Weekly Reflections

“What religion are you?” asked one of the administrators not long after I got to the ER in New Jersey. 

Unitarian Universalist.

“We don’t have that.  Do you have another religion?”

Is that like choosing soup when they don’t have salad?

“Um, Buddhist.”

They had that.

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Pain.  The unsmiley face.  A ten.  I surpassed my previous pain threshold on Saturday, breaking through Morphine, then Dilaudid, and finally finding relief with double Percocet.  At 3 a.m., before relief, there was Mama's hand and my breath.  Love and mindfulness, two of my spiritual practices.  With eight years of using breath meditation to address chronic pain and surgeries, I tried to use those techniques to get through the night.  Stay in the moment; don’t begin to tell stories about what had happened or what might happen.  Look at the pain closely—is it  sharp? Achy? Constant? Pulsing?  Really examine the monolithic idea of pain.  And breathe.  Keep breathing.  Through the nose, out the mouth, if you can.  I know I tend to huff when I hurt, expelling breath as a coping technique.  With the meds, my wife, and my breath, I fell asleep eventually.

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Mama had left a voicemail for the chaplain on Saturday.

I left a written note for the chaplain on the desk on Monday when I borrowed a book from the chapel.

On Monday, near the chapel, I saw the chaplain walk away before I could say hello.  Later a man walked up to us, looking for me.  "Are you the chaplain?" I asked.  "Far from it," he scoffed.  He was one of my doctors.

We left late Tuesday night.

I never met with a single member of the chaplaincy department.

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The chapel was beautiful.  A polygonal building on the hospital’s roof with 200-degree views of the surrounding Jersey Shore, the windows had both colorful stained glass depicting nature—turtles, geese, the sun—and clear etched windows of the nearby boardwalk.

There were a few rows of padded pews and a simple altar with various Christian reading materials.  One was Ernesto Cardenal’s Abide in Love, a small giftbook with short paragraphs on a variety of topics.  I borrowed it to read back in my room. 

Before we left, Mama and I sat in silence.  I meditated, offering metta for myself and all those in the hospital.  I think she was doing the same; or napping.

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Abide in Love.  I can’t really respond to Cardenal’s theology, having read the book between naps and not having a copy with me now.  I do recall thinking that, by defining God as everything—except sin—in order to say that even atheists are religious (actually more religious if memory serves—something about atheists embracing the idea that God does not exist and is nothing, both apophatic ideas), Cardenal was hedging his bets. He focuses particularly on God as love; similar ideas exist in some of my CPE readings, including Karen Armstrong’s Case for God and the writings of Rev. Kate Braestrup.

Love as a practice.  Religion as an action.  Agape, philia, storge, eros. The Golden Rule.  1 John 4:16.

Everything Mama did that week was love in action.  I was surrounded by love—hers, my kids, my in-laws who rushed to help out, my family in Texas, our community in Connecticut and online, the doctors, nurses, aides, and staff members. 

Not the chaplain, though. 

This was religion in practice.   And it didn’t matter what the label in the computer was.

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I have looked on this CPE as a period of discernment in my chaplaincy ministry.  To become a UU hospice chaplain, I would need to complete 4 CPEs and also earn an MDiv, in addition to other requirements.  I wanted to know if I loved hospice and wanted to follow the call to chaplaincy enough to complete the requirements of what would be my second career.  The answer, I have found, is yes. 

The 300 clinical hours and 100 educational hours I have completed have been eye-opening.   At hospice, I have held the hands of a woman deep in dementia, sung to a dying man, read to another.  I have prayed over the bodies of beloved family members; I have sat with a distraught teenager as her father’s life has ended.  I have prayed with Protestant and Catholics, Jews and Hindus; I have offered my ministry of presence to those who do not pray. 

I have reflected on those experiences in writing case studies and weekly essays.  I have analyzed them for transference and theological issues, considered better open-ended questions and prayers.  I have discussed them with both on-site and CPE supervisors and my cohort.   I practice taking the constructive criticism as a gifting and as a learning opportunity, striving to improve my skills as a chaplain and to reflect on myself.  I know there is still so much to learn, to practice.  I’ve grown so much in the last few months and am inspired to continue. 

Being in the hospital and home recuperating these last two weeks have clarified my call as well.  My CPE supervisor asked last night in our ZOOM meeting if not seeing the chaplain had affected my recovery.  And I had said no, but not because I feel chaplains have no effect.  Instead, I received the spiritual nurturing I needed from friends instead of the official chaplain.  I knew I needed the spiritual support and sought it; it does make a difference—and it lifted me during the hard moments in the hospital.  I know when I do the work of ministry that I make a difference for those I work with. 

And I love the work, both with others and on myself.  I want to continue and will be pursuing that MDiv and other CPEs later.  Until then, I will continue to volunteer at hospice.

Bless This Body

I was very touched by being with a deceased patient while the nurses prepared her body last week.  But I searched for something appropriate to say or pray (she was Jewish and I’d already said the 23^rd Psalm.)  Similarly, when I was visiting my homecare patient who has no religious tradition, I wanted a longer ritual for massaging her hands and brushing her hair.  I started reflecting on a blessing for bodies that could be used both before and after death, the very physical bodies that are suffering and dying but had once been full of life.  I thought on the blessing of the hands that I knew from my last hospice position, and then searched online.  There are several variations of blessings of the physical body from the body-washing rituals of Judaism and Islam.  I also found a Wiccan variant.

Here is mine; it is not a poem with a final version but a draft always in progress.  Adapt based on the person; adjust to present tense for the living, past for the deceased.  For a less pagan version, I might adjust “blessed be” to “I bless”; you might even say “thank you for” or “we are grateful for.”

Bless This Body

Blessed be your hair that has felt the touch of wind and rain;

Blessed be your head, where dreams were made and memories cherished;

Blessed be your eyes, that have seen beauty and sorrow;

Blessed be your ears that listened to laughter and cries, music and silence; 

Blessed be your lips that have kissed loved ones good night;

Blessed be your shoulders that have carried children and burdens;

Blessed be your arms that have wrapped us in your love;

Blessed be your hands that have worked and strained, tickled and touched, created and cared;

Blessed be your heart that beat in time to the joys and sorrows of this world;

Blessed be your lungs that gave breath to your voice;

Blessed be your skin that has glowed in the warmth of the sun;

Blessed be your legs that stood proud;

Blessed be your knees that have knelt in wonder—at a child, at a flower, in prayer;

Blessed be your feet that carried you on your own path through life.

Blessed be this body, this person, our loved one.

Blessed be.

CPE Reflections

I don't even know where to start to tell you about CPE, here about one-third of the way through the unit.  Here are some of my reflections:

On being a part-time (unpaid) working mom:

• On my first day, I was an hour late getting home because of traffic and Sis was late to horses.
• On my second day, Sis missed the bus and thankfully a friend could pick her up.
• On my third day, it was a school snow day but not that terrible so I went to work and the kids stayed home.
• One time, a kiddo misunderstood that I'd be home extra late and was upset and scared.
• Many times, I have just not had the ingredients or wherewithal to cook; we're eating a lot of take-out and odd dinners.
• Same with laundry not getting done regularly and kids wearing not-quite-clean uniforms to activities (so now they are doing their own laundry!)
• and we are weeks behind on regular medical check ups (and will be weeks more.)
• I have to hibernate away from everyone so I can write, attend online classes, and read.
• Even when it's not actual work, I'm distracted and feel like I'm out of time and missing something.

On my CPE professional, personal, and spiritual goals (which we had to write up in the beginning):

• I will seek out my place in spiritual care as a humanist Unitarian Universalist chaplain, because I sometimes feel a lack of worth and authority as a chaplain—“impostor syndrome” perhaps—which hampers my ministry.  I think this is the result of at least two issues: 1).  I am at the beginning of my journey in pastoral education and still very much learning in all areas, and 2).  I am not a Christian but currently often only see Christian chaplains as work at hospice—while they are good role models in so many ways, we have theological approaches.  Many of Connecticut Hospice’s volunteers are Roman Catholic deacons, brothers, and priests and so the focus is often on communion, mass, and the Sacrament of the Sick, for our Catholic patients (I’d say 75% of our patients are Catholic).  I believe I have something to offer all of our patients, but I struggle sometimes with overcoming my doubts;
• I will become more familiar with the stories of the Bible so as to communicate more effectively and authentically with my Christian patients (I was raised in a decidedly non-Christian, atheist family and I continue to make great and conscious efforts to overcome the lacuna in my Biblical literacy) and to understand the spiritual metaphors of the stories to inspire my own spirit;
• I will continue to expand my multicultural/multi-faith competency so I can connect more authentically with people of different faiths;
• I will work on my communication skills, particularly my initial visits with family and patients in order to overcome awkwardness and promote greater connection.  I do a lot of “cold” visits and know that the first few minutes, my first few sentences, are crucial to establishing connection;
• I will improve my use of open-ended questions to facilitate discussion;
• I will learn NDoc, the platform used at Connecticut Hospice for tracking patients; 
• I will learn the processes for IDT for Connecticut Hospice homecare patients;
• I will continue to master the reporting practices for Spiritual Care visits.
• I will reignite my meditation practice;
• I will continue to study spiritual resources of prophetic men and women from many faith traditions for my own spiritual growth;
• I will investigate and adapt traditional religious language—notions of grace, faith, blessings, God, etc.—as relates to my liberal progressive beliefs and use this language to facilitate interfaith dialogue.  (For example, I have learned to think of my metta—lovingkindness—meditations as prayer and to describe them as such to others; similarly, I do not use the term “God” to express my understanding of the universe but recognize that my beliefs in love, the spirit of life, and community are encompassed by the word God for many people.)

On patients and visitors I remember:

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• the young man with the brain tumor whose extended family and friends circled around him daily to provide comfort and support.  The hardest part?  Seeing his toddler running around the lobby and talking to his parents about watching their beloved son slowly die.
• the African-American Baha'i gentleman who believed in a loving God but wasn't sure religion had made the world a better place, seeing how so many Christians and others preached such hatred, especially now and who said that we couldn't have talked like we did when he was younger because the white supremacists would have killed him for being alone with a white woman.
• the happy Finnish woman with the beautiful crocheted blanket her mother made 90 years ago, who liked to talk of her home and the summer place by the sea and had seen her parents visiting her.
• the very angry woman who blamed hospice because her husband was deteriorating and she didn't have much time left with him and who then got another woman in the room upset that her brother was dying, too.  That woman, the sister, did find some comfort that day in my singing to her brother.  
• the woman who wanted came at me in the hallway sobbing, begging me to pray aloud for her mother in accordance with her own conservative Protestant Christian views--so that I convince her sister and her dying mother that they were wrong to be Catholics!
• the family that demonstrated so much equanimity in the face of the medical malpractice that had led to their mother's dying in hospice.
• the woman who didn't understand what her dying father was waiting for (because he would have hated being like that and they had all said goodbye but would stay with him until the end--was he waiting for his birthday? the Patriots to win the Superbowl again?) until she opened the window and he breathed the fresh air and died.
• the woman who was an artist who painted lovely portraits and landscapes and hated that people would patronize her because she couldn't talk above a whisper because of her cancer, who felt comfort in knowing that her siblings had been through the same thing before her.
• the woman whose friends held happy gatherings everyday, raucous and joyful--and teased me that as volunteer chaplain I must be too pure for them.
• the woman who was telling funny stories when I showed up--and someone asked if I had "the weed?", leading to a conversation about spiritual care, family and friends, and recreational drug use.
• the woman who kept crying out in pain for help and for a daughter who was not there with whom I sat until the third dose of something finally relieved her.  
• the Catholic patient who died right on his arrival at hospice whose family was still arriving--and how devastated and guilt-ridden they felt that he hadn't received the sacrament of the sick, whom I led in prayers at the bedside because I was the only Spiritual Care volunteer there.
• the woman, who was a "fan" of Mary and Catholic television but belonged to no particular faith community (though she had been Lutheran, Presbyterian, and "Epistopalian") who begged for reassuring verses on heaven and all the prayers, blessings, and rituals of any religion in her panic about her mother's active dying.
• the Ukrainian Jewish siblings who were transferring their 90+ year old dying father back home so their mother, who couldn't travel, could be with him at the end, and who were sad that he had received such indifferent care at the nursing home when there was such loving care at hospice (what was America coming to?)
• the woman deep in the grip of dementia who would become so anxious and agitated when I came to her bedside that I quit visiting so she wouldn't become upset.
• the young gay man with HIV/AIDS who was not quarantined or discriminated against the way he would have been thirty years ago--and all the loving friends and family who surrounded him and how we talked about Pride parades and Macy's.
• the older gay man whose partner was always there, who loved dogs; it was heartbreaking to hear how he had said goodbye to his own dogs before entering hospice.
• the woman who was a writer/illustrator and had left such a creative legacy for all of her children.
• the woman whose bedside table was decorated with photos of many years of annual family reunions (all over North America) and all the happy memories her children shared with me about her.
• the older Catholic gentleman who came to Mass every week but didn't talk much to anyone when we'd visit his bedside; he had a kind face.
• the former UN employee who wandered the halls during PT and would talk to me about books he loved to read and asked what the nautical flags on our pole meant (they are non-sensical.)
• the former hospice volunteer who had many employees at hospice visit and invited me to sit down when I said I was a UU.
• the visiting family member with the beautiful voice who sang along with the pianist and me to a version of "Water is Wide" with words referencing the mass shooting; we all hugged at the end.
• the patient and his wife who regularly sailed out of the harbor seen through our window who told us that the island with the green buoy was Mermaid Island.
• the gentleman who was actively dying and whom I was praying for with a volunteer when the grumpy nurse snapped at us for trying to wake him up (which was not what was happening; same grumpy nurse has snapped at me for visiting a woman with dementia, thinking it encouraged her hallucinations.  I avoid whatever room she's assigned to now.)
• the daughter who came into the Commons room while I was playing Greensleves who thought it was a sign from her mom who had just died minutes before because it was her favorite song.

Other Observations about clinical hours at hospice:

• As a volunteer, it took awhile for me to be recognized as a member of the team by the full-time employees; they are very used to me now and know to come find me.
• There is too much paperwork and no one seems to understand the whole charting system, which is both done by hand and by computer but we're not sure how they integrate the two.
• I am more nervous visiting a patient who has visitors than one who has not; I feel like I'm interrupting their visit.
• I never wake a patient.  Like sleeping dogs and babies.
• Patients who are still awake and alert often suffer from loneliness and welcome company and my visits.
• The view is most comforting to the visiting family; I'm not sure how well our elderly patients lying in the (very fancy and expensive beds) can see the Sound.
• The staff, volunteers, and families were intrigued to watch the Bald Eagle eat his lunch on the ice floe this winter.  There apparently have been a few meaningful bird sightings, like the hawk that watched a memorial service for an employee and flew away when it was over; other hawks have sat outside windows until a patient's death and then flown off.
• Everyone loves the therapy dogs--staff need them as much as patients, I think!
• Psalm 23, the Lord's Prayer, and/or "Amazing Grace" seem to transcend any particular faith and are comforting to so many.
• I like our terrible old out of tune piano in the Common Room.  I try to play Greensleeves there but can't avoid the worst notes.  Still, I like to play.  I also like to sing at Mass or the Interfaith service, even though Christian hymns aren't my favorite (especially because they don't use the UU changed lyrics!)  Two that stick with me are "How Great Thou Art" and "In the Garden."  
• I've made a few small afghans for hospice and have been touched to recognize them on the beds of patients.  Gotta buy more yarn!
• I don't wear scarves to work because they dangle and could cause infection to spread.  I also always wear short sleeves because it is so warm in the building (due to all the windows and the need to keep patients warm); I usually have a very light sweater, which I take off if I have to gown up for infection protections, which is doubly warm.
• Nurses order a lot of take-out for and any snack brought disappears super quickly.  Even faster than with teachers.
• I really like the people in the art therapy department--mainly music and art people, which really isn't a surprise.  In fact, when they hold events, it's a lot like a museum education program with different crafts!  And the musical ones are so gifted.

CPE Observations:

• Thank goodness for this blog and my reflective writing habit of the last ten years.  Everything I write for CPE is similarly reflective, not like academic writing at all.
• So far, the verbatims and class sessions have been less daunting than I expected from the memories of friends who have done them elsewhere before.   I just shared my first case study verbatim this week and have only received a few "giftings" (critical/analytical comments.)  But oh, one of them was very touching and encouraging.  Still, I've been anxious waiting for their responses.  And I have to present to the group this week in our class, which is doubly nerve-wracking.
• And while the online modules were very informative, the final test was ridiculous--it didn't really evaluate what was learned but focused on minute details (what hospital did the author of that one article work at?) and word-for-word definitions and comprehensive lists (I think the module instructors must have a chip on their shoulder in the heavily evidence-based medical field in which many of them work and are trying to make it more scientific.)  Blah.
• The book we have to read, by Anton Boisen, reminds me of Spring Awakening, with the struggle of repressed sexual desires causing an emotional/spiritual crisis for the author.  I've about 1/3 of the way done with it.  Boisen is often seen as the founder of the discipline of hospital/healthcare chaplaincy.
• Other things I'm consulting:  Karen Armstong's books Great Transformation: The Beginning of Our Religious Traditions, The Bible: A Biography, The Case for God, The History of God; Scotty McLennan's Christ for Unitarian Universalists; John Buehrens's Understanding the Bible: An Introduction for Skeptics, Seekers, and Religious Liberals; Neville Kirkwood's Pastoral Care in Hospitals; Interfaith Ministry Handbook; The Work of the Chaplain; What do I Say? Talking with Patients About Spirituality; Arthur Becker's The Compassionate Visitor; Professional Spiritual and Pastoral Care: A Practical Clergy and Chaplain's Handbook.  And, yes, The New Oxford Annotated Bible.

Hopefully that gives you a sense of what I've been doing for six weeks or so.