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


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


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.

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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?


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?


"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


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?