Wednesday, December 30, 2009

Up, Up and Away

The "ride along" program with the hospital's helicopter EMS unit allows folks to hang out with the "in the sky" medical team and even join them in the air for a half-day (that would be 12 hours in medical lingo.) During that time, the ride-along person (that would be me) gets to be pastorally present, surrendering to whatever comes along. I found this very much like being on call - you just never know what might arise.

My first assignment: check out the aircraft with one of the team. She explained the emergency exits, the plug for my helmet's microphone, the "off" switch for the aircraft's power and how to take the transponder with me ("in case of a hard landing"). I learned about where the fire extinguisher was. I learned how to use the seat belts, which basically wrap over the shoulders and across the lap like a straightjacket. I learned my role: "When you are seated, your job can be to look out for other aircraft. Using the clock-method, you might say, 'Plane at 3 o'clock' or 'Tower wire at 9 o'clock,' okay?" Oh, um, okay!

Methodically, she checked out the safety of the aircraft in between instructions and safety education. Clearly, this woman was comfortable with multi-tasking.

Next, back to the common area of the base. It is a comfortable but not fancy space with couches, a 32" TV and WII device, a cold draft flowing under the front door, and good lighting. The decor includes various greeting cards, notes about safety and a window-enclosed American flag given by a unit of the armed services in memory of the 2004 flight crew that perished in an accident. We hung out in this common area as the two medical team (my chatty buddy nurse and a very focused, serious-looking paramedic) and pilot inventoried their gear and shared light conversation. Serious-lady was also taking down the base's Christmas tree.

Fairly early, we got a call. In the base office, there are no overhead announcements or fancy buzzers or ringing bells or flashing lights. It was a telephone call, just as benign as any other call. Chatty buddy got the basic info, called out in a gentle voice that we were going to such-and-such county hospital and off we went.

I followed chatty buddy closely. Her easy going nature allowed me to ask her naive questions without an ounce of shame. As we approached the aircraft, she paused and looked at the pilot. My chatty buddy waited for him to change from the "fist" gesture to a "thumbs up" sign - just like she taught me in the check in. Hey, they really use this stuff!

We lifted off within minutes of getting the call. I was still smashing my helmet into my head (wow there's a lot of foam in this thing) and finding the buckle when I heard chatty buddy communicate to our hospital that we were outbound to pick up a patient. When she then radio'd ahead the other hospital, we found out that he was a big person. Very big. Like 375 pounds big. "We can hold the weight, no problem" the pilot replied to us all.

We flew about 8 minutes. I was alternating between "looking out for other aircraft" and adjusting the amazing wrap-around seatbelt when the pilot announced "2 minutes" until landing. The serious-lady took over the radio communications and got further details about the patient.

We landed without even any kind of bump. Heck, I've landed harder on my office chair when returning from a chaplain visit. Once we were on the ground, I fumbled with my helmet and seatbelt and walked quickly (kind of ducking, like they do in the movies) toward the waiting ambulance. They drove us around the parking lot to the emergency center entrance of the other hospital.

We traveled in a pack and I felt so honored to be in this company. These two strong, athletic, female paramedic/nurses, me, two gigantic EMS men with bright green jackets and a stretcher. We arrived en-force in the unit where we picked up the patient. (Well, they all shifted him from his bed-like-medical-device to the skinny board used in the aircraft.) We all herded out, placed him in the ambulance and rode through the parking lot. He WAS a big guy, so I really appreciated why they used an ambulance to move him and not even think of wheeling him down the parking lot between the cars.

A second set of EMS folks arrived to assist in loading the big guy into the aircraft. As four EMS guys and the two paramedic/nurses moved him into position, they all realized that the only way he would fit is if one of us did not go back. Serious-lady looked right at me and said, "Sorry, you'll have to stay here." Then she radio'd back to let our hospital know that one "of us" stayed at this other hospital. I really felt fine about that.

I grabbed my helmet and walked behind the security guard. He was directing traffic in the parking lot next to the heli-pad. Security guy was very talkative and his pride at serving in this once-in-a-while capacity ("I retired from the military so I know how to direct aircraft") was contagious. I, too, felt like I was part of something bigger. It so was not about me but our group effort in working with Big Guy to get him to our hospital.

I was starting to get the idea about care, about how we are part of something bigger...

I want you to think about how all this makes you more significant, not less. A body isn't just a single part blown up into something huge. It's all the different-but-similar parts arranged and functioning together. If Foot said, "I'm not elegant like Hand, embellished with rings; I guess I don't belong to this body," would that make it so? If Ear said, "I'm not beautiful like Eye, limpid and expressive; I don't deserve a place on the head," would you want to remove it from the body? If the body was all eye, how could it hear? If all ear, how could it smell? As it is, we see that God has carefully placed each part of the body right where he wanted it.

1 Corinthians 12:18-20 (The Message)

Thursday, December 24, 2009

Communion

Facing the people, the Celebrant says the following Invitation
The Gifts of God for the People of God. - BCP 364


As I meandered up to one of my intensive care floors, the nurse manager on duty caught my eye. "Hello!" The nurses were very casual today - hanging around the station chatting about nothing in particular. Very friendly mood. Nurse manager noticed me scanning the floor and checking in with "mitchell," a patient whom I have been following since July.


"He's just waking up," she tells me. They have all been following him since July. "Oh, well, then I'll just check in on him." I was curious to hear his reaction to the complimentary facial massage provided by the hospital (with a little organizing by the chaplain ). Since "Mitchell" has been paralyzed from the neck down, a tender touch on his face might brighten his day.


"It was great," he tells me. "It nearly knocked me out!" He was smiling. "Can you get my donut?" I scan the room. "Where is it?" I'm looking for one of those pink styrofoam medical devices that are used on patients like Mitchell to stabilize his head position on the pillow. "Its on the table over here," he tells me.


Oh, THAT donut! Krispy Kreme! (what a ditz, I think to myself!) I gingerly feed him a bite of his donut. I try not to knock his neck-and-head stabilizing contraption. He raises his arm to get the sugar off his face, but his hands don't work anymore, so I take the clue and use the napkin to wipe that little blob of tastey high fructose corn syrup off his mustache. "Mmmmm." He's happy.


"Drink?" "Sure," I reply, "what'll you have?" There's a pepsi with a straw on the table there. "Breakfast of champions, Mitchell!" I say as I tenderly slip the straw in his mouth. Slurp slurp. He's happy.


I wish that I could say that at that moment I understood this was communion for us both. I wish that I had the insight to say, something about this holy food and drink of new and unending life in Christ. But I didn't. I realize it now - his Christmas gift to me was in asking for me to serve him breakfast - er, communion - of donut and pepsi. I'm happy.


And I believe that at the last day, Christ will bring us with all his saints into the joy of God's eternal kingdom.


All this we ask through your Son Jesus Christ: By him, and with him, and in him, in the unity of the Holy Spirit all honor and glory is yours, Almighty Father, now and for ever. AMEN.

Tuesday, December 22, 2009

Words

Let the words of my mouth and the meditation of my heart be acceptable in your sight, * O LORD, my strength and my redeemer. - Ps 19:14

I am so familiar with this prayer; it's one that I use often as a mantra while making the long walk up the tower stairs to visit patients. I hope that I come up with some words that might help, or at least won't hurt. I hope that God fills my heart with compassion so that no matter what I say it somehow comes out "right." Dang, that ego thing again.

Then I meet someone like Sammy. He was sitting up in the critical care area as I walked by, looking for someone with whom I could visit. Most patients on this day were intubated, comatose, sleeping so soundly that they snored aloud, or were dilusional. When I peaked in his room and saw him peaking back, I walked on in and introduced myself.

Reticiv solter kywor shway lested diste? Eddy was. Costeallo rivals parliament abrading iron budgets. Then Larry quoted gitlow the whereat at toasted to Lancers return.

He continued in this vein and yes, you read right: it was gibberish. Or was it mumbling? Or did I simply forget that he was on the neurological (brains etc.) critical care unit. I listened for some time, adding my "uh-huh," "oh...," and "okay." This generated more conversation on his part. Eventually, he paused, looked at me and smiled one of those left-sided smiles. I smiled back. We parted by sharing the namaste peace gesture.

A little while later on the neurological "step down" floor, I met Rita. Her long, stringy, white hair and deeply set wrinkles gave me the impression that she had lived a long life. I walked in the room and after introducing myself, she grabbed my hand. She began telling me her story.

However festival handcuff re-election merris numbers grimaces. Rosemary and boxcars the be roscile. The klansmen mischeif the was unafraid. Liberation frieda Abraham overlain refus- and impinges.

I know, it takes a minute to realize that this was the same language that Sammy had used just a few hours earlier. Her story was mezmerizing and filled with facial expressions. She grabbed her sheet to use as a tissue as she cried, wailed and expressed her concern. Every once in a while, I recognized a word. "...unafraid?" I would repeat back. Then she would begin anew. So much of what she was expressing to me was anxiety, apprehension and fear. As I prayed with her, she closed her eyes and when I said amen, she opened them back up and began expressing herself in the same way.

I noticed that one of her electrodes was sticking to her gown, not her skin, and she seemed to want me to tell the nurse. As I left to go let the nurse know that the electrodes were unattached, she called out to me, "you come back!"
I'm sure that the words of Sammy and Rita were perfectly acceptable in God's sight. I felt God's presence in my heart as I listen to them. I believe that God knows what was on their mind and through me, they were able to express it.

How are your words and heart meditations giving you strength, right now?

Joyful

Be joyful in God, all you lands; *sing the glory of his Name;sing the glory of his praise. Ps.66:1

Let's call her Kathleen. I can't remember her real name, but I'll never forget her.
As I introduced myself, she interrupted me by excitedly telling me about her trip. See, she was an astronaut and maybe since she had been away was why she had not met me yet? She just got back from Mars, she explained. Since her husband (Joe Namath) was in the space program, she got to go with him. Oh it was an amazing trip.

What was the sky like? Was it blue?

The sky was not blue, no, it was red. Actually you could see the rings, you know? And the animals were all around, running free. Those creatures weren't like the ones we have here. They were kind of dinosaur-like. Not really house pets.

I guess not. What else was there?

Oh, the houses were very modest, you know. Kind of country style, nothing impressive. But there was not much air there so many people died when we arrived. I got to go because my son is Neil Armstrong. Have you heard of him?

Yes, he's a great guy.

Yes, I'm so proud of him. I think he'll be by to visit me and .... With very little probing, she continued to share all about her trip, her visits, her experiences. She continued in this way, Kathleen did. So excited and animated.

She was joyful, indeed, at all that God had created. Her free spirit and creative voice brought alive the simple TV room where the other patients were alternatively zombie-like and asleep. As I wished her well, she gave me a blessing.

I left with a boost in my step and a praise for all that God had created. What fun this is!

How are you showing up to this moment in joy?


Sunday, December 20, 2009

All Bets Are Off

In our chaplaincy work, we have all been working on "getting in the hole" with patients. (See EM's blog about this and NR's too.) I think this phrase comes from the idea that when someone is suffering, they are in a hole of sorts. Well-meaning friends and family may walk passed the hole and say how it will get better, or ask what it's like down there, or say 'call me when you can,' but few actually get down in the hole and invite the suffering person to share, really share, what it is like.

It's a dark, dingy place that hole. It takes guts and honesty and rigor to get there. And, when we are fully present to one another's suffering, the emotional connection dissipates the suffering and Spirit's healing can be brought to bear. It takes time and trust.


That is to say, instead of feeling "sympathy" or feeling "sorry" for the care seeker, we chaplains have been learning (and pushed by our supervisor) the experience of empathy, where we really connect at the feelings level. For me, this is one of my growing edges - this art of getting-in-the-hole.


I continue to be baffled by my need to dodge the deep emotional issues. I have found an enormous capacity to change the subject or not invite God’s spirit or even my own sense of self to the moment to inform how to share the person’s feelings. As a learning edge, I know that I need to stay aware and awake to how I am feeling, right then, right there and try to connect with the patient.


The other day, I visited with a patient who was down in a dark hole. I sat in a chair across from her and listened about her situation. She was very animated and as I found myself getting in the hole with her, she became more animated, angry, talkative and agitated. I felt that same way! As I encouraged her to say more about how she was feeling, she pulled me right into the hole.


I felt like I was making progress... until...thankfully, a nearby therapist came over, tapped me on the shoulder and asked me to step out for a minute. Folks with this type of mental illness, he shared, will do anything they can to get you to buy into their feelings. People with this diagnosis often have highly unstable patterns of social relationships and may switch unexpectedly to the another extreme, angrily accusing the other person of not caring at all.


Here I thought that I was getting in the hole with her and it might actually help. Trouble is, I was completely manipulated to get in the hole and was on the border of becoming the target for this patient's anger. Basically, all bets are off in terms of getting in the hole with patients on this unit. Mr. Therapist recommends letting this kind of patient "roll off you like water off a duck." Oh, this goes so against my training and my nature.


This unit will definitely challenge me. When I think that I am "connecting" with a patient, I cannot ever assume it had anything to do with my newly honed art of getting-in-the-hole. Surely, I will begin to experience a different way of being with patients through this rotation that will be different from all other units.


The crowd rebuked them and told them to be quiet, but they shouted all the louder, "Lord, Son of David, have mercy on us!" Jesus stopped and called them. "What do you want me to do for you?" he asked. "Lord," they answered, "we want our sight." Jesus had compassion on them and touched their eyes. Immediately they received their sight and followed him. - Matthew 20:31-34

How are you changing your approach, in this moment?


Tuesday, December 15, 2009

Mid Point

December 15, 2009

Today is the official mid point of this year. December 15 is exactly six months since our start date, June 15. I'm thinking about how when you run a marathon, the real "mid point" is the 20 mile mark. That's usually when I hit the wall.


In marathon training, we gradually work up to those long runs. The cycle is three consecutive weeks of increased mileage followed by a week of restful runs. Eventually, the "long run" for the training is only 18 or so miles, with the theory that if you can run 18 miles, you can run 26.2. It's weird but it works!


Also, there's a three-way principle in place: you need to run and train, you need to eat and eat well, and you need to rest. Train, eat, rest. That's pretty much what life is like when you are training for a marathon.


In chaplain residency programs, I think the same principle applies. We need to train (initial visits, trauma calls, dying patient vigils), we need to learn how to eat right to sustain us and we need to rest.


I'm aware that this time is bitter sweet - half way done means hooray! and it also means Oh No! I love my team, the learning, the supervision, the course work, the ministry, the staff of the hospital, the routine, the experience. And, it's exhausting.


At this mid-point the advice that I give myself is to remember to train, eat and rest - and all shall be well.


"All shall be well. And all shall be well. And all manner of things shall be well." Dame Julian of Norwich (1342-1416)


What is your mid-point at this moment?

Service

"There is no true service unless both people are being served." - Frank O, from Zen Hospice audio series (CD #2)

As I listened to this CD some time ago, I learned about "the mutuality of service and the crucial difference between helping and serving. We see how the true definition of compassion—‘suffering with others’ —allows us to serve from our whole self and leaves us with a feeling of profound gratitude."
The message he imparts has influenced how I minister and makes me wonder... am I confirming some identity in myself by setting myself apart from the patient, either from pity, fear or by performing some action? I learned how the helper in me actually imprisions me.

Frank suggests instead that if I minister, or serve, from my own wounds (wow, I find hospitals really awkward, do you? or I imagine that I would feel so dependent on the nurses with those mitts on my hands, is that how you feel?) then I can "serve" instead of "do for" and the power differential can begin to dissolve.

I love the ideas that he provides for ways to express compassion while serving:
1. attending to the body with the gift of touch (the oldest form of healing)
2. attending to the heart and mind through the gift of listening and being completely present. He calls this "keeping company but staying alert"
3. attending to the spirit with the gift of awareness

I appreciated some questions he offered as ways to help the care seeker discover their own truths - (not to be asked right after the other, more just ideas as conversation starters) What was your childhood like? Were you a troublemaker? Who were your heroes? Is there anything that you wish you could forget? Is there anything that you wish you discovered sooner? What was the one thing you were certain of in this life?
I hope that I can use these kinds of questions in my service with the Behavioral Health patients in a way that I, too, can be healed. This gets me away from the "why are you in the hospital" questions that, ahem, aren't so helpful. (see previous blog)

"Lord," they answered, "we want our sight." Jesus had compassion on them and touched their eyes. Immediately they received their sight and followed him. Matthew 20:33-34
How are you showing up for mutuality in this moment?

Don't Ask, Don't Tell

Apologies for using this quite common phrase in a new way. This post has nothing to do with the military's policy on homosexuality. That said, I think it captures what I learned the other day in Behavioral Health.

Don't ask if you really don't want to know. Don't tell if you really don't want them to know.

So, in our chaplain training we learned about some simple questions we might often ask a patient when assessing their understanding of their possible stroke. We chaplains receive a printed notice to go talk to a patient about their stroke and we go to assess it. It's a fairly straight forward formula:

1. what brought you to the hospital or why are you here? (their understanding of their diagnosis)

2. what are the docs saying about how long you'll be here or what is the next step? (their understanding of their prognosis)

3. who is your support group - you know, family? friends? (support systems)

4. what kind of faith community includes you - church? other? (faith community)

After we have the "assessment" chat, this also opens up the discussion for other kinds of topics as per whatever the patient/family might have on their minds and hearts.

I learned yesterday that this formula doesn't really help in Behavioral Health. Don't ask unless why they are here unless you want to see the self-inflicted wound and staples along the wrist which are accompanied by bruising where the police had to restrain him to get him in the ambulance. I don't think that having the patient re-live that whole scene was particularly helpful for his spiritual health, but then again, he freely told me. And told me. And told me. And told me.

So perhaps I served as a loving listener, but I did find myself feeling annoyed after about 20 minutes of it. I was afraid that I was going to slit my wrist if I heard the story one more time. But I wasn't going to tell him that.

Something to learn there. Something about boundaries? Something about manipulation? Something about being a door mat? I think I'll pray about this one.


After Jesus had gone indoors, his disciples asked him privately, "Why couldn't we drive it out?" He replied, "This kind can come out only by prayer." Mark 9:28-30


What is best left unasked, untold in this moment?




Thursday, December 10, 2009

Wit

Just in case we don't see enough grief and suffering around the hospital, we also have a "once a month" class on grief and suffering that rotates to the other three CPE programs around the Upstate. Each month when we get together, one of the supervisors presents a topic and engages us in dialogue about our own inner grief work.

This week we went to one of the other hospitals and watched the movie Wit. This profound movie epitomizes grief and suffering in one's own experience of illness. Starring Emma Thompson (magnificently acted), the story revolves around a professor of English literature. This professor's knowledge of poetry and her tough teaching style are both challenged as she endures various chemo treatments for her stage IV cancer.

During the film, the viewer learns of the professor's feelings as she looks directly into the camera and describes in poetic and often ironic style what she is experiencing. In one poignant moment, she realizes that she can only get her head around what she is doing by describing it. She says, "my only defense is the acquisition of vocabulary." In many ways, her words are not enough to heal her. In the end, we hear her voice quoting from one of her own literature research subjects, John Donne, "Death, be not proud".

Moving and troubling, the film for me portrayed a deep loneliness that accompanied her suffering throughout. I connected with my own loneliness, and the fear of my own mortality. Who will be there with me as I vomit my last guts out? Who will put hand lotion on my dry, lifeless hands? Who will crawl into bed with me and read me a children's story? Of course, I yearn for this to be my intimate love. Of course, I yearn for my family to be at my side. Of course, I yearn for my wit to remain with me to the end, so that I can at last describe it.

Theologically, I believe that God will be with me through my own death and dying process. I do believe that in those suffering places, I have seen, do see and will see God face to face.

So if you see the film, bring a box of tissues. And a gaggle of chaplains to debrief all the feelings that arise.

Instead he went out and began to talk freely, spreading the news. As a result, Jesus could no longer enter a town openly but stayed outside in lonely places. Yet the people still came to him from everywhere. Mark 1:45

What color are the feelings you have at this moment, the ones beyond words?

Wednesday, December 9, 2009

Saving Others

I sat in a 12-step meeting in the unit, listening to the therapist explain the cognitive issues describing how addictions affect our brain. Next, he began sharing how, although it is scary, we addicts will need to find new friends and new social networks. The patients all nodded, some shook their heads and chuckled, knowingly.

The therapist offered that in some cases, finding a church may be a helpful place for newly-clean addicts who seek out new friends and new patterns. After some sharing by other patients, I heard one say how at first, his new church really helped him. Then he got really involved and really active. He led trips, helped the homeless, taught Sunday school, held bible study, and really over committed himself.


I am sure that I took a deep breath when he said, "I got so busy saving others that I forgot about saving myself."


How am I like this patient? Well, I better learn to know when to say when. I pray for God's guidance, for my family's patience and for my colleagues' perseverance to help me not forget about self-care.



The people stood watching, and the rulers even sneered at him. They said, "He saved others; let him save himself if he is the Christ of God, the Chosen One." - Luke 23:35


How are you saving your SELF in this moment?

Tuesday, December 8, 2009

Developing Pastoral Image

For our final session in "Pastoral Images" course, our assignment was to integrate our reading from Dykstra's book to form a pastoral images of our own style of care. What metaphor works for me? Wounded Healer? Intimate Stranger? Wise Fool?

As I thought about the last five months, I realized that I am finding a deep faith in how God moves me and enlivens me in my care giving. I variously serve as a witness, companion, investigator, awkward hospital staff person, translator, interpreter, loving listener, reframer of perspectives and affirmer of God’s love.

It suddenly hit me today, Saturday, as I watched the World Famous Lipizzaner Stallions. The presentation of these amazing athletes by their equally well-educated riders captured my imagination as I realized how the role of the Dressage rider/trainer resonated so well for me and my pastoral functioning.

The idea of dressage is a way of training the horse to emphasize a horse's natural athletic ability and willingness to perform, so that its potential as a riding horse can be maximized. A fully trained horse will smoothly respond to a skilled rider's minimal aids - all the while the rider remains relaxed and appearing effortless. In chaplaincy, I find that my role is to smoothly respond as a rider, with minimal aid, remaining relaxed and making it look effortless – so that the patient/family can sense their own potential as a human being in which God delights.

The Lipizzaner horses, in particular, are bred for their athletic ability and are allowed to roam free until they are four years old. During this time, the trainers observe the horses in the natural environment and learn their natural rhythm. Only after this waiting time do the trainers begin to work with the horses for re-enacting their athletic ballet moves in the show ring. In chaplaincy, there is a bit of a "waiting time" associated with caregiving, in which I observe the situation and am better able to invite the care seeker to re-enact their own theology or to realize God’s ever-presence and how it can bear on the situation. This “background” perspective informs my pastoral functioning.

Historically, it was Xenophon (427-355 BCE) who is well known as one of the earliest European master trainers. His treatises, written in Greek, advocated the use of sympathetic training of the horse and many of his methods and ideas are still widely praised. Also in Christianity, there is a long tradition of pastoral care methods and these are mirrored in my pastoral image formation. With God's help, I hope to bring this long tradition to bear on the moment of care.

The Dressage Rider/Trainers train the horses to fully use their artistic ballet gifts, such as changing lead on every step at a canter, take years to master by the horse as well as the rider who needs to learn the appropriate cues. As a chaplain, my role is also to recognize the inner life of the care seeker and connect with my own, so that together our histories can find something new in our time together.

Further, the rider/trainer's goal is to have the show be about the horse, not the rider. The riders themselves have learned their own skills for riding and cuing the horse over years of education, usually a lifetime. The less obvious the moves are, the more effective the “show” is and the horse’s true essence comes out. This is much like chaplaincy. The less “showy” I find that I am, the more of God can show up and the more the patient/family is central to the intervention.

Even though there are standardized methods, each combination of horse and rider is unique. With horses, it is not uncommon that one horse trained to perform at a high level may be completely spooked by a venue that is loud or unfamiliar. The trainer’s role is to deal with the venue that comes up and work with the horse’s personality in that moment to bring out the horse’s gifts and graces in that particular instance. As it is with each pastoral intervention, where every relationship of chaplain and family is unique and changes based on the patient’s diagnosis/prognosis or sense of the future. As a chaplain, I am learning to adjust my interventions, my use of “training methods” to each situation.

Riding horses requires balance, harmony and relationship. This subtle type of sport requires some translation of ideas to the horse and interpretation from the horse’s response back to the rider. The rider must always listen to what the horse is “saying” in silence – through body language (horse’s ears are perked or lay back, how the horse moves away from or into the leg pressure or even how the horse may cling to the bit or avert from the movement of the reins). The chaplain, too, must listen to what the care seeker is "saying" in silence - through body language, facial expressions and reactions to others in the room. My role as chaplain is to then translate what's going on and interpret how the care seeker is responding to have any sense of how we can be together in the care intervention and become aware of God's ever-presence.

Sometimes, training a horse involves reframing a“scary” situation, such as “threading the needle” movement. In this movement, horses face one another as the riders guide them and weave between their neighbor horse/riders. Normally, horses avert or shy way from trotting or cantering directly towards another horse. Only after coaxing by the rider and developed trust in the relationship does the horse allow this “threading the needle” move. This kind of relationship takes loving listening, companionship, and true affirmation from both the rider to the horse and from the horse to the rider.

In chaplain work, I find that some patient/families, while gifted in other situations, are completely "spooked" by being at the hospital - a venue about which they are unfamiliar. When appropriate, I might reframe a ‘scary” situation for the patient/family into one of “normalcy”. This usually takes time, trust, and relationship. My pastoral functioning is one of relationship as is dressage riding.

In Dressage, as in Chaplaincy, both the horse and the rider (care seeker and chaplain) become more of themselves through this relationship – they know their own strengths and weaknesses individually. As a unit, something new happens.

Grace and beauty

For the LORD will rebuild Zion and appear in his glory. He will respond to the prayer of the destitute; e will not despise their plea. Let this be written for a future generation, that a people not yet created may praise the LORD - Psalm 102:16-18 (New International Version)

Monday, December 7, 2009

Redefining Life and Death...and Mike

In "Journal Club," we chaplains have an interdisciplinary time of sharing an article that speaks to the intersection of faith and medicine, or ethical dilemmas, or bio-ethics, or ... well, we don't really have much direction so any kind of controversial topic that touches on spirituality and medicine is fair game.

One of our medical resident colleagues recently shared an article about how "Death" is being defined - and redefined - as the medical profession begins to understand that "...there is no "moment" of death." In medicine, the "moral" lines move. "Dead" means irreversibly stopped, and stoppages are increasingly reversible.

Is it when the heart stops? How can that be when the plan is to restart the heart in a new body?

Is it when the brain stops? Then we can take organs from people on a ventilator. "Failure to take body parts looks like lethal negligence."

I can tell you that this was one of the most vibrant discussions we as a team have had in our 5 or so months of chaplaincy. The medical team was spot on with all their scientific wit. The behavioral psych team got into our own fears of death. The chaplains were spiritual and religious.

Then, Dr. Kildare told us about Mike and all bets were off. Oh, you've never heard of Mike, the headless chicken? Well, talk about redefining life and death. You see, Mike was supposed to be dinner, one summer evening in 1945. The only problem was that he lived for another 18 months after his head was cut off. He grew to be 8 pounds of robust chicken and for this feat was eventually valued at over $10,000.

Who needs a head, when you can be a chicken?

Which brings us back, of course, to chaplaincy. Where is God in all of this? Well, there's a good question. I hope you keep asking.

This day I call heaven and earth as witnesses against you that I have set before you life and death, blessings and curses. Now choose life, so that you and your children may live and that you may love the LORD your God, listen to his voice, and hold fast to him. Deuteronomy 30:18-20

How are you redefining life and death in this moment?

Chaplain, Can You Pray?

The other day we received a note, "Hey, y'all, in about one hour a group of people were gathering for a memorial service and perhaps y'all might want to go."

What memorial service, we asked?

  • Every year at this time, a Christmas tree is placed in the lobby of the hospital.
  • Every year, ornaments are placed on the tree by family members of patients who have died and have given their bodies to science.
  • Every year for at least the last 15 years, family members show up and place their ornaments on the tree, commemorating their loved one ("for Johnny, my 18 year old son, who was killed by a drunk driver," or "for Suzanne, my fiance, who died in a terrible car wreck," or "for Pamela, my cousin, who had a brain aneurysm and died suddenly.")
  • Every year, the organization that works with organ donation families holds this memorial service and some dozen or so families show up to remember their loved one.
  • Every year, the medical team (nurses, case managers, physicians, staff) assists in this memorial service as they, too, remember these families and their loved ones.
Of course we'd go to this service. In the somewhat awkward lobby of the hospital, just behind the information booth and next to the cafe, the audio equipment was set up and began projecting soft music to set the mood. Danish and coffee was being served while the families gathered. Several small groups of people stood near each other and tearfully shared stories of their ornament and why they come back every year.

I recognized "my" nurses from one of my floors. That's the floor with the most number of brain injuries or deaths and those nurses see many of these families. That's when the nurse manager suddenly called out, Chaplain, can you pray to open our ceremony?

And two minutes later, I began...O, most gracious and loving God...

In those moments, I realized that if I had more than two minutes to think about this, I might have been a little more freaked out. In some strange way, it was a bit like an initial visit or a middle-of-the-night call to pray with a family in the midst of some crisis. I asked in a sort of round about way what would be appropriate to pray for/about. The MC gave me just a few short words. That's all I needed and out came the prayer for courage and strength and gratitude...

I felt that the prayer was not about me, it was about God's presence in that moment for those people and for all the cloud of witnesses in whose memory we hung the ornaments. Okay, it was a bit bumble-y and so what. Just as soon as my inner critic began to work, I shoved her back in the box. Hey, I showed up. So did God.

Coincidentally, just a few days later, my colleague Erin presented this reading. (She had not been at this spontaneous entry-way memorial service and was simply commenting on how often we Chaplains are asked to pray.)

The following comes from Eugene Peterson's Living the Message.

"One of the indignities to which pastors are routinely subjected is to be approached, as a group of people are gathering for a meeting or a meal with the request, "Reverend, get things started for us with a little prayer, will ya?" It would be wonderful if we would counter by bellowing William McNamara's fantasized response: "I will not! There are no little prayers! Prayer enters the lion's den, brings us before the holy where it is uncertain whether we will come back alive or sane, for 'it is a fearful thing to fall into the hands of a living God.'"

Don't be flip with the sacred. Banter and silliness give no honor to God. Don't reduce holy mysteries to slogans. In trying to be relevant, you're only being cute and inviting sacrilege. Matthew 7:7

How do you show up for prayer in this moment?

Sunday, November 29, 2009

Fell Off The Wagon

The blog wagon, that is. Not sure why - could it be that I've been just plain tired?

I'm learning about balancing demands of sleeping in three different beds each week, diasporic access to the internet to get into blogspot, being a patient myself (twice!) over the last two weeks and perhaps hitting the "over 50" number of deaths to which I have attended.

In spite of that, my faith is deepening, my love for my colleagues is expansive and my sense of call is clarifying. And, I'd love to blog about it all.

Thanks for journeying with me as I seek for this Advent season to blog when Ms. Muse shows up and technological moons align.

I'm going to just keep showing up in the moment!

Thursday, November 12, 2009

Waiting

I recently heard about a new book called "The Meaning is in the Waiting," by Paula Gooder. In this run-up to Advent season, it offers ways of learning to love waiting.

I am learning about waiting; we do so much of it in chaplain work. My own tolerance for waiting has grown immensely, mostly by denying that I am waiting and instead accepting that I am present for the other person. I'm not waiting at all. By being present, I remove my expectation from the room and can accept what each moment brings.

This book offers more depth to waiting that I had not yet considered. The summary indicates that in the company of the biblical characters we "discover very different kinds of waiting..."

* Abraham and Sarah -- who waited a lifetime for the fulfillment of God's promises.
* The Hebrew prophets -- who waited for God's intervention, both longed for and feared.
* John the Baptist -- whose ministry marked the end of one era and anticipated the new.
* Mary -- whose life was shaped by waiting and by events beyond her control.

These are different kinds of waiting. I still dance with that tension between waiting and being present. "To be 'expectant' rather than urgent, yet focused on God's presence rather than on some future." It's subtle, I think, this delicate difference.

Usually, the family member or patient helps discern it for me. Sometimes, it is too traumatic to ask where God is in the moment. Sometimes, asking that question is the only way to tolerate the waiting. If I name that we are waiting, and that I am present with them, I find that somehow a mutuality arises about what kind of waiting we are both experiencing.

I ask, how does waiting affect my abililty to show up to the moment?

Mark 15.43: Joseph of Arimathea, a respected member of the council, who was also himself waiting expectantly for the kingdom of God, went boldly to Pilate and asked for the body of Jesus.

How does waiting affect you?

Wednesday, November 11, 2009

Time. Out.

This week I am taking a time out.

The image uploaded shows the morning sunrise from our window of this worn-out but beach-side apartment we rented for the week. I love the way the sun poked through the clouds and highlighted the waves that come crashing into the beach.

Long beach walks. Sandy yoga by the pool. Beach scum on my sunglasses. Sweaty runs along the water. Canceled surf lessons ("too windy") and lazy afternoons reading a very long book that I have (603 pages).

I recall one of my priest friends telling me that part of his job description includes "not going crazy." I think that taking a time out falls in that category.

Just rest, the meditation tape says.

okay.

Compassionate Companion

A colleague loaned me three CD's of concepts used at Zen Hospice in San Francisco, called "Being a Compassionate Companion:Teachings, stories and practical wisdom for those accompanying someone who is dying - An intimate conversation with Frank Ostaseski".

The series, dedicated to compassionate companionship, comes into play, for me, particularly during death events. The practices, reminders, and stories originate from ZHP's founder's Frank Ostaseski's 20 years of experience being with death and dying. The topics offer support in preparing for death, serving the dying, and grieving.

I love that their stated core activity is "bearing witness," as expressed in their slogan, "Stay close, do nothing."

The approach at ZHP is a process that Ostaseki describes as, "a mutually beneficial relationship between caregivers and people who are dying." Both parties listen to death, and learn together. A notion that has deeply impacted my pastoral care is the mutuality aspect of service, which differs from usual notions of charity and help.

I quote Ostaseki here:

"Service-a very different experience than charity-recognizes wholeness: there is no 'helper' and no 'helped.' Something bigger is happening in service than the two individuals involved. Mindfulness practice helps to transform generosity from a charitable 'I and other' expression to one of service, where we recognize that we're both in the soup together. I understand that in order to work with someone else who is dying, I have to do a kind of individual exploration. I have to look at my own relationship to sickness, old age and death. While I'm working with someone, I'm also investigating my own fear, my own grief. In Buddhism, we recognize that someone else's suffering is also my suffering. So when I take care of myself, I care for others; and when I care for others, I am taking care of myself."

The 18-minute meditation at the end of the first CD ("Preparation") allows a contemplative reflection of the five precepts of a compassionate companion. I have found it so meaningful that I carry around the short list of precepts to which I refer during my visits.

1. Welcome everything; push away nothing. No clinging, no aversion.
2. Bring your whole self to the experience. Moments of sensation: seeing, hearing, tasting, touching, feeling, thinking.
3. Don't wait. Be present for this moment, letting go of any expectation.
4. Find a place of rest in the middle of things, cultivating kindness and ease. No need to interfere with what's arising.
5. Cultivate a "don't know" mind, opening moment to moment, without preconception or resistance, letting the mind and the body be open and receptive.

At four minutes remaining, he whispers very intimately, "just rest."

That's all. Just rest.

My soul finds rest in God alone; my salvation comes from him. He alone is my rock and my salvation; he is my fortress, I will never be shaken. (Psalm 62:1-2)


For whom are you a compassionate companion in this moment?

Thursday, November 5, 2009

God as More

For our Pastoral Theology course, we are watching a series called Living The Questions. One of the recent chapters challenged us to consider God as more than a supernatural "being" that is "out there." One of the speakers suggests that we might find a more satisfying understanding of God to be in the relationship with the sacred reality right here. His emphasis is on leading a Christian life that is in a relationship with God as known in Jesus Christ - this is the God who is out there but also right here.

It's a bit of a challenge for me, since this resonated deeply for me. Here in the hospital, in my pastoral functioning, I hear myself refer to this "being" God. And I hear it from patients, families, staff, and colleagues - even though I tend to believe in a God as more than a being but as everything all around us and that we are within God. Perhaps God is both/and?

Recently I re-listened to an interview by the late Irish poet and philosopher John O'Donohue. He spoke about poetry as always having had a vital role in Celtic and Irish culture, history, and spirituality. He offered up a beautiful, ancient, archetypal poem, the "Song of Amergin." These are some of Ireland's oldest known verses illustrating the Celtic sense of a symbiotic and seamless relationship between the natural and the divine.

I found that it speaks of God as More.

I am the wind on the sea.
I am the ocean wave.
I am the sound of the billows.
I am the seven-horned stag.
I am the hawk on the cliff.
I am the dewdrop in sunlight.
I am the fairest of flowers.
I am the raging boar.
I am the salmon in the deep pool.
I am the lake on the plain.
I am the meaning of the poem.
I am the point of the spear.
I am the god that makes fire in the head.
Who levels the mountain?
Who speaks the age of the moon?
Who has been where the sun sleeps?
Who, if not I?

How do you experience God as More in this moment?

Yesterday, Today, Tomorrow

There is a strange time vortex that happens with "On Calls." They start on one day, finish the next morning, and conclude around noon that day, after our classes, group work and lunch. Time flies!

It's not uncommon for me to start charting a call that occurred at 5am the following day of starting "On-Call" and forgetting that it's actually another day gone by - it happened today, not yesterday, which was of course tomorrow when this shift started.


Confused? Try staying up for 30 hours and then having a case study due. That will clear it up.


Fortunately, God is there in the midst of each On Call. God was there, is there and will be there.


...And remember, I am with you always, to the end of the age. Matthew 28:20b


Which moment are you in at this time?


Wednesday, November 4, 2009

Cell Phones

Cell phones. What a unique and creative way to make a statement; to personalize one's life. Especially with ringtones, the latest fad in personalization.

I'm in the trauma bay conference room, with a mother whose son had a mishap on the football field. Her phone rings.


"Ma? Mom? Mommy? MMMMMMMMOOOOOOOOMMMMMMMMMYYY?!! Ma? Mom? Mommy?..."


"Oh, my son recorded that so when he calls, I know that it's him. His sister must have his phone!" It felt silly laughing, given the tenuousness of the situation, but this mother welcomed the break from the heavy air and explained her latest ringtone.


Cell phones. Everyone has them.


I'm attending to a motor vehicle accident family in the large family waiting room. Great-Grandma (92), Grandpa (70), Mom (45), sister (20) and a cousin (23) all have cell phones. Each one is talking on their phone, calling the neighbors, the pastor, the extended family, the cat sitter, the piano teacher... all delivering the news about how their family member is doing and what the next steps are. One turns to me, "Do you have the yellow pages?" They understand - they are on a family plan with free minutes, but with extra charge for "information." They won't use the landline in the waiting room ("Dial 9 for an outside line) but they want the yellow pages. Gratefully, they all had their phones on "silent" or "vibrate." Except Great-Grandma whose phone rang Born in the USA, or some other rock song, when the pastor called back.


I think about how God is calling me and what ringtone God uses. What kind of "family" plan do we have with God's calling service? What tone does God use when I call? Or is God listening all the time?


Before they call I will answer, while they are yet speaking I will hear. Isa 65:24

What ringtone resonates in your heart, right now?

Silent Scream

"What you are saying speaks so loudly that I cannot hear a word you are saying," my mentor told me many years ago. I took it to mean that my body language, tone and volume of voice, cadence, facial expressions, eye movement, and countenance delivered the message. No words necessary.

I visited a very troubled patient the other day. (Actually it was weeks ago, so troubling that I needed some time to reflect on it.) Her contorted face and deep-set, shifty eyes let me know there was more at stake in her overall health than her physical condition. I'm sure her altered mental condition (mental illness, psychosis or dementia, I do not know) influenced her message delivery. What she was saying spoke so loudly that I didn't need her to speak. She didn't say a word, but her message was loud and clear.


Very, very, very loud. I couldn't think. I found myself checking the time on my watch. I looked into her eyes. I touched her shoulder. I asked her if she would like a prayer? I closed my eyes and prayed out loud with her. When I opened my eyes she was still watching something floating around the airspace, seemingly gagging on something.


In my clinical charting, I used little tick marks to indicate my assessment: distraught, in pain, suspicious, angry. My pastoral care left me feeling very impotent. I charted: presence, no change. *sigh*


Likewise the Spirit helps us in our weakness; for we do not know how to pray as we ought, but that very Spirit intercedes with sighs too deep for words. Romans 8:26


What message are you loudly speaking, in this moment?

Friday, October 30, 2009

Your Delivery Has Arrived

There's this strange phenomenon around the hospital. It's a robotic delivery box for medictations, mail and, well, whatever else needs to be delivered around the hospital. It's name (their names) are Tuggle, Tugster, Rx2D2 (say that three times fast!)... etc.




About the size of a small freezer, Tuggle makes its own way on its own around the hospital by wireless routers positioned on the hospital ceilings. It has a large camera-eye on the front that informs itself if it's about to run into something (a wall, a nurse, a chaplain...).



Seriously, we'll be milling about in the ICU hallway, comiserating about an impending death with a wailing family member and ... oops - here comes Tuggle. Look out. Part comic relief, part hospital work horse, part bane of the unit secretary's existence.



When Tuggle arrives at it's destination, it cries out in a semi-robotic, non-gendered voice, "Your delivery has arrived." Tuggle patiently waits. If the appointed recipient does not respond promptly, Tuggle repeats it's statement. "Your delivery has arrived." I was with one unit secretary when Tuggle arrived and annouced it's presence. The secretary was on the phone with someone and said, "Oh, hold on a minute, my husband is here..." as she went to get her delivery and then send Tuggle on its way. In another unit, I saw the classic stacks of folders for mail delivery; there were three levels, "In" "Out" and "Tug."

Just down the hall from our office, where the Behavioral Health Unit is locked, Tuggle waits and repeats any number of times before that unit secretary, at the end of the long hall behind those locked doors actually hears Tuggle. "Your delivery has arrived." "Your delivery has arrived."



But while they were on their way to buy the oil, the bridegroom arrived. The virgins who were ready went in with him to the wedding banquet. And the door was shut. - Matthew 25:10

How many times has God stated this to me and I did not hear? How many times has my delivery arrived, and God patiently waits; waiting for me to unlock the key and receive with gratitude what God delivers.

What has arrived in your delivery today?

Wednesday, October 28, 2009

Talk to the Hand

I did my daily sweep through the NICU this morning. This visit always begins with an obligatory 2-minute handwashing (timed!) before entry.

I wash my hands in innocence, o Lord, that I may go in procession round your altar, Singing aloud a song of thanksgiving and recounting all your wonderful deeds. - Ps. 26:6-7


Baby after baby, small (700g) and large (2900g), healthy and not-so, sleeping and awake. At this time of the morning, only a few parents are visiting. Each little babe receives a little prayer from me and a peek under the hood. Each baby space is kept dark to assist their little brains in forming and maturing. It's kept light in the space only if there is a need to help their liver functioning, in which case a blue-ish disco light is on.


So many wonderful little babes!


I wonder what they are thinking? I wonder what their parents feel, seeing them here? I wonder what their future holds? I pray for God's presence and comfort and healing.


Today, I met the mother of precious little twins. They've been here a month as of today. "Baby Girl 1" and "Baby Girl 2" is about all the identification they get. I talked to the mother, asked how she felt about going home with them soon, and knelt beside her to say a prayer for their little family.


Life was good, mom was glad to see me, and I was on my way. "Before I leave, may I peek under her blanket?" I asked Mom. "Of course!" she replied.


There's the little girl, trying to sleep. Her head is turned away from me, but her perfectly formed hand is poking out towards me. From under her swaddling blankets, she's saying to me with her hand, "STOP RIGHT THERE... talk to the hand."
Well, she put me back in my place. It ain't about me here.


Into your hands, O God, we place your children. Support them in their successes and in their failures, in their joys and in their sorrows. As they grow in age, may they grow in grace and in knowledge of You.

In Whose Hands are you, right now?

Friday, October 23, 2009

Wishes

This week in journal club we discussed several articles about Medical Ethics Dilemmas.

47 year old woman in the Emergency Center from a motor vehicle accident. Her only hope is blood transfusion, but she is a Jehovah's Witness and so refuses the transfusion. Does the doctor give her the transfusion against her will or honor her religious believes and allow her to die?


An elderly woman transported to the Emergency Center with severe respiratory distress. She has severe, end-stage lung disease and has clearly expressed to her family, friends and physicians that she does not want her life artificially prolonged. However, her loving husband and family cannot bear the thought of her death, and beg that "everything be done" to preserve her life. Her medical condition is precarious and only the placement of an "endotracheal" (breathing) tube and attachment to a respirator will allow her to survive. What should the doctor do?


While these are thought-provoking and conversation-generating ethical dilemmas, the real meaning comes in how this impact my life - your life - our lives. What are my wishes, I ask myself?


If I am in a trauma situation and I am unable to speak for myself, who do I want to speak on my behalf? Do I want to be resuscitated? Would I want to be on a breathing machine? What about tube feeding, if I am incapacitated for such a time that I need nourishment - would I want that?


I see this in the hospital time and time again - families anguishing about what their loved one would want them to do. So, have I talked to my family about my wishes?


Have you?

Thursday, October 22, 2009

Verbatim Redux

...do not worry about how you are to speak or what you are to say; for what you are to say will be given to you at that time. Matt 10:19

As a team, we chaplains have been learning about "getting in the hole" with folks. That means getting into the dark and deep places where the patient/family member is hanging out and connecting with them there. Deep companioning, witnessing and sharing can happen. And sometimes healing can happen.


It's the opposite of responding with "oh, that happened to me one time... let me tell you about it..." It's a scary place to be vulnerable with another and connect in fear, loneliness, alienation, confession, or hopelessness.


So last week, I presented a verbatim about an encounter that I had with a man who was very worried about the future and regretful about the past. [Verbatim: an account of an exchange between me and a patient or family member. Includes "she said, then I said, then she said, then I said" as well as an analysis of what I was feeling and my theological take on it.]


At the time, I sensed that I connected with him. However, one of the gifts of "verbatim" is that I can stand back and look at the exchange and realize with my own two eyes and with no small amount of humility that I perhaps missed him. I am fascinated by my blindspots.


It took some nudging and coaching from my supervisor and my colleagues for me to realize that no, I did not get into the hole with this guy. I merely reflected back to him that yep, he was in that hole. How's it look from down there?


The redux came this Monday. I had a chance to take a timed-release capsule lesson from that verbatim and ruminate on it over the weekend. Funny thing was, that I could not remember what the "solution" was for that guy. As I talked it out with my colleagues and my supervisor, I got to experience it all over again.


As my supervisor modeled one way to "get in the hole," I realized how much I need to stay awake and alert even as I am present to the patient's story. I'm really blessed to be with a team of colleagues that will be with me on this strange and sometimes repetitive journey of learning.


Over and over, I hear the words of Matthew, "do not worry about how you are to speak or what you are to say..." and, well, show up one more time to the next patient to see if I can get into their hole with them.


How did you show up today?

Who Ya Gonna Call?

As a mother comforts her child, so I will comfort you; you shall be comforted in Jerusalem. - Isaiah 66:13

Code Trauma: 45 yom - gunshot wound to the ... When I arrive in the trauma bay, the man is talking and explaining to the police what happened. Yes, he is in pain. Yes, he can feel it when the doctor pushes *there.* No, he doesn't have any allergies. Okay, he says, you can take an x-ray. I approach him... Is there someone I can call for you?

Trauma Alert: 38 yom - fell. They wheel him into major care. The EMS explain how he was climbing a roof, slipped and fell. Oh, when he slid off, he landed on the fence. I can see from the size of his hands that he's done construction most of his life. He lies still as they shift him from the transport gurney to the hospital bed. Registration asks his name, address, did it happen at work, and other questions. I approach him... Is there someone I can call for you?

Multi-Car Accident: husband and wife both in trauma bays. Both talking. X-ray for him. Wound care for her. On their way home from a church event and "that lady" turned right in front of us! ... Is there someone I can call for you?

Burley macho guys. Gang folks. Construction workers. Church couples.

Who can I call for you? MY MOTHER! I WANT MY MOMMY!

It is kind of a surprise, but really not. It happens over and over. I feel warm inside when they ask me to call their mother. Of course, I say... what is her name? I am honored to speak on their behalf to the one who is first on their lips for comfort.

Can you say a prayer for me, too? is usually the second thing they ask. Of course, I say...

Who is your comforter right now?

Be Changed

Listen, I will tell you a mystery! We will not all die but we will all be changed,... 1 Cor 15:51

Q: Will you pray with me?
A: What do you pray for?
Its one of my responses to the request for prayer.
- For healing of my pancreas
- For my children that they may have the strength to help me through this
- For patients in this hospital who are sick (not for me)
- For the family of the man next door - - they are taking this really hard
- For my doctors that they will find out what is going on with me
- For courage to make the right decision
- For God's glory
- For my grandson on his first day of kindergarten
- For my pastor that he will have strength to hold our church together
- That I will see my sister again before I die
- That I can breathe again without effort
- That God will take me home

I continue to be changed by the responses. I may not "die," in the way that Paul means in his first letter to the people of Corinth. I *will* continue to "die to my old way of being" - to die to my old self that held presumptions about what people hold in their heart. I will continue to be changed.

Prayer changes things. And, it continues to be a mystery, and a marvel, and a wonder.
How are you changed, right now?

Wednesday, October 14, 2009

First Things First

Where is the contemplative mind being taught?


In today's CAC (Center for Action and Contemplation) email, Fr. Richard Rohr invites the reader to consider where the contemplative mind is being taught. He offers, "The contemplative mind is really just the mind that emerges when you pray instead of think first. Praying opens the field and moves beyond fear and judgment and agenda and analysis, and just lets the moment be what it is—as it is."



What struck me is his follow-up comment, "...We really have to be taught that mind. We now are pretty sure that it was systematically taught—mostly in the monasteries—as late as the 13th and even into the 14th century...."

So in the ancient churches, the monks were taught that before engaging the brain, first engage the spirit. I find this very inspiring.

Upon reflection, I notice how my visits which I precede with a short, silent prayer almost always are the ones at which I can be fully present, and leave with a sense of Wholeness and Shalom. I hunger for a teaching that offers to pray first, and a mind that can get out of the way for a Spirit of prayer to enter my heart at all times. I hunger for the Holy Spirit to come and re-form me.

What is your first thing, first?

Tuesday, October 13, 2009

Plentiful Harvest

Then he said to his disciples, "The harvest is plentiful, but the laborers are few." Matt 9:37

It was early in the evening when I was paged to the Emergency Center. As I stood around waiting for the medical team to stabilize the patient, a woman from a nearby EC room stepped out and asked for a cup of water. Of course, m'am, one moment please. When I delivered the water (with a lid on it!), the patient in the bed looked at me with such sad eyes. She was ill, clearly, and simply sought some reassurance. I took a moment to be with her and her friend.

As I walked out of that room, the patient rep asked if I could meet a different family who was now struggling with a new diagnosis. They were in the small conference room. I sat with them as the doctor explained next steps. We prayed together and one by one, the family members visited the patient.

Walking back to the original page, I met the patient and the family members and provided pastoral support. As I left that situation (by now it was late night), one of the nurses asked if I could just step into one of the other rooms to be with a young adult who was all alone and very tearful....

As I reflected on the evening, I found that whether I was paged or not, the harvest of spiritual needs was indeed plentiful, and with only me in the EC at that time of night, the laborers were few. Where were my colleagues? Shall I wake them? ... (grin)

I'm curious about how your harvest is plentiful right now?

The Life You Save May Be Your Own

“Our hearts are restless until they rest in You”: St. Augustine, favored author of Thomas Merton

Listening to Speaking of Faith's Krista Tippett the other day, she interviewed Paul Elie in a segment entitled "Faith Fired by Literature." He discusses his new book, The Life You Save May Be Your Own: An American Pilgrimage, a literary pilgrimage through the lives of Dorothy Day, Thomas Merton, Flannery O'Connor, Walker Percy.
His thesis is that through literary works, each of these authors found their own authenticity to grow and be themselves, while making a difference in the world. Through each author's own struggle to become them-SELF, they found an integrity that saved their SELVES and thus fueled their writing and work in the world.

For example, Thomas Merton's restlessness provided a tension in his life as a monk and writer. It fueled his on-going questioning about how he was to serve God and grounded him with a sense of determination that drove his contemplative life, his inner journey. He, having gotten to the monastery of Gethsemane in Kentucky, which he thinks is really the perfect place on God's earth for him, he then proceeds to imagine other places that would be more perfect, and he does this scarcely leaving the monastery for the next 20 years.

Paul Elie writes, "He imagines monasteries in the Andes or on an Indian reservation, or hermitages in France or in the hills of Italy, or in the Far West or in Alaska, again and again thinking, 'If I could only find this place that was ordered to my peace and solitude and experience of God, everything would be right.' And this is what, in his case, one of his mentors identified as Augustinian restlessness. "We are restless until we rest in you." And this feeling of restlessness was the core of Merton's spirituality."

Ms. Tippett later asks Mr. Elie to tell the story of the title of this book and what that phrase means to him. Mr. Elie explains that it comes from a story of Flannery O'Connor's.

"The story was originally called "The World Is Almost Rotten." But O'Connor's friend, Sally Fitzgerald said, 'Call it "The Life You Save May Be Your Own"' because at the end of the story the protagonist drives down the side of the road off into the distance, passing one of the signs that were on the side of the road in the '50s, telling people to wear their seat belts because the life you save may be your own. This, to me, is the pattern of pilgrimage distilled into an expression: "The life you save may be your own."

So the process of pilgrimage is how we take others' stories and, while remaining faithful to them, make them our own.

As a resident in a CPE program, I couldn't help but relate this to what I am experiencing here. It is through my experience of others' stories and, while remaining faithful to them, hear my own story. I then learn how to connect my story and by my SELF with patients to become whole in my pastoral functioning. Through these dances with death and birth and trauma that I am forming my own sense of SELF that is now fueling my theology and work at the hospital.

Yes, I provide pastoral support to patients who experience spiritual crises.
Yes, I provide pastoral presence to family members in trauma situations.
Yes, I pray with folks for God's presence to be known, felt, and ingested.

And, it affects my own life. Each day, through each visit, in every interaction, I'm saving my own life.

How are you saving your own life through your inner or outer journey, right now?

Authority

For I also am a man under authority, with soldiers under me, ...
When Jesus heard him, he was amazed...


I've been "working on" my understanding of pastoral authority.

How do I understand my - or any - pastoral authority? How does my theology inform my understanding of it? What does my experience say to my cognitive knowledge of it? How and when is my self-doubt triggered and how can this be a teacher for me? These interrelated questions pull deep within me for reflection and ponder. I believe these questions, and their answers, hold some keys for me in becoming more authentic in my pastoral care.

I find myself using pastoral authority:
- to contact the chaplain at a prison to arrange for the grandson of a dying patient to speak to the woman who raised him for the last time.
- at the bedside of a newly-dead patient to commend her spirit into God's Love as she passed from death into Life.
- to say nothing to the wailing mother whose young adult son died on the operating table, while all the folks around her gave cliche responses to the unnameable horror that happened.
- when the doctor waited for me to be present while he delivered delicate treatment news to the family of a trauma patient.
- to sit with the child and play word games as his mother tearfully said her last goodbyes to her father.
- to invite a patient to think about how or where God is in all of "this" (arm waving)

Pastoral authority is so ambiguous. At this stage in my awareness, sometimes I am sensitive to it, other times it is only afterward that I notice how I used it (or did not).

Even Jesus was amazed (read: astounded, dumfounded, stunned, flabbergasted) by authority. Okay, I have a lot to learn. Thanks be to God!

What shape does your vocational authority take right now?

Friday, October 2, 2009

I'm Not Here To Make Friends

September 25, 2009

Today, I listened to the Sept 11, 2009 podcast of This American Life entitled "Frenemies." In it, Ira Glass brought together stories about friends. Or wait, enemies? How about both? Tales of estranged sisters, BFFs breaking up and making up and breaking up, and how reality stars walk the fine line between making friends and making a name for themselves.
  • The sister who the author is stuck with, but from whom she becomes estranged after her marriage to man from another religion.
  • The bridegroom who was requested to toast the marriage of his best friend to his ex-fiance.
  • The two women who met through a now-ex boyfriend of both.
Act Two included a story from deep inside the natural habitat of frenemies: reality TV. Rich Juzwiak, a full-time blogger spends a lot of time watching and dissecting reality TV shows. And last year, he noticed that one sentence seems to repeat an awful lot in the frenemy friendships that happen on reality TV. Once, he geeked out on common phrases that he hears on these programs. By far the most common phrase that reality show contestants like to share is "I"m not here to make friends!" It's so popular, in fact, that he spliced and recorded four minutes from dozens of reality TV shows into one youtube video. It's not a pretty sight.

As I completed the reading for this week's didactic on Pastoral Care, I read from Henri Nouwen's article on the Wounded Healer. He writes, "A minister is not a doctor whose primary task is to take away pain. Rather, he deepens pain to a level where it can be shared...and in sharing it can understand it as a basic human condition." (read: I'm not here to make friends)

"Perhaps the main task of the minister is to prevent people from suffering for the wrong reasons..." He proposes that through common wounds, the care giver can liberate people from the supposition that there should be no fear or loneliness, no confusion or doubt. "...these sufferings can only be dealt with creatively when they are understood as wounds integral to our human condition. Therefore, ministry is a very confronting service. " (read: I'm not here to make friends)

"...[ministry] does not allow people to live with illusions of immortality and wholeness. It keeps reminding others that they are mortal and broken, but also that with the recognition of this condition, liberation starts." (read: I'm not here to make friends)

"These wounds and pains are openings and occasions for a new vision. Mutual confession becomes a mutual deepening of hope, and sharing weakness becomes a reminder to one and all of the coming strength."

As a Chaplain, I find this difficult. I so want to be a people pleaser. I so want to tell people that it will be okay. I so want to fix what's broken, take away the pain, offer immortality and wholeness. Then I remember: I'm not here to make friends. What a paradox.

How does your woundedness draw you closer to others and bring healing, right now?

Thursday, October 1, 2009

Earth Awe

September 27, 2009
The earth has brought forth its increase; may you, our own God, give us your blessing. May you give us your blessing and may all the ends of the earth stand in awe of you. Ps. 67:6-7

If you know anything about me, you know that I love to be in nature. Today, I got to be in nature with my family and new friends. What a way to restore and renew myself!

The psalm reminded me of the wonder of all creation. Being in nature feels like a prayer and a gift - it goes both ways. It's a mutual relationship that I have with The More of life. As I ask for Creator's blessing, I also notice how the tall trees stand in awe of that More.

After climbing the firetower for a view of the Smokey Mountains, we descended into the valley along a ridgeline just outside of Hot Springs, NC. We jumped a few springs, busted through some cobwebs, spoke loudly to a fantastic spider, pushed back several thorn-covered vines, ducked under low-hanging rhododendron, and saw two (or was it three?) silver-blue beetles making babies.

We laughed, we pondered, we questioned, we observed, we appreciated and we breathed deeply.

We stood in awe of You.

How is the earth bringing forth its increase in your world, right now?

The Nose Knows

September 24, 2009
Pray then in this way: Our Father in heaven, hallowed be your name. Your kingdom come, your will be done on earth, as it is in heaven. And forgive us our debts as we also have forgiven our debtors. And do not bring us ot the time of trial but rescue us from the evil one. - Matt 6:9-15

Okay, this is a bit of a stretch, but I think this prayer is about how to live as a human, with senses, on the earth. I hope that I learn each day how to live into God's will in this moment, on earth, since heaven is so outside of my realm.

One of the aspects of being human with five senses to remind me of my humanness, is the sense of smell. When I eat, my smell muscle informs my taste buds what's coming up and they get ready. When I hike in the woods, I love to stick my nose into the bark of a tree and smell the scent of butterscotch or of eucalyptis or pine. My smeller reminds me of my humanity.

This day, during my on-call rotation, I had a bouquet of scents to color my work time. The scent of septecemia surrounding the patient in isolation. The scent of starvation hovering around the patient who was too sick to eat and whose family declined the feeding tube. The scent of charcoal that the OD patient swallowed to absorb the drugs he had consumed. The scent of race car fuel from the jeans and boots of the young man who, in the words of his Pastor, "won the final victory and who can breath the sweet fresh air of heaven."

I pray, then, in this way... that through scents that stir my soul I may be reminded of my own humanity and may I be reminded of Love on earth, as it is in heaven.

What is earthly scents fill your airspace in this moment?