Your Delivery Has Arrived

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




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



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



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

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



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

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

What has arrived in your delivery today?

Talk to the Hand

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

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

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

So many wonderful little babes!

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

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

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

There's the little girl, trying to sleep. Her head is turned away from me, but her perfectly formed hand is poking out towards me. From under her swaddling blankets, she's saying to me with her hand, "STOP RIGHT THERE... talk to the hand."

Well, she put me back in my place. It ain't about me here.

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

In Whose Hands are you, right now?

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?

Verbatim Redux

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

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

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

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

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

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

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

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

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

How did you show up today?

Who Ya Gonna Call?

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

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

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

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

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

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

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

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

Who is your comforter right now?

Be Changed

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

Q: Will you pray with me?

A: What do you pray for?

Its one of my responses to the request for prayer.
- For healing of my pancreas

- For my children that they may have the strength to help me through this

- For patients in this hospital who are sick (not for me)

- For the family of the man next door - - they are taking this really hard

- For my doctors that they will find out what is going on with me

- For courage to make the right decision

- For God's glory

- For my grandson on his first day of kindergarten

- For my pastor that he will have strength to hold our church together

- That I will see my sister again before I die

- That I can breathe again without effort

- That God will take me home

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

Prayer changes things. And, it continues to be a mystery, and a marvel, and a wonder.

How are you changed, right now?

First Things First

Where is the contemplative mind being taught?


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



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

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

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

What is your first thing, first?