A way to go

For two weeks now, I have been the new Bereavement Services Coordinator for a hospice organization in Alaska. So far, it's going well. I had the privilege to have worked here this past summer while I was a resident. During that time, I served as the interim chaplain of sorts while they transitioned from one chaplain to another.

My job is to see to the bereavement (grief) needs of family and friends after our patients die. These services have many different forms; however, part of my job is spending time with and counseling those who are experiencing particularly complicated or at risk grief, and during these times I get to function basically as a chaplain (which i'm trained for).

The office is a good place to work. The organization is growing steadily, which means there's plenty of work to be done by all, includinga a 4-month back log in bereavement work that hasn't been done! (Job security for me, I guess.)

Recently, one of our patients died (I know, big surprise for a hospice organization), and the nurse thought the patient's wife needed a bit of extra support. So, I went to the house to spend some time and walk with her through, at least, her first bit of time grieving. But this blog is not about that time. It's about how he died.

I've been to a few different seminars or whatnot on death and dying. And to get into the perspective of a grieving person, presenters often have participants do certain exercises which engage our sense of loss. One exercise was to draw a picture of how we want to die. For the majority of people, the answer is similar. We want to die at home, in our bed, with our loved ones around us and without pain/suffering. (Consider trying this exercise yourself. Just answer the question: When you die, who, what, when, where and why?)

The night before this patient died, his elderly wife was trying to stay up to take care of everything, the busybody she is. But her husband, now bed bound, insisted she come to bed, because he sleeps better with her nearby. "He made sure to give me a hug, and he kissed me saying, 'Good night sweetheat,' like he always does," the wife told me through her shiny and watery eyes. He went to sleep and died during the night.

But his wife didn't realize. She got up and went about her morning routine, assuming her husband was sleeping in. Even their live-in care giver, when she peaked her head into the darkened room, thought the patient was sleeping peacefully. It wasn't until the nurse showed up to do her routine care that his death was discovered. The nurse said as soon as she turned on the light she knew from his coloring he'd been gone for several hours.

But, what a way to go? In bed next to his beloved sweetheart this man transitioned from this life to be with God the way most people want to do it--in bed, loved ones near, without pain, at home. Talk about a way to go.

I'm glad to be a part of an organization that helps provide people with a peaceful and dignified death. I've been present for numerous tragic, heart-wrenching and just plain ol' not-peaceful deaths in the ER that involve chest compressions loud noise, anxiety and pain without the presence of loved ones. It's nice to see the other side of the spectrum.

As expected

If you haven't read the previous post titled, "My way or the highway," then STOP here and go read it. This is an addendum.

For those of you touched by the story of a man choosing to time his own life to his dying wife's life, know that only two days afterher husband passed away, as expected our lady from the last post, Wilma, died peacefully this morning.

No doubt it will be very difficult on their children to lose both parents within a few days; however, I can totally understand their desire to "go" together. My wife and I have joked about, as well as talked seriously about, dying together knowing just how difficult it would be to go on living without the other in our lives.

This is a messy situation, to which all kinds of emotions are surely attached. I wonder how those of you reading this are responding. Care to share your thoughts?

My way or the high way

A man died the other day. Peacefully, he lay in his bed, which was pulled up next to his wife’s bed in the assisted living facility (ALF) where they have both been patients for quite some time. Both are hospice patients. We’ll call them Fred and Wilma.

Wilma has not spoken a word in years because of severe dementia that has held her mind captive. Daily they puttered around the ALF, and Fred saw to her every need and acted as her voice since they’d been married longer than many people live. Fred was considerably healthier than Wilma.

Fred was a retired colonel in the military and has a gift for stubbornness and is used to getting things his own way. “My way or the highway,” was a frequent phrase used to describe him. Wilma had been nearing death for quite some time. In talking with Fred I learned just how afraid this formerly very powerful officer was. He was afraid of being alone when his bride passed away. So afraid, he expressed to me that if it weren’t for the insurance problems it was cause, he would “expedite his own process.” They had been living together most of their lives, Fred wanted to die together as well.

A few days after our conversation, Wilma took a down-turn and stopped eating or drinking. The next day, Fred decided not to eat or drink as well. He would accompany his wife in every way he was able. Like a race to the finish these two declined together and stubborn Fred seemed to be moving more quickly toward his last breaths.

On his third day without food or water Fred died. As he preferred, he died either before or alongside his now unresponsive wife. I have no way of knowing her level of awareness; however, I hold on to the romantic idea that when his body and spirit are removed from that room she will know something is missing.

I can’t imagine Wilma holding on much longer. I’ve heard numerous stories of people being so connected that when one dies, the other doesn’t last much longer. But this was the clearest case I’ve ever witnessed. It has served to change some of my assumptions about life and our innate instinct to stay alive. Fred went against that instinct by choosing to time his life to his wife’s.

In talking with one of their daughters at the time of death, she showed me the last birthday card all her siblings had gotten Fred that was taped up in the room. On it were two arrows pointing in diverging directions. Above one arrow was the caption “Dad’s way,” and above the other read, “Highway.” That sure was the case through his dying breath.

Strokes of genius

I have visited with countless patients who have suffered a stroke. Some were completely immobilized, some seemed still completely normal and able, and many were in between having lost some sort of mobility or means of communication.

Strokes are pretty horrible, generally speaking. A blood clot forms and get lodged somewhere in the brain cutting blood flow to our body's super-computer. Very often, results of strokes are loss or lessened use of the left side of the body, arm, leg, face. As I've said, I've ministered to countless stroke patients, but never have really understood what it is like to be a stroke victim.

Recently, I had the opportunity to learn just a little bit more as a stroke patient recounted his experience just after the stroke happened, and it was scary. We'll call him, Bob, and he lives alone.

Bob was sitting in his favorite chair one evening, resting before bed. Not unusually, he fell asleep. Eventually, Bob woke up and felt strange. Like he could see, but couldn't see right. He looked around the room, and though it was familiar, something was funny, off, different.

Not knowing really what was going on or what had happened, he thought it best to go to bed and sleep it off. He tried to get out of his chair, and all his body did was tremble a bit. He moved, but didn't move. Something was definitely wrong. Trying some more he discovered that he couldn't use his left arm or leg, and his right side was weak. He needed help.

But, how could he get it? No one could hear if he yelled. He thought of how else to get help. A phone! He looked around and spotted his cordless house phone in it's usual spot on the reciever atop the refrigerator. "Only a few steps away," he said to me, "It might as well have been miles away. I've never felt so lonely in my life."

What is normally a simple task of standing up, taking a few steps and picking up the phone whenever it rings was now a monumental, seemingly impossible task. He told me about sitting in isolation, trying, struggling, tearing at himself for what to do, "I must have sat there near an hour trying to figure this out." That may well have been the longest our of his life.

Finally, some determination welled up in him. He used his "good" arm (the weakened right one) and strained as hard as he could, "It's never been so hard to get out of a chair. It was like having to move dead weight, except you are the dead weight." Prying himself from his favorite chair, Bob tumbled onto the floor. Military style, as if with a wounded arm, he painstaking slow pulled himself with his right arm across the smooth luckily linoleum floor toward the refrigerator.

But how would he possibly get up high enough to get that phone. He recounted, "I probably laid there in the floor ten minutes before it hit me." Reaching his arm into the crack between the refrigerator and wall he grabbed and pulled on the cord to the receiver, and the phone came falling to the floor -- plumb out of reach, bouncing over underneath the dining table.

It's a wonder the phone didn't bust into pieces falling from that high, but luckily this one was made sturdy. Bob told me that he didn't have anymore energy to pull himself over the phone. He was able to roll himself to where he could grab a nearby chair leg. And using that chair leg like he was fishing, he tried to bump and knock the phone toward him with the chair leg diagonal from the one he was grasping. Like trying to play golf using the wrong end of the golf club, he was able to nudge that phone of salvation within reach of his exhausted, weakened but usable hand.

This story is like fighting on the battlefield, only the field is your own home. I'm terrified to think of ever having to be in a position like that. Especially, when I heard from Bob's own mouth just how alone he felt when he realized he couldn't move, and no one knew he needed help.

Though he'd had a stroke, I think is was quite a stroke of genius the way he was able to retrieve the phone. Pulling on the cord, using a chair like a fishing pole, the courage it took to drag himself out of his chair an over the floor is something I hope I have inside me if ever presented with such a simple yet daunting task as getting the phone.

Universal Grief

I sat with an Alaska Native woman, whose common law husband was brought into the ER in critical condition. Since she was uncomfortable being right outside the patient room, we wound up sitting together in the waiting area, while she ate and drank with shaky hands, wondering if the staff would allow her the same rights as a legal spouse.

She eventually began telling me about life growing up in the village she lived in and later moving to Anchorage. She then shifted the conversation toward me and commented on the difficulty of being a chaplain. She thanked me for being a calm presence, and then she began to ‘read’ me, as a shaman might, telling me of my gifts, struggles, fears and motivations. Only, she wasn't looking at my palm, she was staring me straight in the eyes. Some of her statements were spot on, others were less accurate. But enough of what she was saying hit close enough to home to make me uncomfortable. She told me that one of her functions in the village was as a healer. She wasn’t the physical kind of healer, but another kind, a healer of the insides. She told me I have the same gift: to be a healer of the insides.

Despite my level of discomfort during this part of the conversation, I felt honored afterward feeling as if she put herself in a vulnerable place by sharing that part of her culture with me. I also felt a little bit humbled, as my usual response to such things is to relegate them to the category of tribal hocus-pocus. However, given this experience, my assumptions are now being re-ordered. One thing was certain, we came from very different cultural backgrounds.

After this ‘reading,’ I was able to redirect the conversation back toward her and the present situation with her live-in partner. And, in the following discussion she seemed to feel much safer, sharing with me her worries, grief and flowing tears. When she cried harder, she spoke a few words in a language I didn’t recognize, presumably the language of her native village. I was blessed to simply sit with her.

This snippet is one of many opportunities I’ve had this unit to minister to and be with people from a culture or cultures either mostly or completely unrepresented in the south. One of the lessons this visit, and others like it, taught me is that grief is universal. While expressions of grief vary between cultures, indeed they vary person to person; the pain of loss seems to remain a constant across humanity.

One social justice issue present in this visit was whether or not the medical staff would treat this woman with all the rights and privileges of a legal spouse or keep her at arms length, because she lacked a piece of paper from the court house with their names on it. In the end, aside from one comment by a nurse, she was treated as the spouse and spokes person for the patient who died soon after in the ER.

Blessing

Before I begin my weekly night shift, the chaplains there in the evening come together and update me on any need-to-know cases. "There's a trauma in the ER but family hasn't arrived yet. The patient in room 100 would like a prayer this evening if you have time. There's a man in surgery now whose wife is an RN here, she's very upset, please check in with her." Things like this and so many other situations get passed along usually giving me a check list to go through before settling in for the night.

Recently, at nightly report, I was told this, "You will probably be called to the Mother-Baby unit tonight. There's a pregnant mom who came in yesterday for her first ultra sound, and everything was fine. This morning she started bleeding, came to the ER, and found out that her baby has died en-utero. She's been induced for labor and says she wants her baby blessed after delivery."

I have to be honest, this is not the kind of referral I look forward to. Baby deaths in the past have been difficult for me. (Read one account here, and how I coped with it here.) However, I have grown as a professional chaplain and matured as a person to the point where, pregnant women and acute compounded grief over loss of a child don't scare me. I am now able to enter their space, sense their pain, and minister within it.

Sure enough, later that night the pager erupted. The baby blessing was requested. This is not my first blessing of an infant, alive or dead, and I haven't done many. But, I must say, as sad as they can be, I really love doing them. In preparation, I grabbed a small plastic heart shaped container that has a little lid (about the size of a 3-liter bottle cap), put in it a cotton ball and poured some anointing oil over it. I took with me a certificate of blessing and one of those crempy sealer things like notaries use to make the certificate feel official.

Entering the room I saw mom, holding her darling deceased baby that weighted about a pound. She was staring at his beautiful tiny wrinkled face as if she was looking into her entire universe. Her dad, grandpa, was quietly sitting nearby. We talked for a few moments but mostly gazed at the little guy who never had a fair shot at life. Mom had already cried so much she was temporarily out of tears and in a sacred and serene place of wonder as she imagined what might have been but now never will be.

She told me his name and why she chose it. Naming helps the grieving process for parents so much as a way to connect with and honor the life that was lost. She had taken pictures of him and dressed him, things parents do, and she would do it for her son, even if only once.

I brought with me a short "service" of blessing for a baby. We prayed together, I read a few words about how God loves this child who is a member of the family, and we heard a short passage from Matthew about Jesus and children. Making the sign of the cross on the little tyc's forehead with oil on my finger was so special. It was heartbreaking and endearing. It makes me sad to have to do one of these blessings, but I so enjoy being able to walk with parents through this process of caring for their deceased child and honoring his life with ritual.

The room that night was a sacred space. Her love for her son is what sanctified that sterile hospital room making it a sanctuary for God's love, expressed by a broken mother with dreams shattered who saw nothing but beauty in the tiny motionless eyes and translucent fingers of her son. I pray that in time her heart will mend.

Jesus said, "Leave the children alone, and don't try to keep them from coming to me, because the Kingdom of heaven is made up of people like this." After he put his hands on them, he went on from there. Matthew 19:45-15

Y2 EPIC

Remember back in 1999 as New Years approached, the start of a new year and millennium? I sure do. Remember the huge Y2K scare? People were stocking up on canned goods, water, survival equipment, guns, MREs, gasoline and all manner of other items which seemed so vitally precious to a comfortable life. Convinced the entire global computer network would crash as soon as the date changed over from 1999 to 2000, people were frantic. Anticipation was high, along with anxieties, and some were predicting the beginning of a third World War while others predicted God would dramatically and finally enter history in some climactic apocalyptic event.

But then, after the midnight bell tolled, after the ball in Time Square filled with thousands of lights dropped, after toasts were made and champagne bottles uncorked, after all the whoopla, storage shelter building and fear mongering...life went on as normal.

At Providence Hospital in Anchorage, we have recently been undergoing a huge change as the computer system has been switched from McKesson to a newer and supposedly better system known as EPIC. This is a process that has been in the works for at least 18 months. Millions of dollars and countless extra work hours have been committed to this change so that a new computer charting program can be introduced. The idea is that EPIC will consolidate the three separate programs the hospital previously used, and it will ensure better more efficient patient care.

I started at Providence about one month before the "EPIC go live" date, which was last Saturday, Feb. 26th. And I noticed that during the weeks and days approaching the go live date, the atmosphere around the hospital was so very much like 1999's Y2K scare. Tensions were high, anxieties through the roof, and some people were predicting the whole system would crash, paralyzing the hospital's ability to function while others threatened just to leave and get a job somewhere else rather than suffer such a change.

To make this transition happen, EPIC and Dell have flown in hundreds of tech support people to rove the floors offering aid for charting. A command center full of phones computers and experts was set up in the large conference room next to the cafeteria.

But when the bell tolled at midnight Feb. 26th and the new computer system became self-aware (wait, this isn't Skynet from Terminator!), active, nothing blew up or crashed. Life went on.

Now, that's not to say that there haven't been some problems, because there sure has. A colleague of mine tried to print a patient census list and the printer began spitting out hundreds of papers with gibberish on them. She claimed she's made the printer speak in tongues like some of the people in the book of Acts. Later, the printer wouldn't print anything, and I joked that it had been struck with silence, like another character in Acts.

Many of the RNs and MDs and other have been quite stressed out during this computer system overhaul, and I don't want to down play that. However, I have this feeling that in a few more weeks we will be acclimated, and just like 11 years ago New Years Eve...life will go on as normal.

Jack and Jill went up a hill

During the day, the chaplains take shifts holding the on-call pager for about 2 hours usually. It was exactly 5 minutes until I was to hand off the pager to the next person for his turn. It had been silent for me during my hours with that evil beeper on my belt. Until, my streak of silence was broken. A phone number came through. I called and spoke with the RN on the line.

"One of the surgeons wants you to come to room 948 with him." "Okay," I said, "can you tell me more about it?" "Sure," she said, "his patient expired during surgery, and he's heading up to inform the family." I knew that the work I had planned to get done that evening was now not going to happen.

The way hospitals work, it is very rare for someone to actually die during surgery. If someone is too ill, doctors will simply refuse to perform the surgery saying it's too risky (which, of course, it is), or if a patient begins to go down hill during a surgery he/she is stitched back up and sent to the ICU.

Arriving a few minutes before the surgeon, I found the RN and learned that the husband (we'll call this couple Jack and Jill) was in the room expecting his wife to be through with her procedure about now. Jack and Jill were in their mid-30s and had to young children, 3 and 4 years old. That changes things.

An entourage of about 5 people wearing light blue scrubs, hair nets and shoe coverings came onto the nursing unit. The OR staff was here. The RN and I followed them in as we crowded the room in which only Jack was present. He immediately knew something was wrong.

The doctor broke the news quickly like a machine reading a script, ending with the formal line, "...and despite our best efforts, we were unable to save her. I'm sorry for your loss." Shock. Denial. Anger. All three struck Jack at once. Then tears. Pain and numbness seemed to mix together to form an emotional concoction of surreal-ness. There's no right or easy way to do this.

Finding the breath that had been taken from him by the news, Jack asked, "What happened?" And then, I think the doctor realized that it was not only Jack's loss. The surgeon suddenly stopped being a doctor. Something changed in his voice. He told Jack they were trying to intubate her but couldn't get the tube past the mass in here trachea. They brought in experts at intubation. "I tried. He tried. We all tried, but we just couldn't..." His voiced choked up, and tears filled the eyes behind the doc's glasses. The anesthesiologist, a younger looking doctor, spoke up sharing that the medicine was right, but Jill wasn't getting enough air. They tried for 30 minutes to save her, to bring her back. But the couldn't. His face was beat red trying to suppress his emotion.

I looked at Jack. He was broken. I looked at the medical staff in the room. They were hurting. I passed out tissues to everyone there. Heads were hanging, bodies were slumped, and I realized that though these people were only recent acquaintances, they were all hurting over Jill's death. My heart broke for all of them.

Jack called his family. These phone calls are always the hardest to make. The grand parents arrived with Jack and Jill's two darling children, an angelic 4-year old girl wearing pink sweats clomping around in little black shin high snow boots, and a 3 year old boy with a toy airplane and head he was almost grown into. The boy was a little too young, but the girl knew something wasn't right. When she entered the hospital room she asked where her mommy was. And like swords plunged by an expert musketeer, those words pierced at the hearts of daddy and grandparents. And as with Jack, there is no right or easy way to do this.

They talked to her about grandpa's old dog that got old and then went to be with God. Just like uncle Joe got sick and went to be with God. "Mommy also got very sick and had to go be with God." She didn't completely understand, but she knew things weren't right. She knew she couldn't see her mommy. Two of the OR staff had remained, one was the doctor. They stood back and cried silently with other family members as this little sweet girl's big brown eyes filled with fear and uncertainty. These children's lives had just changed forever.

I spent over two hours with the family and staff. I offered tissues, hugs, consoling hands on shoulders and backs, I contacted Child Life Development to get some resources to the family, I stood outside with Jack as he smoked a much needed Swisher Sweet cigar, I held elevator doors, trash cans and offered water to Jack after he vomited in the toilet. I've come to a point where I do not need to cry during tragedies like this, but my heart breaks no less. I am grateful to have witnessed and acknowledged their pain and to have journeyed with them for a brief time. My prayers and sympathies go out to the newly single parent Jack and his two beautiful children, daily reminders of his precious Jill.

Skin Hunger

I don't know if this story is true or not. I could not find it during a 5-minute google search. However, it was told to me by a person I deem credible, and that says something. But here it is.

One of the ancient Roman Emperors (I can't remember which one, Mabye Marcus Aurelius?) had an interest in science and early human development theory. He conducted a rather inhumane experiment by today's ethical standards, but it is telling.

He took a group of new born babies from their mothers/families and placed them into the care of his own nurse maids. One half of the babies were to be cared for like any other baby, fed, changed, cleaned, held, spoken to and loved. For the other half the babies, only their basic physical needs were to be met. Nurses could feed, clothe, change and clean them, but as for the holding, talking, touching and loving, none was to be done. They were to be left in isolation.

As I said, it was an horribly inhumane experiment with (brace yourselves) an unhappy ending. The first half developed normally as you would expect. The second half, neglected of intimacy, despite having all of their physical needs met, died.

I'm sorry if this story makes you angry. It breaks my heart as well. But I'm writing this post to reflect on the importance, indeed, the power of touch.

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In the NICU they practice something called Kangaroo Care. This is time holding your baby (mom or dad) with as much skin touching as possible. Moms lay their tiny premis on their chests to share warmth between them and practice for breast feeding later. Dads open their shirts and hold the dear ones on their (sometimes hairy) bellies so babies can learn their skin texture and smell. Since the mid 1980s Kangaroo Care has been emphasized more and more as vital to a baby's development and ability to thrive.

During Kangaroo Care, or put another way 'skin time,' a life-long attachment between parents and child is formed. It's during this time that children learn a sense of safety outside the womb and first learn of love for another.

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In the ER, when a critical patient comes in needing CPR for a long time they sometimes wrap this machine around the patient which preforms the chest compressions automatedly. It's basically a piston that straps over the chest and repeatedly compresses the sternum to pump the heart. One of the advantages to "thumper," as it is dis-affectionately referred, is precision. Unlike human compressions which vary, thumper compresses evenly each time. It's actually very disturbing to see it for the first time. But I suppose from a medical point of view it's worth something.

I've never been the biggest fan of ol' "thumper," and recently one of the ER nurses articulated for me why. To one of the other resident chaplains in our group this nurse said something like this, "Part of the effectiveness of CPR is the love that translates through the hands of the one doing compressions."

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One of yet another of our resident chaplains recently told me about some new and interesting observations on something called Skin Hunger. The basic idea pertains most often to senior citizens and/or people in assissted living or nursing homes who are alone and don't receive much physical contact. Sometimes these people develop Skin Hunder where they need, more than anything medical, human contact. Simply holding someone's hand can be life giving or sometimes, when suicidal thoughts enter the picture, life saving.

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For some time now I have made it a point to try my best to physically touch each patient I visit. Part of this is to provide a physical means of connection along with the emotional connection that often develops with patients. Also, I hope to express my theology through my body language, position and phsycial distance or lack thereof. My theology envisions a God who moves close to the suffering, is on their level, and touches our lives in one way or another. So, it is with theolgical intentionality that I give good eye contact with, move toward, get on an even level with, face my shoulders toward and reach out to every patient or family that I encounter. At least this my goal.

Little old ladies just love the shoulder pat, the tight hand grasp or the arm rub. Some folks, once you surrender you hand to them, seem as if they're never going to give it back. At times it is not possible or realistic to touch each patient, but I try as circumstances allow.

I think most of us know that human contact is important, but things like these help me to remember how important and vital to life a simple touch can be.

Who have you touched today?

Valentine's Day

If you've read my blog for very long you know that being a hospital chaplain is a very unique kind of job. It's unique because 99% of what chaplains do is intangible, unquantifiable and almost always unseen by all save those we are serving. This last part is probably why most people don't actually know what chaplains are up to.

This post is yet another attempt to demonstrate just how one-of-a-kind this job can be. As I visited a number patients throughout my day, the fact that today is Valentine's Day was brought up more than once. I encountered a number of couples in the hospital. A husband in the patient bed with his wife by his side looking a little brighter than usual as she did her best to be festive in an unusual place. I met a patient with her husband at the bedside, both looking a little dull as their V-day plans had been cancelled due to a midnight run to the ER and subsequent stay in Cardiovascular Recovery Unit.

These kinds of visits are within the bounds of what I might call normal, even though each room I step into contains a different person with a whole new life story. But on to the reason for this post. I had a very interesting hour this evening, during which I had three very different encounters.

5:45pm - I was called to the ER to speak with a lady who had requested the chaplain. Upon arrival, I notice she's wearing the hospital gown as a shirt, regular pants and huge black combat-like snow boots. I greet her gently and inquire as to what is on her mind. She looks at me suspiciously. "I just can't....and..th....these people....," she mutters to me or to nobody. She's lying on the bed, I sit next to her and ask what happened that she wound up in the ER. Silence. I maintain eye contact. Nothing. She looks away and then back at me. This time she has a suspiciously defensive and apprehensive look on her face. I am perplexed.

All of the sudden she convulses. Her arms and feet jet into the air, and I braced for impact as I expected her boot to connect with my face. My adrenaline kicked in, and I remember getting that hair raising defensive feeling like my dog when the fur on her back and tail suddenly stand up. She blurts out, "Oh, hell, you know what's wrong and cain't do sh#* 'bout it! I don't think so!"As she's talking she's quickly getting to her feet, as am I, and begins pacing around the room. Her words become hostile, and more explicit, toward my inability to solve her problem, and I don't even know what it is yet. "I can't get it out," she says through her grinding teeth and she shoots me warning glances with her head down and squinted eyes looking past raised eyebrows. "It feels like my insides are gonna just burst out," she says again, this time walking out of the room and into the hallway. I keep my distance as I half expected her to slap me one of the times she paced back and forth past me.

It turns out, she had taken methamphetamines which induced psychosis in her. And this isn't her first trip to the ER for this. She felt possessed (though she didn't use that word) and wanted me, a minister (she thought I was a priest), to exorcise (also not her word) it out of her. In the mean time, I'll be honest, I was scared. Eventually, she became almost livid with me and wanted me gone; however, she did kindly ask that I get a real priest. I said I would and got the h#!! out of there.

6:05 - "The family in room 928 wants to speak with you," said the nurse on the phone. I make my way to the palliative care (where people prepare to die) wing and enter a room with dimmed lights and three large people in tears. The patient is unconscious on the bed and slowly breathing. Three adult children were gathered around their mother's death bed (literally) holding vigil, counting her inhales and exhales until the ceased.

One son, holding he hand tightly looked up at me, "Was wondering if you could say a prayer for us? Sometimes it's hard to us to..." Before praying we talked a bit about their mom, the kind of ornery lady, tender-hearted and goal oriented person she was. It was very sweet. I prayed, doing my best to voice to God what I'd heard them say and what I witnessed in the room. (For some reason, when I sense that people are crying more during my prayers, I want to pray longer, to make them cry more. But it feels like I'm hitting the right spot when I make them cry. Is that wrong?)

Afterwards (or should I say, afterwords), I quietly exited, thanking them for letting me be there and share in their grief. They seemed appreciative and heartfelt as they greeted me goodbye.

6:30pm - My wife sends me a txt msg of one word, "Here." I walked up to the front entrance of the hospital to greet her as she carried in a bag of food from TGI Friday's (recommended as one of Anchorage's best restaurants). Dinner time. Today, she worked the day shift, and I am working the night. No time for V-day celebrating, so she was bringing me dinner. What a nice surprise. We walked down the stairs to the cafeteria (a most romantic setting) and she asked, "Where would you like to sit?" I gestured toward a single table standing out as the only one with two pink roses set up in a vase and suggested we sit there. She found a small note in the flowers written to her from her valentine (who purchased roses in the hospital gift shop). We had a lovely dinner date together, talking about our days and how lovely they'd been.

It was during dinner that I realized what a weird last hour I'd had. It began with a psychotic woman angry with me for not exorcising the bad stuff out of her. I spent time with a broken family saddened over the immanent passing of their momma. And I ended it sharing a delightful meal with the love of my life sitting at a dirty table and walking on grease covered flooring. I couldn't have been happier.

Happy Valentine's Day!

Saying hello, saying goodbye...

I was called to the 8th floor to visit with a patient and his wife. The patient had terminal cancer in his abdomen and there was nothing else the doctors could do to treat. There were no illusions about how this was going to end. Pain management and comfort care was now the highest goal.

As I entered, I noticed the patient, sitting in the bedside chair, covered in cheap hospital blankets hiccuping every second. Like clockwork, he hiccuped and took shallow breaths as he could. His wife sat on the bed edge holding his hand with the resolution of never letting go, as if she were holding her own source of life.

The patient could hardly speak. Somewhere between a whisper and a scratchy growl, his words came out faint and sincere. "I woke up this morning, and said to myself, 'I'm ready to go.'" I sat with them and listened. He expressed no qualms about death. "I'm ready to die. Not tomorrow, not in 10 minutes, now," he said while his wife could hardly keep a dry tissue for all her tears.

He was ready to say "hello" to God.

Turning to her, we discussed how difficult it is for her to be in that room. Watching her husband, suffering from unrelenting torturous hiccups, stomach pain from the cancer, and his body deteriorating, she also expressed that she wouldn't be anywhere else.

They talked about their life together and their journey through medical diagnoses and cancer treatments. She, always by his side, understood his readiness to pass from this life into death but could not ignore her own desire to keep her husband with her just a little longer. "I'm ready for it,....I'm just not ready...you know?" she said to me, with tear-filled eyes shimmering under florescent lights.

She was saying "goodbye."

I sat, and I witnessed this heart breaking and beautiful scene. Both were present with each other and at the same time present with themselves. He was in pain and wanted it to end, the only way left to him was to die. He also hurt in the thought of leaving behind his bride. She was terrified for her husband to be gone from her sight, and yet understood that his only release from suffering would come in the form of death.

It was a tender moment. My heart goes out to them both as they each make this transition, together and separately. One saying, "hello," the other saying, "goodbye."

Differences

I have now worked for 2 weeks at Providence Alaska Medical Center in Anchorage. During the next 7 months, I will be completing the majority of a second year residency and 2 more units of CPE (Clinical Pastoral Education). I accepted the offer for the position for a few reasons.

1) I tend to really like the learning that happens in CPE. It follows the action-reflection model of learning. You act, then you reflect/learn. The supervisors encourage you to be introspective, and thus the learning is mostly about yourself. Someone once said to me, "There's only so much of that self-reflection you can do." Respectfully, I disagree.

2) I am not one who spends much time making long-term goals and planning for the distant future. However, one of my few (I mean, few) long-term goals (at this point) is to enter the training to become a CPE supervisor. And completing 2 more units can only help in that regard.

3) Third, let's be honest, it's a paying job.

4) I value the service to people that often goes unseen between chaplains and patients. If you peruse my blog during the time of my first residency, I think it will speak to this. No where else in life did I daily encounter people in crisis, crying out for help, support, crying on my shoulder, hugging me goodbye after just meeting them, and people in their most vulnerable and authentic moments trusting me to hold them safely. Yes, I value this work as something that speaks to, and feeds, those "human parts" inside all of us.

A Catholic hospital, Providence is the largest hospital in Alaska with an inpatient capacity somewhere around 360-375 beds. I'm not sure the actual number. The main units are, a busy Emergency Dept., surgery, a 30-bed ICU, general medical floors, rehab., cardio, a childrens' floor (which they call the children's hospital), a 50-bed NICU (neo-natal), Palliative Care, and an out patient cancer center. "About 100 beds fewer than my last employer, it certainly feels just as big.

The chaplain resident group has 7 people: two Presbyterians, 1 Evangelical Free, 1 Disciples of Christ, 1 Catholic priest from Tanzania, 1 Unitarian Universalist, and of course me, a half-Baptist half-Methodist fully confused guy ordained CBF who cares very little for denomination. Our supervisor is a Catholic priest from Nigeria with a most interesting life story.

The group welcomed me warmly, allaying much of my anxiety as I remember my previous groups apprehension when we thought a new person might be joining mid-year for one of our didactics. Of the 7 of us, only two are on their first year of residenc, so it is a season bunch with many talents and gifts for ministry. I have much to learn from all of them over the next 7 months.

Because my last job was as a CPE resident, I can't help but note the many differences between this place and that place, this program and my old one. This section is mostly for my old CPE yaars. Here, we still all share one big office, which is a little crazy when we're all here. Not every desk area has its own computer, so we have to share those. (No sitting for long periods of time reading articles and blogs.)

The charting system is McKesson! So, I'm totally familiar with it. However, the hospital is in the misdt of changing computer systems in order to consolidate the 3 that they use right now, so on Feb. 26 there will be no more McKesson. But, I thought it was great that I already knew how to chart.

Learning goals are given much more emphasis. We went over every one's together as a group. Then we have to submit and sign with our supervisor a final version of them. They were always so minor at Spartanburg. IPR is called "PPR"(something like Peer-Professional-Relationships). I just don't like saying "PP." Their didactics here are stand alone. An hour-long didactic may be about assessment, another about Suicide patients. The topics change each session, unlike at Spartanburg where they were more like classes that lasted several months on one topic.

We've had two verbatims already (I was one of them), and nobody cried! Here, they are on the "feelings train," but not to the degree that Robin was. No body has been grilled and pressured to dive into the "hole" yet. So, in a way, I kind of look like an expert on lots of the feelings stuff. I guess Robin trained us well. The torture was worth something.

In addition to having 7 residents, there are also 6 staff chaplains in the department. So, the hospital has 13 chaplains covering fewer beds than S-burg which had a total of 5 chaplains. My schedule is Sun.-Thurs. Some people have a Tues.-Sat. schedule. Some shifts are 8-4:30 and some are 12:30-9p. This gives a much fuller coverage of chaplains over the hospital all seven days a week. It also means that the only days when everyone is in the office are Tues.-Thurs.

The ED is not classified a Trauma I Center, or Trauma II for that matter. It has no classification, and neither do the other two hospitals in town. It's not classified here as a Trauma I Center, because it just doesn't meet all the criteria necessary. However, it still gets all the same traumas as anywhere else because, heck, where else are they going to go? Therefore, chaplains get paged to Status 1 traumas and Status 2 (less severe) traumas. So far, the two Status 2s I've been to wouldn't have been worthy of paging a chaplain were I still in S-burg. But, oh well.

As far as patients go, the grief is the same. Their pain is universal. That part is no different. The culture here, however, is. There's a strong Catholic presence. As well, the diversity is significant. For example, in the Anchorage public school system there are 90 different languages spoken by students. This illustrates the hodge-podge of cultural diversity in the city. Good thing Robin had us do a diversity didactic.

More differences later, as the pop up. All right, yaars, that's what I'm into now. Being here makes me miss you. I think about you everyday and how truly fun it was back at ol' SRHS. Adios.

The End

Well folks, I'm done. Last year on June 15th I began a year long CPE residency as a hospital chaplain at Spartanburg Regional Hospital. Here on June 11th 2010 I leave the hospital for the last time as an employee. The End.

It's been a long year, a short year, and eventful year, a tough year, a year full of learning and new experiences. I dare say, this year has shaped the kind of person I am, the kind of life I will lead. I've been challenged in ways I didn't even see coming, and I've learned things I didn't know I needed to know. And best of all, I've gotten a lot, I mean a lot, of good blog posts from this experience.

And that's what CPE is: an experience. The strange part is, many of you out there still don't know what CPE is. And I still can't explain it; but, I can tell you some of the things I've done this year and how many times I've done them.

I was on call 60 times. That's two months sleeping away from home. I made ~2,600 total visits this year. Approx. 120 were deaths, 107 were traumas. I helped about 30 folks with advanced directives.

I sat with people sad people, counseled with grieving people and spent time with countless people on the worst days of their lives. How could anyone enjoy this work? I don't know, but I love it.

This year I have learned about my inner-self and found God in that deep sometimes dark place within me. I've learned to manage my own feelings/emotions so that I can better serve others to deal with their own. This part of the training is priceless. I've wrestled with my own inner-deamons and learned how my family of origin impacts me everyday.

I have read 19 books, written countless weekly self-reflection papers, 20 virbatim accounts, 106 blog posts, sat under 5 greuling committees evaluating me, cried a lot, authored over 60 pages of theology with my sister, read article after article on topics ranging from ethnic diversity to theological reflection to dream interpretation to how people respond pschologically during crisis just to name a few.

I've bonded with Vicki, who taught me that my voice is valuable. She showed me how to honor other people listening and listening well. Her inner drive to get things done is inspiring, and she is an example of trustworthiness. She honored our relationship enough to tell me she was angry with me, and I thank her for her constant gift of resoucefullness.

I've gained a new friend in Erin who puts a smile on your face whether you want one or not. She's gregariously interested in how everyone's doing and fights off dullness with wit. Her sarcasm always brought the gift of laughter and her pastoral nature cared for our group like she cares for her family.

I've learned so much from Cathie, a steady and reserved motherly reservior of life experience encased in a strong regality who sets goals and hits them. Her inner confidence is something I will strive for, and no better teacher of compassion can be found.

All good things come to an end, they say, and so it must be with this residency. After saying many goodbyes and doing some decompressing therapy, my learning and growth for this year will end with a sense of finality. I am a healthier, more whole person because of this program. Every minister should have at least one unit of CPE (I've now done 5). I think the best thing I can do to honor the growth from this year is to keep growing and keep learning. I will use what I've learned as a spring board of opportunity to continue doing inner work, theological reflection and spiritual integration.

Thank you Robin, Carson and Lizzie (dept. staff) for showing me love in times of self-hate, grace after my bumbles and for showing me what kind of growth is possible. By offering me love, by offering me yourselves, you have offered me God.

(Here are the links to Vicki's final blog and Erin's goodbye blog.)

Hands

Hands. Our hands are so very precious and yet so under appreciated. Our hands are a vital part of who we are. Our finger prints are each one unique. Our hands are blessed parts of our body.

One way our department each year tries to show the nursing staff how much we appreciate them is by leading them in a service to bless their hands.

Hands are a major theme in scripture. The hand of God represents power. The work of our hands signifies our livelihood, it's how we live. We lay hands on people to bless them and offer healing. We say hello and goodbye with our hands; and the holding of hands is a timeless display of intimacy. Hands are important. In the hospital, nurses give and sustain life with their hands.

St. Augustine said, "What does love look like? It has the hands to help others." After these few words of appreciation I anointed each of their hands with olive oil from Israel, a treat for them. To each nurse I recited, "I bless your hands as they give life and love in this place," and I shared a quick memory of working with that person.

This was in my favorite unit in the hospital. These were my favorite nurses. Words cannot say how much my heart was warmed by their faces, and smiles, and girly sighing "aawwees." This will make it much more difficult to leave in two days.

It last only 7 minutes, but it meant the world to them, and to me. In seven short minutes one nearly cried, one hugged me before I finished, another asked if there was anyway I could stay on at the hospital (sadly no), and when it was over the last thing I wanted to do was leave. I wanted to cry. Officially, I was the one blessing them, but in doing so I received a blessing more meaningful than I expected.

And finally, if they needed for anything else, I was able to bless their stomachs with the brownies I brought!

Thank you CCU nurses, you're the best!

Inappropriate Chaplain

For each visit we make in the hospital, we have to log it into a computer program called Midas to keep up with our activity. We use Midas as a verb around the office. Every chaplain Midases differently. At the end of the week I usually check my Midas count, and everytime, the entire year, chaplain Crawford has the highest amount. I must confess, I believe she has a small competitive side to her. But as long as the rest of us get our 50 per week, everybody's happy. Chaplain Crawford just happens to usually have near 100.

it being our last week, I decided that, for once I was going to have more Midas entries than her. So, I began making them up and entering them into the computer. They got a little zaney, so I thought I'd share some with you. I'll probably enter a number of bogus ones each day and keep track of the count to be sure I'm ahead of Chaplain Cathie Crawford.

Enjoy.

(I put an "*" by the bogus entries for tallying purposes later. And if you can't figure it out, Pt. = patient, and RN = nurse.)

*Told my wife a bunch of HIPPA violating pt. information
*Tried on pt.'s shoes while he was intubated
*Had bizarre lustful thoughts toward elderly pt. in ICU
*Laid down in bed with pt. who had died to see what being dead was like
*Tried making an authentic smile with pt.'s false teeth in my mouth. Taste: not bad
*Had recurring lustful thoughts about same elderly woman
*Cut holes in bed sheet and walked around pt.'s room pretending to be a holy ghost
*Another recurring lustful thought. This time about a man
*Tried on hospital gown while naked. Think I had it on backwards
*Felt nice but chilly breeze through backwards untied hospital gown. RNs said it was normal
*Tried to faith heal pt. God responded with, "You had me at 'hello.'"
*Pretended to be MD, told a pt. he was supposed to have been discharged yesterday but was accidently taken to surgery today.
*Asked family if I could kiss unconscious pt on forehead. They said, "Only if it's not hard." (That's what she said.) So I did. And it wasn't hard
*In the morgue: played hide and go seek in the dark
*Another recurring lustful thought toward old women
*Realized I had put on two left shoes this morning
*Followed chaplain Crawford around the hospital for an hour without her noticing
*Switched one of my left shoes with a pt's right shoe so that my feet felt better
*Followed chaplain Crawford during a pt visit, but hid in the bathroom the entire visit
*Pretended to be the pt in one of chaplain Crawford's rooms when she came for a visit
*Tried to go the whole day as a low-talker
*At lunch I put on a chef's uniform and served chaplain Crawford her food without her knowing
*Messed up the sheets in the on-call room on one of chaplain Crawford's nights
*Stole gun from lock box outside of behavioral health unit
*Blamed gun theft on chaplain Crawford
*Tried to convince CEO of hospital to come tail chaplain Crawford with me
*10 months ago I slipped drugs into chaplain Hesse's food to make her faint in middle of night
*Went an entire day introducing myself as chaplain Crawford
*Pretended to be a trauma pt when chaplain Crawford was responding to pages
*At employee health: tried to convince them I had a new disease no one's ever heard of: got referred to a specialist
*Snuck into chaplain Crawford's apartment with CEO of hospital and tried on her clothes

There's nothing else to say. Perhaps I'll add some more tomorrow.

Presence

Yesterday, while driving home I noticed that there was a strong police presence in I-26 after I crossed into NC. A state trooper watching for speeders, a car pulled over in the other traffic direction, a semi-truck pulled on an exit ramp, there were a lot of them.

And then, after about 5 minutes of driving carefully and watching my speed like a good citezen, I saw something daunting in my rear-view mirror. It was another trooper. He tailed me for a mile before making to pass me; but, after coming alongside me to take a look at me (a suspicious character I'm sure) he moved back behind me and soon turned on his lights.

Arg! I wasn't doing anything wrong! I hadn't been speeding. Then I remembered my sister who (I think) once got a ticket for going 1 mile over the speed limit from a cop trying to meet his quota for the month. This is not what I needed.

Very politely the officer greeted me through the passenger window and said why he'd pulled me over: "North Carolina law states you can't have anything blocking or covering your liscence plate." Oh. A fair rule I sure; however, I wasn't aware that my liscence plate frame which says Tar Heel Alumni on it was blocking my plate. He asked if I'd like to see what he meant, and I agreed. Behind the car he pointed out that, yes, the lower bar on the cheap plastic $6 frame was indeed covering the bottom half of the still-clearly-intelligable words North Carolina.

Apparantly, I was doing something very wrong. So now, you are indeed reading the blog of, yes, a criminal. I confess I was concealing my liscence plate in a devious attempt to carry out my master scheme of......concealing my plate. I understand if you quit reading from here on out and don't want to be associated with me anymore. I, personally, wouldn't want to be involved with such riff-raff myself, but apparantly I do reside in a den of theives.

The officer issued me a warning and indeed wrote on it that this violator's violation was to "cover/conceal registration plate."

My real guess is that the armada of state troopers was attempting to make known their presence on this stretch of highway. They did a good job. Presence noted.

But this got me thinking on the power of presence. Because I know more keenly of the troopers' presence on the highway, I will surely be driving more prudently during my last week to-and-fro from Spartanburg. Presence can make a big difference. For instance, there are times in the hospital when the security guards hang around the ER or the cafeteria (to keep people from stealing 24-packs of soda), and I'm convinced they make a difference. Because of the vast amount of shady characters who enter the ER I've no doubt the staff feels a bit more secure with a security presence.

Presence is also a big part of my role as a chaplain. When a baby dies, or there's a horrible car accident, or when someone's wife passes away after a long bout with cancer, when heart attacks take the life of a loved one or when someone is terrified about a risky surgery there's usually not much I can say that will do much good. No, words are more often less helpful than simply my presence.

My presence is the best and most life giving gift I have for sufferers in the hospital. My presence let's them know they're not alone, let's them know that I'll walk with them step-by-painful-step through these few hours. Often my stays with people in the ER begin with my asking, "Do you mind if I just sit you with?" and they end with someone hugging me tightly and saying "thank you" even if they can't articulate what the thanks is for.

Similarly, there's something about the divine presence with us during these moments that has a life-giving result. My role as a minister reminds people that God is also present, also hurting, also wounded. My being present with them is God being present with them. No, I'm am not God; but, by loving them with my caring presence I believe I am in fact incarnating a God who is most often described as just that, love.

Rob Bell, in his book Velvet Elvis writes:

Suffering is a place where cliches don't work and words often fail. I was at lunch last week with a friend who is in the middle of some difficult days, and I don't have any answers. I just don't. I can't fix it for him. I've tried. And we sat there and talked and ate, and I let him know that I'm in it with him. It isn't very pretty and it isn't very fun, but when we join each other in the pain and confusion, God is there...And it is in our suffering together that we find out we are not alone. We find out who really loves us. We find out that with these people around us, we can make it through anything. And that give us something to celebrate.

Phone calls

Cell phones. They're everywhere. I see 12 year olds walking around with Blackberrys and iPhones, eyes glued to the screens, thumbs blazing on the keypad, heads turned down on a fast track to early neck and spine problems.

This generation of children will be stunted in their development of social skills - relationship ignoramouses. Instead of talking during school lunch, high schoolers are now texting and sexting their way to countless inevitably unfulfilling cyber "non-relationships." When you look some of them in the eyes, it's like they don't compute.

Sometimes, I hate technology.

When someone dies in the hospital, usually the first thing people go for is a tissue. The second? You guessed it, the cell phone. We've got to tell everybody, get the word out, and in doing so avoid our body's nature grief reaction to the loss of a meaningful relationship. The cell phone is our portal of escape...we think. But most people can't get through the second sentence. Like Jerry McGuire, grief has them at "hello."

In January, my wife was in a car accident, and I was on the cell quite a bit, telling people and updating, jibber-jabbering and yammering on. I was surprised when I called the first person and tried to say, "Heather was in a car accident." Halfway through the sentence I choked up, got misty eyed and got jerked back to the present. My body was trying to tell me that I was scared, that my world had just been shaken up a bit, and it was going to let me know this whether I wanted to know or not. I'd rather stay busy, do all the calling and conveying, taking care of details and the tow truck. But no, at some point I had to check back in with how Nathan was doing. The answer: not good.

That's how so many people after the death of a loved one respond: what do I need to do, who do I need to call? Details details details. Let's get it done. But when they pick up that phone to call and tell their sister or neighbor or pastor that Johnny is gone, they can't. Like me, most people get choked up good, tears show up and the conversation is over as quick as it began. The person on the other end usually figures it out.

However, there was this one time... A woman's 56 year old husband collapsed on the church softball field and went into cardiac arrest. He was gone before he got to the hospital. When I arrived in the consult room doc was talking with the wife who broke all the grief rules. Shock and disbelief were her chosen grief manefestations, which can be surprisingly helpful at certain times. She was chipper and as even-tempered as someone coming to the doctor for a check-up.

She casually said things like, "I know he's gone, but I just can't believe it," and "I guess I should be crying, but it just ain't happn'n." Then she went for the cell phone. "Uh oh," I thought, "this will get her. No one makes it through the phone calls." Because you see, this is the hardest phone call people ever make. But this woman called her daughter with a level head, and didn't even try to let her down easy. "You're dad's gone," she said in a temperate voice clearly showing concern for her daughter's grief but none of her own. We could all hear the daughter crying on the other end, but mom never budged. Slightly frantically, she answered questions but not in a painstaking kind of way.

Some people, you can tell, do their absolute best to restain their tears and sadness. (I don't know where we got this cultural mindset crap that thinks tears are a sign of weakness.) But this lady was not straining to hold back anything. She was in shock. This is how her body was dealing with it. For the entire hour I spent with her, she never broke. You could tell the grief was there, that she was frazzled, that when she got home and her husband of 34 years wasn't there she would finally cry. But, I've never seen anyone last that long before.

She will go through the greif process, and I pray she does it in a healthy way. It's terrifying to think that a completely healthy man, like her husband, could just drop on a Tuesday evening and take his last breaths for no apparant reason. He is the same age as my parents. Now that's a reality check. From now on, my parents are prohibited from strenuous physical activity. Otherwise, me or my brother, or my sister might be making one of those dreaded phone calls, and I don't know if we're ready for that.

Sorry there's no happy ending to this post. I realize it's kind of a downer, but sometimes that's just the way it has to be. "And now, we are ended." -A. Niska

Don't even try it

For our honeymoon, my wife and I took a week long cruise in the Carribean. It was wonderful, and we had a blast. I learned that one of the appeals to cruises is you get to go to other countries and take advantage of duty free liquor and cheap cigars made in countries with whom America doesn't do business.

Many people prefer to buy certain items, such as cigars and liquor and take them back home. Heather and I did not do this. In fact, one man, I called him the "fun manager," on the boat convinced us not even to try smuggling certain items back into America when he said something like this, "If you think you can beat customs, think again. It's these people's jobs to catch you, and they're good at it." And he was right. What hawaiian-t-shirt-wearing jerk thinks he can sneak something past people who catch you for a living. (Except for the time I smuggled 3 miniature Cuban cigars through customs on a high school cruise when I was 16. But, I wasn't wearing a hawaiian t-shirt!)

My advice, if you think you can fool these people, don't even try it.

Similarly, I was in the trauma bay recently when a man was wheeled it smelling of strong alcohol. Not unusual. As he was conscious, the doctors began asking him what happened.

"I fell," was his first attempt.

"Mr. K, you have a knife wound here," said the doctor skeptically, "who else was involved?"

"Uh, nobody," said the man eyeing the police officer waiting in the corner, "I was by myself." Getting frustrated the no-nonsense doctor said, "Sir, you want to tell us what really happened so we can help you?"

Lie after obvious-no-time-to-concoct-a-worthy-story lie, this man tried to hide what really happened to him from the medical staff and police. In his drunken stupor, and because they'll only ask what happened so many time, he seemed to believe that the docs and nurses believed him. But, if you've ever considered lying to ER staff, let me be very clear about something: you're not the first inebriated bonehead who thinks he can slip one past these people!

They see injuries everyday and know what certain injuries should look like. Like the customs agents, it's their job. It's actually not that uncommon for people to try and lie their way through the trauma bay, but it never works. People have tried to say it was a bar fight when clearly they'd been driving, or some have simply claimed that they don't know what happened even though they were awake the entire time. "I don't know how the car accident happened," is a common explanation even when EMS finds a cell phone with part of a text message typed. Honestly, how can you not know how it happened when your father-in-law shoots you in your own living room?

Actually, the best patients in the ER are the ones that tell the truth. The med staff often starts chuckling when a man begins a sentence with, "I'm not going lie to you..." because we know it's usually going to end with something good: "...I had way to much to drink, and she was smok'n hott." Or, "I wanted to show my buddies that you can jump a moped off a ramp just like a dirt bike. Guess I wa' wrong."

The best what the guy with the finger nail scratches on his face from the girl he was cheating with claiming it was his cat to his girlfriend wouldn't find out.

My advice, if you're going to try and fib your way through the ER, don't even try it.

Colleagues, what other wacky tales or truths have you heard pass through the ETB?

{Note: picture not from SRHS trauma bay.}

Pain

It's hard to watch another person suffer. There's something about another person's pain that makes us (me atleast) very uncomfortable. In the hospital, I've had ample opportunity to be present when others are hurting, and so far, I haven't really figured out what to do with it yet.

I went to talk to a patient who, aside from heart problems, suffered from seizure activity in her brain. As I began to speak with her, she suddenly became silent, turned her head slowly to the left and twitched her eyes to the left as far as they would go. She was having a siezure as I sat beside her. I don't know if siezures like that are acutely painful or not, but it can't be pleasant to suddenly lose control of your body. When it was over it was like her eyes snapped back under her control and she slowly turned her head forward again.

One man, after a grueling heart surgery, could only respond to me using one word, "help." I asked if I could enter the room, and he nodded clearly fixing his attention on something not visible in the room. I soon discovered his attention was fixed on the severe pain he was experiencing. He was able to talk, but when I asked him any question the only response he would give was, "help," as he winced in pain.

I've stood over car accident victims in the trauma bay in excruciating pain to which pain killer medicine can only do so much good.

As a non-medical person in the hospital, my job is not to relieve pain. Were I a doctor or nurse or whatever, I'm sure I would be able to offer hurting patients something to relieve their suffering. But, as a chaplain, my job simply to sit there. In the pain, watching pain, feeling some pain of my own. This is an awkward thing for me. I am trained to help you deal with your emotional pain (if you want to go there), but regarding physical pain, honestly, I'm pretty useless.

So, for me, at this point in my job, I'd have to say that sitting and watching a person in pain is one of the hardest things to do. But what are my other options? I think it's bad form if the chaplain fled the room everytime somebody was hurting.

Sometimes, I'll be talking with a patient who has pain hit him all the sudden for a few moments. I sit there, and when the episode is over we continue our visit. Sometimes, it's as if nothing had happened. Sometimes we talk about the pain the frustration, anger and fear that random acute pain can cause.

So, what do I do? Suggestions are welcomed. Other chaplains reading this: what do you do with tangible pain during a visit?

Lying

Here's the situation. I live in Asheville, NC 50 miles away from Spartanburg, SC where I work. Different state, different city, different sub-culture.

Occasionally, patients will ask where I live, or where I'm from or how long I've worked at the hospital. If I say Asheville, I then have to go into a long explanation about living in one city and working in another. And honestly, the drive isn't that bad, yes it takes an hour, sometimes I carpool, it's because my wife is in pharmacy school, and it's only for 1 year. But this has grown tiresome. So, I try to steer conversations away from myself and my situation. Sadly this doesn't always work.

One recent conversation left me chuckling, because when I left the room, I had the patient convinced that I had recently moved to Spartanburg and was still learning my way around. The problem is, I'm not so sure I ever lied. What do you think?

Patient: Do you know where the (something) is out on Pine St.?
Nathan: No, I'm not too familiar with that part of town.
Patient: Well, how long have you been here?
Nathan: Only about 9 months.
Patient: Is your wife working? Does she like it?
Nathan: She's completing here final year of pharmacy school.
Patient: What church to you go to?
Nathan: Well, we're usually in Asheville for the weekends. Our parents live there. We've been going to a church up there.
Patient: Oh, that's nice to have them close and get to go out of town on the weekends. So, how have you liked living in Spartanburg so far?

At this point, I'm so far into the illusion that I actually live in Spartanburg, I can't correct her now. But I can't recall ever answering with a straight forward lie. All her questions were legitimate, and all my answers were true statements.

So, I never intentionally misled her; however, I didn't correct her apparant assumptions either. Is that passive lying? Is there anything wrong with that? Help me out here.

I don't know, but either way, I giggled as I left the room thinking, "Heather's gonna hate having to move to Spartanburg now."


Contrasting quotes:

"You shall not give false testimony." Exodus 20: 16

"It is always the best policy to speak the truth, unless of course you are an exceptionally good liar." -Jerome K. Jerome