horrible honor

I stood in the Neuro ICU with my arm around a lady I had met 40 minutes earlier.  Together we watched as her friend told her husband goodbye.  She was weeping and petting him, telling him that she loved him and wasn't ready for him to leave.  The friend and I watched as the lines on the monitor straightened out and the beeping stopped.  We cried quietly for the pain that was palpable in that room. "This is horrible,"  she sniffed.  "How often do you have to do this?"  "This is my third death tonight"  I whispered.  She was shocked. "You do this every day?  You chose this?"

I didn't know what to say.  What is the answer in those dark moments?  I did choose it, but I had no idea....?   I didn't choose it,  I was called to it?    I have no choice but to hang on until I can head home?


It IS horrible.  I never imagined the frequency of death or violence that such a large hospital hosts.  But....how can I explain the experience of standing with another human in those thin moments where life changes forever, hearts are broken and love is intense.  How can I convey the honor of being, holding, and crying with someone in those moments of pain and need.


It is a horrible honor.  And for this year at least, it's our horrible honor.

He will call upon me, and I will answer him; I will be with him in trouble, I will deliver him and honor him.  Psalm 91:15

off call - laundry baskets

   Here is a picture that pretty much sums up my life as a wife/ mother/resident/human at the moment.  And no, I'm not proud.  

I get ambitious on Sunday and do 5 loads of the boy's laundry.  I wait to put the clothes away until the last load gets done.  It never gets done.  Every morning I tip toe around the baskets at the foot of my bed.  Every day I plan to put the clothes away.  Every night I'm too tired.  The dirty clothes go in a basket behind the door.  When I wash them they get put on top of the clean clothes in the baskets at the foot of my bed.  Every morning we dig through the baskets to find the boys clothes for the day.  I considered selling the dressers upstairs due to neglect.  But that would take more work than putting the clothes away.  This Sunday I vow to break the cycle.  Oh wait.  I'm on call this Sunday.

Purify me from my sins, and I will be clean; wash me, and I will be whiter than snow.  Oh, give me back my joy again, you have broken me— now let me rejoice.  Psalms 51:7 and 8

transparency

I met a tiny baby today.  This little person was born 17 weeks early.  Perfect and precarious.  Hanging on life by a thread. 
      
A wonderful doctor is involved.  He spent 20 minutes or so talking me through the plans and hopes and challenges that are part of this story.  I learned about things that naturally take place in utero that are having to be contrived on the outside.  We peered at tiny ears, eyes still fused shut, beautiful but underdeveloped hands, shiny, clear, translucent skin.  That especially fascinated me.  Dr. W told me that the top layer of skin hadn't developed yet. That is why the arteries and veins were visible. 


      I watched his baby heart beating so fast.  And his tiny lips suck in air.  I saw him jerk with a startle reflex, then relax again inside his cozy incubator.  I felt like I was watching creation in process.  Awesome and sobering.  
    
 Hang in there little man.  I will think of you all weekend.  And you will be the first person I ask about and check on Sunday morning.


He tends his flock like a shepherd: He gathers the lambs in his arms and carries them close to his heart; he gently leads those that have young.  Isaiah 40:11

chaplain down

We've been whittled down to four.

So every morning we show up for morning report eager and concerned to hear how 1/4 of us managed the night alone in the big hospital. We are hoping for a cheerful "easy night, 3 calls, lots of sleep." When the report is bad and the night has been loaded, I feel a mixture of guilt (that I got to sleep in my bed at home) and relief (that I got to sleep in my bed at home).

This morning's report started normally. Then 1/4 of us reported that she had responded to a trauma in the early morning hours, ignored the blood, did her part, disregarded her light headedness, noticed the trauma bay was especially hot, thought she needed air, and....... came to on the floor in the doorway. 1/4 of us was wheelchaired into Chest Pain, to have blood drawn and heart rate monitered. 1/4 of us spent over an hour there, checking the bump on her head. 1/4 of us got supervisory chaplain support and breakfast and was feeling better even before she was told she was fine.

We watched her carefully this morning. And sent her home early this afternoon. With promises that she would take it easy. And then we tiptoed around.

Whew. So glad. So sorry. So relieved it happened to someone else first. It could have been me. It might still be me some time. Be careful 1/4. We aren't complete without you!

My flesh and my heart may fail, but God is the strength of my heart and my portion forever. Psalms 73:26

vivian crow

*names have been changed to protect the......well, just changed.

"From the moment my husband went to Heaven, Vivian Crow has been after my money."

What an opening sentence! I was hooked. I had just stepped in to a new patient's room and introduced myself. "And how are you today?" I naively asked. "Sit down honey. I will tell you the whole story." And she did.

This lady was good. She was dramatic and convinced and spinning a tale. I'm not sure she realized how good a tale it was. I love a good story. I love hearing them. I love telling them. The hospital is a great place to hear a wide variety of stories.

One probable reason I enjoy stories is that I am part of a larger story. Eugene Peterson writes "God works with words. He used them to make a story of salvation. He pulls us into the story. When we believe, we become willing participants in the plot. We can do this reluctantly and minimally, going through the motions; or we can do it recklessly and robustly, throwing ourselves into the relationships and actions. When we do this, we pray. We practice the words and phrases that make us fluent in the conversation that is at the center of the story. We develop the free responses that answer to the creating word of God in and around us that is making a salvation story."

My little lady had more to tell. Vicki happened upon her later and heard the whole Vivian Crow story too. It's becoming a legend in our office.

Jesus always used stories and illustrations like these when speaking to the crowds. In fact, he never spoke to them without using such parables. Matthew 13:34 NLT

Can't wait to hear His stories for myself.

24

24 is broadcast in real time with each season depicting a 24-hour period in the life of Jack Bauer, who works with the United States government as it fights fictitious terrorist threats to the United States.  Each episode is adrenaline filled and terrifying as Jack escapes death and saves the world.

Of course Jack has never tried hospital chaplaincy.  That will probably be saved for the eighth and most exciting final season. Because really Jack, compared to our 24 hours on call, your little missions look like child's play.

Los Angeles, New York, DC?  Come on.  Everyone knows the real danger zone is Spartanburg.

Tortured by the Chinese Government?  Please.  Have you ever been in Neuro  ICU all night, got to sleep at 4 am and had oncology page you at 4:55?  Now that is real torture.

CTU agents sold you out Jack?  How about having 3 male security guards send you into the halls alone  at 1 am to clear a crowd of  30+ hysterical family members.

And with all your terrorist stopping and gun waving, have you ever sat in a room with a doctor to tell someone their wife just died?  

      Have you ever patted the back of a mother who was wiping blood off her 12 year old son's face while she told him goodbye?  

      Have you comforted parents whose adult son was killed by a bullet two years after their other son died of liver failure?  

      Have you been hugged by a sweaty RN who just spent 45 minutes doing CPR? Have you triaged spiritual care for multiple car wreck survivors? 

      Have you ever talked anyone into stopping futile, heroic measures so their loved one can pass away in peace.  

      Have you hopped over blood puddles in a trauma bay? Or attempted a stroke assessment on a patient who can't talk?  

      Or giggled at a man so grateful to be ok after swerving to miss a deer and hitting a tree. - "Thank you doctor, thanks to all you nurses, thank you all of you wonderful people..."  

      Have you ever left everything you had physically and emotionally "on the field" and limped home?

That was my last 24 hours. Eat your heart out Jack Bauer.

Take your positions; then stand still and watch the Lord’s victory. He is with you. Do not be afraid or discouraged. Go out against them tomorrow, for the Lord is with you!”  2 Chronicles 20:17

thank you for the 24 idea Sandy!  I was just waiting for a day that did it justice.

nests

We've had a crazy stretch of on calls - between interns leaving and externs coming.   Saturday, Tuesday, Friday, Monday - in a row for me! Sleep deprived and on sensory overload, I've developed a little nesting ritual to make the on-call room home.

My LLBean bag packed to the gills with my pink striped blanket and pillow. A couple good books. My beloved laptop with netflix and itunes (for weekend ambiance). My black yoga pants and red shirt, comfy yet dressy enough under the white lab jacket. My eye mask and water bottle. A cup of fruit salad and animal crackers from the Tower Cafe.  And my phone for goodnights from Steve and Jake and Josh.

My nest is settled, cozy and mine.  And then the waiting begins......

On the phone in the on-call room there is a yellow sticky note with these beautiful words in Vicki's thoughtful handwriting. I read them every on-call night.

Now guide me waking, O Lord, and guard me sleeping; that awake I may watch with Christ, and asleep, I may rest in peace.  Amen

I really think that little bird looks like me!

out chaplain'd

When you are a chaplain, you kinda get used to being "the spiritual one" in a room.  You expect that you will have to lead out in spiritual questions, take the hits for God, say the prayers and give the blessings.  But today two people out chaplain'd me.

After an unexpected death of a father and brother, family members poured into the large consult room in the EC.  With the last wave of family, the man's pastor entered, greeting everyone by name.  He politely asked me if he could have a prayer.  I said of course, thank you.  He then led that packed room in a spirited and meaningful conversation with God, through a chorus of amens, while I hung on for the ride.

Four hours later and six floors away another man was slowly losing his life.  As the monitors dropped I stood with three women.  One grabbed my hand and said "We need to say the 23rd Psalm!"  And so we did, fumbling and passionately  (them in KJV, me in NIV with a couple Thee's when I remembered)  "Yea though I walk through the valley of the shadow of death, I will fear no evil, for you are with me. - Thank you Jesus, Thank you Jesus."

Both times I felt sheepish for not being the one holding all spiritual reins.  Both times I took a deep breath, remembering that I had a place in each room, and that God works through many people in so many ways.

Now you are the body of Christ, and each one of you is a part of it.      1st Corinthians 12:27 NIV

change

Abi, Andy, Ashley, Gary and Liz. (Names to be read slowly and with deep feeling)

The interns were here two weeks before us. They were the pros, patiently teaching us how to chart in Midas and showing us how to get to the heart center. More than their usefulness though, were the five full personalities they added to the group. We shared calls and devotionals, classes and IPR, lunches and office chats, tears and laughter. We got attached.

And now they are gone! Scattered to schools and work. The Bat Cave (interns office) is lonely. The lunch table is small. The on-call schedule is overwhelming. The externs are new. The hall is quiet. We miss you!!

I hope to see you soon, and we will talk face to face. Peace to you. The friends here send their greetings. Greet the friends there by name. 3 John 1:14

heart

Yes people.  That is a human heart.  I know because I saw one today.  Not just saw one.  But saw one taken from someone's chest and then looked at it close up and opened up.

Today the new externs and old residents (us) were taken on a tour of the morgue.  My tour was cut short by a page to a death in the emergency room.  (truly dark humor says Steve) But a couple of us were invited back for an autopsy later in the afternoon.

No way.  Not me.  Not interested.  OK a little curious.  Maybe just for a minute.  I wobbled down there.   Sat across the hall looking through the doorway.  Clammy. Weak knee'd.  It was brutal.  Drippy.  I closed my eyes repeatedly.  But then the intestines were pulled out.  Miles of them!  Then the liver.  And kidneys.  The lungs.  Stomach.  The heart.  It looked just like this one. The big brain.  The tiny pituitary gland.  The optic nerve.  Wow!  Before I knew what was happening, I was standing right in the thick of things, peering in and around.

Horrible.  Amazing.  Gross.  Beautiful.  Sobering.  Awe Inspiring.  Wow.

I will give them an undivided heart and put a new spirit in them; I will remove from them their heart of stone and give them a heart of flesh.  Ezekiel 11:19 

ps - Nathan, your inquisitive fortitude will be legendary.

off call - rest

I've spent many Saturday mornings home alone in the last 8 months.  Steve and the boys leave for church.  The house is quiet.  I sit in my big blue chair looking out the window at trees and clouds. Then my mind starts spinning.  I'm not at the hospital!   I'm home!  I've got free time.  There are things to be done.  Unload the dishwasher, load up the laundry, the bathroom needs to be cleaned, bills to pay, I could cook, have dinner ready when they return..... 

Then Jesus said, “Come to me, all of you who are weary and carry heavy burdens, and I will give you rest.  Take my yoke upon you. Let me teach you, because I am humble and gentle at heart, and you will find rest for your souls.  For my yoke is easy to bear, and the burden I give you is light.” Matthew 11:28-30 NLT

That's right, rest.  Sit quietly, enjoy the wind moving in the trees, pray, count my blessings, wow, an hour and a half.  I could read that book I've been meaning to or blog, or catch up on emails, or organize my magazines.....

"Be still, and know that I am God;  I will be exalted among the nations,  I will be exalted in the earth." The LORD Almighty is with us; the God of Jacob is our fortress.  Psalms 46:10 and 11

I'm trying to.  But.  It is hard to slow down.  It is hard to be quiet.  It is hard to be ok with who I am in the quiet.  It is hard to not get busy.  It is hard to be still.  It is hard to be... 

Brennan Manning writes ..the longer you spend in the presence of Jesus, the more accustomed you grow to His face, the less adulation you will need because you will have discovered for yourself that He is Enough.  And in the Presence, you will delight in the discovery of what it means to live by grace and not by performance.  Abba's Child,  pg. 45

I want that.  

Therefore, since the promise of entering His rest still stands, let us be careful that none of you be found to have fallen short of it.  Hebrews 4:1 

great picture Jacob! The very view from my blue chair in my bedroom.  It relaxes me just to look at it.

close to death

This morning I got paged to the room of an 92 year old woman.  I stood with my arm wrapped around her daughter as we got the news that her breathing was slowing.  We were still hugging when mom's breath stopped.

This afternoon I sat with a mom and dad and held their 13 week fetus.  13 weeks.  A tiny little alien creature, with a tiny head, and a nose and arms.  He already had a name.  And great plans.  They strained to make sense of my English words as I tried to comfort them and shared their grief.

This evening I stood with 20 family members and watched their father's monitor as his heart slowed down. Then got erratic.  And then stopped.  I watched the line go flat.

Then late late in the night I watched a medical team try to keep someone here.  I watched as they had to give up and make a pronouncement.  And then I went with the doctor to go tell the family.

The end of an era, the death of a dream, the loss of a leader, the finale of father.  One moment alive.  The next moment gone.  Full of life.  Then lifeless.

Is this post depressing you?  Me too.  I can't share a hug, the snot on my shoulder or the mascara on my cheek. But I can share a little of the pain in my heart.  And then say to you the same thing I've been saying all day long.  I'm sorry.  I'm so sorry.  I'm so sorry.  I'm so so sorry.

God himself will be with them. He will wipe every tear from their eyes, and there will be no more death or sorrow or crying or pain. All these things are gone forever.” Revelation 21:3 and 4 NIV

Yes.  This verse again.  Won't be the last time either.

good underwear

Remember the little saying about how you should wear good underwear in case you are in a wreck and end up at the hospital?  You know how every one thinks that is a joke?  It's not.

Yes, the 20 people in the trauma bay cutting off your jeans are only focused on saving your life.  They've seen it all.  They aren't looking.

But there are others on the outskirts.  Waiting to get your insurance information.  Waiting to contact your family.  Waiting to pray.  We aren't saving your life. Yet. We do notice the baggy grayed undies that should have been thrown out years ago. We still love you.

But buy some new underwear.  Just in case.  I'm just saying....

Therefore keep watch, because you do not know the day or the hour... Matthew 25:13

told off

It was a tough day at the hospital for me and God.  

It started this morning when I headed toward a patient's room in the EC.  I greeted her husband and was pushing aside the curtain when she began to yell "shut the door Jim, you know I don't want anyone in here."  He yanked the door shut and I was out before I even got in.

Several hours, many visits and two deaths later... I was upstairs with a family when their father passed away.  Grief erupted.   One girl laid on the hospital floor, pounding it with her fists, screaming "why would you take him God? Why?  Why? Why?"  Another woman rocked back and forth in her chair crying "Not my daddy, God, not my daddy."

I'm sure it's not the first time He has gotten a good cussing out at this hospital.  One quick glance at the Psalms and the Gospels remind me that He has taken some pretty harsh criticism. Sometimes even getting kicked out before He actually got in.

Made me want to give Him a hug.

And at the ninth hour Jesus cried out in a loud voice, "Eloi, Eloi, lama sabachthani?"  which means, My God, my God, why have you forsaken me? Mark 15:34 NIV

evaluations

The good news - we spent the whole day out of the hospital.  All eleven of us "chaplains"  at a beautiful house on the lake with huge windows and comfy couches and fresh air. 

The not as good news - we spent the whole day presenting and listening to summer unit final evaluations.  Five pages of detailed questions times nine.  Lots of sharing and delving and explaining and defending.

It is strange to talk about my strengths and weaknesses, forces that have shaped my life and experiences that are molding my ministry, in one concentrated session.  It is reassuring to be that vulnerable and have people engaged with a nod and smile or a question and probe.

I saw myself in a part of every paper shared and my story in tears that were shed.  I find it difficult to believe that two months ago I did not know the ten people in the room.   I now sit so comfortably in their presence, with tears and laughter.  Such gifted, amazing individuals.  I am so enriched for knowing them this summer.

You use steel to sharpen steel, and one friend sharpens another.  Proverbs 27:17 The Message

schedules

It's been a busy couple weeks.  We've all been coming and going.

This morning I went upstairs to make sure Josh was awake.  He was sitting at the edge of his bed pulling on his shorts and t-shirt.  What a big boy!  With wild hair and half opened eyes he asked me "Mom, what day is it?" I was tired too.  All of a sudden I had no idea.  I sat down next to him.  "Joshy, I don't know."  And Josh just rolled with it. "OK Mom, let's just go eat."

And that's just one of the many reasons I love him!

O LORD, you have searched me and you know me. You know when I sit and when I rise,you perceive my thoughts from afar. Psalms 139:1 and 2 NIV

touche

We were driving home from the gym and then the boys were headed for a sleep over at their friend Ashton's.  I launched into my motherly speech about how they were to behave while away from home.  Jake said "Mom, have we ever not been good when we stayed at someone's house?"  I said "Jake, have I ever not given you this talk before you went?"  He said "Touche Mom."

I laughed and told both boys how proud I was that they were such great little men.  After a pause Jake said "I just can't believe I got to use Touche correctly!  I've been waiting to say that for such a long time."

And that's just one of the many reasons I love him!

You know what I am going to say even before I say it, Lord.  You go before me and follow me.  You place your hand of blessing on my head. Psalms 139:4 and 5 NLT

pillars

Life in the hospital is so all consuming.  (Surely you sensed that in my last whiney post.)  It is a complete world all it's own - emergencies, patient rooms, classes, other chaplains, the cafeteria, etc.  

Then I drive up the mountain to another whole world - Ashevillia.  This world is populated with my three best blond boys, my blue bed, Steve's date shakes, treadmill walks with Jenn, the penguins of madagascar and laundry.

Sometimes I feel like a rickety, wobbly bridge trying to span the great distance of the two polar worlds.  It is daunting.  But I am growing in awareness that my bridge has amazing girders and support beams.  People from "the old country" who willingly and empoweringly span with me.

To name a few...

   In North Carolina, Steve listens to way too many depressing tales and amusing antidotes of my job, and prays me into each day.  Matt and Jenn keep themselves available for whatever it takes to make life work this year, and add sanity and smiles.

   From Maryland, Lisa is awake and phone ready during my 7:00 am drive, encouraging me to exercise my energy up.

   Tennessee Sandy and Hugh (my inlaws) encouraged me to blog this whole experience, and keep encouraging me with love and ideas and childcare.

   From Georgia, Dave does his own commute.  His CPE background and insights helps me to feel a little less crazy.

   My favorite New Yorkers, Ben and Jenny, are considering being local support, in addition to the emotional kind.

   My Barbs! Barb M and Barbara T insist on the much needed off call movies, lake trips and chocolate.

   And all the way from California.....my giant buttresses (hee hee, is that flattering?) Karen and Stuart are tireless over the constant phone communication that is the oxygen to my emotional lungs.  They are fluent in both my worlds.

My girders!  If this was Israel I would plant a tree for each of you on the avenue of the righteous.  But for here I am honored and blessed and lucky to have you as my pillars of strength.

 Every time your name comes up in my prayers, I say, "Oh, thank you, God! ... And I keep praying that this faith we hold in common keeps showing up in the good things we do, and that people recognize Christ in all of it. Friend, you have no idea how good your love makes me feel....  Philemon 1:4-7 the Message Bible

Happy Birthday GBBM Karen Janette! (giant beautiful buttress mamma)

flight risk

Today the four residents sat in our office and made up an on call schedule for the next 5 months.  The reality has set in that the interns are leaving next week, and no matter how hard we thought life was.....it is going to get harder.  Our anxiety rose as we realized that many weeks we will have two overnights, sometimes two days apart.  The walls closed in.  The more our names were written down, the lower our moods dropped.  When we finished we staggered out of the office to head to lunch.  As we rounded the corner we all faced the large sign on the behavioral health wing.

EXTREME FLIGHT RISK.  OPEN DOOR WITH EXTREME CAUTION.

We are getting the same sign for our office door.

"I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world."  John 16:33 NIV

held

Several times a week interns, residents, and supervisors sit together in a little 11 person circle.  And in that circle we share things close to our hearts.  An encounter with a patient that mystified us or made us proud.  A trauma call that upset us.  A coworker's behavior that challenges us.  A verbatim that reveals "a deeper layer of emotion."  An idea we have been wrestling with.   Anything.  There is usually laughter, usually tears.  And always the struggle to trust and lean and be vulnerable.  When we do take the risk we have been asked "do you feel the group holding you right now?"  I do!  What a gift to be held by others- in their emotions, attention, care and support.  Thank you little circle!

Yet I am always with you;  you hold me by my right hand.  You guide me with your counsel,  and afterward you will take me into glory.  Psalms 73:23, 24 NIV

npo

nothing by mouth (NPO)

Etymology: L, nil per os, nothing by mouth

a patient care instruction advising that the patient is prohibited from ingesting food, beverage, or medicine. It is usually posted above the bed of a patient who is about to undergo surgery or special diagnostic procedures requiring that the digestive tract be empty or who is unable to tolerate food and fluids by mouth for some reason.

I have now reached a level of medical expertise where I can both understand and use the above abbreviation correctly in a sentence. I am very proud of this milestone! And learned it quickly after attempting to bring an NPO patient a glass of water in the EC. Most EC patients are NPO. Which is why I was surprised to walk into a room where a woman sat with a large box of fried chicken from the fast food establishment across the street from the hospital. I immediately asked if the nurse had ok'd such a feast. "Oh yes", she good naturedly assured me, "all my tests are done, and we are just waiting to go home." We had a pleasant conversation and as I left I remembered to ask what she was in for.  She told me matter of factly "Congestive heart failure."

I don't know exactly what congestive heart failure means. But I'm pretty sure if you are in the EC for it, your picnics might need to lean toward fresh vegetables and away from fried foods. I fought the urge to ask her if she wanted ice cream or a cigarette to accompany the greasy feast. A block of cheese? A dozen doughnuts? But since I am not her doctor or nutritionist, I refrained and listened to the little voice in my head whispering things like people in glass houses shouldn't throw stones, and judge not lest you be judge. So nothing came out of my mouth. I just smiled goodbye.

Pray also for me, that whenever I open my mouth, words may be given me so that I will fearlessly make known the mystery of the gospel.. Ephesians 6:19 NIV

thank you genius editor M6.  We are a good team!

off call - blueberries

After 24 hours in the hospital, everything looks different on the outside.  A simple task like blueberry picking takes on a spiritual, soul restoring aura.  The fresh air, the rows of bushes, the hike to the perfect row.  The mix of bright sky, white clouds, green leaves and beautiful blue berries.  The buzz of bees and flutter of butterflies.  The drops of sweat running down your back as the baskets fill.  Jake and Josh excitedly calling that they found the mother load.  The absence of disinfectant or beepers or computers. Big, fat, juicy berry after yummy berry.  Planning what you will make with this bounty.  The knowledge that the humid stickiness you are feeling will disappear as soon as you are in the boat on the lake.  Friendship, banter, laughter.  Big, deep breaths of gratitude, anticipation and life.

⁷ For the LORD your God is bringing you into a good land—a land with streams and pools of water, with springs flowing in the valleys and hills; ⁸ a land with wheat and barley, vines and fig trees, pomegranates, olive oil and honey; ....¹⁰ When you have eaten and are satisfied, praise the LORD your God for the good land he has given you.  Deuteronomy 8 NIV