surreal

Late in the night the pager buzzed a code blue.  When I arrived a medical team was already surrounding the bed of a elderly man.  A nurse was kneeling over him doing CPR.


I'm always surprised at how physical codes are.  The team take turns pumping a chest, putting their everything into it.  Codes end with a group of sweat drenched people.


This time the life saving measures went on and on.  I perched on a chair right outside the room.  On one side of the patient the vital signs monitor shows lines jumping and falling, jumping and falling.  On the other side of the patient another TV was broadcasting Jay Leno's new show.  I watched one....then the other.  It was surreal.  I could almost hear the Twilight Zone music in the background.


At first it struck me as very irreverent.  A man is dying.  Heroics are being performed.  Do we really need to hear Jay and Steve Carrell cracking up?  Was everyone on the medical team too busy and focused to notice?


But we got into the second code, the vital lines were more erratic, and flatter.  The medical team was tired and grim.  The family was on their way to receive bad news.   Jay's cheerful banter reminded me that outside this room there are people full of life, people with big plans and little annoyances - home after a busy day, curled up in bed or on the couch, having one last laugh before they fall asleep peacefully.


Therefore do not worry about tomorrow, for tomorrow will worry about itself.  Each day has enough trouble of its own.  Matthew 6:34

refueling

After years of oblivion, I've now become one of those people who is obsessed with gas prices.  Every morning I drive past our best gas station and note the price. (say $2.42)  Then I drive down the mountain, into South Carolina and watch the prices fall.  (say $2.19)  I time my fill ups and my routes to get those satisfying low prices.


In our Pastoral Care class we talk a lot about keeping our tanks full.  There we call it Self Care - the act of intentional awareness and care to ourselves, when most of our effort is focused on taking care of others. As we head into busier holiday months, it will be imparative that we are practiced at keeping our emotional, physical and spiritual tanks full.  One of our biggest self care advocates, our teacher, Sherry, reminds us to get plenty of sleep, step out of the hospital and breath real air, play, eat well, and be gentle with ourselves.


This week I took my first two vacation days. (2 down, 12 to go) Our family spent 4 days at Myrtle Beach refueling.  I slept in, took long walks in the sand, watched my 3 guys body surf, felt the waves pulling me out and crashing over me, cooked a little, and read......


Oh yeah, baby.  Those tanks are filling up.

I have come that they may have life, and have it to the full.  John 10:10 NIV

spiritual clown

I wasn't at all sure about the pastoral image of circus clown.  There is not a lot of  mirth and hilarity on the floors. But two pages into the chapter, and it was my favorite so far.  What an out of the box way of looking at ministry.


Heije Faver writes "Charlie Chaplin..spoke to thousands because he managed to show the ability to find the genuine, the authentic on the edges of life.  The wry smile in the face of failure; the strange victory of the man who recognized his weakness, his powerlessness in failure, and accepts it as part of the scheme of things;   the little man who continues to have faith in something indestructible.


This is also the function of the clown in the circus itself; that is why he belongs to it, this place in which people perform great feats, tame wild animals and do hair raising stunts on the trapeze.  They make us feel tense and frightened, but the clown puts it back in perspective.  In a childish way he makes these stunt men look a little foolish, he makes us feel that they are, after all, only human and ordinary, and thus reestablishes a sort of spiritual balance."  Images of Pastoral Care - Robert Dykstra


postscript - On Monday while discussing this chapter, our teacher Sherry brought each of us a little colorful bag with slinkys, sour candies, pinball toys, wind up robots and monster finger puppets.  She talked about how in the midst of the heaviness and seriousness of our job, we need to be intentional about having fun.  What great homework!


Instead, God chose things the world considers foolish in order to shame those who think they are wise. And he chose things that are powerless to shame those who are powerful.  1 Cor 1:27  NLT

wounded healer

There are times when everything lines up for me.  Good family time, good exercise, a good sleep, and I come skipping into the hospital ready to take on what ever is waiting.  Love those days, few as they may be. There are plenty of days where the last thing I feel like is a spiritual expert.  There are days when I just want to crawl into a hospital bed and have random medicines IV'd into my system.  There are days when I feel proud that I got dressed and made it to Spartanburg on time.


One of our assignments for next week is to read two chapters in the Images of Pastoral Care book.  The first image is Henri Nouwen's Wounded Healer.  It was a thought provoking and hopeful chapter.  Here are a few excerpts.


He is called to be the wounded healer, the one who must look after his own wounds but at the same time be prepared to heal the wounds of others.


This is not a form of spiritual exhabitionism but a constant willingness to see one's own pain and suffering as rising from the depth of the human condition which all men share.


A minister is not a doctor whose primary task is to take away pain.  Rather, he deepens the pain to a level where it can be shared.


The main task of the minister is to prevent people from suffering for the wrong reasons.

What a picture of God.  A God who redemptively employs wounded people, who brings good out of our pain, and who truely knows what wounds feel like.

So then, since we have a great High Priest who has entered heaven, Jesus the Son of God, let us hold firmly to what we believe. This High Priest of ours understands our weaknesses, for he faced all of the same testings we do, yet he did not sin. So let us come boldly to the throne of our gracious God. There we will receive his mercy, and we will find grace to help us when we need it most.   Hebrews 4:14-16 (New Living Translation)

wanderings

It had already been a busy evening on call.  Around 9:00pm I got a page asking me to meet Doctor X in the O.R.  That was it.  No heads up or explaination.  I headed quickly out of the on call room toward the elevator when I realized that I had never been to O. R.  "Oh well, I've got the basic idea where it was."

Basic idea was not good enough.  I wandered around the second floor for 5 minutes looking for a sign for  the Operating Room.  Or a door.  Or a doctor waiting for me.  Nothing.  Finally I walked into a room marked Tranfusions (terrifying) and asked them.  A nurse walked me down the hall and keyed in a code to get into an unmarked door.  Ah Ha. The mysterious O. R.


But no Doctor X.  Apparently he was too speedy for me.  I wandered around some more hunting him. A new page informed me that I was now to go to surgery waiting.  This was like a bad scavenger hunt.  I still didn't know what was going on, but I had a sinking feeling.


I walked into surgery waiting moments after Doctor X had left.  There were more than twenty people lining the walls of the big waiting room, all sobbing, weeping, crying, and hugging uncontrollably.  I guessed that someone they loved had just died unexpectantly in surgery I had no idea who.  I began to move around the family, patting backs, saying I'm sorry.  Fourth person in was a relative who was able to talk.  She explained that Mr. B's heart had stopped during surgery.  He couldn't be revived.  She pointed out his wife, his kids, his sisters, his grandchildren, his friends.  And again I wandered.  This time from person to person.


Forty minutes later, a call came from O.R.  Mr. B had been taken to the morgue.  I called O.R. back.  "The family wants to see him.  Bring him back.  We need a respectful place to say goodbye."  But they were facing the next surgery, and he was gone.


So I wandered again.  This time with twenty-five family members following me.  Over to the heart center, past MICU, meandering toward EC, jamming into the elevator and down to the basement.  I felt like Moses in the Red Sea.  We overflowed the morgue, and paid our respects.  I got my first glimpse of Mr. B.  as they took their last.  But by now I was one of them.  Part of their journey and grief.  


We all piled into the elevator again.  Then more hugs and more goodbyes.  They scattered to the parking lot and I headed back to the on call room.  Finally I knew exactly where I was headed.


Teach me to do your will, for you are my God; may your good Spirit lead me on level ground.   Psalm 143:10 (NIV)

distractions

What did patients do before there was a tv in every room?  
Did they heal faster in the peace?  Did they die of boredom?  I'm curious.  In so many rooms the tv is on twenty four hours a day.  Bonanza, The Price is Right, HGTV.  Always on in the background.  While I'm introducing myself, while I'm trying to hear about them, while we try to talk, during prayer.  It makes it almost impossible to concentrate.  And so hard to compete! If our conversation is going any where I am learning to ask if I can turn the tv down, so we can talk without as much distraction.


I was thinking about this and wondered what are the continuous distractions in my life?  What do I need to turn down in order to hear better?


An idea from Eugene Peterson.  When we are noisy, when we are hurried, we are incapable of intimacy - deep complex, personal relationships. If God is the living center of redemption, it is essential that we be in touch with and responsive to that personal will. 


I love the focus described in this verse.


Every morning I lay out the pieces of my life on your altar and watch for fire to descend.  Psalm 5:1-3 The Message

exploring

The chaplains have been exploring!  We found the secret back route from the on call room, through the deserted roc hall to the emergency room.  We unearthed an urban legend about a mysterious exercise room and then found it hidden on the 5th floor.  We trespassed into the medical resident's decked out lounge.  We discovered the beautiful pond and fountain on the other side the cancer center.  It's a definite improvement from a couple months ago when we were wandering the halls blind trying to find the heart center.  We are enlarging our territory.


All this reminds me of a couple quotes I picked up at the Celtic Spirituality workshop.  They inspire me!


We shall not cease from exploration and the end of all our exploring will be to arrive where we started and know the place for the very first time.  TS Elliot


Follow truth wherever you find it.  Even if it takes you outside your preconceived notions of God and life.  Even if it takes you outside your own country into the most insignificant alien places like Bethleham.  Be courageous.  George McLeod, Iona Scotland.

sculpting

One of our assignments this week was to shadow another resident.  During their visit with a patient we were to observe them and later, in class, tell them the image that came to our mind as we watched them minister.  This was a bit nerve racking, but very interesting.  We shared images of a courageous lion, a calm, refreshing pool and a family butler.

Cathie observed me.  I loved the image she came up with.  And now have a new ideal with which to strive for!  Here is part of her observation.

Chaplain Miller reminds me of a sculptor becasue she has the tendency to touch patients.  Chaplain Miller is a very tactile person.  Being in a personal space using hands, eye contact with a slow communicating voice to engage the patient and nodding at times, is much like sculpting.  It is not so much of a totally hands on sculpting but a type of a social sculpting with a person using her language and thought to move a person from the pain or discomfort that consumes them as they lay alone in their rooms.  Chaplain holds their stories as a scultptor hold clay and instrument to carve.  The scultptor sits with the story as the sculptor sits to carve.  Like Michealango said of David, "David was already in the stone.  I just had to carve him out."  So does Chaplain Miller as she carves out the discomfort and pain to bring some healing and comfort to patients.


Thanks for seeing that in me Cathie.  I will think of that image as I walk into people's rooms, and try to do just that.

Yet, O LORD, you are our Father. We are the clay, you are the potter; we are all the work of your hand.  Isaiah 64:8

tired

oh. so. tired.  long week.  migraine.  a few days solo parenting.  a sick kid. 


yesterday i found myself standing in front of the elevator wondering why on earth it was taking so long.  finally realized I had never pushed the button.


i know i'm tired when i have to remind myself to put one foot in front of the other.  i know i'm tired when i feel envious of the patients who get to just lay around in bed and watch tv.  (i don't know what pancreatitis is, but seriously, there is no visible oozing, no blood or wincing, so how bad can it be?)  i know i'm tired when i pick out the room i want to be in.  (5 Tower, smells ok, not crowded, big corner room, great views, out of heavy traffic areas)


wednesday.  only two more days. quit whining.  bed tonight.  yeah.  you. can. do.  it....


Do you not know?  Have you not heard?  The LORD is the everlasting God,  the Creator of the ends of the earth.  He will not grow tired or weary, and his understanding no one can fathom.  He gives strength to the weary  and increases the power of the weak.  Isaiah 40:28, 29


Barbara and Barb - I await your deserved lecture on pancreatitis!

off call - on call

Whew.  Made it through the week.  Home for two whole days.  Plenty of time to sleep in my wonderful very own bed.  But even though I'm in a totally different state, 70something miles from the hospital, sickness has followed me.  At 9:30 pm my son calls me.  "I don't feel good Mom."  A cold washcloth and a back rub seem to do the trick.  At 11:00 pm his coughing wakes me up.  I deliver some medicine.  I get paged again at 1:00 am and at 2:00 am dragging myself from sleep to respond.  This feels too much like work!


But then I crawl in bed with the little miserable fellow.  I restack his pillows and tell him he will feel so much better soon.  I wrap my arms around him and brush his hair back.  And it's all worth it when I hear his sleepy little "Love you momma."  Now that never happens in the hospital.


That's right. Because I, your God, have a firm grip on you and I'm not letting go.  I'm telling you, 'Don't panic.  I'm right here to help you.'   Isaiah 41:13  The Message

morning

I so lucked out with a decent on call night of sleep!  11:30 pm was the last time the pager went off.  I slept deeply and woke up with little rays of light peeking through the 4th floor window.  I took a hot shower, enjoying the baptism into the day.  I ate Total cereal and a hard boiled egg.  Matt and Meredith bantered the important news while I got dressed.  Soon I was organized and ready for the day.  

I'm so much more hopeful in the morning!!

And then at 7:30 am the pager vibrated off the bedside table.  With a quick phone call I was headed to oncology.  During the night a father had suddenly worsened.  He was unresponsive and struggling for each breath. His daughter and son had arrived first.  They were stunned and devastated.  They would summon strength to lean in close, hold his hand and face, tell him how loved he was.  Then they would step back from the bed and collapse in grief and fear.  I put his bed rails down so they could get closer.  I scooted up chairs to protect their knees from the floor.  I restocked the kleenex supply. 

 But I could do nothing for their pain.

It got worse when Mom arrived.  Grief anew for her shock, and her pain.  And the loss she was facing.  As they wept together I found myself in the door frame silently witnessing and crying.  

I thought "what kind of world is it, with this much sadness before 8:00 am?"

And then all I could think about were the words of my mom's favorite song, hanging over her desk.

One of these mornings, bright and fair

Gonna wake up to the music of Jesus.

Gonna drop my sorrows and despair

Gonna join the singing in the air.

Singing Hallelujah everybody,

going to meet my sweet Jesus

when I hear the trumpet sound.

pastoral identity

One of my goals this quarter is to work on the appropriate claiming of my pastoral authority here in the hospital. There are a lot of people here, with a lot of opinions, expectations and agendas.  I need to hold to that intricate balance of toughness and tenderness that will be the most healthy for all.


Two experiences this week remind me that only I can craft the pastoral identity I want to have.


I stopped at the nurses desk.  "Hi!  I'm Erin, the chaplain.  Do you have anyone you especially want me to see today before I start with the new admits?"  She looked blank.  Then had an idea. "Room 925!  She is very religious."  I asked if she had any special needs.  "No she is fine, but she prays constantly - when she goes to bed, when she gets up, when she eats.  She would be happy to see you."   Great.  So the crazy praying lady is the only one on this floor in the hospital that would appreciate a chaplain's visit?


Nathan took me through the Behavioral Health wing.  Last quarter this was his rotation.  Now it is mine.  We met an elderly gentleman who is new.  He was very friendly and chattery.  He asked Nathan "Is this your wife?"  "No", we told him,  "we are both chaplains here."  Even though I spoke loudly and clearly, he kept asking "huh?" and then looked at Nathan for conversation.  As we wrapped things up he volunteered to pray.  After a unique rendition of Now I Lay Me Down To Sleep, he closed with "and be with the nice chaplain and his little lady.  Arrgh!


So yes.  I will keep forming and growing and protecting and shaping my pastoral identity.  And wincing and laughing and sharing....


Then Jesus, still teaching in the temple courts, cried out, "Yes, you know me, and you know where I am from. I am not here on my own, but he who sent me is true." John 7:28 and 29 NIV

cliff hanger

I don't like television cliff hangers.  I don't want to wait until next week or next season to see if Pam and Jim have a baby,  if Barney and Robin get together,  if Patrick Jane figures everything out in time or if Betty forgives Don.  (if you can name the 4 shows I'm talking about, you are my kind of TV person!)  I like to watch the end first and then rewind.  (yep, you read that right) My favorite part of a show is the scenes from next week.  I want to know what is going to happen!


No such luck here.  Every day in the hospital there are never-to-be-resolved cliff hangers.  I spend 2 hours with a car wrecked family whose son is getting a cat scan.  I never see them again.  I get turned down at a room by a woman with a black eye and broken jaw.  I never hear what happened to her.  I pray with a family in surgery waiting and never know if it all went ok.  I talk with a NICU family every day for 3 months, then come in one morning and find them discharged.   My time with all of them is brief and defined.  The next step, the next phase, the rest of the story has nothing to do with me.


That is a hard part of this job for me.  Sometimes I have to remind myself that God knows their whole story and that He walks with them from beginning to end, even though I can't.

Last Sunday, the four residents provided a memorial service for anyone who had lost a loved one here in the last three months.  Our thoughts were on making it a fresh and meaningful service.  We were all surprised to see families walk through the doors who we knew from hard moments in the Emergency room or Neuro ICU or the Heart Center.   And they recognized us!  I saw family members in line light up when they spotted Nathan.  "He's our chaplain!"  I watched people make their way right over to Cathie and Vicki to catch up.  I felt warm hugs and soft smiles from my people.  And I had time to ask "how are things going for you?"  My little follow-through-deprived heart was overflowing!

He has made everything beautiful in its time. He has also set eternity in the hearts of men; yet they cannot fathom what God has done from beginning to end.  Ecclesiates 3:11

self care

Wow!  Who knew Jesus told the Good Samaritan story just for chaplains.  What a rich parable.


We talk a lot about self care in this hospital.  With all the intensity and heaviness we have to be careful.  Self care may mean thorough processing of tragedies.  Or eating lunch outside after a morning in the dark NICU.  It may look like finding ways to get your homework before you go home, or laughing with the other residents after a patient has been particularly rude.  It may even take the form of obsessive blogging to mark the path and remember lessons learned.


The Samaritan gives us a great image of balance and self care.


"The Samaritan finished his journey.  The Samaritan finished his journey while meeting the need of a wounded and marginal person.  The Samaritan did not give everything away; in this enigmatic parable, he did not injure, hurt, or neglect self.  He loved himself, and he loved his neighbor.  He relied in a sense on the communal, on a type of teamwork as represented by the inn and by the host at the inn."  Images of Pastoral Care, Robert Dykstra.



'Love your neighbor as yourself.'   "You have answered correctly," Jesus replied. "Do this and you will live."  Luke 10:27 and 28 NIV


Stuart - that's a van gogh!  how you like me now?

testimony

At the end of my last verbatim, my supervisor asked me "what picture of God did this patient see in you?"  It was a hard question for me since the visit was cut short, and no religious dialog took place.  It's easy for me to want to judge the worth of the visit by the depth of spiritual conversation that we shared. 


In our Pastoral Care class we are reading Dykstra's book Images of Pastoral Care.  Here is a great quote I read this afternoon.   "Perhaps the man going from Jerusalem to Jericho had made the trip a hundred times without incident.  If the Samaritan had fallen in step with him on one of those occasions, he might well have presented verbal testimony to his faith.  No oil or wine or bandages would have been required.  But this time nothing else would do.  What was needed was oil, wine, bandages, and an inn.  This was the sole relevant testimony for this occasion. Whatever might be true in other places and at other times, the one way in which proper testimony might be given in this place at this time was by shepherding."  


Jesus told him, "Go and do likewise."  Luke 10:37 NIV