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 wrong.....so 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 doing....do 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.
Ouch.

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


Saturday, June 18, 2011

CPE - Week One


I think I'm going to like being a chaplain.
I really do.
Granted, with just one week of CPE under my belt I've barely dipped my toe in the water, but where I once thought the experience would leave me feeling extremely anxious and stressed I instead find myself feeling enthusiastic and hopeful about going through this program.

The floor assignments I received have me doing a little bit of everything, and for that I'm grateful. My primary units are Medical/Surgical (which includes a 4 bed hospice unit) and in-patient Psych. I also have the Childbirth Center, and I'll be running an evening spirituality group at the out-patient Addictions/Mental Health unit across the street from the hospital. I'll also be running a weekly group in the in-patient Psych unit. When I'm "on call" I could be called anywhere in the hospital including Critical Care and the Emergency Room.
And I will be on call a lot.
Each student has to carry the emergency on call pager once a week during the day shift, in addition to that we have to do one 15-hour on call overnight shift every week and three 24-hour on-call weekend shifts during the 10-week program. There's also a back-up on call pager that has to be carried by someone every day, so I could conceivable be "on-call" for 55 hours during any given week.
They say the "Summer Intensive" CPE program is 40 hours per week.
That's not quite accurate.
At this hospital it's more like 50-70 hours.
Ouch.

There are seven students in our CPE group. Two women and five men. One Catholic, one Jew, two Lutherans, one Episcopalian, one Presbyterian, and me, the lone member of the UCC. Our immediate supervisor is a Quaker and the program supervisor is an ordained Disciples of Christ minister. As a group we have very interesting conversations at lunch. ;)

We spent the first few days getting to know each other, getting to know the hospital and the staff, spending time in the classroom, and doing role plays.
On Wednesday we shadowed the per diem chaplains, on Thursday we went out and did a few visits on our own, and on Friday we had 5 hours to do patients visits in our assigned units. I've found that getting into the rooms, introducing myself as a chaplain, and asking patients if they'd like a visit has been easier than I thought. A few years ago I volunteered at a health/rehab facility and it was my job to go around and ask patients if they'd like me to take them down to the recreation room for the regular Friday afternoon entertainment. I also had the chance to visit with patients afterward, many of whom where elderly and were long-term residents of the facility. Having that experience has eased my nerves of "cold calling" on patients in CPE...it's what to say AFTER I get in the room that has me stumped at the moment.

We're supposed to keep in mind that these are not social visits, but pastoral visits, so we have to do our best to steer the conversation away from the normal niceties and explore any underlying feelings or spiritual issues that crop up. That's a lot to do in a 5-15 minute visit with someone you've never met before.
I expect I will be grappling with this social-pastoral dichotomy throughout the 10 weeks that I'm there.

My first week of CPE ended with my first opportunity to sit with a fellow human being in the last hours of his life. At 9 am Friday morning a call came in from the hospice unit to let us know a patient was dying and a chaplain was needed. This is my assigned unit so I was sent. Thankfully the program supervisor went down with me and got me started. The patient, Bob*, was in the last stages of lung cancer. He had no family, and had only one friend who was on her way. My job was to sit with him until she arrived and then be a presence for her, and for the staff, who were visibly shaken.
I was quickly reminded that these caring compassionate people never "get used to" dealing with death.
The staff expected that Bob's passing would be quick but he ended up hanging on for most of the day. Jay (a fellow CPE student) and I tag-teamed through out the day, relieving each other as needed and spending time talking to Sister Jane, Bob's friend. It turns out that Bob was a Franciscan "novice" and was a few months short of taking his final vows in the Order. Graciously, just the day before, his Order made the decision to fast-track him and that night Bob chose his Franciscan name, Brother Jacob. Bob had a hard life. He suffered from mental illness, struggled with addictions, and was often homeless, until he found God, and Sister Jane.
It was an honor to spend those precious hours talking to this wonderful woman as we sat with Bob in the last hours of his life.
I was not there when Bob passed. Jay and I were called away for classroom instruction, and Jay took the call when we were notified that Bob was passing.
Bob was already gone by the time Jay arrived, and Sister Jane, spent from the experience, left soon afterward, grateful that her beloved friend's pain was finally over.
Rest in peace, Brother Jacob.



When I was first brought down to the hospice unit on Friday morning it was chaotic. Nurses and doctors were milling about with two crisis cases unfolding in adjoining rooms. At one point we had 4 chaplains tending to patients, family, and staff in this one small space. And in the midst of it all I was amazingly calm. It was my first day going solo, it was my first call, and I was told that Bob's death had the potential to be difficult and "messy." But I felt privileged to be there. I felt like I had a purpose and the staff wanted and expected me as the chaplain to be there. God was present, the Spirit was present. All I had to do was be present as well.

I expect to face much more difficult, and chaotic situations in the coming weeks.
The thought of it makes me anxious, which is to be expected, but I no longer feel afraid. And I never expected that I would say that, just one week in.
I think I'm going to like being a chaplain.
I really do.



*Names and details have been changed to protect patient anonymity

Wednesday, June 8, 2011

The World I Know



My family threw a joint Graduation/Birthday birthday party for me and my mother this past weekend. My mom turned 85 on May 17th. It was a wonderful party and it was great to see everyone again, but the highlight for me came when my partner Stephanie sat with my mom in a quiet part of my sister's house and showed her the video of my graduation speech.
Stephanie told me that half way through the video my mom started crying.
And afterward she sat with Stephanie and talked with her as she never had before.
She told her about the difficult time I had when I was growing up....how shy and withdrawn I was, how I felt as if I would never "fit in," and how much pain I experienced just trying to make it through high school when I had no hope for the future, and saw no value in my own existence. My mother told Stephanie how worried she was for me as I struggled to get through those difficult years, and how proud she is of me and what I've accomplished.

Hearing this made me cry.
My mom is not one for huge shows of emotion, and she has never been one to feel comfortable in the presence of those who are showing emotions.
It took many years for her to return the "I love you" I shared at the end of our phone conversations without hesitation. I don't recall her saying those three words very often when I was growing up, although she showed her love in a million other ways.
When I was going through those difficult years, I would often pour my heart out to her at the kitchen table, and not knowing what to do with my pain or how to ease it, she would simply get up and go about her business. As I sat there crying she would get up from the table and go fold the towels in the laundry room.
I now understand that after years of listening to my fears and frustrations she had run out of calming words to offer. She felt powerless in the face of my pain, and feeling her own discomfort with my displays of emotions she reacted in the only way she knew how.
I understand that now.
But at the time I felt abandoned and unheard.

For years as a teenager and young adult I had nightmares in which I was following my mother from room to room, screaming to get her attention and she would never even turn to acknowledge that I was there.  In other dreams I would tell her one thing and she would hear another, and I'd spend the entire dream trying to get her to listen and understand that she had misunderstood me.
Feeling abandoned.
Feeling not heard.
These have been life long issues for me.
And I know these fears originated long before I became a forlorn teenager.

As I've mentioned here before, I was born with a cleft palate - both my hard and soft palates were not fully formed (I was essentially missing the entire roof of my mouth), which made eating difficult and caused a noticeable speech impediment. Before the age of five I had several operations to repair the hard palate deformity, all of which were unsuccessful. The scar tissue that formed as a result of these operations precluded any further attempts to fix the deformity, and I did not have my cleft palate completely repaired until a new type of operation was presented to my parents when I was 16-years-old.

But the emotional scars that formed during the early years of my life went much deeper than the physical scars. I had my first operation when I was 18-months-old and I vividly remember standing in a crib in the hospital, reaching over the side and crying hysterically as I watched my mother walk away. I was too young to understand what was going on or where I was. Even at the age of 5, I don't recall having any comprehension of what was happening to me. My mother tells me that I screamed so much after each operation that I tore the stitches out every time. For weeks after I was brought home I would wake up screaming in the middle of the night and calling for my mother.

These early experiences influenced the fear of abandonment that overwhelmed me as a teenager. Added to the mix was the fact that I was naturally shy, and the speech impediment only enhanced my social inhibitions,  and I was not yet fully conscious of the fact that I was gay, which led to all sorts of issues surrounding gender expression and feeling like I didn't "fit in." Add these all together and you have a recipe for one unhappy teenager.

And then there was the bullying. Taken by themselves any one of these factors would have been enough to slap a target on my back. Taunts about my speech impediment in parochial school led to outright expressions of hatred and disgust in high school. By that time I was so withdrawn and experiencing the symptoms of depression that my mere presence seemed to trigger the worst in my peers. I didn't talk in class, I didn't socialize with anyone, and like many who experience depression I had little concern about my appearance - I would often wear the same clothes day after day and showered only once a week. In the societal microcosm that is high school I was "the other" in a group of young adults who were desperately trying to find and assert their own identity while trying to conform at the same time. I was the weakest link.

I am still amazed that I made it through those years without taking my own life.
I thought about it. Often.
I saw a psychiatrist briefly who prescribed some anti-anxiety meds for me - which I rarely took but instead saved in massive quantities for the day when I would finally end it all.
When I was 15-years-old I was convinced that I would not be alive to see my 18th birthday.
But yet I was.

I can't put my finger on any one single reason why I made it through those years.
I had the operation that finally fixed my cleft palate when I was 16, which helped me feel more confident about my speech.
I saw the move "Breaking Away" and fell in love with the sport of cycling - Cycling gave me a sense of freedom and accomplishment that I so desperately needed.
And I had a friend, a pen pal, who reached out to me and helped me to feel valued and special. She would end each of her letters with "I love you" - the words my own mother had such a hard time saying.

As these three influences converged in my life my depression seemed to wane and I grew to be more comfortable in my own skin.
I stopped caring so much about being different and not fitting in, and instead embraced it.
And once I learned that I could face this kind of adversity, and live through it, there was no experience or fear that I couldn't face, and ensuing disappointments would not bring me down for long.
Life was a roller coaster, with ups and downs.
And it's realizing that the downs don't last forever that is the secret to survival.

I don't know if my mother has ever fully understood what I was going through during those difficult teen years. I don't know if she has ever realized how close I came to taking my own life.
But she knows that I was in pain.
She knows that I had lost hope.
And feeling partly responsible for that pain (she often blamed herself for the fact that I was born with a cleft palate) and feeling unequipped to restore my sense of hope, she clawed and dragged her way through that period of my life the same way that I did - Not knowing what to do or say, and often doing or saying the exact opposite of what we should, but holding onto each other none the less.

In recent years my mother has never held back from telling me how proud she is of me and what I've accomplished, and how much she loves me. And I know in the core of my being that she has felt this way all along.
Hearing that she cried upon viewing my seminary graduation speech connects two moments in time.
One moment I am standing in the pulpit using the voice that God has given me, and in another I am sitting at the kitchen table with my mother, trying desperately to speak from my silence.

Both moments are gifts from God.
Both are woven into the fabric of my life experience and both moments inform how I have come to live and be in this world.

This world is not perfect.
Our lives are not perfect. Not by a long shot. 
There are many reasons why we might lose hope.
But this is the world that God has given us.
These are the lives that God has given us.
What we end up doing with both is up to us.

When I think about the days when I felt as if the only way to end my pain was to end my life, I can't help but cringe at the thought of what I would have been throwing away.

These lyrics from a song by Collective Soul come to mind:

So I walk up on high
And I step to the edge
To see my world below.
And I laugh at myself
While the tears roll down.
'Cause it's the world I know.
It's the world I know. 

This is the world I know.
And I wouldn't have it any other way.
Happy Birthday, mom.
I'm glad I was here to celebrate your 85th year.
And I'm glad you were here to celebrate my graduation from seminary.
I can't wait to see what we'll do next!






Thursday, June 2, 2011

Jesus Rode a Roller Coaster - An ode to Cynthia Rylant


The following poetry is inspired by Cynthia Rylant's wonderful book, "God Went To Beauty School" ~ She chose God as her focal point, I chose Jesus. :)


**********


JESUS RODE A ROLLER COASTER

Not one of those new
super-fast coasters
that turns upside down
and does loop-d-loops,
but one of those
old fashioned
wooden coasters
that makes a
“click click click” noise
as it climbs up
into the sky.
Jesus was happy
that he was
tall enough
to ride the coaster.
He sat
in the first car,
in the front seat,
because that’s where
The Son of God
should sit.
But really,
he sat there
so he could
raise his arms up
and pretend
as if he were
flying.
It’s a good thing
Jesus doesn’t
wear eyeglasses.
Because he would
have lost them.


*********
JESUS BOUGHT A BICYCLE

He wanted a shiny 10-speed
like the one
he had as a child.
He and his cousin,
John the Baptist,
used to ride
their bikes
to the corner store
and buy candy
after Hebrew school.
The bike store
was confusing.
Apparently 10-speed
bicycles are no
longer made.
So Jesus bought
a mountain bike.
With front shocks
and big knobby tires.
The bike
had 27-speeds.
That’s more
speed than Jesus
knew what to
do with.
So he put a pink
basket on the front,
and he rode to
the corner store
to get some candy.
Root beer Bottle Caps
were his favorite.


*********
JESUS SUBSCRIBED TO TIME MAGAZINE

Because he likes to keep up
on the latest news,
and he doesn’t know
how to use the internet.
The articles are brief
and he likes to
look at the pictures.
Jesus keeps a stack
of TIME Magazines
in the bathroom.
That’s where he does
most of his reading.
This week’s cover story
is titled, “What if
there’s no Hell?”
A hip, young pastor
named Rob Bell says
“every person who ever lived”
could have a place
in heaven.
“Hell, a place of
eternal torment seems
irreconcilable with a
God of love.”
Jesus liked the fact
that his dad was mentioned
in TIME Magazine.
And he secretly hopes
that one day “Jesus” will be
named as TIME Magazine’s
“Person of the Year.”
But he hates it when
the subscription cards
fall out in his lap.


*********


JESUS WENT TO KENTUCKY

Because he had heard
how beautiful it is
in Appalachia.
He brought his
banjo in the hope
that he would find
some genuine bluegrass
musicians to jam with.
When Jesus got there
he noticed that some
folks lived in houses
that were falling
down around them.
Jobs were scarce,
unless you were willing
to work in a
coal mine and
inhale black dust
all day long.
And risk having
the ceiling fall in
on your head.
Jesus noticed what
was lacking in
these folk’s eyes.
Hope.
So Jesus picked up
his banjo and he
began to play.
Some come to help
by building houses
or writing checks.
Jesus helps by
breathing new life
into tired eyes.