Who You Calling A Liar?

Thanks to Sojourners, I am taking the

Truth and Civility Election Watch Pledge

Won't You, too?

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For the duration of the election season, I hereby pledge to uphold the highest standards of truth and civility in word, thought and deed.

On my honor, I will:

1. Just say no to crazy email forwards, and to any other noxious electronic communication that comes my way.

2. Communicate in a spirit of truth, humility, love, and patience with all people I come in contact with, despite our political disagreements or family relationship. (That goes for Uncle Frank. Especially Uncle Frank.)

3. Question any and all statements that sound mean, vindictive, or absurd; that provide no source or context; or that are politically motivated. (So, pretty much everything I hear on cable TV news.)

4. Share and enjoy stories of folks who are living out an attitude of truth and civility.
(Making sure each story meets both requirements: Nice people telling lies don't count.)

5. As a witness for God, encourage and spread a message of hope and reconciliation to a world that is deeply divided by political and cultural differences. (You know, like Jesus taught.)

Affirmed and signed by,
Vicki Hesse

Conviction

One of our colleagues quit this week.

Here's why. One of the agencies funded by UW of Asheville & Buncombe County is the local chapter of the Boy Scouts of America. As you may know, there is controversy around the national BSA discrimination policies.

"...In June 2000, the United States Supreme Court ruled that New Jersey public law violated the Boy Scouts of America's First Amendment right of expressive associate and ...is therefore entitled to establish their own exclusionary membership criteria...."

The website that describes the discrimination says that since the 1970's, the central issue of their exclusionary policy is "...the "3 G's" (gays, girls and the godless)..." (Those are fightin' words!)

In other words, the BSA can legally discriminate against gays.

Every United Way is locally organized and some have disassociated with the BSA and not funded any programs. However, as my colleague learned after researching it further, UWABC believes that the program offered by the Asheville-based BSA creates important results in our community. Results that impact educating children and meet the Education, Income and Health needs established by the over 100 community-based expert volunteers earlier this year.

This decision was not taken lightly - not the UWABC's decision to fund BSA of Asheville, not my colleague's decision to quit, not our team's decision to support her and not our individual efforts to confront our own allegiance to the UW of ABC.

Several of us decided to "undesignate" our gifts - that is, to say that we support our moneys going to the Community Fund, as long as NONE of our gift goes to the BSA programs. I'm sure that will create some accounting nightmare for the accounting department, but this was how I was able to live with myself.

Perhaps these pledge cards might raise the awareness at the board level of UWABC to be more discerning next year when funding programs. I give to the UWABC because I believe in a strong community. And, I cannot support discriminatory practices. For me, this was how I live into my conviction with love and compromise.

My colleague, however, felt that she would not be living in integrity to continue in this work. Her conviction was deeply felt in her heart, guts and being. I honor her efforts and learned a lot from her modeling living into what is "right" for her. I will miss her gifts and her grace on our team even as I support her doing what she needed to do.

Keep your eyes open, hold tight to your convictions, give it all you've got, be resolute, and love without stopping. 1 Corinthians 16:13 (The Message)

How is conviction showing up in this moment, for you?

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?

Dignity Police

Would you consider joining a new vocation? It's one where we, the Dignity Police, would live fully into our baptismal covenant to respect the dignity of every human being (BCP, 305).

Here are some of our dignity paraphernalia:
1. Orange spray to dissipate free-flowing flatulence produced by unsuspecting patients.
2. Hair brushes, combs, hair spray and "bed head" products to coif matted and cow-licked hair
3. Lip gloss, with just a tinge of reddish-brownish natural lip color

Our duties would be to attend to post-surgical patients or those preparing to move on to God's eternal love. We'd coif hair, close legs, cover up private parts, shut eyes, and remove hand mitts.

I know, I know, we are all made in the image of God. It just seems that to respect the dignity of every human being we need some assistance. Call in the Dignity Police!

Out of respect for Christ, be courteously reverent to one another. - Ephesians 5:21

How do you respect others, in this moment?

Blog Alert!

I confess, I'm completely stealing Nathan's blog idea.

Here's the deal - there are four of us residents and three of us have blogs. Okay, we are geeks. Misery loves company? Allow me to introduce you to the other two bloggers now and their experience of this year.

Nate's 'Davar' - Nathan's blog - has a catchy subtitle. It's simply, "I laugh. I write. I care." This about sums him up! He's the one who keeps me grounded and honest and prevents me from saying "that's interesting."

His blog contains both personal and professional anecdotes. You can smell his dog here , you can learn about his practical joker here, sense his tender compassion here and there, or his ability to be present here.

I'm sure you won't be disappointed! He keeps showing up in the moment.
________________

On Call - The Spartanburg Year is the title of Erin's blog.

After serving as a pastor for a decade and a half in the
7th Day Adventist tradition, Erin brings humor, perspective and a natural talent for pastoral care to our team.

She shares her smooth, silky words with readers on this blog. We all agree, she has kept this blog restricted to only "approved: readers for too long. We want Erin to Come Out Of The Closet!

All of you out there who read this.... (all three of you!) it's time to make Erin's blog open to all readers so you too can enjoy her whitty writing and gift for story-telling.

Click on the link above to see her blog. If access is still denied, you can email her by clicking here. To help you out, I've included a sample message to a stranger for you to copy and paste... just add your name!

Dear Erin,

Reading Vicki's blog lacks context without your insight! Please open your blog to the public so I may enjoy some quality blogging, and so that I don't have to get your address from Vicki and begin texting you while you are driving. Your compliance will make this easier on both of us.

Sincerely,


On her site, be sure to read, "Bear Hunting," "Cheese Pastor," "Chaplain Down," and "Wading In" (one of her favorites).

So, there you have it folks. Two quality blogs full of wonderful, heart-warming and wrenching, sad, hilarious and whitty stories about life and chaplaincy.

That's how you show up to the moment!

Peek-A-Boo

Very often in the intensive care units, the patients wear "Peek-A-Boo" mitts.

These attractive white mitts, made by Posey, are for "...Patients who disrupt medical treatment by pulling at their IV line/catheter or are prone to self-injury..." I have seen how these mitts help patients who, in their sedated and altered mental state, are unable to restrain themselves from automatically pulling out their respirator or IV lines. While they look kind of scary, they are a good thing.

"It's a feature, not a bug," as we used to say in the computer programming business.




Today I met a woman who was very lucid, although she could not talk. The ventilator prevented her from doing so. I'm sure she was sedated, but she had something to ask me. Her mitted hand and arm motions indicated, "can I write something to you?" As I responded with, "you would like to write something?" she pulled off her mitts (note: SHE pulled her mitts off), held my pen and pad of paper and wrote down a question for her nurse. "I will go ask your nurse that question. Be right back."





I found her nurse and asked the question. Then, I realized the seriousness of what was going on. I innocently left the barely sedated patient un-mitted in her room across and down the hall. The nurse told me that the patient is prone to trying to pull out her respirator and that she needs to keep the mitts on so that she can heal. With some amount of terror in my heart (quickly get back! don't let that patient do the pulling on my watch!), I returned to the patient. She was fine. I took a deep breath and explained to the patient that she needed to keep the mitts on and why.





I felt like I was a scolding school teacher. Bleh. She looked at me with puppy dog eyes as I put her mitts back on and explained to her that they were a good thing. The bubble over my head read, "Really, it's a feature, not a bug!" while the bubble over her head read,"Yea, right. Bla bla bla."





I wonder how God puts mitts on me sometimes. Perhaps to keep me from disrupting spiritual treatment by jabbing at my Love lines? Perhaps to keep me from pulling out my Respirator - that enlivening thing that keeps me breathing. Perhaps to keep me safe when I am innocently prone to self-harm. Maybe this is how I am saved, today.





Restore us, O God of hosts; show us the light of your countenance and we shall be saved. Ps 80:18.





What mitts are you wearing, in this moment?

Bad Hair Day

Being in the hospital, as a patient or as a grieving family, can wreak havoc on one's hair style. I am learning to enjoy the blessings of freely coifed hair. This is one area that gives me joy and wonder in God's reign here on earth.

The other morning, I was called to be with a family as their father/husband/cousin/neighbor was dying. He was nearing his last breaths when his wife licked her fingers and tried matting down his bed-head hair. He had been in critical care for weeks - there was no changing how his clowny-styled-hair was going to fall. His wife laughed through tears as she tried, in his final moments, to give him some measure of dignity. His kids started chuckling, too, and before we knew it, the whole room erupted in a "we aren't laughing at you, we are laughing with you" kind of way. We were all relieved for the tension that was let loose in her feeble attempt to control his hair.

Another time last week, I was making initial visits and glanced into the room to see if a patient was awake or sleeping before I entered. The aging woman's mid-length hair was - I am not kidding - sticking straight up. It was cartoon-like. I thought to myself, "I'd have to use a lot of product to get my limp hair to do that!" With a smile, I entered the room. I briefly woke her, but since she went in and out of consciousness I simply wished her peace and said a silent prayer for healing. Instead of jotting my usual scribbly reminders about my visit, I drew a sketch of her head on my notes. A few days later, I met her husband at her bedside and he explained her prognosis. She looked at me and her hair was - still - sticking straight up. I smiled, keeping this sketch image as I wondered with awe at this hairdo.

Last Monday on our second helicopter EMS trip, the crew (and I, the rider-along) landed safely at the heli-pad near our hospital. I had figured out how to swiftly unbuckle my wrap-around seatbelt without decapitating myself. I gingerly exited out the side, still wearing my ball-o-foam helmet smashed and clipped tightly to my head. I felt like an old pro as I "ducked" under the whip-whip-whip of the helicopter blades to accompany the patient and the paramedic/nurses into our emergency center. The transport-nurse was yelling something to serious-lady and chatty-buddy was running up behind with several syringes at the ready. The patient's health was declining, but on the helipad was not the time or place to try any medical care. Quickly, they rushed inside with me trailing behind just experiencing all the wind and sounds and critical energy. I followed in turn as they all unclipped their helmets and left them near the communications station on a stretcher outside.

En mass, we accompanied the seriously ill patient to a room filled with the trauma medical team. I was just starting to breath again as the paramedic/nurses were calling out the patient's situation, confirming with the doctor what was going on and what kind of care had been provided on our 10 minute flight in. The whole scene was very engaging and tragic.

Just then, I caught a glance of myself in the reflection of a window. Wow! my hair was completely - I am not kidding - wind blown and flat. All that product that I had used that morning didn't have a chance with that helmet, not to mention the wind of the helicopter before and after our pick up. Oh, well, I thought to myself. I'm having a great time. Hope my hair is, too!

Perhaps that will be the last time I make fun of someone else's bad hair day. "If you spot it, you got it!"

“And why worry about a speck in your friend’s eye when you have a log in your own? How can you think of saying to your friend, ‘Let me help you get rid of that speck in your eye,’ when you can’t see past the log in your own eye? Hypocrite! First get rid of the log in your own eye; then you will see well enough to deal with the speck in your friend’s eye. Matthew 7:3-5

What concern gave you concern earlier that in this moment gives you joy at it's ridiculousness?

Communion

Facing the people, the Celebrant says the following Invitation

The Gifts of God for the People of God. - BCP 364

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

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

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

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

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

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

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

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

Silent Scream

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

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

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

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

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

What message are you loudly speaking, in this moment?

Wishes

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

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

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

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

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

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

Have you?