Of Demons and Angels

"We were so worried about our dad on Saturday.  He was thrashing about and yelling things.  Totally not like himself.  He was possessed.  But then someone from our church came and prayed.  And the demons tormenting him left.  So we've kept up the prayers and he's been okay." 

I had never personally heard demons discussed in a literal manner before.  Metaphorical ones, sure.  And many friends believe that angels watch over them, especially deceased love ones.  But real demons?  No.  And my logical, rational mind kept thinking, "It's not unusual for dying people to have terrors and outbursts.  And then, with medications, they do settle down."  Just Google end-of-life anxiety.  It doesn't happen to everyone, but it happens, in varying degrees, some much more powerful than others. 

I think I underestimate the number of people who believe the supernatural world is as common as the natural one.  For me, it's just entertainment on television, our favorite series "Supernatural" about ghosts, werewolves, vampires, angels, demons.  Like "X-Files" and "Buffy, the Vampire Slayer" with two handsome brothers kicking butt with heart and humor each week.  But these two sisters as hospice truly believed a demon had inhabited their father on the way to hospice and had made him act out until the special prayers exorcised the demons.

And they weren't even Catholic!  I had only thought of exorcisms with respect to the Roman Catholic Church (when I wasn't thinking of the 1970s movie or our tv show.)  I checked in with our chaplain, the priest, who said there was a huge belief in demons in the evangelical church.  These Christians believe in deliverance (yep, I hear banjos and I haven't even seen that movie!), the idea of being delivered from demons via prayers and such and of needing to actively avoid being contaminated by demons.  This is why you hear that Harry Potter, Halloween costumes, rock and roll, yoga, etc., are tools of the devil.  There are even lists, like the one that appeared in my inbox recently:

I think I can tick off more than a few of those, including Eastern Religions, Meditation, Vegetarianism, Postmodernism, LOTR, Video Games, Harry Potter, Halloween, Fornication, Rock Music, and, yes, I've even seen Twilight!  And I have experienced, at least once, Palmistry, Tarot, Ouija, Wicca, Earth Worship, Divination, Dungeons and Dragons, too.  But I've never been a vampire or a werewolf (Lycanthropy.)  

I must admit to some cultural and spiritual prejudice--I really never believed people actually thought music invited the devil.  It's like a superstition out of the dark ages. Yes, the kids have friends who can't celebrate Halloween because it's satanic, but I figured that was a one-off.  How wrong I am, how small my world sometimes.  

And I don't really know what to do with it all.  I don't believe in demons, just like I don't believe in hell.  To be fair, I don't just reject the negative; I don't believe in angels or heaven either.  My world is decidedly not supernatural.  

But what if the supernatural is just the natural we haven't come to understand yet?  What invisible forces exist that we don't understand, like Chi or Chakras?  We've only recently come to understand x-rays, bacteria, atoms, radio waves, microwaves, Wi-Fi; and yet, we do not give them a second thought.  I'm still not saying I believe in demons or heaven.  But what don't we know?

Just this week, the NYTimes published an article about the Placebo Effect and how there might actually be bio-chemical processes unrelated to prescribed medicine or surgeries that can result in healing.

And how do I explain my own healing?  I've written (here and here) about how my physical therapist used alternative treatments to heal my back injury when a variety of specialists in the tri-state area couldn't.  I did benefit from what she would call spiritual healing--a combo of accupressure, chakra alignment, Integrative Manual Therapy.  It won't surprise you that she believes in angels and demons.  I suppose I could call it the Placebo Effect, but I really can't explain it and am often uncomfortable reflecting on it, or more importantly, the implications of it.  If I can sit and walk because of energy healing, do I need to believe in angels and demons?  I can't make that leap.

But to push against my beliefs and expand my experiences, I recently attended a Reiki workshop at hospice.  Reiki is a type of energy meditation and healing that is frequently used by various caregivers in hospitals and hospices.  One of the chaplains at my old hospice used to offer it.  And yes, my PT has been trained in Reiki, too.  I know and believe in the benefits of Buddhist meditation so I thought I would learn more about Reiki, which does include chakra cleansing (chakras believed to be energy wheels in the body, represented by the colors of the rainbow, backwards, purple to red), which is beyond my usual rationalism.  It was an intriguing day, not only for the instruction, but also to hear from my fellow students--who believe not only in spiritual healing and energy work, but also angels, demons, ghosts, past-life regression, auras, Tarot, psychics, and mediums.  My mind couldn't wrap around those things.  BUT then I had a Reiki session from one of my classmates and she was drawn to my lower abdomen--completely without knowing of my multiple abdominal surgeries and three recent trips to the ER for severe abdominal pain.  Coincidence?  Educated guess?  And then, when I received attunement--yep, the instructor tuned me towards the chi--I saw these amazing flashes of deep blues, greens, and purples quite unexpectedly. 

Our teacher repeatedly said that Reiki was not dualistic, i.e. not good and bad, it just was, based on chi, the Chinese theory on energy in the body ("ki" is the Japanese spelling.)  She assured us that we could only do good things with Reiki, not hurt anyone.  Which is akin to believing in angels but not demons.  How does that work?  If Reiki can be used to help or heal, how come it can't be used to hurt?  Especially since it is isn't specifically considered a good force, just a natural one?  Nature causes hurt, depending on your perspective, but in itself is a neutral, balanced force--I watched a beautiful Cooper's Hawk devour one of our yard squirrels yesterday; neither good nor bad, in sum, just natural (certainly, from either the hawk or squirrel's vantage point, it would have been a good dinner or a bad evening!)  I think I'm overthinking it all.

But it does seem to keep popping up for me, even with regards to our upcoming trip to Thailand.  I've been reading about the animism that flows through Thai life, in addition to Buddhism and Hinduism, a belief in spirits everywhere.  We have even watched two Thai movies recently, Pee Mak and Uncle Boonmee Who Can Recall His Past Lives, which heavily featured ghosts.  A belief in spirits participating in everyday life is so common that, I read, taxi drivers put icons or altars on their dashboards and trust in spirits, to the point of not wearing seatbelts.  Que sera, sera. I checked in again with our Catholic chaplain, who does wear his seatbelt (and has also officiated at an exorcism, which was a force of evil like nothing he'd ever seen, certainly beyond any psychological issues that people bring to him regularly, he told me.  He doesn't see demons appearing regularly in the world, and certainly not because of yoga or music), and he said that God expects us to help ourselves.  Which reminds me of that story of the man dangling from the side of the cliff and praying to God for help, but refusing the climber and then helicopter that comes to his aid, saying he's waiting for God; when the man gets to heaven and confronts God, God said, "I sent you a climber and a helicopter!"  Or a seatbelt.  

Whew.  That's a lot.  And it's all been swirling around in my head.  Still, I tend to see the world as more natural than supernatural.  And I'm really more concerned about the human community in our world than anything else (both how we fare as people and what we do to the Earth and each other); that's the work in front of me.  But that human community includes people who believe in a whole range of forces.   I don't have a tidy way to sum it all up beyond this poor paraphrase:  there is more in the world and in people's beliefs than is dreamt of in my imaginings.  

Hard Times at Hospice

I've been having a challenge at hospice this week.  But I can't tell you the most details because of healthcare privacy.

There is a person I'm visiting who is near the end of life.  I'm composed in her and her loved ones' presence, but when I leave the room, I get all teary and upset.  And when I've talked to our hospice priest and volunteer director about it, I get equally choked up.  I've always said, when people who've had loved ones in hospice admire my work in hospice, that it isn't the same as losing someone I know.  And that's true.  A couple of years ago, when I had the same patient for 18 months, I got teary in the same way the last few times near the end when I would leave, knowing it was very close to her end.  This hasn't even been like that.  And I'm somewhat surprised.  But our dear hospice priest, my buddy, teases me that I'm human. 

It doesn't help that many of my recent trips to hospice have been consumed with paperwork.  There seem to be fewer volunteers doing the data entry and filing, and I get stuck doing a lot of it, which means spending less time with patients.  I'm almost out of practice!  And then I'm reluctant to head to hospice because I dread the paperwork. 

So yesterday, in my sad state about my current patient, I just abandoned the paperwork, leaving it to someone else.  I sat with her, made her a card for her nightstand, spoke with her loved ones, meditated, and then had a jolly lunch with the priest instead.  I did the good work of chaplaincy and self care, not the bureaucratic stuff.

May she be free from disease, pain, and suffering and the causes of disease, pain, and suffering.
May she be at peace.

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.

-=-=-=-=-=-

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.

-=-=-=-=-=-

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.

-=-=-=-=-=-

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.

-=-=-=-=-=-

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.

-=-=-=-=-=-=-

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.

Reflecting on Yesterday

I have 79 hours left!  And five papers.  Here is an edited version of the one I wrote for Monday.

(Trigger warning:  death, medical descriptions)

Today I watched the nurses prepare a woman’s dead body for her daughter to come in the room to see her for the first time.  The daughter had arrived just after her mom had died, after a protracted illness in her late 80s/early 90s.  While the daughter called her Rabbi and her sister (in that order, I believe, because there was some family tension) in the hallway, I stood just beyond the foot of the bed, right inside the curtains, to watch.  The woman was not 10-15 minutes gone at this time, no rigidity had set in; when I touched her later, you could still feel some residual warmth.

The CNAs rushed, carefully, to get the woman ready, which mainly involves removing all the unsightly signs of death.  Bodies drain, a lot, when death happens, out of more than one orifice—and every time they moved her body, there was more drainage.  I think they had to change the sheets and her gown twice; she was on the small side but very clearly dead weight—they used a sheet under her to roll her from side to side.  Lots of linens piled up.  They put her in a new set of diapers, just in case.  Once she was positioned, they wiped her face and arms really well, removing all the schmutz that seems to gather on ill people.  The nurse wiped eyelashes and lips and front teeth and inside her nose and between all of her fingers and in the folds of her neck.  They added cleanser to her hair to comb it.  And used lots and lots of deodorizer, apricot-scented.  They covered her back up in blankets, tucked a pink carnation in her hands, and then tidied up the room.  All the medical supplies from her hospice stay were removed and her bedside table was put in order.  She was ready. 

Her daughter’s first comment was “Dead looks . . . dead.  She really looks dead.”  There is no way around that.  She kissed her mom and stroked her face, noticing that the warmth was beginning to leave.  She was sad but relieved.  No prayers now as she went in search of her arriving husband.  So much to organize for the funeral service and luncheon and shiva arrangments and apparently that sister to fight with.

After that, I went to meet and visit with the homecare woman about whom I’ve written before and in my last reflection.  She has become more lethargic and confused, owing to the meds used to treat her high levels of anxiety and increased number of panic attacks.  But she was glad to see me.  She can barely talk and fiddles with her oxygen (her levels dropped into the low 70s while I was there because she takes the mask and the tube off to cough and eject mucus.)  And so I massaged her hands with nice lotion and paraphrased a blessing I learned as a hospice volunteer years ago. 

Blessed be the hands that have touched life.Blessed be the hands that have nurtured creativity.Blessed be the hands that have held pain.Blessed be the hands that have embraced with passion.Blessed be the hands that have closed in anger.Blessed be the hands that have planted new seeds.Blessed be the hands that have harvested ripe fields.Blessed be the hands that have cleaned, washed, and scrubbed.Blessed be the hands that have become wrinkled with years.Blessed be the hands that are scarred from doing justice.Blessed be the hands that have reached out and been received.Blessed be the hands that feed those who are hungry.Blessed be the hands that comfort the dying and touch the dead.Blessed be the hands that greet strangers.Blessed be the hands that guide the young.Blessed be these hands.

We didn’t talk about death and dying, faith or the afterlife, she craved presence.  But I know what I would have said; I would have told a story, drawing on Kate Braestrup’s story in Marriage and Other Acts of Charity (as well as her idea that logos can be translated both as “word” and “story.”)  A religion professor (a student of Paul Tillich) used to ask his class to name what a woman looking out his window at the lake would most likely see.  They predictably answered “people, boats, water, birds, trees, etc.”  No one would mention the window, the glass right in front of the woman’s face, though even the cleanest window is a tiny bit visible as you look out it.  The religion professor noted that Jesus Christ was the window through which people look at God and that, continuously through the New Testament, Jesus points away from himself to God.  In that way, not just Jesus but all prophetic men and women point us towards the sacred; religion helps us understand our world and our place in it.  I would have reassured her that it didn’t matter which window she looked out of, as long as she took in the view.  But I didn’t want to tire her with talk, especially as her afternoon meds kicked in.  Her partner of 25 years ever so gently administer her meds and fluids through her feeding tube, carefully gauging the measurements and checking for leakage.  I hadn’t seen a feeding tube in action.  I felt my day come full circle--death and dying, illness, fluids, leakage, love, and care.  And I meditated, "grant peace to those who suffer and strength to those who help."

In Honor

Last week, I had a conversation with a hospice patient that touched me deeply.  He was an African American man born in the South in the 1920s.  And as he told it, he had seen so much violence and hatred in his lifetime--in fact, he said that when he was a young man, he would have been killed for talking to me alone as we were.  What was it all for, he wanted to know.  And where was religion?  Did I think that the world was a better place because of a belief in God?  He was thinking not only of our present challenges--terrorists in the name of Islam, Catholic priests who molest children--but of all the white preachers who supported racism especially in the Civil Rights era.  He was incredulous, saddened, at the anger and hatred.  He said he believes that God is love and wishes more people knew that, acted like it. I said that I vacilate in my thoughts on religion--that there has been much violence and prejudice and hatred in the name of God and belief systems, but that I had also seen many people trying to help their fellow humans and the world--feeding the hungry at our local soup kitchens and food pantries, collecting clothes and coats for those in need, housing the homeless in our churches during the winter, working for non-violence and social justice and the like.  He asked me if I had any good news.  I told him that I had hope for the future, paraphrasing King, that the moral arc of the universe bends towards justice. That while we couldn't have talked like this in his childhood, we can now and I teach my children so that they recognize the inherent worth and dignity of all people and work for justice and equality.  He seemed to agree. We said goodbye soon after.  I hope I get to talk to him again.

Hospice Happenings

A bit of a challenging day today at hospice because I got caught up between two sisters warring over their mom's faith (all were Christians; this was Protestant vs. Catholic.) I had tried a more inclusive prayer about light in darkness bringing comfort, but one sister wanted me to pray aloud at the bedside in support of her specific beliefs to let her sister know she was wrong and because she didn't believe her mom had truly converted. Whew. Don't ask me how I addressed it; it was messy and I have much to learn. I did manage to diffuse the situation by asking the passing guitarist to play some spiritual songs. They might not see eye-to-eye on theology, but they took refuge in the same songs. Still, I felt dissatisfied--just ugly in-fighting at the bedside all wrapped up in religion. I think if the one sister wasn't so afraid she wouldn't need to cling so hard to being right. And of course, I'm one of the last chaplaincy volunteers there who would be interested in which one was right.

I was pleased to see, in the midst of all the conflict, a crocheted blanket I had just donated on the patient's bed opposite us. Just a little subtle encouragement.

Some days are down, some are up. I'd had a really positive interaction on Monday, when I entered a patient's and met a visiting family member who was Deaf. We had a nice little chat in ASL about how they were celebrating the holidays with the patient and how I learned sign language. I was proud of myself because I sometimes have difficulties following long sentences but could understand everything he said. Yay!

And I received another compliment on my piano playing, this time from one of the music therapists. It certainly encourages me to practice more.

I have a two-week break because of the holidays, which will be great R&R. Then I'll be gearing up for my CPE which starts at the end of January.

Today's Surprise

What a day.  It started with FB posts about the death of a bright star in our local firmament.  I'm not upset by hearing about it online--it's no harder for me than a phone call or newspaper obituary--just sad in general, as I explained in an earlier post.

And so I stayed home from hospice, because I was down and a bit teary.  My chaplain supervisor encourages us to take time for things like this.  So I did.

I went to PT, getting in because of a canceled appointment, and then ran some errands.  I got home around 12:40 and logged in . . . only to find an email asking if I could confirm for my CPE interview--TODAY, at 1 PM!  Apparently, I'd missed the initial email last week.  And so I said yes, even though I had no preparation.

I interviewed with a chaplain at an NYC hospital and two other applicants via video conferencing (thank heavens my laptop was charged and easily compatible!)  I've had interviews but never a group interview (and I don't usually like skype/facetime stuff.)  And there was a mock verbatim for us to discuss and analyze.  My analysis differed significantly from the others (one who was a minister, another who had a DDiv!), which made me a little nervous.  But the interviewer said he sided with me and thought the chaplain in the mock scenario was avoiding and denying issues raised with the patient.  Whew.  Now I'm even more excited about the possibility of CPE, about which I hope to hear soon.

Coincidentally, the woman who died had received treatment at the interviewer's hospital, though I don't know if she knew the chaplain. And I wouldn't have been home except . . . .

At the End

My hospice patient, who broke her leg a few weeks ago, is declining.  And now she has a bad cold which compromises her breathing.  She was exhausted and uncomfortable.  It hurt to see her.  And I'm not sure I'll see her again.  So I said goodbye to her as I left, wishing her ease and peace.

I've had a lot of touching experiences at my in-patient hospice job in the last week or so--laughing with a patient and her friends who I interrupted during "girl talk" (they worried that they'd shocked me), admiring a man's dogs with him and his partner, listening to a daughter talk about her dying dad as her best friend, listening to several children describe the family reunions of their large and close family of which their mom was the matriarch, talking to a family member about embracing the goodness of life even in the dark times.

Lambeth thinks I'm morbid for thinking about the end of my life so much, but I think perhaps it's a way of understanding death, and therefore life, in some small way.  And I don't want to leave my family or myself less prepared than they could be (though of course, you're hardly ever really prepared and it's hard regardless.)

Some things I see as a chaplain:

• chaplains and various staff notice if there are no flowers or photos by the bedside--those things, as much as visitors, indicates support and love of the patient.  So, bring on the flowers and photos, blankets and stuffed animals, cards and signs.  One of my patients has a digital photo frame which holds many photos of her loved ones;
• a tip from a social-worker friend of mine: even if a patient can't eat or drink, sometimes they can still taste--swab their mouths with a favorite drink or flavor.  I don't know what mine would be; I can think of several (chai, chocolate, vanilla pound cake);
• to continue the tour of the senses, I must mention hearing, which is supposedly the last to go.  Favorite music on a player, favorite movie on the tv, someone reading a favorite book--these all bring smiles.  I routinely sing to hospice patients and they love it (and think I have a pretty voice, which is kind);

-=-=-=-=-

I wrote the above after my visit last week; my hospice patient is still hanging on and so I will see her tomorrow.  I didn't finishe it because I was focused on my CPE application, which I submitted today.  If all goes well--and I don't know how long it will take for me to hear--I should start in February.  

A friend of mine is having a double masectomy today to fight an aggressive breast cancer.  I've been thinking of her and all of the people struggling this holiday season.  There were a lot of family and friends at hospice this morning, visiting patients.  But one of the patients whose daughter I'd talked to several times had died.  And I think of my uncle and his widow.  And the woman in town struggling with advanced cancer.  And the family I took a meal to as part of my church lay ministry.  

And so I've been saving tonglen meditation.  Tonglen is a Tibetan practice with three parts where you open your heart, breathe in grief etc./breathe out love etc., and then breathe for a specific person or incident.

I breathe in darkness; I breathe out light.I breathe in suffocating, dank heat; I breathe out a refreshing breeze.I breathe in fetid, foul air; I breathe out freshness, the scent of the spring.I breathe in fear; I breathe out strength.I breathe in grief; I breathe out comfort.I breathe in despair; I breathe out hope.I breathe in hospitals; I breathe out home.I breathe in crisis ; I breathe out peace.

An Open End

It's been a really good week here at the beginning of my journey to chaplaincy.  First, because I was home with a painful knee (an inflammation flare up of some minor arthritis, apparently--age, weight, conditioning, and most importantly life-long limp related), I was able to spend last week completing my online Chaplaincy Care Volunteer Training course.  And I passed!  This was introductory but gave me some important vocabulary and strategies for my chaplaincy visits.  I also liked the administration of the course and mechanics of the online course and am therefore encouraged in my hopes to do a CPE (Clinical Pastroal Education) unit with them in the spring.

Then I spoke to my chaplain supervisor.  He encouraged my studies and liked my go-getter attitude.  When we reviewed my verbatim--a record of an exchange between patient and volunteer chaplain--he said that I was on the right track and learning quickly.  Yay!

And then last night, I attended a Lay Ministry training, with my fellow UU lay ministers (kinda like amateur community chaplains for our congregation.)  We discussed not trying to "fix it," being vs. doing, empathic listening, non-anxious presence, and open-ended questions.  I was familiar with all of these (from my online course and experience) but picked up some new strategies, specifically a great list of open-ended questions.  I sometimes flounder when talking to patients in how to get them to go deeper and be more reflective.  I rush through the silence, trying to get to the right question to unlock that next level.  Not exactly the best practice.  I liked these questions and look forward to using them.

• What's helping you get through this (really lousy situation)?
• What do you think keeps you from fixing the situation?
• What's been the hardest part for you?
• What's helped you through times like this in the past?
• How would your parents/grandparents have helped a situation like this--rituals, prayers, etc.?
• What are you hoping for? [This one was my addition and is one of my favorites.]
• Is there anything you would find comforting right now? What brings you comfort? What strengthens you?
• Is there anything from a spiritual perspective that helps--music, poetry, meditation?
• How is your family handling this?
• Are there any relationships that need healing?
• What is a moment of awe that you remember? What puts a smile on your face as you reflect?
• What gives your life meaning now?  What is meaningful to you?
• Are there any symbols that are sacred/important to you right now?
• What's on your mind/agenda today?
• What are your biggest concerns?
• Have there been any changes since the last time we met?  What has changed for you?
• Where do you turn for help?  Do you turn to yourself for help?
• How is your spirit today? [I really liked this one and can see using it instead of "How are you today?" which always seems to elicit something physical.]
• Is God/the sacred/the holy part of your life or spiritual practice? [Our minister says she often prefaces this with "This is something I ask everyone."  This is a great way to introduce the spiritual, akin to my question, "Do you have a faith community?"]
• Where is God/the sacred/the holy in all of this?
• Are you connected to something bigger?

In fact, these are great questions for anyone to ask themselves.

I just got a call that my longtime hospice patient had a fall and broke her leg.  I'll see her Tuesday, though, because she can't really verbalize, I won't be using those questions.  We've been together for more than 18 months.  And falls often hasten the end . . . .

Talking Faith

Today at Hospice, a Jehovah's Witness proselytized to myself and my fellow spiritual care volunteer about her faith.  I'm not sure how often I've been on the receiving end of such a strong impulse to convert me (even my Mormon friend doesn't try that!)  But she was so dedicated to her faith, supporting her through the death of her spouse.  I couldn't agree with her about her Savior and his Resurrection, but we all agreed on the importance of hope and community, which permeate most faiths.  We just give the light that sustains us in the darkness different names. Christ, God, Jehovah, Allah, Buddha, Spirit, Love, Mother Nature, Beloved Community . . . even science and humanity.  Afterwards, I spoke with my colleague, who is Jewish (and so was equally unmoved by the conversion attempt), and we continued our discussion of faith, hope, and community and how we functioned in a predominantly Roman Catholic environment. She likes Psalm 23 but rarely recites the Lord's Prayer, since it isn't about honest or true connection for her.  I've done the Lord's Prayer and "Amazing Grace" but not the Catholic blessing with the cross on the forehead.  For both of us, listening to patients and their families, truly connecting with them, serving our communities is a main tenet of our faiths, above and beyond communion, salvation, and witness.  Beyond this deep conversation, we talked kids and Connecticut.  I'm going to enjoy working with her.

The conversation reminded me of church, where I'm teaching RE this year--the kiddos' class, even.   "Neighboring Faiths" is the curriculum, which introduces kids to other religions--Judaism, Islam, Hinduism, Catholicism, Protestantism--through visitors and field trips.  I'm really looking forward to it, which is why I volunteered to teach (it'll help with my hospice work, too, even if most patients are RC.)  I think it's really important for the kids, too.  I learned through going to church with childhood friends--whoever I spent the night with on Saturday, I'd go to church with on Sunday (mostly on the Protestant spectrum, though--Presbyterian, Lutheran, Methodist, Southern Baptist, some Catholic, and my Hindu neighbors, though they didn't go to temple much.)    The kids groan a bit about going, but they know it's important to me.  And maybe, years from now, it will help them in their own discussions of faith and interactions with people of other faiths.  Or, they might even change faith communities.  Okay, sure, I'd be shocked if they became Catholic--like my cousin did, becoming a monk even--but I think as long as they kept to the spirit of UU principles--the worth of all beings, the importance of community, the responsible search for truth and justice, the respect for different sources of wisdom--well, it'd make for some good conversations.

Besides, having a better understanding of Catholicism will come in handy for our trip to Italy in the spring!

Hospice Thoughts

A Hospice Metta

May you be comforted.
May you be at ease.
May you be strong.
May you be free from suffering.

I've been working on the words of metta to fit hospice work.  Health, safety, happiness just didn't seem to be the right things to focus on.  And so I've been trying to think what I most wish for my hospice patients.  Strength instead of fear at the end of life, comfort and relief not pain, the support and comfort of family and friends, even hope for relief and good days though not a cure.

Since the middle of summer, I have been volunteering as a chaplain-in-training at a local hospice residence.  I go for several hours once a week.  As of yet, there has been no formal training beyond initial HIPPA, fire safety, and universal precautions.  I will have official in-service training later this fall, but they had wanted me to start right away.

I have been following various volunteers and the senior chaplain, going on rounds, going to IDT (interdisciplinary team meetings), learning about paperwork (oh, so much paperwork.)  The procedures have been a little overwhelming; there are just so many more patients than my one or two-at-a-time in my other organization.

But it is wonderful to have mentors with their guidance and support.  I've been often alone at my previous place (I'm still seeing my last patient, who is quite amazingly holding on.)  I'm learning new ways to interact with people and beginning to clarify my own style.  The senior chaplain even teste me last week; he had me go into a room, look around, and come back out.  I did and he quizzed me about the spirituality of the patients.  So, I guess absorbing and analyzing visual cues is something hospice and art history have in common.  That, and I'm much more adept at reading symbolism and religious icons than I otherwise would have been.

 One volunteer, who is a Catholic eucharistic minister but not quite a Roman Catholic anymore, has advised me that it's okay to give Catholic blessings with a cross on the patient's forehead.  I haven't been sure about this; indeed, I'm quite unsure.  I think prayers are one thing, but formal blessings in the manner of a priest are outside of my purview.  It seems to me deceitful, as if I could offer what a priest does (leaving belief aside.)  And so I don't.  Prayers, ecumenical blessings, wishes and hopes, listening, comfort, support, presence--these I can do.  For those to whom it has meaning, even "Amazing Grace" and the Lord's Prayer.  I would do similarly for someone who is Jewish or Muslim, etc.

In Unitarian Universalism, the first principle we affirm and promote is the inherent worth and dignity of all people.  And while it's not a principle per se, I would argue that we also support the idea of community.  For me, hospice work is about these UU principles--companioning the individual through the dying process, supporting their family and friends, doing this service for the larger community, so no one is alone.  For myself, I don't believe in heaven or hell, or even an afterlife.  But I know we all die and that it is one of the greatest fears anyone has, for themselves or their loved ones, almost regardless of their religious beliefs. My faith concerns the present, this life on earth, for it is all we know.  And so I sit with my hospice patients--the Catholics, the Jews, the Protestants, even the one Unitarian a few weeks ago--and I wish them peace.

May they be comforted.
May they be at ease.
May they be strong.
May they be free from suffering.

My NYC Field Trip

Yesterday, I took my own field trip into NYC yesterday for a conference on palliative care and the arts at Fordham University.  I hadn't been into NYC by myself in years; it's been more than twelve since I commuted regularly.  Because of my sensitive back and anxious tummy, I was nervous about going in for the day, but I also really wanted to go not only for the conference but to prove I could do it.  And it all came back to me.

I was on a pretty early train, earlier than I ever left when I worked in the city, and I fell asleep in my favorite window seat almost immediately and woke up at 125th Street.  Getting from GCT to Times Square on the shuttle and then to 59th on the 1 train (I want to say 1/9, but there isn't a 9 train there anymore.)  I could almost do it with my eyes closed.  Because it isn't hot yet, it thankfully didn't have that subway smell; nor did I see any rats on the track!  Otherwise, it felt like going home.

The conference itself was okay.  I loved the topic of "palliative arts" but they could have done so much more with it.  The conference was mostly for people in the field--social workers, palliative and hospice specialists, chaplains, and volunteers like me--but the talks were just incredibly introductory, as if for the general public.  Like "poetry is good for sick people" or "movement is good for sick people" with a lot of "I did this and it was wonderfully effective" or "I wrote this article to prove how effective my specialty is."  The music therapist really underlined this--she repeatedly contrasted music (like "the music your grandmother likes") with music therapy ("I match specific rhythms to physical or emotional aspects of the client"), emphasizing that only music therapists could do this.  So why tell us?  None of us were music therapists.  And I'd expand on that by saying that patients are much more likely to come across social workers, chaplains, and volunteers than the rare music therapist, so why not give us some tools that we CAN use?  Give us a music activity or a writing activity.  I'm happy with learning about and celebrating their successes, but I also wanted to know how to adapt their best practices to my work.  And in that respect, I was disappointed.

Still, I did glean a few things (just not as much as I wanted):

• One of the keynote speakers was very influenced by Buddhism philosophy, specifically the Japanese therapist Itami's Meaningful Life Therapy (see local Todo Institute), plus Morita (which I don't quite have a handle on) and also Naikan, which delves into gratitude.  She repeatedly used words like constructive or creative living, meaningful living, and the like.  She believed that palliative care should be introduced within the first day or two of diagnosis.  I can see where that would be really helpful.  Just like starting hospice earlier than the last few weeks is really helpful.  It allows patients to utilize resources, consider their own needs, and implement some new habits or practices--like Morita and Naikan--to help get them through.  
• Music therapy--"it doesn't always have to be harps."  She's had success with drums for a woman from the Virgin Islands too.  But don't try this, YOU are not a music therapist (yes, I was a bit annoyed.)
• Dance or movement therapy--she had us do a breath meditation (with a bit of a body scan) and then mirror, or more specifically, respond to the movements of our partner by watching them for awhile and then joining in.  The pause is very important; it's about respect and letting go of control.  I liked that movement therapy is non-judgemental and focuses on what the body can still do.
• I really liked the woman who talked about comic books and palliative care, or "graphic medicine."  There is apparently a whole genre of graphic novels dealing with medical issues--books by the patients themselves, not the practioners.  She noted that comics could touch deep emotions and clarify feelings about difficult topics.  I just don't know if I've had hospice patients with the fine motor skills to do any drawing; I tried Zentangle once and the patient couldn't really hold a crayon.
• The poet shared many of the poems written by his patients.  Of course, poetry, like graphic novels, clarifies feelings and brings on self-awareness and transformation.  Both reading and writing poetry can be valuable.
• Lastly, a filmmaker introduced a new documentary on dying in America, entitled Defining Hope.  I like the bits we saw and welcome the chance to see the whole thing--it's screening on Nov. 1, in Palliative Care and Hospice month, on the Day of the Dead/All Souls Day!

I loved being in the city.  Mercy, I walked more in a day than I ever do here at home.  And it's much more interesting walking, not just looking at yards and houses.  I grabbed a snack at Hale and Hearty soup, one of my old favorites--a tasty pennette vodka soup, plus a chocolate croissant.  No Junior's there anymore though.  But I did enjoy perusing the newsstand.  I miss it all.  But I also realized that now I can take the kids in on my own this summer.  They're independent and I am capable.  Let's see when we go and what we do.