Friday, May 28, 2010

1985

I've gone through phases in my life when I indulged in random, specific, niche-like, passionate interests.

One summer, I collected pictures of a longed-for red TR7. One fall, I read every book I could about Beryl Markham. One spring, I attended every Grand Prix Puissance event that was held. After getting my driver's licence, I would drive with my best friend to late-night horse auctions to scheme about saving a horse from becoming glue. The year that my siblings and I entered into "Mom-world," I began to sketch cartoons about what was happening as a way to find humor in the tragedy.

Many of these random interests, it seems, have come back to help me make sense of life. Just a bit later than I thought.

At hospice the other day, a man shared with me some poems he wrote in 1985. He didn't know then why he wrote them. While we sat by his dying family member, he realized why *then* he had that random, passionate muse who helped him write every day. It was because *now* he could turn them into hymns to be sung at his family member's memorial service. His nephew would sing them.

I think that in these 'long time ago' anecdotal interests, our passions link us to something that is going on in our life right now, in this moment. Or niche-interests that I have now might be useful or helpful in the future.

I continue to be amazed at how God connects these passions and our lived in a way that brings healing and hope.

Now we see things imperfectly as in a cloudy mirror, but then we will see everything with perfect clarity. All that I know now is partial and incomplete, but then I will know everything completely, just as God now knows me completely. - 1 Cor 13:12

What is in your moment now, from "way back when"?

Work It

Sometimes I have lots on my mind. I'm worried about this or that, preoccupied with what I said or didn't say, planning for this project or that. Then I meet a patient or family who pull me back. I hear their story and I realized these folks are putting their faith to work - and somethin' fierce. They have to.

She met me in the hallway of the critical care unit after visiting with her brother who had just come out of "repair the hole in the lung" (how in the world do you do that?) surgery. The nurse said that he'd be "on vacation" for a day or so while he recuperates, so don't expect much activity out of him. I asked her what's going on.


In our discussion, she shares with me more and more about her situation:

  • three weeks ago the brother had been in the trauma bay for a broken arm from a bicycle ride, this lung puncture had occurred then but only recently diagnosed

  • their mother had just been admited as an inpatient from the EC, having just experienced severe shortness of breath and complications from lung cancer

  • her brother's children are currently grief-stricken by the death of their mother's mother - the wake will be tomorrow and the funeral the day after

  • last year her husband had been in an accident, received a hip replacement and she was his main care giver. Last month, he fell off a ladder during a painting job and his leg was broken in several places. Between the hip and the leg he needs her constant care

  • on the friday before the hip replacement, the storm that blew through the town flattened three trees onto her house

  • her work is requiring her to put out 115% productivity and so she's on mandatory overtime

I look in her solid brown eyes. She looks back at me with a sigh. "What gets you through this?" I ask. "The Lord," she smiled. She shares how it's her faith that God will be with her through all this. She shares how she surrenders each day to how God's creating something new.

She's workin' it... and meanwhile she ministered to me.

We're not in charge of how you live out the faith, looking over your shoulders, suspiciously critical. We're partners, working alongside you, joyfully expectant. I know that you stand by your own faith, not by ours. 2 Corinthians 1:23-24


How are you workin' it in this moment?

Tuesday, May 25, 2010

Tell Me A Story

We've learned so much in this CPE program!

One of the special tools we got early on is to ask the patient what their understanding is of their situation. I usually ask something like, "What's going on?" or the even more direct, "Why are you here in the hospital?"


For some reason I asked this man, "How did you get here?" What *was* I thinking?



Had I looked at the census, I would have noticed he was born in 1919 so he had some years on him. Had I been a bit less enthusiastic, I would have noticed the nurse manager was very happy that I came to visit with this man. Had I not been pre-occupied with how hot it was in the room, I would have noticed the PCA (patient care associate) sighed with relief that I "took over" his attention and I would have noticed much earlier that he spoke with a very, very slow drawl.



Well, missing all those clues and out came my question. He talked about being orphaned at 5 years old - once by his parents and then again by his aunt and uncle. Then, his sister and brother took care of him and he began working near where he lived in Bronx. Then they moved to Brooklyn. Then Long Island. [by this time, I'm beginning to realize that he thought I asked for his *life* story, not his *last two days* story.]



"During WWII...," he began... well this went on for a while and since he was hard of hearing and sight-challenged he didn't notice my fidgetiness. Probably better. Once I noticed this, I took a breath and relaxed into his story.



Between our mutually-missing clues, we had a funny, endearing visit. At the "end" of his story, when he described what happened that got him to the hospital, we were holding hands and just enjoying each other. He said as I left how glad he was that he could share his story. He said it helped him remember when he got to tell someone.



After I visited a few more patients, the nurse told me that he said, referring to me, "That doctor knows more about me than I know myself!"



You know, I hope that when I am 91 years old someone comes to hear me into speech! He gifted me with reminding me that we all have stories to tell. Someday in the not too distant future, I hope someone takes the time to hear me tell about my CPE stories. *Warning: this may take some time.*

So the man went into the house. The camels were unloaded and given straw and feed. Water was brought to bathe the feet of the man and the men with him. Then Laban brought out food. But the man said, "I won't eat until I tell my story." Laban said, "Go ahead; tell us." - Genesis 24:32-33



What story are you telling, in this moment?

Wednesday, May 19, 2010

White Board

I can't dance. I can't talk. Only thing about me is the way I walk.
- Phil Collins
In hospice I visited a patient whose illness affected his voice box - he can't talk.
My first visit with him (last week) was one of those times when I mostly talked about what the day was like and asked yes/no questions. He was quite tired and unable to share much about what was going on. His family was not in the room, but I could tell from the cards, flowers and balloons that someone cared deeply for him. We talked about this - or, rather, I talked to him about this and he listened and nodded. He was helpless and sleepy, so we shared a short prayer and I let him know that I would visit again.
These kinds of visits are awkward for me, so I try to let them go and just place them in God's Love.
My second visit with him (this week) revealed that he has become much more alert. He's walking around his room with a very long nasal cannula that keeps him pretty much connected to the wall - but it's still long enough for him to get outside on his little porch. His eyes were bright and he was munching on a nutty-type sports bar when I entered the room. Nearly a different person!

Yes, he's up for a visit. No, he's not watching TV. Wife is gone to get her hair done.
There's not much you can talk about with yes, no and demo-type answers. "Aha!" his eyes revealed. Just a moment. He walked across the room, dragging his cannula along, and grabbed a whiteboard that is just big enough to fit across his lap. With a dry-erase marker, we had a marvelous conversation.
As I guided the conversation with questions, his SELF came alive. He told me about where he worked before he retired, where he was raised, what his daughter is like, when she was born, what she does now, that kind of thing. We spent a good bit of time just me getting to know him.
I was aware that as he wrote very methodically, I found myself trying to fill in the writing for him, kind of like finishing the sentence. Soon as I noticed this, I took a chill pill and relaxed into his cadence. I waited for him to wipe the board clean, to carefully place the top of the dry erase marker on the end, to hold his nutty bar with one hand as he wrote with the other. It was a spiritual practice to concentrate on his letters as much as he was.
I found it to be very intimate, particularly when I asked him what he hoped for. He paused, looked at the ceiling, and began to write...among other things, he hoped for a strong faith in God. He gestured that he felt many others had such a strong faith and he hoped that during his time here at hospice, he might grow in his faith. It was at once a confession and a faith statement. I felt honored that he would share this with me. I wanted to save those letters on the white board, but instead we prayed together and offered them up to God. Standing on his cannula, he gave me a big hug as I left our visit.
I think that writing causes us to be very careful and thoughtful about the words we choose. In my mind, God knows what is on the white board that I write in my heart each moment, and is gracious to allow me to dry-erase them willy nilly - God knows that I'll come up with some new letters and new phrases next time.
May the words of my mouth and the meditation of my heart be pleasing in your sight, O LORD, my Rock and my Redeemer. - Psalm 19:14
What's on your white board, this moment?

Feed Me, Seymour

Sometimes, when I am really hungry, this line from Little Shop of Horrors comes to mind. "Feed me, Seymour!"

Here's the relevant portion of the little tune that the plant, Audrey II is singing to his care giver.

Feed me, Seymour / Feed me all night long - That's right, boy! - You can do it! Feed me, Seymour / Feed me all night long / Ha ha ha ha ha! / Cause if you feed me, Seymour / I can grow up big and strong.

It's a little creepy, to tell you the truth, but it as a jingle it sure stuck in my mind.

When I worked at the animal hospital in Oregon, there was a word that they used for feeding small animals that were unable to do so themselves, gavage. It's used here at this human hospital, too, and not on just small humans.

Yesterday, I walked into the room to visit with a mid-30's man who had a head injury (from an un-helmeted motorcycle accident - but that is another blog for another time). "Mind if I visit?" I asked the nurse. "Sure, I'm just feeding him. "

He has been "out of it" for two weeks and was recently extubated (his down-the-throat breathing tube removed) and a trach installed (direct-connect to the little "hole" in the throat). With his breathing okay, he's pretty stable, medically. Only thing is, his brain is still not working.

So they are gavaging him directly into his stomach.

As the nurse filled the tube, she chatted with me about how it worked. She poured something that looked like "ensure" into a tube that connected to his stomach. Often, patients in this situate might receive tube feeding through a long tube that goes down the nose and into the throat to get into the stomach. But today, this patient went direct.

I reflect on how this seemed like a really fast way to get food and nutrition into a patient. She plunged away and *poof* in five minutes he was done with a pretty high calorie meal.

I wonder if God has a way of gavaging me with spiritual nourishment sometimes. It goes directly to my heart - this over dose of compassionate interactions with patients, families, and staff. I'm filled up, *poof*, with gratitude for this high potency experience of God's presence in every corner of the hospital.

After breakfast, Jesus said to Simon Peter, "Simon, son of John, do you love me more than these?" "Yes, Master, you know I love you." Jesus said, "Feed my lambs." John 21:15

What's in your gavage in this moment?

Iwanna

There's a newspaper-size shopping guide in our area called the Iwanna. It publishes thousands upon thousands of user-generated classified listings every week. General merchandise, home and real estate, cars, motorcycles, trucks, jobs, businesses, agriculture - pretty much the whole gammut. If you want it, it's probably advertized in this so-called "shopping network."

I'm pretty sure that there's one thing that's not listed in this rag that I hear requested over and over. Here's one example.

I enter the patient's room and he looks right in my eye. He's confused anyway, and with my white chaplain jacket he assumes that I am a doctor or therapist or nurse or some medical treatment person. No, I reply, I'm the Chaplain. He pauses to consider this but he's very aggravated.

I WANT TO GO HOME!!! NOW!!! AND NOT IN THREE DAYS!!! NOW!!!

This is his echoing request, even after I remind him that I'm simply there to be with him and visit with him until his mother arrives in a few minutes. "My mom?" he asks. He pauses to consider this. Then he remembers what he wants.

I DON'T WANT MY MOM. I WANT TO GO HOME!!!

After a while, he gets more aggravated and more angry, waving his white-mitted hands at me and speaking gruffly through his recently extubated throat. His 75 year old mom arrives after five agonizing minutes. She reminds him that he had died. "Don't you remember, son? You stopped breathing. You were blue! I rolled you over, gave you CPR and then the ambulance brought you here to the hospital. You are in ICU." He pauses to consider this, but still...

MOM, I WANT TO GO HOME!!! NOW!!!

I reflected on this visit all afternoon. How am I like this patient? I want to go home, too! And, thankfully, I reflect on how I am not like this patient. It will be soon - 3 1/2 weeks - and I'll cry and grieve the loss of this program, the transitioning of relationships, and even the familiar pattern of sleeping in three different beds a week. What I "want" comes with it's costs and it's benefits - that's a big difference between me and this patient.

Still, what does this patient's theology say to me? That it's okay to yell at God. To keep asking for what I want even with the knowledge that God has a bigger sense of what's possible in the big picture.

...I'm trying to be helpful and make it as easy as possible for you, not make things harder. All I want is for you to be able to develop a way of life in which you can spend plenty of time together with the Master without a lot of distractions. 1 Cor 7:32

What do uwanna in this moment?


Tuesday, May 18, 2010

Percept

I took a Rorschach test recently for a psychological evaluation. I asked the administrating PsyD what was the purpose of this test? He said, "Well, it would take hours to explain it to you - let's just say that it tests your percept." "Oh, you mean my perception?" "Something like that."

I was curious about the word. According to dictionary.com, Percept is the noun: "the mental result or product of perceiving, as distinguished from the act of perceiving; an impression or sensation of something perceived." Anyway, I think that being vague with me and seeing how I handle vagueness was part of the test, too.

What did I see in those inkblots? Sometimes I stare at clouds and I can see critters. Have you ever done that? Well, that's what I saw in these images. I could kind of make out some shapes that were familiar - bears, ducks, dragonflies, a bat, a possum, a butterfly... that kind of thing. Oh, and a mountain range. I wonder what that will say about me. I'll get the results in a few weeks when this PsyD combines my MMPI, Neo-PI, and Conflict "Forced Choice" test.

It occured to me that the test was a bit like sharing dreams with someone. We did this in group for the last didactic. We first learned about the concept that dreams reveal something about what our unconscious is "working on." Then, each of us shared our dreams for the others to "see" what they saw through our shared images. Only when the others saw the dream did I get any insight to what the bizarre dreamstory revealed.

I wonder if we are like inkblots to God. We are the Percept of God. The Noun in the equation of an ever unfolding, ever changing, ever surprising world. Sometimes, God might see in me the "indian flute with feathers" and sometimes I appear as "that goofy dork that can't remember names" but in whom God delights anyway.

That's the background image of it all - Love.

God spoke: "Let us make human beings in our image, make them reflecting our nature So they can be responsible for the fish in the sea, the birds in the air, the cattle, And, yes, Earth itself, and every animal that moves on the face of Earth." God created human beings; he created them godlike, Reflecting God's nature. He created them male and female. God blessed them: "Prosper! Reproduce! Fill Earth! Take charge! Be responsible for fish in the sea and birds in the air, for every living thing that moves on the face of Earth." - Genesis 1:26 (The Message)

What of you is God's percept in this moment?

Friday, May 14, 2010

Backwards

My colleague shared this wonderful poem with me the other day.

Daring Playfulness

Life is tough. It takes up a lot of your time,
all your weekends, and what do you get at the end of it?
I think that the life cycle is all backward.
You should die first, get it out of the way. Then you live twenty
years in an old-age home. You get kicked out when you're too
young. You get a gold watch, you go to work. You work forty
years until you're young enough to enjoy your retirement.
You go to college; you party until you're
ready for high school; you become a
little kid; you play. You have no responsibilities.
You become a little baby; you go back into the womb,
you spend your last nine months floating; and you
finish up as a gleam in somebody's eye.
- Chapter Four of Dangerous Wonder: The Adventure of Childlike Faith by Michael Yaconelli


That afternoon, I met the 96 year old husband of a woman who was dying. She was 78.


He said to me, "She wasn't supposed to die first." "Yea, I get that, it wasn't supposed to be like this." I said. He said, "I mean, look at her! Dying is so ... horrible. It's a horrible way to go."


That's when I thought of this poem and shared it's premise with him. He was amused and when he laughed, it filled the room with some tension-breaking levity. We talked about other things - what she was like, what their family was like, how she was so giving that hundreds of people called her "Mom."


The poignant moment came when we prayed together. He hobbled over with his cane, his daughter on his arm and their friend already sitting in the visitor chair near his wife's bed. Then he knelt at the foot of her bed. His cane fell to the floor. He bowed his head.


We all cried as we prayed for peace and anointed her spirit into God's Love. With tears in his eyes, he stood up and shared about her - how she was the gleam in his eye.


I wonder if we are the gleam in God's eye - every day of our life. Somehow I've forgotten that and I thank this man for reminding me that even when I am at the end of life, I am still in the beginning.


Give thanks to God—he is good and his love never quits. Say, "Save us, Savior God, round us up and get us out of these godless places, So we can give thanks to your holy Name, and bask in your life of praise." Blessed be God, the God of Israel, from everlasting to everlasting. Then everybody said, "Yes! Amen!" and "Praise God!" 1 Chronicles 16:34


What is backwards about this moment for you?

Thursday, May 13, 2010

God of Surprises

This week as I drove down the mountain for my weekly move-to-the-hermitage, I listened to my favorite NPR show, Speaking of Faith.

Krista Tippett interviewed Desmond Tutu about how his understanding of God and humanity has unfolded through the history he's lived. He speaks of reforming South Africa and the exuberance and despair experienced in the 1990's.


Then he shares, "...and just as we were recovering our breath, the god of surprises played his most extraordinary and incredible card..."



All day this notion of God of Surprises has shown up for me. In particular this afternoon when I met with the family of a motorcycle accident victim. His condition has been grave for the last week and even yesterday, his wife replied, they were considering "survivability" - or not. It was certainly been a despairing place.



Then, surprisingly, this morning he moved his arms. The family requested a meeting and the doctor was available. The chaplain (me) arrived just at the start as they began chatting. The second opinion neurologist appeared seemingly out of nowhere. The nurse was available to hear what the doctor recommended. All within two hours, the God of Surprises acted in a previously unplanned and unexpected way.



I count on this God of Surprises to bring newness every day. It's not always so smooth and it's not always good news, either. I do count on God to surprise me. I guess that's something to add to my pastoral theology paper!



If I were in your shoes, I'd go straight to God, I'd throw myself on the mercy of God. After all, he's famous for great and unexpected acts; there's no end to his surprises. Job 5:8 (The Message)





How is God surprising you in this very moment?

Wednesday, May 5, 2010

May I Have A Word?

I've been soaking up stories from the Bible recently. If you knew me, you'd know that's something new!

I can't quite say why this has happened, but it has. Perhaps it's my Baptist chaplain-mate and his ability to "name that chapter and verse in two notes." Perhaps it's my Adventist chaplain-mate and her ability to find a banquet of scripture for just about any topic that comes up. Perhaps it's my Presbyterian chaplain-mate who knows just the right Psalms for just the right spiritual balm.

As I wondered out loud one day, a friend read me this "thought for the day" from one of her daily devotions. It really struck home for me.

"What's so special about the Bible?
She was a shy African woman. When teased by her loud-mouthed neighbour, she was tongue-tied, unable to produce a ready answer to her taunts. The reason fo the scorn which was heaped upon her was the place tha thte shy woman gave to the bible. Not onl did she read it regularly; if any problem or dilemma faced her which she found difficult to deal with, she would go into her hut, turn to her passages which she though might help her, meditate upon them, then emerge to deal with the situation.


Things came to a head. In front of others, the neighbour took her to task. "Ther are all kinds of books in the world which can help us find how to live," she said. "Yet you turn to just one, always the same one. Why, tell me, why? Why this one book?"

At last, the woman's tongue was loosed, the words came. "Other books I read," she said, "This book reads me." - Ian Fraser



I think that's what's happening - it's reading me!


= = = = =


Blessed Lord, who caused all holy Scriptures to be written for our learning: Grant us so to hear them, read, mark, learn, and inwardly digest them, that we may embrace and ever hold fast the blessed hope of everlasting life, which you have given us in our Savior Jesus Christ; who lives and reigns with you and the Holy Spirit, one God, for ever and ever. Amen. - BCP 237



What Word has seeped into your being in this moment?


Good Bye

There's a patient that I have been working with since last July. I've written about Mitchell a few times before (here and here). Last week he was discharged to his next care facility.


I heard about his upcoming discharge during a routine visit. I showed up at *just* the right moment when the physical therapist(s) were preparing to remove his stabilizing halo. (God has a way of arranging these things!)


(The halo had been installed in February, following a decline in his neck bone quality. This device, which sets on top of a sheepskin chest harness, held his head and neck completely still via the four screws that were placed into his skull and attached to the round ring that encompassed his head. That ring was then held in place by four bars connected to the aforementioned harness. )
When I showed up for my routine check in, I asked Mitchell if he was up for a visit? Sure, he replied, and behind me I heard the voices of his PT and nurse team. They all invited me to stay as they removed the halo. Lefty loosey / Righty tighty - get the angle of the dangle just right and with the flip of the last screw, just so, *poof* he was free of this contraption!

There was no shortage of applause from the eight medical care givers in the room and comments like, "Moses said Let My People Go!" or "Freedom, yay, Freedom!"

This was the last major medical barrier before Mitchell could move to a more appropriate living situation. (I keep telling folks, any hospital is not the place to get well... we want you to go home as soon as possible!) On that halo-removal day, he let me know that the following Monday he had a ticket to ride!

On Monday morning, I showed up for my last check in with Mitchell. His PT was about to give him instructions about his electric wheelchair when I popped in his room. PT allowed me some moments with Mitchell as she prepared the chair for his daily work out.


As I told him goodbye, I realized many things that he had taught me in the last 9 months.

  • He taught me the importance of perseverance through his patient responses as I bumbled my first few conversations with him, asking over and over "what did you say?" (That was before he had his trac removed and he could not speak ~ only mouth his words.)
  • He taught me humility when he shared his inner courage to get strong and show his kids how he can still be their strong papa.
  • He taught me how to suffer with when he invited me to stay with him during medical procedures and I learned to not shy away.
  • He taught me the importance of simple presence when he thanked me for watching TV with him one day.
  • He taught me how a smile from someone who otherwise cannot move a muscle can mean the world.


I'm not the only one who received gracious lessons from Mitchell. I am pretty sure that I was one of dozens. The day after Mitchell left, I saw the Art Therapist at the cafeteria. She explained, ...


"I went in to say goodbye to Mitchell yesterday. When I walked in the room there was a circle of nurses praying for him and wishing him well. It was quite moving."

It was a Good Bye, indeed.

Tuesday, May 4, 2010

Seduce

An unlikely word to begin a blog with, so allow me to explain.

In the middle of the night on my last on-call, I was paged to visit a patient in spiritual distress. He was very anxious about his upcoming surgery, but that was not all. With respect and honor due him for his personal and courageous confession, I can't tell any details. I can tell you that he was struggling with a challenged belief and value system, a sense of meaninglessness, a feeling of remoteness from God, a good dose of disruption of spiritual trust and a strong sense of guilt and shame. Add in a bit of fear for his life and voila, he needed a loving, listening ear.

One of the greatest gifts of this program has been the curiously wonderful side-stories that arise in the midst of someone's narrative. The cool thing was that his innocent sharing gave me great insight to his anxiety and to my own anxiety as I listened.

He shared about his little nephew of six or eight years old who has become a voracious reader. His teacher gave him a book and when nephew came across this word, seduce, the boy asked the teacher what it meant. [At this point, my care seeker patient apologized for using this word.] The teacher, of course, replied, "Look it up in the dictionary."

My middle-of-the-night care seeker chuckled about how the teacher was too embarrassed to explain to the boy and so foisted it back to him to find his own answers. Later that night the teacher called his mom to explain. The mother (this man's sister) graciously understood and sat with her son and explained the word in the context of the book. The important thing, the man said, was how proud he was at his nephew who had this yearning for knowledge and truth.

I thought a lot about that interaction the next day. How am I seduced (being led or drawn away, as from principles, faith, or allegiance) from what is important in my life? How easily I lose focus on my God, my neighbor, my self-valuation when stress gets piled up!

"The serpent seduced me," she said, "and I ate." - Genesis 3:13 (The Message)

What is seducing you in this moment?

Finish The Sentence

Recently we have had a series of curious messages on our pager.

For some reason, the communication team sends a long text message about what kind of trauma is on it's way and how long it will take to get here, but we only get the first 20 characters. For example, here are a few recent ones:


"Trauma Alert: GSW to the "
"Trauma: GSW through and "
"Trauma Alert: ETA 9 - mo "
and my personal favorite:
"Code Trauma - Pt is "


I was on call when the last one came in. In our usual style, I read the pager out loud and heard a variety of clever responses from my whitty chaplain-mates.

...naked?
...happy?
...here?
...asking for a Chaplain?

A few of these responses were actually correct!

I've written before (and again) about clever fill-in-the blank exercises that we can complete to expand how we envision God and God's relationship to humanity. These usually come from serious didactic session with our supervisor.

Now, it seems, I am encouraged by my on-call pager to get creative and playful in my work. I just need to stay awake to these subtle cues. I think, "How am I finishing the sentence that God started?" Or, "How does God finish a sentence that I started?"

God, investigate my life; get all the facts firsthand. I'm an open book to you; even from a distance, you know what I'm thinking. You know when I leave and when I get back; I'm never out of your sight. You know everything I'm going to say before I start the first sentence. I look behind me and you're there, then up ahead and you're there, too— your reassuring presence, coming and going. This is too much, too wonderful— I can't take it all in! Psalm 139:1[ A David Psalm ] (The Message)


How are you finishing the sentence today, "Blog reader is..." ?