Seminary, Chicago). He was right, of course, though I have to qualify that my last year at seminary was so transformative both theologically and personally that I can’t regret a single pang of the stress. I told Ben prior to the meeting that I felt a need for a deeper understanding of the Hebrew Scriptures, and how they inform my theology of community; I had to teach this in my ministry. That was my call. In his charge to me before the assembled members, Ben joked about what he’d said prior to the meeting (in my defense, I want to say that I firmly believe that the hallmark of a good teacher is someone who wants to be a good learner!). To me personally, he said this as his charge: I want you to run away. Take that call, and run away with it. Run away from seminary, from book learning, from academics….learn through living.
I have to say that his words have been very prophetic, in more ways than one. I have mentioned previously that I spent many years trying to be self-sufficient; part of my defense was learning to express myself meticulously well in words. Unfortunately, this led to an overemphasis on the academic and too little attention to reality. It showed when I met with the committee for my annual review 12 months later. On paper, my theology is not only sound, but excellent and firmly in line with the Reformed Tradition. The issue was that I had a problem pulling it off paper and living it out, because for so many years I avoided community. The committee debated at great length over what we discussed; in the end, they recommended that I cease my candidacy at the time because I didn’t seem to be growing in a manner consistent with a candidate for ordination. Five weeks later I began my first unit of CPE, during which I had to bare all to my fellow chaplains (metaphorically speaking). Halfway through the unit, they stunned me by telling me that they knew little or nothing about me as a person; I’d shared so little of my true self. That was the turning point for me, the morning I realized that I hadn’t truly opened up to others with whom I shared such intimate experiences. From that day forward, I had to consciously think about everything I did and said, and how it appeared to others, as opposed to assuming that they’d understand what I was about. The more time I spent living outside myself and in community with others, the more I questioned my call. I found myself dissatisfied with the lack of spontaneity in Calvinism, and the continuous, laborious process of debate that never seems to lead to a transformation. In December 2008, at the end of my second unit of CPE, I officially resigned my membership in the Presbyterian Church, USA and joined the United Church of Christ, through which I will be seeking ordination. In four days, I will be attending a local board meeting for the first time, to get a feel for the governing body. Over the next day or so, I will be composing the letter I will present to the governing council of the church I have joined; its members, in turn, will make a motion to our local Committee on Ministry to take me in care as someone seeking ordination. After this, I’ll be appointed a tutor to teach me more about the history and polity of the UCC, and eventually I will write a masters’ level type paper demonstrating my understanding of UCC polity and how I integrate it into my ministry. At that point, the Committee will, God willing, approve me to seek a call to ordained ministry.
I went through a sort of grieving process after leaving Presbyterianism; it’s the church in which I was raised and has been the faith tradition of my mother’s family for over 300 years. While it’s somewhat similar to the UCC since both are part of the Reformed Tradition, it’s still different – I’ve officially cut the ties. I didn’t realize that when Ben told me to run away, he meant it to a degree that was so literal! Yet, the more I study UCC structure, the more I realize that I made the right choice. I first started having issues with my denomination four years ago, but at the time I thought it was something to be worked out internally (after all, that had been my modus operandi for years). When I moved to New Orleans, I met two staff chaplains at the hospital here who are ordained in the UCC after having left other denominations (one had been Presbyterian, the other Episcopal) and began actively discussing with them the discord I’d felt. They affirmed my concerns, but did not pressure me in any way – merely listened and offered feedback. Three months after my arrival in the Big Easy, with church attendance only one time at one church (and that was Unitarian Universalist, which is not my theology – I love their spirituality, but my Christology is too much a part of me to ever be a UU), I decided to move forward and begin attending a UCC church. I googled it and found one within half a mile of my home – and, as it turns out, both my fellow chaplains happen to be members of this particular congregation. The former Episcopal, who just happened to be preaching on the day I attended for the first time, told me that God definitely played a part in this. The welcome I received that first day was almost overwhelming, and immediately I felt as if I’d been there for years. Ten weeks later, I officially transferred denominations, and now eagerly look forward to serving in parish ministry in the UCC. It may sound abrupt, but it's been decades in the making.
When I first heard the call to ministry, at age 12, I struggled with it because I thought nobody would take a girl like me seriously. The second time I heard the call, in 2002, I spent a lot of time in discernment, to be certain that the path I followed was the one God meant for me. I have high standards, which showed clearly when I went through the required psychological assessment before candidacy. That’s not a handicap, in my opinion – it merely means that I want to represent my faith tradition well. During this discernment time, I asked a minister in my presbytery, who worked with university students, some advice once I realized that seminary was my path. Jason told me something that I’ll never forget – and which I’ve passed on to others in preparation for the ministry, as well. It doesn’t matter whether you’re theologically conservative or theologically liberal. What’s important is that you be able to justify your stance Biblically and theologically. For that reason, he strongly advised me to choose a seminary with the theological and educational ntegrity to respect my views, even if said views are not part of the majority. As a graduate of Princeton Theological Seminary, the granddaddy of Presbyterian seminaries, Jason was very complimentary toward its program, but he also affirmed that my personal preference – McCormick Theological Seminary in South Chicago – was an excellent choice, as well. I visited MTS a few months later as a prospective student, and was invited to a party that evening at Ben’s apartment; he was two years ahead of me in his studies. Though I didn’t mix easily with others at that time, he and his friends made me feel very welcome. Less than a year after we spoke, I gave up my job, my home and my comfortable way of life and moved to Chicago to begin my seminary training. And so it was that about a year after that, Jason left Arizona and moved to Pennsylvania with his wife (also a Presbyterian minister) and two children; his wife was to pastor a large church while Jason made the decision to leave campus ministry and support his wife as a house husband for a while. The university put out their information form seeking Jason’s replacement as the Presbyterian liaison to campus students, and in the end they chose Ben, who now lives with his wife Gretchen (also a Presbyterian minister!) and their child about two miles from where I used to live a very solitary existence. The symmetry in this is very fitting, I think. Jason told me to be able to represent well, both Biblically and theologically, and his eventual replacement Ben – who I met as a result of making the right choice to train me to do such – told me to run away with my call, to live life and stop relying on words as a shield. I’ve followed the advice of both men quite well, and it’s brought me to the place I know I will establish the most effective ministry I can.
The UCC’s official motto is that they may all be one, ‘they’ referring to all people who believe in God. It expresses part of my foundational theology as clearly as it can, and I know that both Jason and Ben would be happy to know that at last I’ve found my niche. After all, as we know, in all things God works for the good of those who love God, who have been called according to God’s purpose.
I have to say that his words have been very prophetic, in more ways than one. I have mentioned previously that I spent many years trying to be self-sufficient; part of my defense was learning to express myself meticulously well in words. Unfortunately, this led to an overemphasis on the academic and too little attention to reality. It showed when I met with the committee for my annual review 12 months later. On paper, my theology is not only sound, but excellent and firmly in line with the Reformed Tradition. The issue was that I had a problem pulling it off paper and living it out, because for so many years I avoided community. The committee debated at great length over what we discussed; in the end, they recommended that I cease my candidacy at the time because I didn’t seem to be growing in a manner consistent with a candidate for ordination. Five weeks later I began my first unit of CPE, during which I had to bare all to my fellow chaplains (metaphorically speaking). Halfway through the unit, they stunned me by telling me that they knew little or nothing about me as a person; I’d shared so little of my true self. That was the turning point for me, the morning I realized that I hadn’t truly opened up to others with whom I shared such intimate experiences. From that day forward, I had to consciously think about everything I did and said, and how it appeared to others, as opposed to assuming that they’d understand what I was about. The more time I spent living outside myself and in community with others, the more I questioned my call. I found myself dissatisfied with the lack of spontaneity in Calvinism, and the continuous, laborious process of debate that never seems to lead to a transformation. In December 2008, at the end of my second unit of CPE, I officially resigned my membership in the Presbyterian Church, USA and joined the United Church of Christ, through which I will be seeking ordination. In four days, I will be attending a local board meeting for the first time, to get a feel for the governing body. Over the next day or so, I will be composing the letter I will present to the governing council of the church I have joined; its members, in turn, will make a motion to our local Committee on Ministry to take me in care as someone seeking ordination. After this, I’ll be appointed a tutor to teach me more about the history and polity of the UCC, and eventually I will write a masters’ level type paper demonstrating my understanding of UCC polity and how I integrate it into my ministry. At that point, the Committee will, God willing, approve me to seek a call to ordained ministry.
I went through a sort of grieving process after leaving Presbyterianism; it’s the church in which I was raised and has been the faith tradition of my mother’s family for over 300 years. While it’s somewhat similar to the UCC since both are part of the Reformed Tradition, it’s still different – I’ve officially cut the ties. I didn’t realize that when Ben told me to run away, he meant it to a degree that was so literal! Yet, the more I study UCC structure, the more I realize that I made the right choice. I first started having issues with my denomination four years ago, but at the time I thought it was something to be worked out internally (after all, that had been my modus operandi for years). When I moved to New Orleans, I met two staff chaplains at the hospital here who are ordained in the UCC after having left other denominations (one had been Presbyterian, the other Episcopal) and began actively discussing with them the discord I’d felt. They affirmed my concerns, but did not pressure me in any way – merely listened and offered feedback. Three months after my arrival in the Big Easy, with church attendance only one time at one church (and that was Unitarian Universalist, which is not my theology – I love their spirituality, but my Christology is too much a part of me to ever be a UU), I decided to move forward and begin attending a UCC church. I googled it and found one within half a mile of my home – and, as it turns out, both my fellow chaplains happen to be members of this particular congregation. The former Episcopal, who just happened to be preaching on the day I attended for the first time, told me that God definitely played a part in this. The welcome I received that first day was almost overwhelming, and immediately I felt as if I’d been there for years. Ten weeks later, I officially transferred denominations, and now eagerly look forward to serving in parish ministry in the UCC. It may sound abrupt, but it's been decades in the making.
When I first heard the call to ministry, at age 12, I struggled with it because I thought nobody would take a girl like me seriously. The second time I heard the call, in 2002, I spent a lot of time in discernment, to be certain that the path I followed was the one God meant for me. I have high standards, which showed clearly when I went through the required psychological assessment before candidacy. That’s not a handicap, in my opinion – it merely means that I want to represent my faith tradition well. During this discernment time, I asked a minister in my presbytery, who worked with university students, some advice once I realized that seminary was my path. Jason told me something that I’ll never forget – and which I’ve passed on to others in preparation for the ministry, as well. It doesn’t matter whether you’re theologically conservative or theologically liberal. What’s important is that you be able to justify your stance Biblically and theologically. For that reason, he strongly advised me to choose a seminary with the theological and educational ntegrity to respect my views, even if said views are not part of the majority. As a graduate of Princeton Theological Seminary, the granddaddy of Presbyterian seminaries, Jason was very complimentary toward its program, but he also affirmed that my personal preference – McCormick Theological Seminary in South Chicago – was an excellent choice, as well. I visited MTS a few months later as a prospective student, and was invited to a party that evening at Ben’s apartment; he was two years ahead of me in his studies. Though I didn’t mix easily with others at that time, he and his friends made me feel very welcome. Less than a year after we spoke, I gave up my job, my home and my comfortable way of life and moved to Chicago to begin my seminary training. And so it was that about a year after that, Jason left Arizona and moved to Pennsylvania with his wife (also a Presbyterian minister) and two children; his wife was to pastor a large church while Jason made the decision to leave campus ministry and support his wife as a house husband for a while. The university put out their information form seeking Jason’s replacement as the Presbyterian liaison to campus students, and in the end they chose Ben, who now lives with his wife Gretchen (also a Presbyterian minister!) and their child about two miles from where I used to live a very solitary existence. The symmetry in this is very fitting, I think. Jason told me to be able to represent well, both Biblically and theologically, and his eventual replacement Ben – who I met as a result of making the right choice to train me to do such – told me to run away with my call, to live life and stop relying on words as a shield. I’ve followed the advice of both men quite well, and it’s brought me to the place I know I will establish the most effective ministry I can.
The UCC’s official motto is that they may all be one, ‘they’ referring to all people who believe in God. It expresses part of my foundational theology as clearly as it can, and I know that both Jason and Ben would be happy to know that at last I’ve found my niche. After all, as we know, in all things God works for the good of those who love God, who have been called according to God’s purpose.
Thursday, April 9, 2009
Pastoral Identity
One of my favorite films is “Catch Me if you Can,” directed by Steven Spielberg and released in 2002. For those who haven’t seen it, it’s the true story of a teenage runaway who became the most successful con artist in US history,, posing as an airline pilot, a doctor (chief resident of a pediatric ward, no less!) and a lawyer – all before age 19. In my favorite scene, 16-year-old Frank (actor Leonardo DiCaprio) is walking down the street in New York City wearing a pilot’s uniform, smiling smugly at the stir he causes among the people who look at him with respect instead of dismissal – all because of the uniform. He’s no longer just plain old Frankie; he’s a Somebody. I was strongly reminded of this scene the first day I wore a clerical collar.
I’d been told by my fellow chaplain Barbara, who always wears a collar, that this would be noticeable. More people will smile at you, she said. They’ll acknowledge you with a nod and perhaps even a greeting, rather than the usual brief eye contact and then looking away. What she didn’t say – and I suppose should have occurred to me, given the rich Catholic history in the Crescent City – is that some people would not only not smile, they’d take issue. One man was clearly taken aback, but said nothing. An elderly woman’s lips pursed as if she’d just sucked a lemon wedge. If I could read minds, I’m certain hers would have said, indignantly, “How DARE you wear a collar! You’re not a man, and that shirt – it’s, it’s GREEN!!!! (very true; it’s a deep earth green to advertise my status as an environmental activist)”. The funny thing was when two co-workers were complaining about a screw up (and they had legitimate cause to harp on it, from what I heard), and one muttered “Jesus Christ!” in disgust at the end of a long diatribe. The other dug him in the ribs, motioned to me and made a ssh! sound with a finger to his lips. What stands out most is my supervisor’s comment when she saw me with a collar on for the first time: “If that’s the only way you can find your pastoral identity then you’ll have a problem.” These reactions did not offend me – they only offered food for thought, and alternately made me confused, amused and thoughtful. Was it only a collar that gave me a sense of authority as a pastor, I wondered? Did I feel less as if I had to prove something when I wore the collar, because the collar spoke for me?
When I started considering this, I recalled that one day when I was on-call chaplain for the afternoon, I was called to the NiCU to meet with a couple who had been told that their newborn daughter had a congenital problem which would necessitate her being on a ventilator for the duration of her life. The doctor offered them the choice of this limited existence or withdrawing medical care, allowing her to pass away peacefully within a short period of time. When I entered the consultation room, they were grieving heavily, clearly in need of support. It seemed fairly obvious from the time we started talking that they would make the decision to withdraw care, but as devout Roman Catholics they wanted first to have their daughter baptized (by their parish priest, not a hospital chaplain) and for the extended family to meet her. I drew on my understanding of Catholic theology when I prayed with them, and for the first and only time in my life I referred to the Virgin Mary in my prayers. Later, in group, I told my fellow chaplains that I felt extremely uncomfortable with it, and they said I shouldn’t ever feel pressure to do something that doesn’t sit well with my own theology; that when I have real pastoral authority I won’t cave in to someone else’s beliefs. In retrospect I realize that I’ve had a sense of pastoral authority all along – the issue is that it’s still integrating itself into who I am as a person. The discomfort was felt by Missy the Protestant Christian; Missy the chaplain has no regrets and feels entirely comfortable with what she said in that prayer. I also recall that the first day I wore a collar, I met with a 40-something patient whose lupus had acted up; she was tired of fighting the back-and-forth battle. Without hesitation, I stretched out my hand, touched her shoulder and prayed for healing. Usually when I pray, I ask for healing, but in a different way – I ask for the Spirit to work through the staff as they try to identify the problem (a very Reformed Tradition way of looking at it). Did I feel as if the collar somehow added to my authority, I wondered afterward – was there a sense of entitlement? No. It was natural and spontaneous, and the collar I was wearing was not part of the equation except as an outward signal to the patient that God sent a representative to express concern for her. That I used different words this time only meant that I look at the healing process through more than one lens when I offer prayer. After all, God speaks to us in a multitude of ways.
I think that’s the real function of the clerical collar – it’s not to point out, “hey, look at me, I’m special ‘cause God chose me to be a pastor!” (I’m not even sure I’d use the word ‘special’ in reference to the ministry) but to remind us of God’s presence in our lives. God cares enough to send this reminder when we’re grieving, when we’re hurting, when we’re angry over something we can’t control. The authority God gives to me as a pastor comes from God’s own self, not from a collar, and the identity I’m forming within it is far more communal than it was before I began the long journey toward submitting everything to God as I expressed so well in words but struggled to put into practice. It’s a nice feeling, this sense of owning my own identity within my function as a pastor. I don’t need to use diversions from reality, like Frank did, in order to be believable. And, okay, I have to admit that the drivers who make a habit of letting me cross the street on my bike – some even holding up traffic to let me through – are a nice little bonus. I think God is okay with that, because if that collar reminds someone else of God, and causes him or her to think about his or her own life and how to be pastoral, then it’s a very good thing. It never hurts to let the presence of God announce itself to others in a multitude of ways.
I’d been told by my fellow chaplain Barbara, who always wears a collar, that this would be noticeable. More people will smile at you, she said. They’ll acknowledge you with a nod and perhaps even a greeting, rather than the usual brief eye contact and then looking away. What she didn’t say – and I suppose should have occurred to me, given the rich Catholic history in the Crescent City – is that some people would not only not smile, they’d take issue. One man was clearly taken aback, but said nothing. An elderly woman’s lips pursed as if she’d just sucked a lemon wedge. If I could read minds, I’m certain hers would have said, indignantly, “How DARE you wear a collar! You’re not a man, and that shirt – it’s, it’s GREEN!!!! (very true; it’s a deep earth green to advertise my status as an environmental activist)”. The funny thing was when two co-workers were complaining about a screw up (and they had legitimate cause to harp on it, from what I heard), and one muttered “Jesus Christ!” in disgust at the end of a long diatribe. The other dug him in the ribs, motioned to me and made a ssh! sound with a finger to his lips. What stands out most is my supervisor’s comment when she saw me with a collar on for the first time: “If that’s the only way you can find your pastoral identity then you’ll have a problem.” These reactions did not offend me – they only offered food for thought, and alternately made me confused, amused and thoughtful. Was it only a collar that gave me a sense of authority as a pastor, I wondered? Did I feel less as if I had to prove something when I wore the collar, because the collar spoke for me?
When I started considering this, I recalled that one day when I was on-call chaplain for the afternoon, I was called to the NiCU to meet with a couple who had been told that their newborn daughter had a congenital problem which would necessitate her being on a ventilator for the duration of her life. The doctor offered them the choice of this limited existence or withdrawing medical care, allowing her to pass away peacefully within a short period of time. When I entered the consultation room, they were grieving heavily, clearly in need of support. It seemed fairly obvious from the time we started talking that they would make the decision to withdraw care, but as devout Roman Catholics they wanted first to have their daughter baptized (by their parish priest, not a hospital chaplain) and for the extended family to meet her. I drew on my understanding of Catholic theology when I prayed with them, and for the first and only time in my life I referred to the Virgin Mary in my prayers. Later, in group, I told my fellow chaplains that I felt extremely uncomfortable with it, and they said I shouldn’t ever feel pressure to do something that doesn’t sit well with my own theology; that when I have real pastoral authority I won’t cave in to someone else’s beliefs. In retrospect I realize that I’ve had a sense of pastoral authority all along – the issue is that it’s still integrating itself into who I am as a person. The discomfort was felt by Missy the Protestant Christian; Missy the chaplain has no regrets and feels entirely comfortable with what she said in that prayer. I also recall that the first day I wore a collar, I met with a 40-something patient whose lupus had acted up; she was tired of fighting the back-and-forth battle. Without hesitation, I stretched out my hand, touched her shoulder and prayed for healing. Usually when I pray, I ask for healing, but in a different way – I ask for the Spirit to work through the staff as they try to identify the problem (a very Reformed Tradition way of looking at it). Did I feel as if the collar somehow added to my authority, I wondered afterward – was there a sense of entitlement? No. It was natural and spontaneous, and the collar I was wearing was not part of the equation except as an outward signal to the patient that God sent a representative to express concern for her. That I used different words this time only meant that I look at the healing process through more than one lens when I offer prayer. After all, God speaks to us in a multitude of ways.
I think that’s the real function of the clerical collar – it’s not to point out, “hey, look at me, I’m special ‘cause God chose me to be a pastor!” (I’m not even sure I’d use the word ‘special’ in reference to the ministry) but to remind us of God’s presence in our lives. God cares enough to send this reminder when we’re grieving, when we’re hurting, when we’re angry over something we can’t control. The authority God gives to me as a pastor comes from God’s own self, not from a collar, and the identity I’m forming within it is far more communal than it was before I began the long journey toward submitting everything to God as I expressed so well in words but struggled to put into practice. It’s a nice feeling, this sense of owning my own identity within my function as a pastor. I don’t need to use diversions from reality, like Frank did, in order to be believable. And, okay, I have to admit that the drivers who make a habit of letting me cross the street on my bike – some even holding up traffic to let me through – are a nice little bonus. I think God is okay with that, because if that collar reminds someone else of God, and causes him or her to think about his or her own life and how to be pastoral, then it’s a very good thing. It never hurts to let the presence of God announce itself to others in a multitude of ways.
Saturday, March 28, 2009
A Tired Lesson but a Good One
One day recently, I met with Jill and her husband, plus a member from their church who was visiting her. According to the patient list she was 40-something, so I was surprised to hear that her admit diagnosis was a mild stroke. It really shouldn’t have surprised me, because though it’s highly unusual to see stroke victims this young, it DOES happen. About two months ago, I had a 36-year-old man as a patient in one of my units for five days following a stroke that rendered him unable to speak. It shocked me; even more shocking – downright scary, in fact – was the talk I had with his nurse prior to my visit. His nurse told me that he had no medical history that provided any evidence that this would have occurred. It simply happened. When I tried to communicate with him, it was clear that he understood me; he simply was unable to form words to respond. I asked a few questions and he grunted in reply. When I said something about what a shock this must have been, he became very animated and his grunts increased in both volume and intensity. I met with his brother and his father, both of whom had a very strong faith that things would get better, though the road was going to be difficult. Unfortunately, I did not get a second chance to meet with him, as he was transferred to a rehab facility before I could.
I didn't get a second chance to meet with Jill, either, only in this case, there was no rehab facility. I met with Jill on a Tuesday afternoon; Friday morning when I showed up to work, I was the on-call chaplain for the morning. As is my habit, I checked our log book from the night before to see what had occurred. We record routine calls in black ink, and deaths in red ink. Imagine my shock when I saw Jill’s name, written in red, by the night chaplain. It seems she coded (that’s medical speak for reaching code blue status, meaning imminent death) and the team was unable to revive her. Death is always difficult for me, but it’s especially tough when it’s someone close to my own age. It takes me back to my high school days; I think about my graduating class – 1983 – and wonder what they’re doing now, but it’s tough to imagine them outside my adolescent memories. They remain frozen in time, like a dream I once had. I don’t see them as adults, parents, or (God forbid – we’re not THAT old!!) grandparents, with expanding waistlines and graying hair. I’m thinking that maybe it’s our way of comforting ourselves over our own mortality, this inability to see ourselves as part of the aging process. The drawback to this mindset is that it’s that much harder when death slaps you in the face.
I met another member of the class of ’83 this week; during an illness, Nancy accidentally ingested too much medication, which caused irreparable damage to her major organs. She died this morning, while I was speaking with her husband in the consultation room. It was the second marriage for both of them; he’s got an adolescent daughter, while she has a son in college. According to her husband, this relationship “seemed too good to be true”….he’d finally found his soul mate after 40 years of searching, and they had four precious years together. His family was unable to come here to grieve with him, due to the terrible weather systems over much of the country, so the best he could do was make phone call after phone call to his contacts. To every person, when asked how things were going, he said, “Not so good….we lost her.” He paced the room like a caged tiger, unable to sit but unable to stand. His hands shook every time he dialed numbers. As a chaplain, sometimes I offer to take care of these things for family – make phone calls, alert people, etc., - but it seemed to give Nancy’s husband a sense of purpose to have something to do, so I let him be. I mentioned prayer only once, but like so many members of my generation, he didn’t quite seem to understand why we would pray when she had already died. What was the point? His answer stunned me into silence, though I did pray for him and his family later. When I finally asked if he’d like to go see her again, he asked me, with the tone of a little boy, if I would go with him. He wasn’t sure he could go in to her room at all, much less alone. I escorted him back down the hall to her room, where her body lay in state with a breathing tube still attached. The thoughtful nurse quickly grabbed a chair so he could sit, since his legs seemed about to buckle. He reached out and touched her cold, dead hand, which was already losing color and stiffening with rigor mortis. Then he put his head down on her chest and sobbed to me, “Tell me it’s not so.”
I can’t write this without crying myself. Death at any age is tough enough, but at my age, it’s simply incomprehensible. Furthermore, he had no chance to prepare himself. She was fine on Thursday afternoon, and by Saturday midday she was dead. While I sat with him in that consultation room, listening to phone call after phone call to people who couldn’t be here, I thought of Liam Neeson and what he must going through. Thinking of the support he must have received from family, friends and countless fans, I drew on that when I spoke with Nancy’s husband. Unfortunately, she has only two family members: her ex-husband and her son. Her current husband’s only wish was that they get here before she died. Sadly, her heart stopped while they were still at the airport, 30 minutes from here. His own family was still trying to find flights to New Orleans, and because this death was not due to natural causes, I had to leave him after a while to make phone calls to the coroner’s office and complete paperwork. I so hated that, but there was nothing else to be done. I’m not Jesus, so I can’t say to Nancy, “Talitha Cum!”, as he did to the little girl who had died. What I can do is urge all who read this to take the time today to let your loved ones know how much you care. Yes, it’s a tired old saw, and we’ve all heard that you never know how much time you have. But let’s face it: whether we’re 44 or 84, we always see ourselves as having another day to say those things we want to be said. But there are no promises in this life beyond the one that God loves us. You never know when that moment will happen to you, so let today be “another day” for you.
I didn't get a second chance to meet with Jill, either, only in this case, there was no rehab facility. I met with Jill on a Tuesday afternoon; Friday morning when I showed up to work, I was the on-call chaplain for the morning. As is my habit, I checked our log book from the night before to see what had occurred. We record routine calls in black ink, and deaths in red ink. Imagine my shock when I saw Jill’s name, written in red, by the night chaplain. It seems she coded (that’s medical speak for reaching code blue status, meaning imminent death) and the team was unable to revive her. Death is always difficult for me, but it’s especially tough when it’s someone close to my own age. It takes me back to my high school days; I think about my graduating class – 1983 – and wonder what they’re doing now, but it’s tough to imagine them outside my adolescent memories. They remain frozen in time, like a dream I once had. I don’t see them as adults, parents, or (God forbid – we’re not THAT old!!) grandparents, with expanding waistlines and graying hair. I’m thinking that maybe it’s our way of comforting ourselves over our own mortality, this inability to see ourselves as part of the aging process. The drawback to this mindset is that it’s that much harder when death slaps you in the face.
I met another member of the class of ’83 this week; during an illness, Nancy accidentally ingested too much medication, which caused irreparable damage to her major organs. She died this morning, while I was speaking with her husband in the consultation room. It was the second marriage for both of them; he’s got an adolescent daughter, while she has a son in college. According to her husband, this relationship “seemed too good to be true”….he’d finally found his soul mate after 40 years of searching, and they had four precious years together. His family was unable to come here to grieve with him, due to the terrible weather systems over much of the country, so the best he could do was make phone call after phone call to his contacts. To every person, when asked how things were going, he said, “Not so good….we lost her.” He paced the room like a caged tiger, unable to sit but unable to stand. His hands shook every time he dialed numbers. As a chaplain, sometimes I offer to take care of these things for family – make phone calls, alert people, etc., - but it seemed to give Nancy’s husband a sense of purpose to have something to do, so I let him be. I mentioned prayer only once, but like so many members of my generation, he didn’t quite seem to understand why we would pray when she had already died. What was the point? His answer stunned me into silence, though I did pray for him and his family later. When I finally asked if he’d like to go see her again, he asked me, with the tone of a little boy, if I would go with him. He wasn’t sure he could go in to her room at all, much less alone. I escorted him back down the hall to her room, where her body lay in state with a breathing tube still attached. The thoughtful nurse quickly grabbed a chair so he could sit, since his legs seemed about to buckle. He reached out and touched her cold, dead hand, which was already losing color and stiffening with rigor mortis. Then he put his head down on her chest and sobbed to me, “Tell me it’s not so.”
I can’t write this without crying myself. Death at any age is tough enough, but at my age, it’s simply incomprehensible. Furthermore, he had no chance to prepare himself. She was fine on Thursday afternoon, and by Saturday midday she was dead. While I sat with him in that consultation room, listening to phone call after phone call to people who couldn’t be here, I thought of Liam Neeson and what he must going through. Thinking of the support he must have received from family, friends and countless fans, I drew on that when I spoke with Nancy’s husband. Unfortunately, she has only two family members: her ex-husband and her son. Her current husband’s only wish was that they get here before she died. Sadly, her heart stopped while they were still at the airport, 30 minutes from here. His own family was still trying to find flights to New Orleans, and because this death was not due to natural causes, I had to leave him after a while to make phone calls to the coroner’s office and complete paperwork. I so hated that, but there was nothing else to be done. I’m not Jesus, so I can’t say to Nancy, “Talitha Cum!”, as he did to the little girl who had died. What I can do is urge all who read this to take the time today to let your loved ones know how much you care. Yes, it’s a tired old saw, and we’ve all heard that you never know how much time you have. But let’s face it: whether we’re 44 or 84, we always see ourselves as having another day to say those things we want to be said. But there are no promises in this life beyond the one that God loves us. You never know when that moment will happen to you, so let today be “another day” for you.
Saturday, February 14, 2009
For Every Season There is a Miracle
The room sits dead center of the high end area of the ICU. Though it’s the same as all the others – a room designed for patients needing critical care – it’s only this one that leaves me with an uncomfortable feeling. The phrase “dead center” always seemed accurate to me, because it feels as if I have attended to an inordinately high amount of deaths in that room. It brings to mind my first-ever shift as the on call chaplain overnight, at a smaller hospital in the Phoenix area. Late in the day the nurses in the ICU paged me. When I responded, they explained the problem: the room across from the nurses’ station. For the two weeks preceding this day, every patient assigned to the room had deteriorated or died. ICU nurses can expect that many times, but aside from this, light bulbs were burning out at an absurdly fast rate, or sometimes found on when they’d been turned off….the nurses had the strong sense of some negative ‘spirit’ hanging around the space, and sheepishly asked if I , as a spiritual leader, would perform some sort of exorcism in the room. They were embarrassed even to talk about it, but it had reached the point where some of the staff were hesitant even to enter the room. I did what I felt was necessary (which I won’t explain here; I feel that sometimes the spiritual process is between the Lord’s servant and the Lord), and though I heard no feedback afterward, the problems in the room ceased. It never occurred to me that I was patronizing anyone; I take my vocation quite seriously, and many times I have a strong sense of the spirit’s presence within a place. All this came back to me when I started feeling that way about the room in the ICU where I now work; just a general feeling of foreboding when I even look at the number. I eventually reached a point where I said to my mom that if, God forbid, anything happen while she and my father visit me, I’d make certain they weren’t assigned this room.
I guess I first noticed it when Leo died in October; I was visiting a patient next door when he coded very late in the day. As is more common than people realize, Leo was not expected to die, so it came as a shock. Though the staff worked to revive him, they were unsuccessful and he died shortly before 5pm, which is when my day ends. I met with his truly lovely wife and 3 of his 4 children, and a son-in-law who was a Lutheran minister, to talk about what happened next. The chaplain who started at 5pm took over for me when I left. It’s happened before, and usually I just deal with it and then move on, but for some reason Leo stayed with me – I felt a sense of unfinished business. One day a few weeks later, Karen died in the same room. Unlike Leo, her death was expected; though only 53, she had stage IV lung cancer. She stuck out to me because her love was also a patient in the hospital on a different floor, and therefore unable to be with her when she drew her last breath. In my less-than-5-minute meeting with Karen’s spouse, I learned more about grace and serenity than I have in some years.
And then, on the eve of the New Year, I wrote about a woman whose son serves as pastor of a non-denominational church in suburban New Orleans. She’d been readmitted to the hospital, having gone home the previous week following a life-threatening episode of renal failure. Charlotte, too, died in the same room where Leo and Karen had breathed their last, yet it was a turning point for me without my even realizing it at the time. I wrote a blog about the Spirit’s work through me, inspiring me to open the large Bible in our interfaith chapel to the 14th chapter of the Gospel of John, and then Charlotte’s son telling me how much he’d needed to see precisely those words, that it was God’s self speaking words of comfort to him.
This week I finally realized why it’s changed for me; James has been the room’s occupant since a few days after Charlotte died. Like Karen, he was quite young, but very ill. From early in his stay, he let his nurse know that he would like prayer as often as possible – daily if we could. When I approached James’ room for the first time after he asked this, I pondered the subject of prayer and the old spiritual ‘What a friend we have in Jesus’ came to mind, along with its lyric “what a privilege to carry everything to God in prayer”. He was often too weak to respond, instead merely listened, when I spoke about the privilege of prayer giving us a connection to the Almighty. Each time we met, I built on that initial talk, praying about giving thanks, praying about asking forgiveness, and praying about our hopes and desires for both our families and ourselves. As I write this, I realize that God was at work within me during these times, because it was such a privilege to pray with James, that it made us two into one part of the Church every time we met and communed with God. Early in my residency, I was so stiff that I would have found this very difficult; now I found it something that I anticipated every time we met. Sometimes James actually had energy enough to speak, and one thing he said to me twice – during our very first visit nearly 7 weeks ago, and very late in the stay when he had been taken off the breathing tube briefly – stays with me: “I never say no to prayer.” The way this prayer circle lifted us together taught me more about why Charlotte’s son pursues the spiritual discipline of intercessory prayer on a weekly basis.
Early this week, James’ family made the decision to remove life support. For all his ills, he had a lot of strength, and his end of life process lasted nearly four hours. I spent three of them with James, his wife, mother-in-law, children, nephews and the pastor of his church. Several things stand out to me about this true celebration among God’s family. His mother-in-law grieving while telling me what a fine husband he’d been to her daughter. His 20-something nephew leading a revival type prayer toward the very end, repeating the phrase “My God” in a meditative manner with no less awe the tenth time than the first time. His 18-year-old daughter yelling her grief as his heart finally slowed to a stop. And, the family prayer around the bed, led by his Pentecostal pastor, with all holding hands. For the first time in her life, the White girl who was too afraid to pray with patients was swept up into a rich Black Gospel prayer, repeating “yes Lord, Hallelujah Lord!” in a chant along with the other prayers, with utter conviction. I’ve never in my life felt truly comfortable in this mode – until I spent James’ last three hours with him and his family.
It’s always emotional when I’m present for withdrawal of care, but this one was tougher than most. I cried a LOT, and the nurses who had tended to James were more emotional than they usually are as well, not only because of his lengthy stay but also because his family had become so close to them. I didn’t have time to come down from it, either, because, like Leo and Karen, James died just before 5pm. The night chaplain (who happened to be the same one who had completed care with Leo’s family) also came on and completed the paperwork for James, while I stayed with his family a few minutes longer before heading to a 5:30pm staff meeting. Without a second thought to how private I’ve been in the past, I mentioned openly how emotional it had been for me, and I think my supervisor was concerned. However, as I wrote this I realized that I’ll always cherish this as a good memory, one of my fondest, in fact, for the reasons listed above.
During his last few hours, James' family covered him with the gift that had been made for them by some relief workers after Hurricane Katrina destroyed their home in southern Mississippi: a handmade quilt with a beautiful rainbow of colors. Every square had a cross, above which was the phrase FOR EVERY SEASON THERE IS A MIRACLE. That’s the standout image now when I see this room. And when I think of James, and how the privilege of prayer with him brought another miracle into my journey of spiritual growth. Yes, Lord. Hallelujah Lord!
I guess I first noticed it when Leo died in October; I was visiting a patient next door when he coded very late in the day. As is more common than people realize, Leo was not expected to die, so it came as a shock. Though the staff worked to revive him, they were unsuccessful and he died shortly before 5pm, which is when my day ends. I met with his truly lovely wife and 3 of his 4 children, and a son-in-law who was a Lutheran minister, to talk about what happened next. The chaplain who started at 5pm took over for me when I left. It’s happened before, and usually I just deal with it and then move on, but for some reason Leo stayed with me – I felt a sense of unfinished business. One day a few weeks later, Karen died in the same room. Unlike Leo, her death was expected; though only 53, she had stage IV lung cancer. She stuck out to me because her love was also a patient in the hospital on a different floor, and therefore unable to be with her when she drew her last breath. In my less-than-5-minute meeting with Karen’s spouse, I learned more about grace and serenity than I have in some years.
And then, on the eve of the New Year, I wrote about a woman whose son serves as pastor of a non-denominational church in suburban New Orleans. She’d been readmitted to the hospital, having gone home the previous week following a life-threatening episode of renal failure. Charlotte, too, died in the same room where Leo and Karen had breathed their last, yet it was a turning point for me without my even realizing it at the time. I wrote a blog about the Spirit’s work through me, inspiring me to open the large Bible in our interfaith chapel to the 14th chapter of the Gospel of John, and then Charlotte’s son telling me how much he’d needed to see precisely those words, that it was God’s self speaking words of comfort to him.
This week I finally realized why it’s changed for me; James has been the room’s occupant since a few days after Charlotte died. Like Karen, he was quite young, but very ill. From early in his stay, he let his nurse know that he would like prayer as often as possible – daily if we could. When I approached James’ room for the first time after he asked this, I pondered the subject of prayer and the old spiritual ‘What a friend we have in Jesus’ came to mind, along with its lyric “what a privilege to carry everything to God in prayer”. He was often too weak to respond, instead merely listened, when I spoke about the privilege of prayer giving us a connection to the Almighty. Each time we met, I built on that initial talk, praying about giving thanks, praying about asking forgiveness, and praying about our hopes and desires for both our families and ourselves. As I write this, I realize that God was at work within me during these times, because it was such a privilege to pray with James, that it made us two into one part of the Church every time we met and communed with God. Early in my residency, I was so stiff that I would have found this very difficult; now I found it something that I anticipated every time we met. Sometimes James actually had energy enough to speak, and one thing he said to me twice – during our very first visit nearly 7 weeks ago, and very late in the stay when he had been taken off the breathing tube briefly – stays with me: “I never say no to prayer.” The way this prayer circle lifted us together taught me more about why Charlotte’s son pursues the spiritual discipline of intercessory prayer on a weekly basis.
Early this week, James’ family made the decision to remove life support. For all his ills, he had a lot of strength, and his end of life process lasted nearly four hours. I spent three of them with James, his wife, mother-in-law, children, nephews and the pastor of his church. Several things stand out to me about this true celebration among God’s family. His mother-in-law grieving while telling me what a fine husband he’d been to her daughter. His 20-something nephew leading a revival type prayer toward the very end, repeating the phrase “My God” in a meditative manner with no less awe the tenth time than the first time. His 18-year-old daughter yelling her grief as his heart finally slowed to a stop. And, the family prayer around the bed, led by his Pentecostal pastor, with all holding hands. For the first time in her life, the White girl who was too afraid to pray with patients was swept up into a rich Black Gospel prayer, repeating “yes Lord, Hallelujah Lord!” in a chant along with the other prayers, with utter conviction. I’ve never in my life felt truly comfortable in this mode – until I spent James’ last three hours with him and his family.
It’s always emotional when I’m present for withdrawal of care, but this one was tougher than most. I cried a LOT, and the nurses who had tended to James were more emotional than they usually are as well, not only because of his lengthy stay but also because his family had become so close to them. I didn’t have time to come down from it, either, because, like Leo and Karen, James died just before 5pm. The night chaplain (who happened to be the same one who had completed care with Leo’s family) also came on and completed the paperwork for James, while I stayed with his family a few minutes longer before heading to a 5:30pm staff meeting. Without a second thought to how private I’ve been in the past, I mentioned openly how emotional it had been for me, and I think my supervisor was concerned. However, as I wrote this I realized that I’ll always cherish this as a good memory, one of my fondest, in fact, for the reasons listed above.
During his last few hours, James' family covered him with the gift that had been made for them by some relief workers after Hurricane Katrina destroyed their home in southern Mississippi: a handmade quilt with a beautiful rainbow of colors. Every square had a cross, above which was the phrase FOR EVERY SEASON THERE IS A MIRACLE. That’s the standout image now when I see this room. And when I think of James, and how the privilege of prayer with him brought another miracle into my journey of spiritual growth. Yes, Lord. Hallelujah Lord!
Thursday, January 22, 2009
Six Years Later
One day recently I met John, who was sitting up in a chair near his hospital bed. His wife Kate stood by his side, her hand on his shoulder, while his daughter sat on the couch across the room beneath the window. During our visit, Kate told me how she and John had made it a practice for many years to pray together, because it not only strengthened their faith, it also strengthened their relationship with one another. We all prayed together holding hands, and I left the visit with the buoyant feeling that comes from an encounter with other deeply spiritual people.
A few days later, John went into Code Blue status and was taken from my unit to another critical care unit upstairs. I found this out from the night chaplain, who happened to meet Kate in the elevator during an early morning visit to another area. Kate was weeping, and our naturally sensitive chaplain spoke to and prayed with her. I had known that John had a lot of problems; he told me himself that it was all but impossible for his lungs to function without some sort of artificial help. Still, I was a little taken aback that this had happened so abruptly. After seven months as a chaplain, though, I have learned not to be optimistic anymore, while at the same time not to be a pessimist, when it comes to my patients and their situations. So I was better prepared when the news came two days ago that John’s family had decided to withdraw life support. He was no longer a patient in my assigned unit, but because I’d established a relationship with the family I followed up, with the assigned chaplain’s blessing.
John had a tube placed in his mouth so that air could be forced into the lungs that weren’t strong enough to work by themselves. When care is withdrawn, the tube is removed and the oxygen machines turned off. During my first weekend as a resident here, I observed a similar situation in this same unit; a woman who stayed alive only because of the machines made the indescribably brave decision (with her sister’s tearful agreement) to do the same. These patients are given a sedative drip so that they are in supreme comfort well before the tubes are taken out and the air turned off. It’s not an instantaneous process; the respiratory therapist I spoke to that first day told me that every person is very different – the longest she knew of had survived thirty DAYS after the machine was taken away. The average, though, is about one or two hours. On that first day, the lady in question took her last breath only 25 minutes after support was gone. The young intern who’d had to tell the family there was nothing else she could do was devastated, as this was the first family with which she’d had such a discussion. I gave her a big hug while she cried afterward, telling her that if I’m ever in a similar situation, I want a doctor like her – someone who gives a damn about me as a person, who cares enough to cry. Knowing people love us and care for us is something we all crave.
John had a dozen family members in the room during this end of life process, people of all ages standing, sitting, holding each other, posing stiffly – every type you could think of. Kate sat at his bedside, softly stroking his hair and at times kissing his forehead. Their son stood on the other side, holding his father’s hand. Seeing the love expressed for him by his family really got to me; it’d been a rough day all around. We were repeatedly paged to witness tragedy, discord and despair….yet in the midst of it all here was a man who was so loved that he inspired grown men to weep like babies over his imminent death. John was a strong one; he took his last breath just over two hours after the machines were turned off. I was not able to talk to Kate again until she and her extended family were back in the waiting area; she was sitting slumped in a chair with tears running down her face. I knelt and took her hands, telling her not only how sorry I was, but how glad I was that she had had a chance to prepare herself for this – that it had not come from out of the blue, leaving her so at a loss that she couldn’t function. She agreed, telling me that it had been like a gift to have those last days together knowing that they could talk about everything. So many couples don’t receive that.
It made me think of another funeral I attended six years ago for a beloved nursing professor, one who didn’t get this chance. She was quite young, but over 500 people from around the country attended her wake; I was humbled by her far-reaching impact on the world. It was also extremely depressing at the time because it made me realize how much I’d missed out on, the love I’d avoided over the years, for fear of being hurt….I thought there was no way I’d ever have that many people upset over my own death, because I simply didn’t take the chance of loving others. I wanted another chance more than anything, a chance to try to have the type of connection with other people that she had made. Today I myself am 44, the same age Cheryl Malernee McGaffic was when she was murdered. Since that day, I have given up my job, my home, my pets and a comfortable way of life to move nearly 2,000 miles across country so I could begin wrestling that blessing out of the messenger of God, as Jacob did. Now a seminary graduate, a much more emotionally open woman, far more sociable again, and successfully learning my way into the human portion of ministry (having attained the academic understanding of same), I realized in the midst of my depression that afternoon that I can no longer claim not to have made an impact. I’ve made friends in Chicago, friends in Phoenix, and friends in New Orleans, the three cities where I’ve lived since then. At last, I can truly claim that there would be people outside my family who would miss me, who would cry over the loss of me in the world. It’s not vanity; it’s knowing that someone gives a damn about you. Feeling alone has been such a habit for me for so long that I did not realize until this day that it’s no longer accurate. John, I can’t thank you enough for helping me to understand how much I really have changed. It was such a privilege to meet you and Kate, and I’m so happy that you two had time to express yourselves to each other before you went forward to that House with Many Mansions. It seems that the habit of praying together strengthens all human relationships, not only marriage.
A few days later, John went into Code Blue status and was taken from my unit to another critical care unit upstairs. I found this out from the night chaplain, who happened to meet Kate in the elevator during an early morning visit to another area. Kate was weeping, and our naturally sensitive chaplain spoke to and prayed with her. I had known that John had a lot of problems; he told me himself that it was all but impossible for his lungs to function without some sort of artificial help. Still, I was a little taken aback that this had happened so abruptly. After seven months as a chaplain, though, I have learned not to be optimistic anymore, while at the same time not to be a pessimist, when it comes to my patients and their situations. So I was better prepared when the news came two days ago that John’s family had decided to withdraw life support. He was no longer a patient in my assigned unit, but because I’d established a relationship with the family I followed up, with the assigned chaplain’s blessing.
John had a tube placed in his mouth so that air could be forced into the lungs that weren’t strong enough to work by themselves. When care is withdrawn, the tube is removed and the oxygen machines turned off. During my first weekend as a resident here, I observed a similar situation in this same unit; a woman who stayed alive only because of the machines made the indescribably brave decision (with her sister’s tearful agreement) to do the same. These patients are given a sedative drip so that they are in supreme comfort well before the tubes are taken out and the air turned off. It’s not an instantaneous process; the respiratory therapist I spoke to that first day told me that every person is very different – the longest she knew of had survived thirty DAYS after the machine was taken away. The average, though, is about one or two hours. On that first day, the lady in question took her last breath only 25 minutes after support was gone. The young intern who’d had to tell the family there was nothing else she could do was devastated, as this was the first family with which she’d had such a discussion. I gave her a big hug while she cried afterward, telling her that if I’m ever in a similar situation, I want a doctor like her – someone who gives a damn about me as a person, who cares enough to cry. Knowing people love us and care for us is something we all crave.
John had a dozen family members in the room during this end of life process, people of all ages standing, sitting, holding each other, posing stiffly – every type you could think of. Kate sat at his bedside, softly stroking his hair and at times kissing his forehead. Their son stood on the other side, holding his father’s hand. Seeing the love expressed for him by his family really got to me; it’d been a rough day all around. We were repeatedly paged to witness tragedy, discord and despair….yet in the midst of it all here was a man who was so loved that he inspired grown men to weep like babies over his imminent death. John was a strong one; he took his last breath just over two hours after the machines were turned off. I was not able to talk to Kate again until she and her extended family were back in the waiting area; she was sitting slumped in a chair with tears running down her face. I knelt and took her hands, telling her not only how sorry I was, but how glad I was that she had had a chance to prepare herself for this – that it had not come from out of the blue, leaving her so at a loss that she couldn’t function. She agreed, telling me that it had been like a gift to have those last days together knowing that they could talk about everything. So many couples don’t receive that.
It made me think of another funeral I attended six years ago for a beloved nursing professor, one who didn’t get this chance. She was quite young, but over 500 people from around the country attended her wake; I was humbled by her far-reaching impact on the world. It was also extremely depressing at the time because it made me realize how much I’d missed out on, the love I’d avoided over the years, for fear of being hurt….I thought there was no way I’d ever have that many people upset over my own death, because I simply didn’t take the chance of loving others. I wanted another chance more than anything, a chance to try to have the type of connection with other people that she had made. Today I myself am 44, the same age Cheryl Malernee McGaffic was when she was murdered. Since that day, I have given up my job, my home, my pets and a comfortable way of life to move nearly 2,000 miles across country so I could begin wrestling that blessing out of the messenger of God, as Jacob did. Now a seminary graduate, a much more emotionally open woman, far more sociable again, and successfully learning my way into the human portion of ministry (having attained the academic understanding of same), I realized in the midst of my depression that afternoon that I can no longer claim not to have made an impact. I’ve made friends in Chicago, friends in Phoenix, and friends in New Orleans, the three cities where I’ve lived since then. At last, I can truly claim that there would be people outside my family who would miss me, who would cry over the loss of me in the world. It’s not vanity; it’s knowing that someone gives a damn about you. Feeling alone has been such a habit for me for so long that I did not realize until this day that it’s no longer accurate. John, I can’t thank you enough for helping me to understand how much I really have changed. It was such a privilege to meet you and Kate, and I’m so happy that you two had time to express yourselves to each other before you went forward to that House with Many Mansions. It seems that the habit of praying together strengthens all human relationships, not only marriage.
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