God models for us in chaos.
“On Communitarian Divinity” (a book by an African-American theologian incorporating an African sensibility concerning community.)
– God is community all by God’s self. (Yes, this is common)
– It is not good that God is alone. (This is an interesting idea for the “Why?” of creation)
– It is not good for human to be alone. (We are in the image of God)
We do not know how to be free! (Absolutely! So many Christians idolize the United State and believe themselves to be free, but they are not. We do not know how to be free, as God defines it!)
God is free to be…
I had a visit with an elderly woman who is worrying something terrible about her husband. She is a Holocaust survivor. It was a privilege talking with her!
Two move weeks! Two more weeks.
I had a run-in with a resident-doctor last Friday. The doctor and the patient were speaking past each other, and at times the resident was speaking in a condescending and demeaning way to the patient. I called him on it. He didn’t like it. He got his Attending and accused me of a variety of things. We worked it all out (at least I hope it is all worked out!).
This whole affair brought to mind the idea of the Art of Medicine and the Science of Medicine, and those who function within each domain of medicine and how they communicate to patients. The resident-doctor spoke well within the Science of Medicine – very technical, very specific, very dry with little or no emotion (accept when we was condescending, that is). The patient couldn’t hear that, because the patient was in the Art of Medicine domain – feeling, sensing, etc. The resident, wanting to effectively communicate to the patient, needed to recognize this, but he did not. He needed to communicate within the Art of Medicine for the patient to truly understand what he was saying. Likewise, he needed to listen within the Art of Medicine so that he could hear what the patient was actually telling him. It is the doctorç—´ responsibility to bear the burden of understanding the best way to get his or her point across, and then doing so.
Anyway, the Art and Science of Medicine. To be effective, doctors need to be able to discern within which domain they need to faction to effectively communicate to patients. Just like we do, too, as chaplains!
We are finishing our mid-term evaluations. Yesterday, we met in Central Park, the day before at Health Care Chaplaincy offices, today, back at Roosevelt. I am completely exhausted! I have been the lightening rod for the past two days, and probably will be today. Why? Well, I have a strong personality, I am self-assured, I like who I am, and I don’t think I am too off base in how I conduct myself. With certain people, all those things are bad things. According to some, I refuse to look at deeper issues because when critiqued I say, honestly, “I understand,” and leave it at that, because I do understand. Well, because I don’t use the right code words or gush emotionally I must be repressing something or denying some underlying pathology – who knows? So, I’ve been blasted the last two days (and one earlier time). And, of course, because I don’t respond in ways they want me to respond, they assume I cannot be an effective chaplain, even though they have never seen me in operation. Ask the patients I deal with whether I am effective. They all want me to come back, so I suspect I must be doing some things right.
I think it is time for some of them to learn how to deal with someone like me, rather than they expect me to completely change my personality and learning style to reflect what they thing I should be. If they expect me to be able to respond and react in ways that they can receive, then they need to do the same with those like me.
“25 Just then a lawyer stood up to test Jesus. Â‘Teacher,Â’ he said, Â‘what must I do to inherit eternal life?Â’ 26He said to him, Â‘What is written in the law? What do you read there?Â’ 27He answered, Â‘You shall love the Lord your God with all your heart, and with all your soul, and with all your strength, and with all your mind; and your neighbor as yourself.Â’ 28And he said to him, Â‘You have given the right answer; do this, and you will live.Â’ 29But wanting to justify himself, he asked Jesus, Â‘And who is my neighbor?Â’ 30Jesus replied, Â‘A man was going down from Jerusalem to Jericho, and fell into the hands of robbers, who stripped him, beat him, and went away, leaving him half dead. 31Now by chance a priest was going down that road; and when he saw him, he passed by on the other side. 32So likewise a Levite, when he came to the place and saw him, passed by on the other side. 33But a Samaritan while traveling came near him; and when he saw him, he was moved with pity. 34He went to him and bandaged his wounds, having poured oil and wine on them. Then he put him on his own animal, brought him to an inn, and took care of him. 35The next day he took out two denarii, gave them to the innkeeper, and said, Â“Take care of him; and when I come back, I will repay you whatever more you spend.Â” 36Which of these three, do you think, was a neighbor to the man who fell into the hands of the robbers?Â’ 37He said, Â‘The one who showed him mercy.Â’ Jesus said to him, Â‘Go and do likewise.Â’”
I have been dealing with how to be a Christian hospital chaplain in a multi-faith ministry since beginning CPE. I have come to some sense of what feels somewhat comfortable, but still wrestle with this issue. To some degree, the issue has been moot because most of the patients I have encountered have been Christian. With a couple particular exceptions, I have had very good conversations dealing with their beliefs. My role has been more an inquisitive inquirer rather than giver of pastoral care (at least it seems this way), although in one particular example the patient seems invigorated by explaining his beliefs and the deep meaning he feels.
I can be, and really should be, however, in the hospital to ease the pain and help dissuade the fear and anxiety that some patients feel. While I may not be able to be about Â“the cure of soulsÂ” as I conceive of the ancient concept, I can ease their fear or loneliness. This will not apply to every patient, obviously. I can be of help with patients in the same way I can help feed the poor or cloth the naked. I can show the person that there are those in the world who do care.
This approach further demonstrates to me that this is not my ministry, but that is beside the point. All of us who claim Christ, and I can only speak for Christians, should be as was the Good Samaritan Â– helping the stranger when few others will. The patient is the stranger; we are the Samaritan. We should all be like the sheep at judgment Â– doing that which is loving and compassionate to our neighbors and not knowing nor caring whom that person may be to the point where we do not even realize what we are truly doing. (Matthew 25:31-46)
Well, today’s IPR (Interpersonal Relations) group got down and dirty, so to speak. Today’s blowout was not nearly as bad as some I know of, and really it was working through some honest interpersonal problems between us (exaggerated, but honest). Some groups have to deal with extreme shouting, accusations of racism, and the like. We just have to deal with people who have issues with other individuals over misinterpretations or miscommunications that might have been better dealt with individually rather than being brought up before the whole group.
Today, I was the focus. I didn’t remember a bit of important information from one of my fellow CPEer’s Genograms concerning a relative. The relative died earlier this week. I asked, “Were you close with ____?” My fellow CPEer took my question as suggesting that this relative was unimportant, and also that I was insensitive for even asking such a question since the CPEer had gone over all that during the Genogram.
Of course, at that point it was an orgy of “How does that make you feel?”
I truly felt bad that my question, which I asked because I was truly concerned about my fellow CPEer, was taken as callousness and insensitivity. Of course, there is part of me that just doesn’t care (which I think is a result of compassion fatigue!).
After four hours of group-work, didactics, verbatims, and the like, who in the world has enough emotional reserves and energy to start seeing patients?
There is no such thing as “summer-reading” this summer. I sit at my desk and see all the books I planned on reading this summer and realize I will read none of them. Can we say, “resentment?”
Two things happened this past week. A patient I was seeing in the ICU died. In a period of three months, she went from a woman full-of-life, as the doctor and the woman’s niece said, to a triple by-pass surgery, to a leg amputation, and finally a stroke. I visited her most every day for about a week and a half – being present, holding her arm, reading scripture to her, and praying for her. I was unable to see her for three days over the weekend, and during this time she died. If I truly believe what I profess to believe, then this woman trapped in a body that no longer functioned well and gave her no way to communicate is now in the presence of God. Her niece said she was a strong woman of faith. How can I be sad for this woman? I am sad for her family who no longer has their sister, their aunt, but not for her.
The second incident: I encountered my first experience of what seems to be anti-religious bias. A unit nurse very rudely demanded to know who I and my supervisor were, what we were doing on this floor, who gave us permission to be there, and proceeded to hunt down the woman on the floor who functioned as a liaison between the chaplain’s office and the unit staff. It was the psych. ward, so I understand that the rules are different and that there are different considerations, but I had been there four previous times and was there to see a patient with whom I already had a relationship. My supervisor said she was actually shocked at the nurse’s response. She had never experienced such a reaction even though she had visited the psych unit’s at both hospital locations without incident. The other staff seemed to have no problem with us being there.
The woman may not have had an anti-religious bias, but it is common knowledge that many within psychiatry view a belief system revolving around a “God” to be problematic to begin with. Then, of course, a clergy person could exacerbate a patient with a religiously based complex, etc. My supervisor said that hospital staff couldnÂ’t stop a chaplain from making a pastoral visit. The hospital pays for the chaplaincy office to be present and has stipulated that it considers the chaplainsÂ’ role in the care of patients to be important, so staff cannot stop pastoral visits by hospital chaplains.
Can I say that already I am over this whole experience, and we havenÂ’t even hit the mid-way point? Hospital chaplaincy is a vital ministry, but it is not my ministry.
I hate verbatims. I hate reflection papers. I hate genograms. I hate doing stuff that I have no inspiration for, no desire to do, no real concern about whether I do well or not. That’s CPE in a nutshell. I do the best I can with patients for the sake of the patients, and I like my fellow CPE’ers, but all this other stuff I can do without. Just painful.
I really do need to spend more time proof-reading these posts. I am embarrassed, but not really enough to make all things perfect. Oh well…
I have visited “C” in the ICU twice more. Her niece and 83-year-old sister were not there either time. Her hand was wrapped yesterday, so we could not even communicate through her squeezing my hand. That was distressing! She opened her eyes, but I had no idea whether she was actually responding to me or whether her eyelids were simply opening and closing involuntarily. How do we communicate? How do we know if what we are doing is helping or causing more harm or distress?
I told her I was simply there to be with her. I stayed about 1/2 an hour. I prayed for her and read more Psalms to her. I wish I knew whether she had some favorite scriptures to could read to her. As I read from the Psalms, I kept thinking that if her mind was still aware and active even in her physical condition, then I might actually be causing her more stress by reading of praising God and of God always being present with us, and the like. If she is in the place of distress with God right now, reading such things may cause her much distress, or reading such things could cause her great relief and comfort. I just don’t know which it could be. A tear did come from her eye. I cannot image the kind of distress and fear, and possibly anger and bitterness that must be felt by someone in her situation.
I listened to a message on the Chaplains Office voice-mail yesterday afternoon. It was a request to visit a patient in the ICU. I arrived in the ICU a while later and asked about the patient. I was expecting her to be present, but as the nurse described her situation I realized that she would be completely unaware of my presence. She had just undergone a cranial operation and was still unconscious. I walked into her room and saw all the equipment, the ventilator, four IV’s containing various solutions, the bandage around her head with blood stains visible, her swollen eyes – I wondered what in the world I could do.
I did all I could do, all that a chaplain could do in a situation like that. I spoke to her and explained that I realized she could probably not her me. Probably, because I know of too many examples of patients that seemed completely unresponsive or unaware only to find out later that they did hear, they were aware in ways we could not have realized. Anyway, to explained who I was and said that I would pray for her. I did – several prayers. Then, I read to her a number of Psalms, beginning with the 23rd. I held her hand.
I do not know whether she heard me or not – probably not. Much of medical literature dealing with spirituality and prayer suggest that it does play a big and verifiable role in healing. I could not deal with the needs of her body. I could only deal with the needs of her soul, and I did all that I knew how to do. I pray that the prayers and scripture read aloud fed her soul.
I ended up not being able to visit my assigned floors yesterday. After visiting the patient in ICU I went to the family lounge to jot down some notes. I found a woman watching a soap opera and one thing lead to another. For the next hour and a half I spent talking with this woman about her aunt, who was also in ICU. We went to the aunt’s bedside and prayed. The aunt suffered a stroke on Saturday, and while you could not tell she was aware from her face, she could respond by squeezing our hands. I held her hand, I prayed with her, I read to hear, and prayed again. She squeezed my hand at various times throughout. The connection was made, regardless of what we saw in her face.