Wednesday, March 31, 2010

Kids These Days

We went to college student potluck last weekend.

My first thought was, "oh, great. raman noodles, mac-n-cheese, dumpster-dived day old bread chunks." But then, I realized, this is not your typical group of college students. No, these folks attend Warren Wilson College.

After small talk, the live-in resident coordinator welcomed us all and we introduced ourselves. While we listened to each student describe their wonderful creative dishes, our mouths salivated with new taste buds ready to dig in. We shared our gratitude for each other and for God's great abundance in our midst.

What was on the menu? Fasten your ever-expanding seat belts, it included:


  • Peanut butter stew (nuts were used in the making of this dish)

  • Quinoa with spices

  • Quesadilla with chipolte chile

  • Penne pasta and red pepper salad

  • Sweet potato bisquits

  • Marinated roasted red peppers and kale

  • Organic, fresh-picked cucumbers and butternut squash (from the Biodiversity farm nearby) and homemade pesto

  • Rice and beans with coconut milk

  • Green beans with slivered almonds

  • Coconut and honey cookie dough blobs (not sure that's what they were called, but they were deliciously slurppy)

  • Multi-berry crisp topped with homemade ice cream

We feasted!

We lounged in the student's dorm living room on well-worn couches and floor pillows with pile-high plates on our laps. As we munched and commented, we (the few "staff/faculty" folks who were privileged to be invited) rejoiced in "kids these days" who out of their own poverty and excessive creativity of "anything is possible" prepared this wonderful feast.

The future is bright, indeed, with kids like these!

When Jesus saw what was happening, he was angry with his disciples. He said to them, “Let the children come to me. Don’t stop them! For the Kingdom of God belongs to those who are like these children. Mark 10:14

How are you finding God in "kids these days"?

God Is. I Am.


In our pastoral theology class, we continue to examine our congruency between our theology and our pastoral functioning. Am I functioning in a manner that reflects what I believe? How do I make sense, theologically, of what is happening in my pastoral interventions? How is my spirituality informing my interpretation or providing insight to meaning making?

Here are two more tools from our supervisor to think about God. And me. Through all these tools, my goal is deepening congruency between my "embedded theology" and my "deliberative theology."

- - - - - - -
GOD IS:
GOD IS ___________________________
GOD IS ___________________________
GOD IS ___________________________
GOD IS ___________________________
GOD SOUNDS LIKE _________________
GOD SOUNDS LIKE _________________
GOD SOUNDS LIKE _________________
GOD SOUNDS LIKE _________________
GOD’S FRAGRANCE IS LIKE ____________________
GOD’S FRAGRANCE IS LIKE ____________________
GOD’S FRAGRANCE IS LIKE ____________________
GOD’S FRAGRANCE IS LIKE ____________________
GOD FEELS LIKE ______________________________
GOD FEELS LIKE ______________________________
GOD FEELS LIKE ______________________________
GOD FEELS LIKE ______________________________
GOD IS ______________________________________


So much has been written about God. I'm including only a few of my favorite references...

"When these confirming signs are accomplished, you'll know that you're ready: Whatever job you're given to do, do it. God is with you! - 1 Samuel 10:7

Whenever, though, they turn to face God as Moses did, God removes the veil and there they are—face-to-face! They suddenly recognize that God is a living, personal presence, not a piece of chiseled stone. And when God is personally present, a living Spirit, that old, constricting legislation is recognized as obsolete. We're free of it! 2 Corinthians 3:16

- - - - - - -
I am:
I am ___________________________
I am ___________________________
I am ___________________________
I am ___________________________
GOD whispers to me___________________________
GOD whispers to me___________________________
GOD whispers to me___________________________
GOD whispers to me___________________________
GOD delights in my __________________________
GOD delights in my __________________________
GOD delights in my __________________________
GOD delights in my __________________________
I know God is with me when _____________________
I know God is with me when _____________________
I know God is with me when _____________________
I know God is with me when _____________________
I am _______________________

God as the I Am is one thing, but how I am vis-a-vis God also informs who I am with my patients, families and staff. I have so much to learn.

Whatever I have, wherever I am, I can make it through anything in the One who makes me who I am. I don't mean that your help didn't mean a lot to me—it did. It was a beautiful thing that you came alongside me in my troubles. Philippians 4:10

Oh yes, you shaped me first inside, then out; you formed me in my mother's womb. I thank you, High God—you're breathtaking! Body and soul, I am marvelously made! I worship in adoration—what a creation! You know me inside and out, you know every bone in my body; - - Psalm 139:13

Who is God to you? Who are you to God?

Friday, March 26, 2010

Ha! Backatcha!

I recently wrote about a unit secretary who was challenging me (me!) on scripture interpretation. Well, that's pretty funny, since I'm the least scriptural-ly credentialed person on our ENTIRE team (residents, externs, volunteers, everyone!). I had several conversations about scripture where I responded to her queries about key bible verses. I felt awkward and usually came back to the office where my Baptist/Adventist/Presbyterian colleagues helped me out.

A few days later, our supervisor asked us to think about God in a fresh way, using the following "mad-lib" reflection on God's characteristics. Try it, you'll like it!

- - - - -
God is....

God is like the color of _____(color), filling the _____(place) with _____ and _____. When I think of God, I think of _____(flower) and the fragrance and beauty that it brings. I recognized God's presence most often when _____. This is when I know that God is real. God must be bigger than _____ because _____. When I pray, I experience God as _____. Often God whispers to me _____ and at times yells to me _____. The name I most use for God is _____ because _____. I wish God could be more like _____ because then God would _____. The most difficult characteristic for me to understand about God is God's _____. God's favorite game is _____. I know this because God enjoys _____. The place where I saw God today is _____. In this place God was _____. Amen.

- - - - -

We completed this and shared our answers in group sessions in order to prime the pump for our upcoming Pastoral Theology paper we'll write for certification. It was very insightful both to reflect for myself and to hear alternative ways that my colleagues experienced God.

So I shared the "mad-lib" with my favorite unit secretary. She was intrigued. She took it home, made several copies and shared it with her friends, and filled it out. Yesterday, I got to be the one with a query for her, "Hey, how is your 'God Is' paper coming?" She, then, got to be the responder in our dialogue. I showed her mine and she showed me hers. We deepened our appreciation of each other in a fresh way.

But Moses protested, “If I go to the people of Israel and tell them, ‘The God of your ancestors has sent me to you,’ they will ask me, ‘What is his name?’ Then what should I tell them?” God replied to Moses, “I Am Who I Am. Say this to the people of Israel: I Am has sent me to you.” God also said to Moses, “Say this to the people of Israel: Yahweh, the God of your ancestors—the God of Abraham, the God of Isaac, and the God of Jacob—has sent me to you. This is my eternal name, my name to remember for all generations.- Exodus 3:13-15

What is your perspective of God, in this moment?

Cross-Hairs

This week, I got a tour of the radiation machine(s) at our hospital's cancer center. The physicist explained the process, from a patient's perspective, of what's involved in receiving radation. Most of his explanation I did not understand. What I did get is that there is amazing technology at our fingertips.

Radiation treatment is very precise. -It happens at the fine point where the cross-hairs of the red laser beam intersect - at the exact height, depth, horizontal, and vertical location. At that exact location a tumor can be erradiated. So, the first step in preparing for radiation is to get measured and for specifications of location of the bad stuff to be precisely noted. This first orientation session involves a kind of giant room with all sorts of GPS-looking devices at work.

Next, because of the precision of the radiation, the patient must be completely immobilized. That means, no moving. Thus, part of the preparation for taking radiation involves devizing a kind of plastic hood that prevents the human from moving this way or that. It's made out of plastic that is fit exactly to a person's body - kind of like how a dentist makes an implant of your teeth. Only this fits over your head and chest. Oh, the final product has little holes in it so that you can breath.

This immobilization hood is prepared for the patient's whose the tumor, with the body, will stay put. The thing is, that sometimes the tumor is on part of the body that moves, like a lung. In that case, they have or they have to use a different radiation machine that can move in synch with the tumor's location. In some cases, they tatoo the person's skin to guide the place where the technician points the radiation device.

In both cases, they titrate the amount and pin-point the location by using these lead-based molds that look like 3-D craters like we might have made in 2nd grade. The crater is thick and solid on the outside, thin and pointy on the inside. That's where the radiation is going. By placing these molded-filter blobs into the machine, the radiation goes only where it needs to - towards the bad stuff.

In all this, I imagine that the patient must feel a bit like an object. Stripped of personality, they lie down in a gown on a cold steel table for measuring and planning the attack. Next, they are immobilized for the laser-beam location to get out with the bad and stay out of the good. Finally, they submit themselves to 5 or 7 or 30 or 35 consecutive days of being zapped for exactly x minutes at a time. Our pastoral ministry is to re-humanize them.

I haven't met a recently-radiated patient in my work here at the hospital. Now I have a deeper appreciation, though, of the oncology patients who do end up being admitted for over-night stays. By the time that happens, they have been through so much objectifying.

Yet, at these cross-hairs, I have this sense that God is present.

For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord. - Romans 8:38-39

How are you in God's cross-hairs today?

Wednesday, March 24, 2010

Dream

"Just when you thought it was safe to go in the water..." one film famously said -

We began yesterday our didactic on Dreams. In typical supervisory style, it was experiential. No, RB did not put us to sleep or hypnotize us, although we were taken on a guided meditation and allowed the opportunity to reflect on our lifes.

From Luke, the parable of the sower: Luke 8:4-8 ~While a large crowd was gathering and people were coming to Jesus from town after town, he told this parable: "A farmer went out to sow his seed. As he was scattering the seed, some fell along the path; it was trampled on, and the birds of the air ate it up. Some fell on rock, and when it came up, the plants withered because they had no moisture. Other seed fell among thorns, which grew up with it and choked the plants. Still other seed fell on good soil. It came up and yielded a crop, a hundred times more than was sown."

Our reflection ~ what places in my life are like paths, so walked upon that not much else can grow? What fortresses of rocks have I scattered some seeds, where I don't let anyone see or know? What birds are found in me that take life from me, that encroach and try to prevent me from taking root and being nurtured? How do these birds steal my joy? Where is the good soil that gives me life? What emotions do I attach to these places?

This exercise helped me to see how my dreams - my own parables - can give me insight to what journey my inner life is taking. As my lenten prayer themes continue to arise in my conscious prayer life [to continue being rigorously honest, to convert condemnation to compassion, to allow the tension of non-connection with others (and find a way to connect to my SELF)] they are deepening in my sub-conscious dream-life.

I wonder if my fairly recent inability to fall asleep is related to my feeling that it is not "safe to get back in the water" - that my dream life has more to tell me than my conscious life wants to hear? My sense is that is where the healing may be found.

Something to ponder in my heart and with which I can live in the tension. Till next week's class!


Saturday, March 20, 2010

Accountability

One of my learning goals this quarter is to connect more deeply with staff. "Be careful what you pray for!" I hear ringing in my ears.

One of my favorite unit secretaries is now asking me to help her with scripture passages. That's funny - she's asking me? Perhaps that's why I'm on her floor - to meet her in scripture discussions.

It's really humbling (or humiliating?), though. Usually I can't understand her for her accent, or for the the din of the fax/copier humming and the constant beeping of monitors exclaiming that infusions are complete or heart rates of patients have exceeded pre-set limits. Besides all that, I also usually don't understand the meaning of her question.

The other day she asked me about Lazarus. Was Lazarus in Luke 16, the one in the parable about the rich man, the same one that Jesus raised from the dead in John 11? And was that the same Lazarus who sup'd with Martha and Mary, who anointed Jesus in John 12? In true CPE fashion, I attempted to divert the question and try to understand her side of these teachings. I am pretty sure that she saw right through me. Argh.

Now, after this Lazarus question, she has begun asking me about Jonah. (Isn't that the guy and the fish?) So it is a constant facing of this, my favorite unit secretary, that is challenging me to "get to know the staff."

Now I realize that she's my favorite BECAUSE she challenges me. BECAUSE she asks the questions. BECAUSE she is in conversation with me. She's tough. And I love her.
"Instead of claiming to know what God says, ask questions of one another, such as 'How do we understand God in this?' But don't go around pretending to know it all, saying 'God told me this...God told me that....' I don't want to hear it anymore. Only the person I authorize speaks for me. Otherwise, my Message gets twisted, the Message of the living God-of-the-Angel-Armies. - Jeremiah 23:35-36 (The Message)

Who might be holding you accountable in this moment?

Encourage

Sometimes, I simply don't know where to begin. So in the words of a previous chaplain colleague, I "just go."

I'm walking down the hall, wondering what kind of family is beside the now-dead patient? I'm climbing the tower stairs, wondering what kind of patient is requesting a bible? I'm rounding the waiting room corner, wondering if it's the patient or family who wants to fill out a power of attorney?

Various prayers come to mind that accompany my wonder-wander. "May the words of my mouth and the meditation of my heart always be acceptable in your sight, O God." or "Open my lips, O God, that my mouth might proclaim your praise," or "Come, Holy Spirit," or simply "breathe."

Last Friday, I found in my prayer book a simple antiphon for the day's Psalm.

When you turn to the right or to the left, your ears shall hear a word behind you; you shall hear your teacher saying, "This is the way, walk in it."

I'm humbled by thinking that God's praying for me just as I'm praying for God's presence. That God's whispering in my ear, "just go."

How are you hearing a word behind you, in this moment?

Part Of

Much has been written about the marginalized position of a chaplain.

We aren't the patient - thank God - who is the center of care. We are not the medical team, who provide amazing services with fantastic technology with profound specificity to an illness or disease. No, we are the ones on the outside, who have the opportunity and honor to be on the margins.

I was watching the other day as a man came in from a trauma. The helicopter people brought him from the field onto which he was ejected from his motor vehicle. The doctors attended to his bleeding face. The nurses monitored and managed his vital signs. The transport personnel removed the hard yellow backboard on which his blood had spilled. The registration guy got the man's ID and found who he was from several ID databases that the hospital can access.

Meanwhile, I observed and prayed and imagined and encouraged and gagged and stood back and witnessed it all. No, it was all of us together that healed him to a place where he could finally say, "Can you call my wife?" to me. That was his prayer.

I've been reflecting on this text from The Message:

But I also want you to think about how this keeps your significance from getting blown up into self-importance. For no matter how significant you are, it is only because of what you are a part of. An enormous eye or a gigantic hand wouldn't be a body, but a monster. 1 Cor 12:19

How are you a part of... in this moment?

Tuesday, March 16, 2010

Helpless

I am trying, these days, to be (not vaguely, but *specifically*) aware of my feelings when I am with patients or families or staff or colleagues. It's really hard work to be aware!

I found guidance from Rumi this week. His work normally only appeals to me when I am either in some altered state of consciousness, hopelessly in love, or very very tired. I'll let you guess which of these (or which combination of them!) I found myself the other morning after being on-call and awake most of the night.

For Rumi, all moments are times of ecstatic knowing. His work, even though written in the 13th century, is very timely for me. I include his poem below that speaks about knowing one's inner state. Between the lines, he calls me to know God.

During the on-call intervention between 2:45 and 6:00, I was keenly, specifically, aware of my feeling very helpless. It was a horrible, sudden illness that happened to a beautiful young adult and her family. Rumi's final line of this poem helped me find some redemption in my helplessness.

~.~.~.~.~
The Guest House

This being human is a guest house.
Every morning a new arrival.

A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.

Welcome and entertain them all!
Even if they're a crowd of sorrows,
who violently sweep your house
empty of its furniture, still,
treat each guest honorable.
[She] may be clearing you out
for some new delight.

The dark thought, the shame, the malice,
meet them at the door laughing
and invite them in.

Be grateful for whoever comes,
because each has been sent
as a guide from beyond.

Always check your inner state
with the lord of your heart.

Copper doesn't know it's copper
until it's changing to gold.

Your loving doesn't know majesty,
until it knows its helplessness.

- From Rumi, as translated by Coleman Barks


Tuesday, March 9, 2010

Evangelism

At first, I could not understand why someone was calling me at the hospital from the hospital. Yes, you read that right. The caller repeated his name and title, "Security for the hospital," and informed me that unfortunately, my car had been broken into.

I was definitely in denial as I walked out to the employee parking lot. Down the steps, across the street, and the last parking slot just before the empty field next to the lot. Hmm. There is the police, taking fingerprints. There is the security guy, taking in the scene.


Are you kidding me? was the bubble over my head. I just finished the 30th hour on call and was fixing to eat lunch and leave. It had not been a difficult night, just the regular stuff: traumas, codes, regional-one-helicopter-drop-offs and patients in distress. I had some "sleep" between 2:45 and 6:45. Now this.

What did the theif take?

My binder of dozen CD's - some home-made, some store-bought, some friend-given.
My clothes for Monday (shoes, sweater, pants) and my dirty laundry (I was headed home after this).
My bible-on-CD set.

I'm pretty sure that "Don't steal" is one of the Ten Commandments - even one biblically-challenged as me can remember that one. But if you are going to steal, careful! Maybe the thief needed the bible-on-CD more than I did?

In the midst of this thiefing, I reflect on my own reactions. After inventorying my missing goods to the police, contacting my insurance agent and moving my car - after "doing" all that was needed to get through this trauma - I broke down. I was a mess. I wailed. I moaned. My colleague, C, held me up and brought me a sandwich for my drive home. I am embarrased to admit that it wasn't until about an hour later, that I realized that God was with me in that mess.

I found strength in remembering the reaction of the wife of a newly deceased man in the emergency center some months ago. Yes, honestly, this is what came to mind, "Jesus, Jesus, Jesus. Oh, Jesus, Jesus, Jesus..." And the wife's round face, with her tears streaming abundantly like rivers and messing up her make up. Her big brown eyes looked up as she wailed for some time, "Jesus, Jesus, Jesus. Oh, Jesus, Jesus, Jesus..."

In the midst of this all, You are with me. You held me close. I felt You!


The thief comes only to steal and kill and destroy; I have come that they may have life, and have it to the full. John 10:10

The Day's Prayer

"I know that a chapter on prayer belongs in this book, but I dread writing it," so begins Barbara Brown Taylor in An Altar In The World, Chapter 11, The Practice of Being Present to God.

We have been dining sumptuously on this book for the last three weeks in our program. The book is chock-full of incarnational anecdotes and insights that kept me wanting to read more. Each chapter voiced "my thoughts exactly!" or "I can't believe she just wrote that!"


For today's "book club" review with our supervisor, we walked to the nearby park. Our assignment? Write a prayer about what the day was expressing to us. So here goes.


I am delicate bubbles on the stream

filled with the full breath of life.

If you have ears to hear

let the tone resonate in your heart.


I am the slime on the rocks

beneath your feet.

If you have bare feet to balance

let my ice cold water refresh your soreness.


I am the stickery blades of dry grass

next to the new growth of clover.

If you have wiggly toes that separate

let my fur wrap your digits with love.


Listen. The birds harmonize.

Breathe. The warm air softens every edge.

Move. I am alive.

In you.


Thursday, March 4, 2010

Rib

This week, one of the two surgeries that I observed was a removal / replacement of the L1 vertebra. In order to access the vertebra where the human-made vertebra would be implanted in place of the human-accident-crushed one, the doctor had to go through the side. Location-wise, it's the part of us that is kind of a V-shape when we lie on our side - the place where the ribs stop and the hip has not started yet. It's the soft "middle" where many folks where their "spare tire."

After preping the patient with mucho sedation, anticeptic coverings galore and lined up the gadgets just "so," the doctor called an obligatory pre-surgical "Time Out." I was impressed that they have this step in the surgery protocol. All activity stops for a short period of time, maybe 1 minute. We all just stood there and breathed. I took the time to feel my feet on the floor.


The OR charge nurse positioned me near the patient's head, behind the IV stand, nowhere near the anticeptic range. I had a little step stool so that I could get really close and above the patient, well - as close as I could handle.

The doctor began. Cutting, but no bleeding because of the cauterizing tool that quickly sealed the flesh and minimized blood loss. Wow. After the flesh, the doctor cut through muscle and moved any organs out of the way with this kind of curvey-spatula-looking steel tool. Gently, tenderly, continuing.

The, the doctor cut out the rib and removed it.

AAAACCCKKKK! I am pretty sure that the doctor looked at me and said, "Look Chaplain, I just removed the rib." Wow, I replied. Now THAT is biblical! For just one moment, I thought the heavens would open and God's Kingdom would be made manifest in that OR room. No kidding.


Later, I learned that this piece of live flesh - this flexible, transparent, fibrous strip of rib - would become the core piece of the human-made L1 vertebra - well, a combo-solution, really. Part human-invention and a whole lot of God's creation all neatly inserted into little ol' L1.


For the next three hours, I continued watching. Amazed, awed, gawking and inspired.


As God was working in all our lives, it turns out that I was with this very patient two days earlier, praying with him about his anxiety for this very surgery. What joy to go visit him again today and praise God with him, together.


I'm sure I have nothing else to say about this. I'm grateful to tears.



God said, "It's not good for the Man to be alone; I'll make him a helper, a companion." So God formed from the dirt of the ground all the animals of the field and all the birds of the air. He brought them to the Man to see what he would name them. Whatever the Man called each living creature, that was its name. The Man named the cattle, named the birds of the air, named the wild animals; but he didn't find a suitable companion. 21-22 God put the Man into a deep sleep. As he slept he removed one of his ribs and replaced it with flesh. God then used the rib that he had taken from the Man to make Woman and presented her to the Man. - Genesis 2:20-22 (The Message)


How are you showing up in this moment?

Fearfully and Wonderfully Made

This week I had the honor of observing surgery.

In one of the 22 "top of the line" surgery suites, gowned and hooded and anticeptisized myself, I watched two doctors, three nurses and a few other support medical personnel perform a "simple" back surgery.

He was face down, and I asked how long his recovery would be. "Oh, this guy will be going home tomorrow!" Oh my.


While observing, the words of Psalm 139 kept ringing in my ears. It was so loud that I was sure everyone else in the surgery suite could hear it above the din of doctor-selected rock music.

"Wow!" I exclaimed, turning to the nurse, "...did you see THAT?"
"Can you believe that the doctor just used a hammer and something that looked like a crowbar to "fix" that patient's back?"
"I had no idea that muscle was so tough and cartilage is so tender!"



You know, it takes some wild imagination (oh, and years of training!) to get from "that's what the xray looks like" to "this is what the flesh and bones looks like" and further to "so here's what we are going to do to fix this..." Are you kidding? This takes the inspiration of the Holy Spirit, too.



I praised the Trinity all day - the God who created us humans, the God who was incarnate with flesh and bone and tough muscle, and the God who sustains us and inspires us.




I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well. - Psalm 139: 14



How are you fearfully and wonderfully made?

Monday, March 1, 2010

Dangerous Liaisons

He never did explain what the tatoo meant to him. His gruff countenance melted soon after we began sharing and connecting. He tearfully mumbled what his diagnosis was and when I asked him what his tears meant, he choked on his breath. He was A Man, he said, and Men Don't Cry, so his tears were pent-up emotions. His endearing story of how he had lived through numerous "end of life" traumas (such as the motorcycle accident he described in great detail) gave him hope and proof that God was active in his life. I quickly felt connected to Mr. Rough and Tumble, who allowed a very private, vulnerable gentle man to be with me.
***

She is her twin sister. She's supposed to live through this little spell and get better! That's what her soulmate has shared with me. Her sisterly love means that she'll be here at the hospital by her side until she can come home. Of course! I quickly felt connected to this woman, whose very ill sister in critical care was *still* on a ventilator after more than a week. If it was my sister, well, I'd be a mess.

***

This young adult has been at the hospital, moving between critical care and step-down, since last summer. He's inspired in me the capacity to ask direct questions about scary-to-me issues. He has evaded just as many questions as I've gotten the nerve to ask. He's told me to leave when he wants to be alone and grasped my hand seeking prayer when he feels desperate. How will I say goodbye to him - as I know that at some point, one of us will leave this hospital.

***

These are just a few of the liaisons that I have experienced today. In these interactions, I simply show up. With God's help, I try to be fully present. It's dangerous work to expose my heart. So when I leave, I say a little prayer in my heart for peace.


"Now I'm turning you over to God, our marvelous God whose gracious Word can make you into what he wants you to be and give you everything you could possibly need in this community of holy friends. - Acts 20:32 (The Message)


What liaisons are showing up in this moment, for you?