How to Skin a Cat

First you read your verbatim aloud to your fellow chaplains and supervisor.

In Clinical Pastoral Education, a verbatim is a written recollection of a visit you had with a patient and/or family. You outline what your goals are; the dialogue of the visit itself; how long it was; your analysis of it; and theological implications you discovered.

Then a brief period of silence usually follows. Then the shrapnel comes.

I’m being overly dramatic, but maybe not by much.

“Why did you do that? Why didn’t you deal with the other thing?”

The person giving the verbatim can speak back and offer defense or critique of the other person, but generally it’s the presenter’s turn in the hot seat.

So far this year, I’ve done two of these. There are four of us in my program so I take my turn once a month. (After which time I realize how much I suck and walk out of the room in a disoriented haze.)

However, if this exercise were merely about beating one another up, I’d have more objections. It’s not. The point is to find the “learning places” where you can develop more fully and deeply in the art of caring for people.

For instance, one of my learning place is engaging with patients and families when I myself feel vulnerable. If I can’t run out of the room, then I can disengage inwardly. Sometimes what’s before me is just too much and yet I still have to find a way to offer care. It takes my colleagues and supervisor to point out these blind spots, when I can’t see them for myself.

The larger picture for me, in my shortcomings and foibles, is that somehow it all works. I have to trust that it does, even when I sputter through my words or forget to say “Amen” at the end of prayer or if I trip while walking down the hall.

Meanwhile if you see my skin falling off my body, give me a pat on the head, and offer me a bowl of milk or some kibbles. Thank you.

Advertisements

Ashes to Go

Today being Ash Wednesday, the chaplains fanned out around St. Francis to deliver ashes to foreheads of those employees who wanted them. Sister Margaret Downing led us in this effort. It was such a meaningful ritual, and I found I needed it, too, partly because I was missing my own service at church.

When it was my turn, I said: “Remember that you are dust, and to dust you shall return.”

Sister Margaret used this phrase: “Remember that you are more than dust, and you shall live forever.”

I had never heard hers. Though I found I preferred it, I also liked that we used different versions. They seemed to work together.

Hers is more uplifting but the version I’m familiar with reminds me that this body is mortal.

Thus begins Lent, which for Christians is the period in the calendar calling us to reflection, repentance and sacrifice. Certainly we should practice those in all times, but particularly during Lent when I am reminded, among other things, of Jesus’ 40 days of suffering in the desert.

The faces of the recipients today offered a picture of beauty. Not only was each face different, but the expressions as well. Some closed their eyes. Others shed tears. Many smiled. I’m grateful for Sister Margaret, and the wider Church, for this rich rite.

Taking one’s own pulse

Today I was called to the ER because a woman was in great distress. Her husband had coded. I prayed with her, then her daughter came and then a nurse took us down the hall where doctors and other nurses were working frantically to save the man.

Someone was doing CPR. It’s not pretty, like on TV. It’s brutal and loud and violent.

After a few minutes, the wife said: Stop! Stop! Give him peace!

They did. Her beloved husband died, one day after Valentine’s Day.

Taking my own pulse in situations like this means I monitor my feelings. Today I was sad and fearful and anxious. Would he make it? I could see myself in the shoes of both the spouse and the daughter, as my husband and father are alive. I could very clearly see and hear this woman’s pain. I saw the intensity in the faces of the staff. I was afraid.

As I monitored my feelings, I also knew I had to act. I had to minister in some way. For me, today, it meant praying for the woman and her daughter; holding the widow’s hand and at times rubbing her head; and giving thanks for the medical personnel who worked hard for this man and his family.

My own feelings don’t go away, necessarily, but once named they don’t seem ┬áto hold as much sway and I can better stand with a person in her pain.

Every situation is different. I don’t always monitor well. Sometimes in my monitoring, I get too fixated on one thing or another. Or I get distracted. When I am overly anxious, I can get chatty and disruptive, and of no service.

Sometimes things click and I can’t explain why. The Holy is like that, working both through me and despite me. It’s not about me, and yet I get to have a role.

A privilege, no doubt.

Sub-plots

Anton Boisen, one of the founders of Clinical Pastoral Education, coined the phrase “living human document.” It means that the patient in the bed, and/or the grieving family, has a history, a present and a future. They are living, breathing stories.

Chaplains, as well, are living, human documents; and, away from the patient, we reflect on our own issues and hotspots that flare up during visitations.

You don’t have to go to a book or a manual to find out about them. They’re right in front of you, either in the mirror or in the bed or hallway.

Patients are more–so much more–than their condition or disease. If they feel well enough, they’re usually open to sharing more than what ails them.

They have myriad life experiences, disappointments, joys, foibles, humor and fears. Just like the rest of us.

I saw someone this week who told me so much more about himself than his upcoming surgery. He gave me this gift both in words, and in signals. (A humorous encounter came when the doctor asked him a question he clearly didn’t want to answer; and he said to me: “Did you hear anything?” That told me he isn’t comfortable confessing, even to a doctor, his vices.)

Often there are clear connections between a patient’s lifestyle and what’s going on with their bodies. If a diabetic, for instance, ignores his diet for too long, he will likely end up in the hospital.

Sometimes it’s not so obvious; a patient experiencing months of stress, who otherwise takes good care of herself, enters the ER with a migraine. She has never had migraines before.

Then sometimes, tragically, these living documents present themselves to us a little too late. Too late for their stories to be read, at least by us.

The stories, like all of our stories, are precious. The Hippocratic Oath guides me in this: “First, do no harm.”

Cheer cart to the rescue

Just before the elevator doors shut at work the other day, I caught a glimpse of color: the pink ladies pushing the cheer cart. (Sometimes there’s a man.) Most hospitals have something similar, I imagine. Surrounded by so much reality, staff, patients and families alike can get cheered up–however briefly–by ordering trinkets and candy off the cheer cart.

Most of our hallways are beige. Patient rooms are kept plain and sterile, and for good reason. Decorations are kept to a minimum.

The cheer cart has a bell on it, too, to let patients know of its arrival. Standing in one of the long halls, especially around dusk, I have come to see it as magic: the cheer cart rolling in the distance, its tinkering bells signaling to someone that help is on the way.

Life in community

The hospital seems like its own little orbit or community, and sometimes I think we should have our own ZIP code.

Because, while the faces of patients and staff change frequently throughout the day, most if not all of us in the building are focused on one thing: serving the sick, and/or serving those who serve the sick.

The kitchen worker may not share the skill set of a doctor, but in a roundabout way she’s serving patients.

One learning curve for me from my previous job is that now I operate more with a group and less like a free agent. As a journalist for 20 years, I worked pretty much on my own, with guidance from editors, but I made a million decisions a day based on what I knew on my beat.

Nowadays, while I do visit patients and families alone, I work closely with four other chaplains as we coordinate schedules and pray for people and wrestle through hard things.

All the honesty and soul searching–with myself and them–at times feels constricting. “Didn’t I/we talk about this before?” We fight and yell and point fingers. We cry. We laugh.

Then our supervisor stirs us up even more.

Community is hard. Friends of mine who live in intentional faith communities speak of its difficulty and joy in the same sentence.

On the joy side, it’s freeing to spin the same wheels, to rehash the same old conversations as we search for clarity. I’m getting to know the others in such a way that trust develops and so, it’s easier to confide in them and be myself. We have many things in common, and that builds bonds. Our quirks add humor to discussion of heavy things.

The Jewish philosopher Martin Buber coined the phrase “I and thou,” meaning I find myself in relationship– you for me, and you in me; and in God we find the Eternal Thou.

It’s messy. It’s complicated. It’s beautiful.