Sunday, June 26, 2011

CPE - Week Two

Week number two at the hospital had me carrying the on-call pager for the first time and doing my first on-call overnight shift.   What I've found most amazing about my CPE experience is that I never know what it is - or who it is - that I'm going to encounter at any given moment.
Every time the pager goes off, every time I knock on a patient's door, I never know what is going to happen next.
In the course of this week I met three woman who came to the hospital for three very different reasons. I had the privilege to step into the lives of these women only briefly, but their stories have stayed with me.*


This week I met Evelyn, a woman in her late 60's who who came in for same-day surgery. She was sitting alone waiting for her husband to arrive when I approached her. She welcomed the visit. Evelyn told me the operation she was about to have was routine and she'd had the same operation several times before, but she was still nervous. We talked for about 15 minutes about her family, her hobbies and her work in the church. I offered a prayer and she accepted.
Then she asked me what denomination I belonged to. When I told her I was a member of the United Church of Christ her face took on a look of concern and worry....."Oh, I used to be a Congregationalist years ago, but then they started ordaining women when the Bible explicitly says that women should not speak from the pulpit....and THEN they went and started welcoming the gays - God does not want that, God says that being gay is I left that church. Now I'm a Baptist."

Her words stung.
In response, I acknowledged the distress she must have felt in leaving her church and left it at that.
I was conscious of the fact that the purpose of my visit to Evelyn was to be a calming presence in her moment of stress, and she thanked me for being just that. She was unaware that in expressing her views she had dismissed my calling, my understanding of God, and my right to be true to who I am. In her eyes I was a nice female chaplain who was doing the work of God.  But I can't help but wonder how she would have reacted to my comforting presence had I told her that I preparing to be ordained, that I had spoken in the pulpit many times, and I am a lesbian as well.
I will never know. She will never know.
And that is how it has to be.


This week I met Alice - an elderly woman who had taken a fall.
Alice told me that she used to work as a cleaning woman at a local hotel that no longer exists, and that she has 5 wonderful sons but she wishes God had given her a daughter.
Alice shared these details of her life with me and then proceeded to repeat them again, and again, and again. In the course of our half hour visit she turned to me 6 times and said, "Did I tell you that I have 5 sons?"  Alice suffers from dementia. She lives in a world that exists in 5 minute increments. Every 5 minutes everything become new again...and in this constant newness she found joy rather than despair.  Each time, after telling me about her sons, she'd look over at me with a huge smile on her face and say, "How nice of you to visit, and who are you?" - "I'm the chaplain," I'd say, "I'm here to see how you're you mind if I sit and chat with you for a bit?" - "Oh yes, please do!" she'd say with a smile, "How nice, I love to have visitors!"
We repeated this introduction four or five times, and each time Alice seemed equally thrilled by the prospect of our visit.
When I returned to the chaplains office to chart my visit I saw in the patient notes that another chaplain had visited Alice the day before. He wrote, "Length of visit: 10 minutes. Patient suffers from dementia. She is incapable of carrying on a meaningful conversation." End of notes.

When I spoke to Alice she was happy and animated and smiled and laughed often. She also expressed sadness and frustration with her pain, and lamented the fact that she could no longer do all the things that she loved to do.
Alice lives in a world that renews itself every 5 minutes, but it is a rich and full world.
Our conversation did not go very deep, we simply did not have the time to go there, but it was a meaningful visit. Alice loves to have visitors...and she experienced the joy of greeting a new visitor 5 times in the course of our conversation. She also repeatedly experienced the emotional release that comes when we're able to express our frustrations and pain to someone who is willing to listen.
In her mind she experienced both ranges of emotions only once, but I have to believe that she found meaning in them.
And if the visit was meaningful to Alice, that's all that matters.


And finally, this week I met Rita, or rather, I met Rita's daughter...and her sons....and their spouses...and her grandchildren.
Rita was in her late 80's. On Wednesday afternoon she sat in a chair in her hospital room dressed and ready to go home. She had spent the morning with a big smile on her face, telling her family, the staff, and the chaplain who came to visit her how happy she was to finally be going home.
She came in with a simple infection but given her age the doctors wanted to monitor her for a few days. Now she had been given the ok to go home.
At ten minutes to five, just after her daughter arrived to pick her up, Rita began to motion that she was having trouble breathing. A Rapid Response was called and within seconds doctors and nurses descended upon the room and placed Rita back in her bed.
That's when my pager went off.

When I arrived all I could see was a swarm of medical personal surrounding the bed, with one doctor making a valiant effort to perform CPR on Rita's small, frail body.
Then I noticed her daughter and her granddaughter crying in the hallway.
"Mom, this is not what Nanna wanted!" the granddaughter shouted through her tears.
"I know," her mother cried out in response, "But we have to at least try!"

It had all happened so suddenly. No one was prepared for this.
Over the next 10 minutes I sat with Rita's daughter Susan, as she made the difficult decision to have them stop the resuscitation efforts and let her mother go.
Then I spent the next hour and half with Susan, and her ever arriving family, as she had to say those horrific words over and over again - "Mom is gone."
In the end I felt like I had done very little but be present with this family in their grief. I handed out tissues and scooped up used ones, and I rubbed their backs and gave them a shoulder to cry on.

I had no words to ease their grief. They shared their own comforting words - "She's in a better place." - "She is finally home." But I had nothing to add to the conversation other than, "I am so sorry for your loss" and "No one is every ready for the passing of a loved one."
This was my first serious Rapid Response pager call, and the first situation where I encountered a grieving family. At times I felt completely inadequate and unsure of what to do or say. At times I felt as if I was just getting in the way. But in the midst of their grief the family does not see it this way.
In the end Susan and her family expressed gratitude for having the calming presence of a chaplain in the room. I felt as if I had done so little, but for them it was just enough.


In the midst of all three of these encounters I tried to be mindful that it is not about me.
This is a ministry of presence.
While my supervisors and my peers may want a blow by blow account of what was said and done so my performance can be critiqued and suggestions may be offered on what I could have done it better, this is of no concern to the patients and families that I encounter.
I may not always say or do the right thing, but I'm quickly learning that just being there, and offering a listening ear, is all that matters.

*names and details have been changed to protect patient anonymity

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