wonder full

Recently I was sitting at Urban Burrito, eating a bonehead salad with two friends.  I was telling them about a trauma I had attended that morning.  One of the women, (not naming any names, Barb) began to laugh at me.  "I can't believe you are being so matter of fact about such an injury.  Who are you?  You have gotten so jaded."


I thought about that later.  I have seen a lot.  And I'm doing better at taking it all in stride.  But I still get paged and wonder if I will be able to stomach what's on the other side of it.  And I still leave a ministry experience feeling awed that I got to be a part of it.  So maybe not too jaded yet.


Today my family and I flew to California.  Everything about flying is excitement to the boys.  Riding the tram from long term parking.  Wow!  Taking your shoes off to go through security.  Wow!  Being greeted by the pilot.  Wow!  Each boy getting a single window seat in our tiny tin can of a plane. Wow!  Steve and I showed them how to lean their seats back and put their tray tables down.  Wow! Mom, look, our own desks!  (We are such genius parent travelers.) 


The boys had wide eyes as they chose Sprite - yes please! and accepted pretzels - thank you!.  And across the aisle Steve and I beamed at our big boys, with their back packs and window views, full of joy and anticipation.


There is still plenty of wonder to be had in this world.  And today I got to enjoy a bunch of it. Wow!


Many, O LORD my God, are the wonders you have done. The things you planned for us no one can recount to you; were I to speak and tell of them, they would be too many to declare.  Psalm 40:5

in between times

There is this in between time in the hospital.  

The bad news has been delivered.  

All hope of recovery is gone.  

We just wait.  

Wait for the lines to straighten out.  

Wait for grieving to officially start.  

Wait for it to be over.

I was surprised to discover how long death can take.  And how different people spend that in between time.

*Some families spend that time hoping and praying for a miracle.

*Sometimes it is one son clutching the last few moments with his mom.

*Or one dad weeping over the unfairness of saying good bye to his daughter.

*Sometimes we stand in perfect silence watching the monitors for signs that it's done.

*This evening it was a wife of 63 years, telling me stories of how John hated onions.  How he would take one bite of her dinner and wrinkle up his nose if he tasted onion in the food.  For a hour and a half of the in between time she told stories - how they met, where they lived, and worked, and traveled, and we laughed at the memories.  We took breaks in the story to be quiet and count the seconds between his breaths, holding our own.  And then when he inhaled, the stories would continue.

It was the strangest yet holiest of in between times.  Waiting and laughing and stories.  Wrapping up his life together.  She, who had known him intimately for 63 years. The love of his life.  Me, who had walked into the room 90 minutes earlier, yet had already fallen in love with both of them.

In between times always end.  The sun set.  The last breath was breathed.  She kissed him good bye and picked up her bags.  Her life would never be the same.  

And in a tiny way... neither would mine.

God said, "You are close enough. Remove your sandals from your feet. You're standing on holy ground."  Exodus 3:5  

naked

Man vs. Wild is The Show around our house.  Last night Bear Grylls trudged through snowdrifts, then stripped off his clothes and chopped his way, waist deep, through a frozen glacial river.  We got frost bite just watching it.  Though the camera blurred the appropriate appendages, the crew's jokes on shrinkage led to an interesting family explanation with our young boys.


The next day it hit me.  In the hospital nakedness is never about sport or sex.  It's about helplessness, loss, pain and vulnerability. 


In the trauma bay, clothes are cut off as the medical team rushes to save a life.
In a hospice room dementia causes an elderly woman to keep pulling her night gown over her head while her sons and grandchildren struggle to retain her modesty.
In well baby nursery several of us crowded around a fat, sleepy, naked baby to view a circumcision "procedure".


Nakedness is everywhere in the hospital, prompting these words during a recent debrief - "sometimes I don't know where to look."  Our supervisor replied "Maybe that's how the friends of Jesus felt gathered around the cross."


Silence.  Wow.  Our Jesus naked, helpless, hurting, vulnerable.  Another reason to look for His face in our patients.


I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.'  Matthew 25:36

ignorance

oh. my. goodness.  Every day at the hospital I see substantial gaps in intelligence and wisdom unfolding.


*a girl wheeled in for her third "texting while driving" accident.
*a boyfriend accidentally shooting his girlfriend while sitting together on the couch.
*people stepping outside the lobby of the cancer center to smoke.
*families bringing "picnics" of fried chicken, donuts and mountain dew to patients in the heart center.
*the lady serving in the lunch line who told me "I couldn't be a vegetarian because I hate all vegetables." (I'd hate them too if the all the veges I'd ever eaten were boiled in bacon juice.)


foolishness thrives.


but reading for our theology class today reminded me that we all miss something.


There is always something we're ignorant of about another person.  And often it turns out that the one thing we're ignorant of about another person was the most important.  T.S. Elliot


just reminds me that with each person I encounter there is so much I do not know or understand.  pain, triumphs, struggles, growth.  maybe the very thing that would make me see them clearly as precious, valuable people.


Now my eyes will be open and my ears attentive to the prayers offered in this place. 2 Chronicles 7:15

security

While roaming all corridors of the hospital at all hours of the night, frequent security guard sightings are comforting.  I'm familiar with all of them and we usually wave in passing.  One in particular I see a lot.  Pete. Stocky, shaved head, wrinkles etched into a scowl.   Tough guy.  I'm glad we are on the same team.  I wouldn't want to cross him.

I got paged late in the evening.  tragedy had happened.  The patient didn't make it.  Family had been summoned and had to be told.  Security had been called too, since this was a large family and the news would be unexpected.  I was glad to see old Pete.


What an awful hour.  When it was over and family had left, Pete and I ended up limping out the same door.  As he held it open for me I was surprised to see tears on his cheeks.  "Just isn't right, telling a daddy his kid is gone." he said.


Then he told me about his sister, sick in the hospital years ago with cancer.  How she talked about heaven and as she was dying they asked for God to give them a sign that she was in good hands.   She breathed her last.  30 seconds later all the lights in the hospital blinked.  Pete said "I knew then that it was ok.  I know i'm saved.  And that I was put here to help others in their hard times."


Sweet Pete.  Gives a whole new meaning to security.


"The word of the LORD you have spoken is good," Hezekiah replied. For he thought, "There will be peace and security in my lifetime."  Isaiah 39:8

handshake

The page for the trauma bay warned me that the patient was a victim of an accidental gun shot wound.  She was wheeled past me, having lost lots of blood and now very pale.  The medical team sprung into action. IV's, bags of blood, oxygen, and chest compressions.  But we were losing her.  Time was running out.  All of a sudden a rib spreader appeared and the next thing I knew, a young doctor had his hand in her chest, around her heart, squeezing the beats out of it.  She revived.  And was rushed to surgery.


3 hours later I was paged back to this story.  The patient had died after a long surgery.  The doctor asked if I would go with him to tell the family.  I stood quietly beside him in the consult room praying for his courage as he broke such horrible news.  Praying for strength for the family hearing it.


When all was said and done, the doctor turned to me, introduced himself and thanked me for coming.  He reached out to shake my hand.  I realized that this hand grasping mine had been wrapped around a woman's heart just a few hours ago.


Yet I am always with you; you hold me by my right hand.  My flesh and my heart may fail, but God is the strength of my heart and my portion forever. Psalms 73:23-26 

communing

In our office we have little, thimble sized cups of grape juice with peel back lids.  They go with the postage stamp size, individually wrapped crackers also on the shelf.  If a patient requests the sacrament of communion we can hygienically, conveniently and painlessly respond.  It's a bit of a stretch as symbols go.  From 12 sweaty, hungry disciples cramming together into the last available upper room to break bread and gulp wine and celebrate the Exodus to this plastic cup?   I can find nothing hygienic, convenient, painless or tiny about our beaten and bleeding Jesus hanging on a cross all day.  BUT... it is a treasured symbol.  And I have anticipated the day when a patient on my floor, or during my shift will call for it and I can lead them in communion.


I love communion.  I've participated in communion in a barn, on a beach, at sunrise on the top of a mountain, in my living room with my small group, and in another country on a mission trip.  I've led communion in high schools and nursing homes and many many times at my church.  There is just something about standing with people you know and love, real people with real struggles, and holding up His body and His blood to remember together.  


It's been 56 weeks since my last communion.  There has been a lot of "water under the bridge" since then.  Many times I have longed for that experience and wondered when it would happen again.  Would there be a time when I would at church?  Should I lead it on a Friday night with my family?   When would a patient request it and I could do it then?


This week we began talking about Lent and Ash Wednesday.  These are new concepts for me since I didn't grow up celebrating either.  As chaplains we were to provide an Ash Wednesday opportunity for the patients and staff of the hospital.  I learned that this is a day of repentance and it marks the beginning of Lent. Ashes were used in ancient times, according to the Bible, to express mourning. Dusting oneself with ashes was the penitent's way of expressing sorrow for sins and faults.   I loved the biblical significance of this and looked forward to offering this experience.


Wednesday morning we found thoughtful liturgies on our desks to help us lead in the imposition of ashes and with communion.  We met in our little chapel to go over the short program.  When I saw the pottery chalice and napkin wrapped loaf of bread I thought again of how I missed communion and wondered when I would get to be a part of it.


Then our supervisor, Robin, called for a moment of silence, and then began a run through of the program.  We read together beautiful words of repentance from Psalms 51 


Have mercy on me, O God, according to your unfailing love; according to your great compassion blot out my transgressions.  Cleanse me with hyssop, and I will be clean; wash me, and I will be whiter than snow.  Let me hear joy and gladness;  Create in me a pure heart, O God, and renew a steadfast spirit within me.  Restore to me the joy of your salvation and grant me a willing spirit, to sustain me. 


The sign of the cross was drawn with ashes on our foreheads, a mark of humility.  Then Robin began to read familiar words from the Gospels. 


While they were eating, Jesus took bread, gave thanks and broke it, and gave it to his disciples, saying, "Take and eat; this is my body." 


All of a sudden I realized that we were really doing this.  It wasn't just a run through "in case someone wanted it".  This was the real deal.  Robin broke the bread and handed me the plate saying "this is His body, broken for you, Erin."  I took a piece and handed the plate to Vicki.  "This is His body, broken for you, Vicki."  And she handed it to Nathan.  We dipped our pieces of bread in the chalice of grape juice, and there in the little hospital chapel we had communion. 


And when He had given thanks, he broke it and said, "This is my body, which is for you; do this in remembrance of me."  1 Corinthians 11:24

close the door

A wise counselor once said to me

that the ability to close some doors,

never to open them again,

is one of the principal signs of maturity.

Robert P. Maloney

I was in the EC when the fire alarm went off.  An annoying siren blared and doors slammed.  It immediately raised my anxiety but none of the medical staff even raised an eyebrow.  Soon it was over and I was paged to the ICU.  A simple trip.  Down a long hall, around a corner, another hall, an elevator, another corner, another hall.  I've done it 1000 times.  But this time everything looked completely different.  The fire doors, tripped by the alarm, were shut every 20 feet.  This made my simple trek a long, arduous and confusing one.  But had there really been a fire, these shut doors would have saved our lives.  

Lately, a number of my conversations have centered around the need to close some doors. From Stuart and Robin and Joe, three people who do not know each other, yet gave the same advice in their own unique and thoughtful words.  And then there was this quote from Open the Door.

There is a time to open and a time to close the door.  If we are going to fly freely and step deeply into our soul in order to live with greater consciousness, certain doors have to be closed.  When we stand on the threshold, we will be there forever until we make a decision to either go forward or turn around and go back.

Alright!  Alarm sounded. Doors shut.  Freedom beckons....

For we died and were buried with Christ by baptism. And just as Christ was raised from the dead by the glorious power of the Father, now we also may live new lives. Romans 6:4 NLT

heart racing

I've always heard the term "heart racing" used in conjunction with the cute guy driving toward you in his jeep, or the big date that starts in two hours.   Now I hear it all the time.  And in the hospital, it's not a good thing.

Thanks to Wikipedia (source of all knowledge) I've learned that Tachycardia comes from the Greek words tachys (rapid or accelerated) and kardia (of the heart). Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heartrate  - for adults around 100 bpm.  For new babies around 182 bpm.  When the heart beats rapidly, the heart pumps less efficiently and provides less blood flow to the rest of the body, including the heart itself. The increased heart rate also leads to increased work and oxygen demand for the heart (myocardium), which can cause a heart attack (myocardial infarction) if it persists.

I will feel so much wiser as I walk the heart floors.  I will nod sagely as the nurse shares that Mr. Jones is tachycardic.   "Hhhmm, 264 is a bit high isn't it. No wonder there was myocardial infarcting...." Aah, such a knowing chaplain.

But for Valentines Day, I will smile when I think of the things that make my heart race:
*having a fun date night out planned for me - thanks honey!
*the darling homemade cards "to my valentine Mommy".
*playing an intense game of "beetle!" during a road trip with my 3 men.
*planning a family trip to a place that doesn't have any snow.
*and the realization that at the end of this week there is another weekend. 

My health may fail, and my spirit may grow weak, but God remains the strength of my heart;  He is mine forever.  Psalm 73:26  (New Living Translation)

kangaroo care

One of the most precious sights in NICU is a parent giving kangaroo care to their baby.  Skin on skin creates warmth and bonding for the baby's body and mind.  The parent's body smoothly regulates the baby's temperature and lulls the baby into a sound sleep.  

Though it seems so simple and natural, kangaroo care has proven successful in improving survival rates of premature and low birth weight newborns and in lowering the risks of infection, severe illness, and lower respiratory tract disease.


Today I sat with a mom doing kangaroo care with her 3 day old twin boys for the very first time.  She was tired but elated.  Little bare skin on her skin.  Little hands resting on her chest.  Little fuzzy heads.  Little tiny ears.  Tiny plump lips.  Totally relaxed.  For 2 whole minutes I wanted to have more babies.  Then I just wanted to be that peaceful and trusting.


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

I see

A recent Newsweek book review, Invisible by Hugues de Montalembert, was another reminder that pain can lead to compassion.  That Jesus often works through wounded healers. Here is that story.

Thirty years ago, de Montalembert was enjoying life in New York City as a painter and a filmmaker when he burst in on two thieves trashing her apartment.  One of them threw paint remover in his face.  By the next morning, the 35-year-old artist was totally blind.  He plunged as deeply into despair as he did into the darkness that greeted him each morning when he awoke in the hospital after dreaming that he could see.

Times of adjustment followed.  Pain and change. Friends vanished, new friends were made.  De Montalembert resumed his world travel - Bali, India, Himalayas, writing and romance.

"The fact that I lost my sight is very spectacular," he says, "but there are things which are much more terrible."

In Paris one day, a Cambodian taxi driver extended his sympathy for de Montalembert's obvious plight.  The author thanked him but remarked that there were "people much more wounded than me."  The cabbie was silent and then said that his wife and children had been killed before his eyes in Cambodia.  "So there he was driving his cab in Paris with this huge wound that nobody could see." Except, of course, for the man who was blind.

Newsweek, February 15, 2010, page 53.

Now my eyes will be open and my ears attentive to the prayers offered in this place.  2 Chronicles 7:15

being pastoral

We verbatim and read and discuss and study about how to be pastoral in a patient's room.  I practice and sometimes feel like everything clicked.  Sometimes I'm just so glad no one else was watching.  Today in our Pastoral Theology class, through our Living The Questions dvd, Tex Sample told us this brief story that made it seem so simple.

A long term patient was dying alone.  The hospital staff put out a call for any pastor in the hospital to come pray with him.  One pastor answered.  He didn't wish to enter the room and be exposed to sickness, so he stood in the doorway and shouted in a prayer of forgiveness for the man's sins.  Confident he had completed his task, he left. 

The hospital staff was horrified.  Again they put out a call for a pastor.  Finally a seminary student responded.  She quietly walked into the patient's room and shut the door.  She didn't come out for two hours, and then only to announce that he had passed.  "What did you do in there?" the staff asked.  "Oh, we prayed, I read scripture, we held hands...mostly I just told him how much God loved him."

“Now which of these three would you say was a neighbor to the man who was attacked by bandits?” Jesus asked.  The man replied, “The one who showed him mercy.”  Then Jesus said, “Yes, now go and do the same.”  Luke 10:36,37

discordance

I spent hours in and around the NICU today.  Shadowing Dr. W, even for a few minutes, is like taking a fascinating medical class.  I absorb as much as I can and then feel little popping noises in my brain when it can't hold any more.  Today I met the brand new discordant twins he was working with.

           Discordant twins are those showing a marked
          difference in size (greater than 10% in weight) at
          birth. The condition is usually caused by
         *overperfusion of one twin and *underperfusion of the
          other.

Sure enough, one twin was obviously smaller and in greater distress than the other.  I kept moving from one incubator to the other, checking and rechecking. Marveling at the differences. And feeling so doctorial as I added "discordant twins" to the other medical words I learned today - hemodynamic and hypocondriachal.

My last run in with discordance was years ago with an assigned piano piece.  The music didn't sound right.  I was sure I was doing something wrong.  My teacher played the awful piece perfectly and assured me that I was playing the correct notes, the music was just discordant.  "Variety is the spice of life, Erin!"

There is no end to the variance and variety here in the NICU.

Today I talked with a 35 mom who has been in labor for two days with her first child.  We listened to the swoosh swoosh of her baby's heart beat and talked about her worries and impatience to have her baby out and safe.  A few minutes later I talked to an 18 year old mom who was hoping to get her tubes tied after her third pregnancy resulted in a preterm birth.  "How else am I going to keep this from happening again?" she asked me.   Argh.  A discordant note.

I peeked over the edge of a crib with an adorable, fat, curly headed baby inside.  This little girl just had to eat on her own one more time and she was good to go.   In a nearby incubator a tiny little alien looking baby, 26 weeks in, was struggling for each breath.  Discordant.

This week there was the addict mom, over all limits on three different drugs.  She prefered not to see her baby after birth, and quickly signed away all responsibility.  And not too far away, two anxious parents, desperate to have a baby, now stand between three incubators, praising the Lord for their three miracles.

Variance and variety. Discordant notes in the melody of the hospital and the music of life.

By day the LORD directs his love, at night his song is with me— a prayer to the God of my life.  Psalm 42:8


*if you know what over/underperfusion is....you should be writing your own medical blog!

depressed

There are two great places to be in this hospital.  One is the Labor and Delivery lobby.  It is usually filled with lots of excited and anxious people whose heads jerk up any time any one in a white coat walks by. 
They are expecting great news. 


5 floors above is the Well Baby nursery.  I regularly walk down this hall to peek in at fat, healthy, full term babies getting their first bath.  Often I am joined by relatives with cameras, cooing and bragging already.


I'm beginning to realize that beyond these two places there aren't that many happy people in the hospital.  Lots of really sick patients.  Some angry, hopeless, lonely or sad people.  Several grumpy and whiny ones. A few truly joy filled people. But for the most part, not a lot of laughter or smiles.  I wonder how that effects us.  Or how that, plus the freezing weather, plus the long hours, plus the never ending stream of patients effects us.


Former pastor Barbara C. Crafton writes about depression. I enjoyed her candid reflections and her view of how depression is another way we can connect with empathy to those we minister to here.


     At first, I didn't know I was depressed.  I thought I was just religious. 
    I knew I was beyond tired, beyond exhausted.  I knew I was out of shape.  I knew I was overworked. 
     What I didn't know was that there was any way not to be any of those things....
     I never would have killed myself, but I would have seen to it that the church killed me. Had it been left to me, I never would have stopped.  And I would be dead now.
    And I am not dead.  I am alive.  My life has changed dramatically.  I have said good-bye to people and things I hated to leave, chief among them that brave, funny little church and all the beloved people in it.  I have told the truth about what I can and cannot give.   
   Sparingly, I have even told it out loud, in public, and have been rewarded for that judicious sharing by answering stories of many other good and faithful people who have battled my old enemy, too.  You're depressed? one of them will ask, seeming a bit surprised that I would own up to such a thing in front of people, and I answer with a firm Yes.  That's probably the most useful thing I say to anyone there.   Jesus Wept -When Faith and Depression Meet.

A hostile world! I call to God, I cry to God to help me. From his palace he hears my call; my cry brings me right into his presence— a private audience! Psalm 18:6 (The Message)