Monday, August 18, 2008

Overcoming Barriers

David at Here I Stand asks an interesting question that has caused me to do a little more reflecting on my summer. He states, "Begging the question of the week: What can you do to help overcome the barriers of faith, prejudice, racism, or classism in the communities in which you live?"

I have blogged before about bridging the faith divide with a Muslim family in crisis. Here are some other snippets of my summer, and honest statements about my responses, for better or worse.

Scenario 1: My largest frustration is in my perception of the lack of sensitivity or concern for those who are not Caucasian European lineage. At times it seems as though these people do not receive the same attention or care, because it is a bother. A gentleman from Mexico was brought into the ER, not on the trauma side. I got a call because family is here to see him and they need to be showed to “somewhere.” I ask the patient’s name and go to meet them. There are two gentlemen. One is the man’s brother and the other is a friend who speaks English. I place them in the large consult and go to find out who is the doctor and nurse. The man was found collapsed and non-responsive by the brother. I find the doctor and let him know family is here in case he needs information or wishes to see the brother who lives with the patient. He does not seem terribly interested even though everyone is trying to stabilize the patient and wondering what is happening and complaining about lack of information. I find out what I can share and go back to family. I also get contact information because no one has gotten it. The patient will be going to ICU at some point, and it is not looking good. “I have contact information for family– do you need it?” seems to be greeted with “if you want to.” No one seems concerned that he may not make it through the night and who might need to be called. I wonder if the mindset is that this is just another Hispanic, maybe it’s drugs- he has vomited all over the room. Turns out he had a brain lesion that herniated. I mention there is a friend who is translating, and am told that is a relief because it is one less thing she has to deal with. Stress of the moment or genuine sentiment? After the patient is as stabilized as can be, and I have again reminded the doctor that family is here, then he comes. I introduce him to the brother and translator. The doctor asks background, the thing he needed 40 minutes ago. He looks at the translator- he never looks at the brother. When the family finally comes to the room, the brother is told there is no reason to stay. Still no one seems concerned about them. I ask if they want to stay, but they seem OK with what has been communicated. Usually there is some question about whether family wants to stick around. I confirm that they will be called if there is a change. They go home.
The next day, I wonder if I should visit. I look to see where the patient now is and find out that there was a Code Blue and the family was called and told there was not much to do and the brother called off the efforts. We were not called, either then or later when family arrived. They faced all of this alone. Coincidentally, I ran into the family at the elevator- the translator recognized me and called out to me. He tells me the patient died. I ask him to express my sympathy to the family- they are tearful and express gratitude. They thank me for all I have done- for caring about them. The translator thanks me for pronouncing the man’s name correctly. Not trying to not trying to make it be an English name. This tells me the perception of the group about others they have encountered. They are on the way to Mexico for the funeral. I am glad to have been there- I just wish that the same degree of care and attention devoted to others by staff had been shown to this family.

What did I do? I brought it up to my supervisor who passed it on to the Vp for Diversity. This incident has passed, but the ongoing training has not.

2. People in the ER are poor and dirty. The staff are joking about it, but not in the presence of the people in question, but at the other end of a very large department. What did I do? I left the circle of conversation and went to stay with the family. I observed to see whether the buzz moved to where it could be heard until they were discharged. It did not. It was a rough night in the ER so I did not use that time to speak up, but to be aware and stand with the family. Maybe they would not talk that way in the chaplain's presence.

3. An increasing number of Hispanic families are at the hospital. There is plenty of charting to let medical staff know the family or patient are Spanish speaking only. But somehow this is not communicated to pastoral care staff in fulfilling visit requests. This makes visiting difficult for non Spanish speakers. But what I saw happening was that rather than trying to arrange for translation or see how far they could go in meeting needs, these visits were being pushed aside. What did I do? In one instance, I made a visit and was able to use my limited Spanish conversational skills and pen and paper to determine that the patient had a church and desired her pastor and made the contact. In another, I tried to visit and met with the daughter. She and I talked about how her mother was doing, set up a time for me to visit when the daughter could translate and ministered to the daughter regarding her stresses. I raised the insufficiency of the communication of language needs.

4. An Amish father came to see his son on the pediatric floor, but was clearly lost. I escorted him to the check-in desk. The clerk gave him an ID and told him he could enter. She did not offer to take him to the room which I knew was far away. So I stayed with him and took him there. On my way out, she thanked me, saying she wondered if he could find it, because " you know how they are" - a people who opt out of parts of culture? who leave school after 8th grade? I said that all I knew was he was an anxious father who was being asked to process a lot of information in a stressful time, and since as a parent it would be hard for me too, I guess I did know "how he was." She stated she hadn't really thought about it that way.

I wonder why others do not make a greater effort to understand. Even with questions about why people’s names are different, a lack of sensitivity to proper pronunciation disappoint me. Often I have not shared this disappointment. I have tried to answer questions when I have been asked in a neutral way, not self-righteously. But I wonder if we are called to love all God loves, if we can see that there is more than surface level. While many times, I can only focus on my own work in this area and encourage others, I wonder if there will be times to be more prophetic.

While I could spend a lot of time wondering why others " do not", I could more effectively focus upon what I can do now that God has sent me, which may be focused upon honoring others as created in God's image one-on-one, or may be working with others to highlight injustice and work to overcome it. And I think that my job is not to make others be like me, or to defend my God, but to meet people where they are- this has meant be sensitive in prayers, use of religious resources, obtaining Qur'an's, rosaries, hand held prayer labyrinths, and honoring traditions that seem diametrically opposed, including the right of a Jehovah's Witness to refuse a blood transfusion that would save his life.

In the end, I feel I often have more questions than answers, but I trust that God will guide me, and give thanks for all of those who strive to love our neighbors, whoever they may be.


DogBlogger said...


Questing Parson said...

Two thoughts occurred to me as I read this moving post.

1) Not long ago the Emory University Hospital went paperless. Every staff person who has contact with patients has a laptop. Their wireless connection allows immediate input with what's being done with the patient. I asked my cardiologist who is a respected member of the Emory Medical School faculty how the paperless innovation was going.He responded that it was wonderful: everyone knew immediately what everyone else was doing with the patient, etc. He went on and on extolling the virtues. Then he said, "There's only one problem. We can't get the doctors to look at the patients."

2) Cherish this time. You'll find these moments to be the most intense times of ministry you'll ever encounter.

The Unlikely Conversationalist: said...

Intensity is a real challenge in any life and death situation. People are raw. They don't know what's coming next for the person they love or what to do with themselves. The old question, "Why God" bubbles up.

Tonight an ICU doctor came by church for the visitation of a member who died. He sought me out after meeting with the widow and his parents to express his condolences. He said it was just right to be there after a week of working hoping to keep him alive.

I've seen good people build barriers around themselves because they judge they can't handle all the emotions of the hard situations.

LawAndGospel said...

Thanks QP and UC for some thoughtful responses. As CPE is done, but I continue in the occasional on-call shift, QP I know that I have truly cherished this experience, and notwithstanding my candid perceptions, the hospital where I am now an employee values spiritual well-being as a part of the whole, and there have been many times where I have ministered to the staff who did all they could, or where they worked hard when their own life experiences were challenging them. Some people who have read my posts focus on how hard this experience can be, but it is so very rewarding. Interesting insight from Emory. UC, what a touching story about the ICU doctor. When there have been rough times or hard losses in palliative and ICU, where bonds have formed, I too have seen what you describe and I concur about the building of barriers.