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.

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.