Laying Down the Burdens

A page to the Behavioral Health section of the EMD- an anxious, upset patient, who is not in need of inpatient care. I’m told she seems to be having a crisis involving faith-maybe the chaplain can help her. I arrive and the nurse begins explaining, “This woman came in and she’s upset and shaking and crying. She looks exhausted. She keeps saying she has committed a sin, but she says she can only talk to a saved Christian. She asked me if I am one and since I won’t answer her she tells me I can’t understand. She can only talk to a saved Christian. I tried naming all of the really big sins and she says it isn’t any of those. Who knows. She’s in there (pointing to one of the rooms). (The doctor comes out of the room, shaking his head, rolling his eyes. The nurse tells him that I am the chaplain. He speaks to me sarcastically. ) “Good luck! Maybe you’ll get farther than I did. Who knows? ! ( he saunters off irritated).” The nurse says, “She’s nice. We told her we could give her an antidepressant. She refused it. We’re discharging her, but you can talk to her here for awhile. (I knock and enter the room.)” She looks up with tear streaked face. “ I’m Carolyn, one of the chaplains here. I heard you wanted to talk to someone, May I join you?” She assents. She is crying and wrapped in a blanket, hunched over. Her hair is pulled back, but a couple defiant strands have come undone and are loose around her face. She is an African American woman in her 30’s. She looks at me with tired eyes and then puts her head down. I pull up a chair facing her and sit down. I ask “what’s going on? You seem troubled.” She puts her head in her hands.” I’ve sinned..I don’t even know where to start. “ “ Take your time. You can start anywhere.”
Her husband is in jail.. has been for a while now. In and out of jail. (she tells me his record).He’s on work release and she has to take him to work construction early and then she watches her grandkids for my daughter who works 6 to 6. Then she picks up her husband and gets him back to the prison. It is a lot to do. “ An’ I’m just tired, you know? I’m worn out an’ I just can’t do it no more.” She’s been doing this for years now. It’s been a long time and a lot to do.“ And I’m trying. An’ I went to my pastor because I needed to talk and he rebuked me! He said I was committing a sin.” ( crying) The sin? He told her she was committing the sin of selfishness. “Well, I believe, you know, that pastors speak the Word to us. They can rebuke us if a person needs it… he told me that I have to be strong for my family and for my husband. My husband has been an addict. I used to be too. He’s been doin’ OK. And I want him to stay clean. My pastor told me if I quit doing all this my husband might backslide on account of me. That if my husband backslides it will be because of my selfishness. That God will hold me accountable in the judgment.” It is up to her; if her husband backslides, it is on her. God will judge her.
“ I don’t mean any disrespect to your pastor, but it seems like you’re not sure if it really is all up to you. Does it seem right to you?” She is not sure. She tells me she knows she has been selfish in other ways and the pastor, he knows.“ Are you sure I am not keeping you from your job?” I look her in the eye and tell her this is my job. “I can stay as long as you need.” Previously she and the pastor had a tiff she thinks is connected. “See we were supposed to go to a ball game with the pastor and his wife. And they got the tickets, but then we couldn’t go and we had to pay them for the tickets. I got some money but I didn’t use it to pay him all at once I paid it over awhile. And he got mad and said I was selfish. ..I used the money for things we needed and I did get it all paid back, just not right away. But that was selfish of me, I accepted that rebuke. I think that he is holding that against me. But I don’t know. “ “ Do you really think you are being selfish? It almost sounds like you’re expected to be perfect.” She responds,“ I need to be a good Christian.”
After awhile I ask, “ You’ve told me a lot of what you are doing. How about your husband?” She shakes her head, “He’s not doin’ much.” So I wonder,“ You are trying to be a good Christian, but can you be good enough for two people?” She pauses. “ Not really.”“ How does it feel to have to work that hard? Besides tired, how else do you feel?” And the tears roll. “ Angry. !” She is angry at her husband. When I ask what she would say to him if he was here, she sits more erectly, almost bristling and proclaims, “ I’d say ,’you need to straighten up and come home and be the man you’re supposed to be!’” How was that to say that? “ It felt good. Mmhmm.”This is what she had shared with her pastor and is that when he told her about the sin of selfishness. Preaching overfunctioning as a virtue. She is just supposed to be strong. After all her pastor’s daughter is very ill and in the hospital and he still is the pastor. She sees he’s tired and needs to be forgiven. But she isn’t sure if there is forgiveness for her. So we talk about how we are all imperfect- God knows this. And I proclaim that she is in fact as loved and forgiven as the pastor, as any of us. We talk about what she can use to be strong, and she mentions prayer and trusting in the Lord. We talk about Jesus telling us about shouldering burdens. About how good it has felt for her to talk with someone and to say things and not be judged for them. To drop off some of the burdens she’s carrying. I encourage her to consider counseling- she has rejected an anti-depressant. She is in recovery and taking a pill is not a step she is willing to take. She’ll think about it. We join hands and pray-
“Lord, I thank you for M, who is trying hard to be a strong wife and mother, and provider for her family. She needs strength. She has many responsibilities Lord, and sometimes they weigh her down. May she remember that you tell us you are there to share our burdens, to lighten our loads. When she is feeling weighed down Lord, help her to turn to you. Lord, M is trying to be a faithful servant. May she know that you are right here by her side on the journey, each step of the way. Lord it is hard to admit we cannot do it all, help us to trust in you. Lord, you tell us that you love and forgive us. May M know that she is loved and forgiven by you. Lord, we pray for M’s husband and her family. Guide them in their lives that they may grow in faith, and be restored. We pray for M’s pastor and his family, that you may bring comfort and healing to them in their time of need. Lord, we pray that you will guide M and place in her path those who can help and care for her. Help her to make decisions that will help her. Lord you tell us that we can cast our cares on you, and that you will give us peace. We pray for your peace for M now. Even when we find it hard to come to you, we thank you that you hear our prayers. .. We ask all this in the name of your risen Son, Jesus Christ. Amen. We sit in silence holding hands for while and then she feels a little better and is ready to go. She hands me the blanket. I show her out, watching her walk back out in the great unknown. I will be praying for her. It was a challenge to honor her theological framework regarding accountability on the Judgment Day, and the authority accorded to the pastor. Even when I first met her, she did not ask me if I was a “saved Christian.” My mere title gave me a role. I was trying to balance offering her space to explore without denigrating her shepherd or tearing apart her framework. Even if what she was using was causing trouble, to take it away or dismiss it would leave a person with limited systems with nothing. As God’s representative with the ability to rebuke or admonish, can the pastor deny God’s forgiveness? God desires mercy not sacrifice. She should not have to be a total sacrifice to atone for another. She is in need of grace. We learn from God and from others. The yoke is not intended to increase burden. This framework of getting right with God may have helped her in recovery. She does not speak of any others who are a resource to her. Maybe faith that she is clinging to is in place of people in her life. Unless she comes back to the hospital, there is no way of knowing where the road will take her. I also wonder if she feels she still is repaying God for her earlier “sins.” And I wonder some more as I live out the prayer- placing it in God’s hands.

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."

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.

Prayer

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.

Where the Women are strong...

Despite my fears that Friday night would be the time of incessant business, it turned out to be Sunday. Sunday was the day that I had planned to bring consecrated communion elements to one of my patients, an elderly German lady who is a Lutheran. Our Synod assembly was preventing her pastor from visiting her, she said. Outliving the Garrison Keillor phrase, " the women are strong," her body is giving out, and hard decisions need to be made about a extended care facilty, not a return home after the fall into the glass curio cabinet. I had offered to bring her communion and share a period of worship with her. It turned out to be such a crazy day that by the time I got there, she had gone for an ultrasound. Her roommate, an even frailer lady was curious about my visit. I had asked her if she wanted to join in communion and she had refused until I was about to leave and return at a better time. Suddenly, her tiny voice cried out, "Wait, you're Lutheran aren't you? " "Yes, I am." "I'm Episcopalian! No one has been to see me from the church, may I join you after all?" I assured her that would be wonderful. I left a note for my original intended visit to have the nurse page me.
I was finishing up a trauma when the nurse called and cheerfully chirped, "The girls are ready for you!" Knowing I had not much time, but how important this connection to the outside world was, I tried to clear my mind as I headed up in the elevator.
When I arrived, each was sitting in a chair, with lipstick on. I explained what we would be doing and offerred a printed copy of the service to Dorothy, the Episcopalian lady. Rita, the Lutheran, knew the service by heart and still would be saying much of it in German.
So we began, and then Dorothy realized part way through the confession that she needed her bifocals. We stopped and after a thorough search could not find them. Rita chastised her for not having them out. I offered that I would speak the confession and Dorothy could follow in her heart. God would still know her thoughts.
We were just about ready to have communion and my phone went off. The family of my cardiac arrest patient had arrived. I responded that I would be there in 5 minutes.
I began to sing "Lamb of God" and they both joined. They each began to cry. After communion and prayer and a blessing, I spoke with each- not as long as I would like but long enough to hear how much the liturgy and sacrament had meant to them. A window on who they had been before the chronic-ness of now. Faded memory, failing bodies, families who are tired and stressed about what to do.
Today was a followup visit with Rita about her options, and as we met. A group of doctors and family came in to tell Dorothy that there are no more options, the cancer is inoperable, hospice is next, and one more diminishment to a once vital soul must be faced.
Then I was called for a death of a 101 year old woman who was surrounded by family, who lived to see great, great, great great grandchildren. Goldie lived on her own until two weeks ago. So for Rita, Dorothy, Goldie and all of the other women who once had a carefree mind of their own and a devilish look in their eyes..

Strange Confluences of Events

OK, so it all started with being called to ICU. Mom of a patient in distress. Daughter's "outcomes are not expected to be good." The nurse says. I know what that means- not is good is final. Through screaming, crying, anger, reminiscing, unpacking of enough baggage to fill more than one Faulkner novel, I not only see why the despondency generally. The mom had reached her end of patience ( which may not have been much) and had yelled at the daughter with AIDS. Mean words, that ended with Mom saying she can't take it anymore - she is going to kill herself. Daughter leaves in a snit, it is 99 degrees outside, and after walking too far she collapses from heat stroke, and is in a coma. These were the last words between them.
Now here is the mother. Wanting the daughter to wake up- not likely. And as we cycle through it all, the mother speaks present tense- I can't go on. I'm going to kill myself, I could take pills. I know she might have pills, or she might not. I have been there an hour. It has been hard. She has gone on and and on - I have barely been able to say a word. Now she is clutching on to me and sobbing.
"Did you say you want to kill yourself, or you do not want to?"
"I WANT TO!"
What to do? I can't take her to mental health voluntarily. I can't leave her there. I could excuse myself to sort this but how long can I be gone? We are into the third of four stages. But what if I am wrong? What do I have to use?
"you said you want to be here when your daughter wakes up, because you are such a loving mother."
" How will doing this change your wish to be here?"
Silence- for the first time
"Do you want to be here to tell her you love here when she wakes up?"
"Yes"
"What does that tell you? Can you hold on for her?"
"I think I can"
"You said you want to be in a support group for families with AIDS - you want to be heard and to help"
"Yes"
"Do you remember the social worker is coming tomorrow."
"I can't be here until 2"
As we talked on we made plans for the next day, we prayed each sharing prayers. She prayed "Lord thank you for the woman who came to see me- I don't remember what her name tag said but I am glad she came"
We made a plan- a different plan for tomorrow, not the frustrated plan of today.
Lots of other things may come, but this crisis passed.
A mother of a dying daughter. A woman whose illness cancelled a long planned family trip. The list could go on. How is God present and speaking? In the presence of ordinary people who are willing to be sent. In the gathering of two or more in God’s name. In the times where for some reason a person in need found or was found by another who really didn’t need to be there then, but was. In the bright light of the person who has experienced a near death experience and finally feels it can be shared with someone who will not judge it, but believes in the light.
When I started this program, I was worried I would have nothing to say, that I might not know what to pray, or how to be present with someone. It is a learning experience, but I have abandoned the idea of props for a lot of things I do pastorally. Most of the time what I need shows up, or is already there, just waiting to be manifested. What is needed by the patient shows up. While I may not fully see this in the midst of the moment, I usually see it later when I step back. But other times I see it then and can be in awe.
Where I struggle is in “trauma.” But if I am honest, I can say that there is a reason it is called “trauma.” It is best to focus on my role and not the big picture. Don’t look at how tall the mountain is, just start taking steps. To know that situations are fluid. That I will have bad days, and so will others. To know that not everything can be resolved and that is how it is for reasons beyond me. That what I am feeling is often very internal, not external – so I can either bring it out and ask for help, or accept a low level of discomfort as normal- part of being human. Just like everyone else. Processing this has allowed me to begin to have a more realistic handle on the concept of competence.
I am getting to know the team of fellow interns, residents and staff better, and to experience different styles. I have come to appreciate even more the mutual concern that is prevalent, even when I don’t know it. The person who thought of calling to see if I was OK. The person who chastised someone who was to relieve me and who was late-“get down there and relieve her in the trauma bay!” The ability to process stressful circumstances when I needed fresh perspective. And the chance to laugh when we are all confused.
I am experimenting with new styles, and trying to embrace some of the concepts in The Skilled Helper. Oddly, it was when I was at my wit’s end that it kicked in- the reflective question that made some one pause.
In my first supervisory session I mentioned having a chance to continue to work on diversity awareness and language issues, particularly with the Latino/a population. Later that day, I did a visit where I was again faced with a closed door of a particular patient, and was ready to leave a note. The door opened and a woman emerged to tell the nurse the patient was feeling nauseated again. The sign on the door said “Spanish-speaking only.” I asked the woman if she was related- she is the daughter. We discussed how the request for pastoral care had not been able to be met- door closed. While today was not good because of a scoping procedure, I got an update on the patient and new concerns, found out that several family were taking shifts each day. Coordinated when the daughter is there and she is willing to translate. Confirmed there was no wish for a priest or communion, but a visit would be appreciated. I then spent time talking to the daughter about the balancing act she was doing, and in the last two years she has lost a brother and father. It was a good visit there at the door, and I think she valued my efforts to bridge the gap and the respecting of the family’s situation and needs.
I am ready to begin The Art of Listening. I hope to read other options that have been offered to me as resources. As I head into my first overnight on call, there is anxiety ( it is Friday the 13th and I am on alone), but I see that I am only alone if I make the choice not to reach out. And that even when I think I am at my wit’s end, there are things that are there if I can self-talk and then accept the anxiety as energy. And I am amazed at how what I need or want to see often presents itself. While this week had watershed moments, I am feeling supported.

Two years ago to the day my life was altered by a family suicide. This week, I paid it forward in one more strange confluence of events.

Healing Touch

This past Sunday's gospel lectionary reading in Matthew told the stories of Jairus' daughter and the woman who had been bleeding for 12 years who reached out at touched the fringe on Jesus' clothes. Here in the land of CPE, I have been thinking alot about touch and healing. In one room there is a man who is experiencing a failing liver and is inelegible for a transplant. Lots of other things are going wrong as the liver fails. I am sure he would love to stand in for the woman. Deeply spiritual, he and his wife believe in earnest that a healing by God could occur. I doubt it will, and some of this is denial, but yet I am sure that those who saw that unclean and probably pretty unseemly woman grovel to touch the fringe, thought it was equally incongruous. And I am certain that value judgements about her sin that brought on this affliction were even more rampant than the thoughts of today about someone who admits to living a wild life in the past. Then there is the woman with cerebral palsy. In the hospital because at her age and with her condition, she is pushing the extremes of life expectancy. Each time in the hospital is closer to assisted care, rather than the apartment on her own where Mom checks in to see how she is. She was praying simply for this crisis to end. And it passed. I came in as she had heard things were improving. And this woman for whom life is not only a challenge, but a compromise, is determined to get out, go home and keep praising God. She loves to sing, she shared her music. A little garbled for most, but to God I am sure it was just as ethereal as any heavenly choir. We shared a prayer, and before I began, I asked if we could hold hands. Her hands have some mobility, not a lot. She was so joyful that I would hold her hands to pray. I did not think twice about asking. But later a peer stated that her joy was the fact that I was not put off by her disability, that I embraced her as she was. Healing touch for the soul. There was the elderly woman with emphysema. Outgoing and engaged, trapped in a body that is letting her down. Sitting with her oxygen she is trapped, yet leaning into our chat. She is feeling good today, she put on her lipstick, a touch that gives her dignity. As we get ready to pray, I ask her if she wished to hold hands. I thought she would leap out of the chair with enthusiasm. Touch is a connection- touch draws her in. Touch for her was a tight sqeeze of my hands- I am still vital. Healing touch.
And today a terminally ill patient- what cancer has not taken, this weekend's stroke did. He cannot talk. He is stuck. Yet when I stopped in to say hello and offer a prayer, he grabbed my hand before I asked at his bedside. Touch cannot heal his body, but perhaps it touched him. God knows.
"If I can just touch the fringe."
I was asked how we know God is present or speaking.When I held the hand of an anxious spouse and prayed,"Lord you know what is on our hearts and minds, our struggles. Grant us peace" the hand relaxed with an audible sigh." When you prayed that I felt angels enter the room," she says. Healing touch. A touch I cannot offer on my own, but by the power of the Spirit, a healing of a soul, for now, just the same. I am overwhelmed.

So How Is CPE Going?

As I began this first week of involvement with the CPE program our Regional Trauma Center , I entered the program with excitement for the learning and the meeting of new people. I also was anxious about what participation in group would be like given some of the “war stories” others had shared with me. I was concerned about remembering the details and protocols. I was worried about my sufficiency to meet the needs of those with whom I would come in contact.
I have been pleased to get to know my fellow team members, and supervisor, as well as the residents, staff and chaplain associates. There is diversity of backgrounds, personalities and faith traditions which has allowed me to have greater insight into my team and their experiences as they relate them. I have valued hearing the paths my team mates have taken to get to this place and time. Hearing these stories aids me in knowing their approaches more fully. The sharing has at times been very personal, both in terms of life experience but also in terms of vocation and discernment. It is a comfort to me to know there is much in common. I sense that our relating these things in community has facilitated the ability to bounce ideas off of one another about practice- I do not feel unable to seek feedback or ask questions. Several others have echoed their appreciation of this openness as well. In my first vocation, I was trained to speak for others. Advocacy was not in the first person. Statements were rarely about myself. While advocacy is a skill, I have had to re-orient my speaking to using first person statements. This is something that requires re-tooling my process away from past usage. I am working with this, so perhaps by the end of CPE, my supervisor will not have to ask about my pronoun choice. While I know there will be times when I am greatly challenged, my perception of the ethos of the group does not jive with the “war stories” I was told. There is a pastoral quality about our conversations in group that I feel is affirming and supportive. I am relieved.
Learning all of the forms, processes, protocols, 8 floors, etc. is coming along. I am not a detail person and tend to over-prepare to compensate. I am aware that this is my style of dealing with anxiety, and is also part of my first vocation where I was expected to have the answer and make quick decisions and judgments. I have been weaning myself away from all of the forms and examples I was carrying “just in case” and for a couple of days had the word “ASK” written on my binder in order to remind myself to not make assumptions or just jump right in. Also it served as a reminder that I can ask rather than worry about large quantities of information. I have also noticed that different people have different styles of handling certain paperwork and other things. I am exploring which of these is best for me.
Something as simple as what I carry with me was a trial and error process. At this point, I have put together what allows me to carry things without them flying everywhere, have what I need to streamline my reporting after responding to a patient need, without carrying extra or unnecessary things. I prefer to not have to run back and forth to the CPE office and to write details while they are still fresh. I know this will not always be possible. By keeping the basics to accomplish this as much as possible, it allows me to put the administrative aside, and enter a room “present” to the person I am seeing. I also find that by stopping at the station where the chart is located, I not only can see what may be going on for the patient, but I can center myself before entering. These are ways I have reduced my concern about paper and protocol so I can focus on caring for people.
Finally, I was worried about my sufficiency to offer people what is needed. Part of this worry is that I tend to be a “do-er” rather than someone can “be.” I tend to try to fix things and to seek answers. The story about the fantasy verbatim with Eeyore’s tail hit home for me. How I saw this play out this week was my concern over having the right things to say or carry with me. Knowing that I struggled with this dynamic I asked for help before visiting on my own. I am grateful that I could engage in role play and my supervisor was willing to do a visit for me to observe. This allowed me to pick up some useful pointers but it also reassured me that my fear of the unknown and lack of confidence was exaggerated. Even though I knew this, I needed some reassurance. I also have found listening to others experiences as well as de-briefing my own offers insight and support. I can pick up useful tips from others. From my past vocation I had learned that there was not a limit to the variety of family dynamics and issues. I was reminded of this during the week and while my approach to situations is from a different perspective, my prior life experience can be informative so long as I do not choose to focus on “been there, done that” in place of listening.
My prior training in listening was to very different purposes. I am aware that I need to redirect the purposes of asking and listening. “Why do I want to ask this question?” I am going to read more about reflective listening with a goal of developing this skill more fully and setting aside my prior framework of asking and listening. I am telling myself that “what facts do I need to know” should not be running through my mind, nor should “ I know what I want to tell you.” These concepts, while useful in my past, as opposed to “ what do you need” and “ what are you sharing?” During this week, one of the team was expressing frustration that his visits were short because no one wanted to talk about faith and he had no purpose. Hearing this allowed me to see “doing” aspects in another- this mirrored for me what I might need to keep in mind. In the light chatting that the patients sometimes offer, I am looking for ways to explore why their statements are important to them- how can they be affirmed, what are concerns, how are they perceiving and experiencing events in their lives. Several of the patients I have visited are eager for a person who will just sit and listen. Being in the hospital one can be surrounded by lots of people and yet be very alone and isolated. There is a great buzz of activity, but it is right outside the door and no one has time to just talk.
I have been amazed at the great insight and faith of some of the patients I have visited. I have also been saddened when I cannot offer more to someone in need. But I am cognizant of the fact that no one visit by anyone can suddenly make everything better given the issues faced by people in the hospital. Just being here shifts the landscape, and takes away frameworks the patient has in his or her life on multiple levels.
I know that I have only observed one trauma alert and the thing that is still in my mind is having to be the person handling the trauma call. Part of this concern is in the unknown of the process. I noticed that the one trauma alert, which was fairly mild in terms of bodily injury did not have the drama I might think of from watching “ER” or “House.” As a lawyer, I was always amazed at how people perceived what it meant to go to Court based upon war stories and TV. I have now been confronted with how that has been a part of my thinking regarding healthcare. While there will be times of great trauma, there will also be many other times where the tone is lessened. But for the patient who is experiencing the event, and the family or loved ones, they too may be bringing not only the physical aspects of injury, and the suddenness of it all, but all of their preconceived notions of what Emergency Department means- these will play on the responding family’s mind until they get here and beyond. Being attuned to my own preconception I hope will help me walk with them in their anxieties and offer what I can to aid them, knowing there will be no magic solution.
“So how does your faith help you in these times?” Probably I should ask myself this question as much I might ask it of others. I hope that I remember this as much as anything else so that I do not artificially place too much on myself and so that I can remain in both worlds.

Good but Bittersweet News

Rejoice with me! Lutheran Chick #1 is going to Lutheran Summer Music Festival and Academy for a month in July at Gustavus Aldolphus in Minnesota! She will be playing flute and singing with other students interested in church music,and making a joyful noise unto the Lord for a month! To learn more about the program, go HERE. She is very excited. She is our quiet, creative, but kind of disorganized child who often has great ideas that just.. kind of.. don't quite come together. In spite of struggles with some learning disabilities, she has always said that music is what makes the day worth getting up for. And we are grateful that she has a song she wants to share. Sadly, this wonderful month concludes with a week of concerts in a festival setting and I will be ... in CPE. It is a blessing she is going. Shouldn't that be enough for me? I have started trying to figure out if I can swing crazy shift swapping and maybe even get out for one day. Figuring out the Northwest flight schedule and how long the drive is from Minneapolis to St Peter. I am preparing to accept that the whole family ( none of whom is video savvy) will see and I will only hear about it. I guess it would be like hearing someone just saw the risen Christ on the road and I missed it. Well, maybe not that extreme.
And do I try to just work this out with my supervisor once CPE has started? DO I try to talk to him now? I have never met the supervisor. The person I met and who told me I was accepted has now been terminated. I have a place in the program but why make waves? Just really not sure what to do. I know there will be great moments in her life that I will not be there to see. Maybe this is one.
If anyone has advice about how to handle this- I would appreciate it. If anyone has info on getting to Gustavus Adolphus from Minneapolis and the like- also appreciated.