Wednesday, July 30, 2008

Am I Worth It? Is anyone listening ?

I have found that as often as I help others to see God, there the moments where I am amazed at the God at work in others. One example of this came when I visited Mary. Chronically ill with COPD, CHF and Lupus-any one of these would be enough to bear. She was having a bad day and was very tearful. As we talked about her feelings, her tears were not for what the future would hold or where she would be, but in the missing of people who she so deeply loves in this life. She shared how her one daughter was never emotionally expressive, and even into adulthood had never expressed love toward her mother as a hug or embrace. It was only since Mary has been sick, and her granddaughter asked “Mommy, why don’t you ever hug Mimi (her nickname for her grandmother)? As Mary tells it, her daughter was so struck by this, that she came over and hugged her mother for the first time in memory. A new pattern has now taken root. Mary tells me that even though her illnesses are a lot to bear, she would live every moment of them again just for that gift. She went on to tell me about her other daughter who is deaf. When her daughter was growing up, someone was talking about a person who died as “being called home by God.” She communicated with her mother, in great fear. She had literally interpreted someone hearing God call to them. “I can never go to heaven because I will not be able to hear God.” Mary shared that she told her daughter, “We hear God with our hearts not our ears.” Mary had never heard this, she says, and has no other idea how it came to her to say this but for a loving God using her to reassure her child.I sat in awe as she shared this story.
In several of my encounters this week, the theme seemed to be people needing to be heard, and loved and to know that they are worth it.
The young wife of an abusive substance abuser who is in the Trauma Neuro Unit. He rode his moped into an electric fence while intoxicated at a level approaching comatose. She is frustrated and feeling disrespected. She is trying everything she can to help him turn around. She is the only one trying and it is sinking in. She is juggling what she thinks faith demands and what her head tells her is reality about their relationship. She is thinking this may be a time to regroup while he is here in the hospital, but wonders if she can. When he checks himself out AMA, she is there to pick him up. I pray for them as they are leaving to walk their hard journey.
The woman who has survived ten gunshot wounds who reveals that has tried three times in the past to kill herself, but now when someone tried to kill her she realized she wants to live, but hopes God still loves her even though she has not been who she should be.A woman who knows she needs to start a new life in a new place to be safe.

The patient who is being emotionally abused by her adult son who lives with her, but sees only that she must return to this toxic environment. She needed someone to give her permission to change. Even when this happens, she is not sure she should. ”I need to go to counseling- maybe that is the answer”, as if there is a magic thing she can do. Change takes strength. Even if life is bad, it is predictable. Fear of the vast unknown. But she ends up leaving with him against all advice.
The woman on IICU who has rarely been visited has a vent so she cannot speak, only mouth words. She has been called "difficult." I read lips pretty well so I take a shot at it. Between reading lips and a note pad we do pretty well and begin to see her regularly. One day I was unable to visit, because she was asleep. I should have left a card, but I did not. The next time I came she had tears in her eyes. I asked her if something had upset her and she mouthed,” I thought you forgot about me.” I explained what had happened and told her that if I came to visit and she was not awake, I would leave a note for her.
As these people thank me for listening to them, being with them and praying with them, I am keenly aware that the pattern in their lives is that they are not being listened to, and they have perhaps come to expect that they are not worth the time.

I spent an afternoon hearing about perinatal loss.I find it refreshing that perspectives are changing about an issue that has been significant in my life and the lives of my friends. One of my friends learned that her baby was anencephalic and could not live. She and her husband were also told that she could die trying to deliver since the skull would collapse. She had to travel to terminate the pregnancy, a begin to mourn this loss on many levels. It was compounded by her family’s response- several of them did not talk to her for years and called her “killer.” I remember many conversations about what God expected. For myself, the near loss of our daughter was more traumatic than most else in my life. The hospital wanted to spare us the pain in case she died, so they did not give her name to the newspaper- her birth was never announced. Hearing “oh, dear, everything will be fine” from a pastor who just did not want to think about the alternative was painful. Both my friend and I wondered if there was anyone willing to listen to our real stories.

I am continuing to process the events in the life of my friend with terminal cancer. She is not only a friend of 19 years, and a member of my church, and a client, she is one of the people who encouraged me to explore whether I was being called to ministry. After the initial wave of shock and pain, I have realized she will not see my ordination. I have visited as a chaplain, as a supplement to our pastors and Sunday administered communion carefully- swallowing is a problem, so a little bit of wafer in a little bit of wine on the end of a spoon. For now her seizures have stopped and she is somewhat more alert, but this glimmer will not last. The family persists in a mode of positive fighting for life. Even as four stage 4 metastatic cancers wield their power. They do not want the parish to know. So we minister to them in a kind of secrecy.
My friend is not always oriented in reality and conversations may involve a few repetitive phrases. She is starting to lose her hearing in addition to her memory. But I am sure she can hear God with her heart. And God is saying to her and to each of these, " I love you and you are worth it."

Wednesday, July 23, 2008

Wipe away these tears

I have had several cases where someone on the team encounters a friend or coworker as patient or family, in trauma and on the floor where staff knows other staff. One that stuck out early on was a suicide attempt by the husband of a staffer. Everyone started forgetting their roles in ER trying to care for the staffer. It was a rough ride all around. This week it was my turn to have this experience directly. A trauma where the patient was in a motor vehicle accident with his granddaughter. I know them, not just casually, but well. We have socialized together for years. The kids have vacationed together. Here is the 80-ish grandfather, crying over the accident as he lays on the backboard wearing the immoblizer. He can’t reach his eyes. “Can you help me wipe these tears? …Tell me she’s OK.” I want to tell him what he needs to hear, not the truth. The granddaughter will be fine, but she has gone to Fast Care. He wants to see her now. I tell him it will be awhile before she can come in. How I felt when I saw the name- took my breath away- suddenly I am torn between rushing to the consult room, and the trauma bay, between the 13 yr old who is one of my daughter’s best friends and the patient who I have known and laughed with for years. Frustration of the son in law who was out for dinner with his wife in Philadelphia – Should grandpa be driving still? This is his only daughter by this marriage. Fears of the daughter who is a nurse. Family friends are here with her- he is a former CPE supervisor. Family wants to talk about knowing me as a lawyer. They did not know I am here. But also how glad they are that I am the one they meet here. I am glad to be the one here. Do I shortchange others in need? I see my own family in my mind- imagine their reactions- have to chase it away. When I hugged her- that was what was hard- don’t cry. I think of my own father and my concerns when he is driving my daughters. My own father could be the impatient driver here. The man without hearing aids in.. And the words of the grandfather- “how can I ever repay you?” I told him a smile would be enough. And it was.
Another family is dealing with a closed head injury patient. He and his girlfriend were in a car she was driving. They were arguing. He had consumed some alcohol. He impulsively decided to exit the moving car. Here we are. She is by his side with silent tears streaming down her cheeks. His father is here from Puerto Rico, praying to Virgin of Guadalupe. I ask him about the medallion around his neck and we talk about his piety and practices. I tell them about Mass times and offer a rosary. The girlfriend and he had planned to marry, once she finished confirmation and got her first marriage annulled. She tells me that she know this will be a long healing process for him, but also for all of them. I think the biggest part of “us” is for her. The guilt, wishing time could be turned back. We pray and I visit a couple days in a row through the crucial time. And she starts to talk about him more. One day he is restrained with leather restraints- he has broken through the others. She tells me he has always been strong, and they have had their problems. I wonder if this has been physical, but do not ask. “There are things I can only share with the priest who knows us, who knew us before.” I encourage this. I feel honored when on a day when he is cycling to awareness, she introduces me to him and tells him I have been here every day to see him and pray for him. Having had a good friend recover from a closed head injury and seeing her two year struggle, I try to encourage caring for self and not being afraid to rely on friends to help her through. She knows this will be hard- “ I have been the strong one- the one in control- I have held this together.” How hard to know that all her effort has not been enough. She cannot will or love it into being. And how hard will it be to walk this journey- how many problems will be swept under the rug that led to the jumping out.
A Muslim family with a tragic birthing experience. The mother/wife is critical. The extended family is here. Originally from Pakistan, some speak English and some do not. The husband stands by the bedside, wrapped in a blanket, bowing and praying and crying. We meet. I ask about his wife, and about his son. We talk about how he has held his son, and his name. I later learn that I am the first to ask the baby’s name. After awhile, he turns and asks me “will you please pray for me, for her?” I ask if he would like to pray together now. Tears streaming, he says he would. I am humbled and honored, given that I am a Christian woman, not dressed in the proper way, but all of this is transcended in this moment. I think carefully about the prayer, and offer it slowly, a prayer which I can pray but which respects their faith. God as creator, God as being gracious, holding us in the palm of his hand, God as healer, and bringer of peace, with pauses for silences. I realize he is also praying in his native tongue, in Urdu, in the silences. We are truly praying together. I ask if he would like a Qur’an to help him in this time. He says he would and I obtain one along with a prayer rug and set aside a place for him to pray.
"Can you wipe away these tears?" is a universal desire, hope and plea. What we all yearn for across time, space, definitions. To play some small role in this grand task is humbling and profound.

Tuesday, July 22, 2008


Just back from the lovely GAC and LSM. More soon, but in the meantime, I know I have not posted for a month. There just was not enough time between the swing shifts of the hospital, the camp and other demands of the children, the ongoing saga of "is the dog going to die?" I have truly been enjoying the learning at the hospital. I know that this is a contrast to some of my peers. Over the next few posts, a view into my world. I could tell you about all of the wonderfully affirming visits I have had, but the challenging ones are...
After a spate of trauma calls where nothing resolves, which I was starting to expect would be my fate, I finally had a trauma calls that were more "normal" where everything had a flow and a conclusion, where family was available, and responsive, and where roles of the team were more clear and consistent. I realized that these calls felt almost “easy” after the prior ones, where family could not be found, or had absented themselves from the person's life. I will always remember the man who died alone. He had been falling for two days at the group home. When he finally collapsed and they decided he needed attention, he was brought in, bleeding and non responsive. He went from a trauma to a Code Blue. "Chaplain you've got to find us someone or some paperwork!" The only paperwork showed that he had no family. The emergency contact was a pastor. The pastor had been contacted by the nursing staff and told the patient was coming in- he then never answered his phone again and did not come for a day and half. The nurse at the facility was distressed as she looked everywhere for some piece of information, someone to call. There was no Power of Attorney or health care designate. How sad to confirm on a chart that this person has no one. He was schizophrenic and his family had "disappeared." The pastor later confirmed that family had never maintained any contact after the man became a resident. In the end it took a legal department and the late arrving pastor to decide to stop the machines. This man had truly been dumped. I found myself standing at a room where the person is about to be declared brain dead, praying for what could have been, knowing that if he had been brought in sooner he would have lived. Wondering what he thought as it got worse and no one comprehended. How much different than the Gerasene demoniac or any of the others Jesus touched? People sometimes ask where was God? In the medical staff and the chaplain who tried all they could. To love the one others have abandoned- for me a true living out of the gospel in caring for a soul even when there is no one to affirm it, there will be no response.

On another day, I was called by a Dr and asked to visit a palliative care patient who was struggling through issues of his diagnosis, losses in his life, and things he will miss after death. I entered this situation expecting that while those struggles would be significant, my presence was either expected or wanted. I knocked on the doorframe, and the patient was in bed. A woman who I later learned was his wife was seated next to him. I said hello, and introduced myself as one of the chaplains, and that I was stopping by to see how he was doing. I stated I could see he had company and could stop by later if it would be better. “It doesn’t matter because I have nothing to say to you. I told one of your other people the same thing. I do not want to be comforted, I do not want to hear about faith in my life, I do not want to talk about God. There is nothing you can say.” I offered that we did not have to talk about any of those things, I was willing to simply listen to his concerns, if he wanted. His wife interjected and stated,” We are ethical not religious people. You have nothing to offer.” The patient added, “ I don’t want to talk to you or listen to you. I thought I told them not to let you people in here. I want it on my chart that I don’t want to see any of you people here again!” I indicated that I understood, that I would note his wishes on the chart and said goodbye. I charted the event. Did the doctor know and simply hoped he would respond differently? Had someone else had a similar experience? Clearly the result was diametrically opposed to my expectation. I was not offended, or upset by this, but felt that I was clearly not only unwelcome but probably escalated his blood pressure while I was there. What could I use here? Probably just the sense to leave. Among the staff I am considered to have earned my palliative care "badge of honor" - being kicked out of a room. And I prayed for this man who has such grief and anger. I prayed outside his room even though in his mind such an act has no purpose.

Another patient encounter began because of a call by the patient’s sister in law to check up on the patient. She is a middle aged woman with COPD. I stopped by and introduced myself as one of the chaplains for the floor, stopping by to see how she was doing. She said, “I think my sister in law called- she always does. I don’t have anxiety but she does.” We talked about her condition and how 15 members of the family have COPD, two others have died, one recently. She told me she felt very supported and all about her loving family and husband and children. She knew what to expect and she was "fine." We laughed and shared stories. I offered prayer, and we held hands to pray. One of the things I mentioned was to sustain the family in their time of being separated from each other and to provide the restoration to the patient that would allow her to return home to those she loves. She had not mentioned separation issues- I don’t really know why I prayed that, but when we were done, she had tears in her eyes, telling me how much that had hit her, that she was missing everyone, that they cannot come because she cannot compromise her immune system. We talked some more and then she assured me she was feeling fine. Later that day I was paged, she was having extreme anxiety, the total opposite. I returned to pray and calm her, and then the next day, I was paged, she was now in IICU and having extreme anxiety, could I come? Each time I was paged it was because I happened to be the on-call person. When we prayed, I was slow and deliberate, and came back to several things more than once in the prayer. I could feel her relax her grip. Later in the evening, I stopped by at the end of my shift. She was off of the bi-pap and sitting up smiling and chatting with her daughter. I thought back to her statements about anxiety that she "did not have." My role was unexpected, but I am glad she trusted that she could call on us to respond. She continues to call sporadically, usually at night when she is alone and the world is closing in. For each of us, openness to God’s leading. I prayed for a person who thought she was strong enough, but who realized she was not.I was the face she knew, but it was not a familiar face that calmed here, but the healing power of God upon her soul. The first prayer was almost perfunctory in her mind, to placate her relative. The rest have been prayers of holding on to the edge of the boat just before Jesus calms the storm.