Chapter 4: For Such a Time as This

The first thing I do when I get home is to take off my shoes, wash my hands, take off my mask, wash my hands again, wash my face, and then let my hair down.  The moment I let my hair down, my body knows it's time to relax, and my mind can start processing.  My holiday on-calls gave me plenty to process.

I thought about the phone call I had made to a woman who was preparing for discharge, after fighting through COVID.  She had come in together with her husband, and they had initially shared a room.  Then, his condition worsened, and he was transferred to the ICU.

One of my colleagues was there when they were parted.  That was the last time the woman saw her husband, in person.  My colleague spoke of how emotional that was, and how it was worth it for him to go inside the room to pray for the wife, and to hold her hand, wearing gloves and a gown.  

Another one of my colleagues had had a phone call with the wife, after the husband had coded in the ICU. According to the note my colleague wrote, the wife was very accepting of reality, and seemed calm in the face of such a terrible prognosis for her husband.

I was able to speak with the wife over the phone during my shift, and arrange for her to Skype with her husband, using hospital equipment, before her discharge the next day.  This, we all knew, would be the last time she could "see" him--their final goodbye.

This case struck a chord with the spiritual care department, because a total of 5 chaplains had gotten involved, over the course of several days.  Unfortunately, this heartbreaking situation was just one of many.  As a CPE cohort, we shared our stories with one another, facing the crisis as a team.

Although some of my peers will refer to patients on their floors as "my patient," I tend to think of each patient as "ours."  Especially in the cases of patients who transfer through several floors, spiritual care also transfers from one chaplain to another.

We had a married couple come in through the emergency room together, and the husband was immediately transferred to the COVID ICU, where one of my colleagues was assigned.  The wife was healthy enough to stay in the Emergency Department and receive enough care to be discharged, without being admitted to a hospital floor.  Knowing she already had COVID, she asked if she could be escorted up to the ICU, to say goodbye to her husband before going home, and my colleagues worked with hospital administration to see if they could make an exception to the visitor policy.  Ultimately, the request was denied, and the wife handled it with grace.

But we as a team really felt for this family--and for so many others whose trip to the Emergency Room meant goodbye forever.  How privileged we were to be granted access to the ICUs--even if all we could do was pray for patients outside the glass doors of a COVID isolation room--when family could not even have one final look, except over Skype.  The harshness of the pandemic saddened us, and it also angered us to see so many outside of the hospital still not taking it seriously.  If they had seen what we had seen, would they still put lives at risk with careless behavior?

I had some strong feelings of my own to process, as several of us had spoken with COVID patients who were members of churches who defied the governor's orders and continued worshipping in person.  One of my patients survived COVID, while her husband in the ICU did not.  And several of their other church friends were also infected.  This was another "case" that had passed through multiple hospital floors and several chaplains, and which we processed together as a team.  As professionals providing spiritual care, we chaplains showed compassion to all our patients.  At the same time, as humans, we were angered by church leaders who put their congregants at risk for this deadly virus.   

There was so much going on during the Holiday surge that our CPE model of action-reflection-new action was compressed into an ongoing process-as-we-go mentality.  Often, my peers would give a play-by-play of a situation they had just encountered, as soon as they came back into our shared office space.  Midway through their narrative, another page would come in, with further developments.  As we all tried to catch our breath, we knew we could count one the team to pull through together.  We had to, to survive.

Now that I have found some time to breath, recover, and write, I am grateful that through the most recent surge, we all managed to stay healthy, sane, and faith-filled.  Each of us has a very different temperament and background, but we have put our differences aside to learn together.  One day, we will look back and see how our call to ministry brought us to the front lines, "for such a time as this."

Chapter 3: "I'm Proud of You!"

The Holidays were upon us, and the post-Thanksgiving Surge was in full swing.  Our Emergency Department was overflowing, with every bed occupied, patients being put in the waiting room even after being admitted, and some patients' location listed as Ambulance 1, 2, etc.

Two other patient floors were now converted into COVID units, in addition to our three "regular" COVID floors.  For each patient that passed away from the virus, another 10-15 people were waiting use that bed in the ICU.  Our morgue was beyond capacity, and we had extra refrigeration in place.

The vaccine was on its way, and that gave us hope.  

I received my first dose of the Pfizer shot on December 19th.  In the weeks to come, I would feel slightly safer as I showed up on the COVID units, wearing an N95 mask, a surgical mask on top of it, and a plastic face shield.  I always put up my hair, too.

One of my Holiday on-calls was in the wake of a full moon.  If I did not believe in "superstition" before, the pandemic has given me full faith that human life cycles are closely connected with larger cosmic forces--full moons are linked with more deaths.  Our on-call numbers prove it.  

That day, there were 6 code blues.  A code blue is a medical emergency, broadcast throughout the hospital system, so that the team can show up with the proper medication and equipment to save a life.  Chaplains show up to offer support as well.

It is always a surreal experience to see up to 10 medical personnel inside a room, performing life-saving procedures.  During COVID times, this also involves wearing yellow gowns and gloves.  Another cluster of staff stands outside the room, ready to hand more supplies, or to relieve the staff inside.  Chest compressions are counted, and are physically taxing to the one performing them.  There is a strange blend of calm and tension during these times.  There is always one point person who informs the family of what is going on.  They also call the family to let them know when their loved one is stabilized--or, if their loved one has passed away.  

That day, 2 out of the 6 patients who coded passed away.  In between the code blues, I was visiting other patients on other floors, carefully compartmentalizing each experience into its own spot, to be processed after I got off my shift, and when I could let my hair down.

The phrase, "ignorance is bliss" really does apply to those patients who receive a chaplain visit, not knowing where we have just come from.  Right after one of the code blues, I had a long chat with a female patient who identified as Jehovah's Witness, during which time we discussed her love of the Bible, her conversion to the religion, and the important names of God.  As the visit progressed, I became aware that she was trying to proselytize, and to get me to join her church.  I kept the visit professional, steering the conversation back to identifying what was important to her, and what brought her strength during difficult times.  Even though she was not successful in getting me to join her church, she did say, at the end of the visit, "I'm proud of you!" (for being so familiar with Scripture, and able to follow along with her sharing).

As I charted about the visit afterwards, I just had to chuckle.  Even as I was putting our conversation into clinical terms--offering my assessment of the patient's spiritual needs and resources, and documenting the type of care I provided--she was perhaps patting herself on the back for reaching out to a potential convert.      That makes two of us who were sincerely doing our best to fulfill our spiritual roles!

Chapter 2: Bearing Witness, Being Present

In the previous post, I described a few examples of what we as chaplains do in the hospital, and how we function on the care team.  Chaplains' formation occurs through action (being put in clinical situations), followed by reflection (processing with their cohort and supervisor), and new action (trying out new ways of being, based on feedback).  In the first few weeks of CPE (this stands for Clinical Pastoral Education, and is the name of our chaplain training), as I was dipping my feet back into the waters of the hospital, I began to reflect on the experience of providing spiritual care during a pandemic.

I noticed that, without family or visitors inside the hospital, patient care seemed more straightforward.  While I often called family members over the phone to offer spiritual care and emotional support, I did not have to navigate the dynamics between patients and their families, the way I would if they were all in the same place (things sometimes got dicey).  Therefore, when I was with a patient, they had my full attention.  And when I was with family, over the phone, they had my full attention.  I was able to feel more focused during each visit.

Hospital staff seemed very appreciative of chaplains.  In the past, I sometimes felt "less" important than medical staff with years of clinical training.  Was my role really "necessary" in the hospital setting, or was it merely an "extra" service we provided to patients and their families, to support the medical care?  6 months into the pandemic, there seemed to be no question in anyone's mind that chaplains were a necessary part of care team for patients.  Even the head of hospital security appealed to us to help face and acknowledge families' anger and sadness at being denied entrance.  "We need you guys on our team," was a phrase I heard from nursing staff, security, and medical doctors on a weekly basis.  "Thank you for helping us support patients and their families."  When there was so much that "could not be done," our willingness to be still in the face of helplessness, and our ability to simply be present to other humans, was valued.

I spoke with a woman who had a hard time forgiving herself for what she had done to her sister, growing up.  She identified as an Italian Catholic, and was well into her 80s.  I asked her to share about the incident for which she held so much guilt--and learned about her family of origin by asking follow-up questions to her narrative.  Although her mother had died when she was but a girl, she still thought of her often.  "My mother was so beautiful," she repeated throughout our conversation.  I validated her mother's emotional presence with us in that room, as a guiding force for her present reminiscing.  Rather than telling her what to think, I explored her beliefs by asking how she thought of God, and God thought of her.  It seemed she had a difficult time actually believing in her heart what she knew in her head: God forgave her and loved her.  

Chaplains believe that helping patients name their feelings and their fears takes away the power that those emotions have.  Behind every feeling is a story, and part of our job is to facilitate patients' telling and discovering of those stories, and to listen with unconditional positive regard--no judgment, and no advice. 

I often find that, by simply being attentive to patients' stories, validating of their feelings, and willing to sit in unresolved situations with them, I will often witness patients coming to small breakthroughs, in the span of one visit.  They often access parts of their Best Self that "worst case scenarios"--being hospitalized, and feeling helpless--allow them to discover.  "Where two or three are gathered" is a sacred space that invites God's presence, and whether or not the patient (or chaplain, for that matter!) "believe" the "right" things does not matter.  What matters is that, when one human is truly seen and heard by another human, the healing begins to happen.  And when healing happens on any level--spiritual and emotional, "intangible"--it contributes to healing on other levels--physical and mental, "measurable."

As chaplains, we bear witness to difficult moments, and we hold space for patients and families facing life-and-death decisions.  Whenever I step out onto the hospital floors, "it is not I who live, but Christ lives in me"--I put on my Chaplain Hat, and I do not take any interaction or situation too personally.  My profession requires that I use my Full Self and show up to be present to others, but none of this is actually about me.  And yet, my recollection of what happens on the job is always filtered by my own belief system, personality type, and human limitations.  So what is about others, also affects me.  We cannot help but be interconnected.

  

Chapter 1: The First Few Weeks of Chaplaincy Residency

We started Orientation with masks on, and seated 6 feet apart.  What a strange thing to meet new colleagues for the first time and not know what their full face looked like until lunch time.  We learned about hospital policy during a pandemic: no visitors were allowed, except at time of death, for 15 minutes each, and no more than 2 at a time at the bedside.  The Viewing Room, which was normally used to allow grieving families to be with their deceased loved one, away from the hospital floors, had strict limitations as well.  Whereas families as large as 30 would come for a Viewing the past, the limit was 9 people now.  

Some of the hospital floors were dedicated to COVID cases, and would require phone visits.  On our "regular" floors, chaplains would only visit patients who had had 2 negative COVID tests.  In addition to our surgical masks, we would also wear goggle or a face shield when visiting patients.  And so it began.

My first few patient visits seemed "normal" enough.  One was with a lady with severe and chronic back pain, who was questioning whether God was angry with her, and who simultaneously felt guilty about her condition keeping her from making more of a difference in the world.  She requested that I bring her a Bible, and on my follow-up visit, I made sure to deliver one.  Another delivery was to a patient who wanted to fill out and sign an Advance Directive, in order to prepare for a time when she would be unable to make medical decisions for herself.  

We had our share of compassionate extubations, when "life support" (in laymen's terms) would be removed from a patient, and the family could come to say goodbye.  Those goodbyes are sad but meaningful.  As chaplains, we often meet the family in the hospital lobby and escort them up to the Critical Care Unit.  We are quiet enough to give the family space to process the situation, but also present enough to make conversation that might help diffuse the anticipatory anxiety.  While the family is at bedside, we stay outside and remain available to answer any questions about mortuary arrangements, bring in water or tissue for the family, and ultimately to escort the family out.  

I have noticed, from my experiences of Extubations and Viewings, that the release of emotions often has families feeling relieved, and is one step in the healing process.  Tears are a wonderful and necessary part of goodbyes.  I have seen grown men cry, and I have held back my own tears as I've seen families process grief.  

There are always humorous moments as well.  Many a grown man has flirted with me on the way out, which seems completely understandable, in the wake of such an emotional moment.  I call it the "testosterone boost" that helps them feel ready to step outside the hospital, ready to "face the world" outside again.  These were all situations I had encountered in my first unit of chaplaincy training, and which come to mind as I think of the first few weeks of my residency.

Chaplain Chronicles: Preface

This time of year brings back memories.  

It was 7 years ago, around Super Bowl Sunday, that I blogged about visiting an open house with my mom.  That was 1 month into my 1st try at this blogging thing, and little did I know I would keep it up.  Super Bowl Sundays during seminary in New Haven meant trekking across town, in the snow, to watch the Game at our friend Dax's house--a time for serious seminarians to devolve into cheering for sports.  And, of course, this time last year was when the world began to truly take the coronavirus pandemic seriously.  

What a year it has been.  2020 brought about economic hardship, devastating deaths, and a mental toll.  If we go by the Lunar Calendar, the year of the Rat is at its tail end, and I'm ready for the year of the Ox.  

But in many respects, 2020 was a restorative one for me.  As society shut down, I reconnected with parts of myself that "normal" life did not always allow me to embrace--my love of staying home, disconnecting from societal functions and expectations, and simply being, rather than doing.  Work remained steady, as I taught music lessons and organized ongoing projects--whether it be for the interfaith network I worked for, or social-justice-oriented collaborations with friends--over Zoom.  And I had several personal calls each week, with individuals and groups of friends from all over the world.  What I did not miss was the guilt of not attending church on Sundays--and the pressure of going out into society as a single person.

And when I did finally "go back to work," this past September, it was as a chaplain, and it was a dream come true.  In the early stages of the pandemic, I found myself dreaming about being on-call at least once a week.  So when the opportunity came to start a hospital residency, I rolled up my sleeves and dove in.

A year into the pandemic, and nearly 6 months into my residency, I have a few stories to tell, in honor of the patients and families who have been severely impacted by COVID-19, and on behalf of the other frontline workers, with whom I serve.  This next set of posts will focus on the some of my chaplain experiences, for anyone outside of the hospital who might be interested.  

As you cycle through them, may you bear witness to the sacred work that is ours to sustain together--whether in person, or in spirit.

Enjoy!  

Matches

 We were quite the match.

I've never had someone whose energy could match--even surpass--mine.  Whose experiences encompassed as many--if not more--than mine.  Whose anger could match mine, and vice versa.  

Like two matches striking flint, we set the connection ablaze.  It was 2 months and 80 hours of intense cerebral and emotional engagement.  Of asking and answering very deep and personal questions.

Ultimately, it was a bust.

And what remains is a warm glow, in the hearth of my heart.

The thing with these once-in-a-lifetime connections is--they change you.

It is impossible to "settle" after someone has touched you so deeply, and excited you so viscerally.

So for now, no one can match what he aroused in me.  And I am content to wait for one who can.

Matching

 I have met my match, it seems.

Others have come pretty darn close, and I loved them.  I learned from and with them.  And they loved me.

[The saddest, hardest thing is when two people love each other, but cannot make a commitment.]

[It can also be hard when the love is one-sided, unrequited.]

But to truly be able to express oneself fully, without filter, and for the other person not only to pretty much understand everything you say, but also to remain curious and teachable to what they don't fully understand--that's a once-in-a-lifetime experience.

Yes, eventually personalities will rub.  Yes, marriage and love is a choice and a commitment.  Yes, that initial spark must be maintained.  

Yes to all the above.  And it also must be said--some connections blow all the other ones out of the water.

Not everyone understands what it's like to have moved every 2 years for the last 10 years, and to have dated lots of quality men along the way.  It can feel hard to meet someone who can understand every part of your experience, and can have meaningful and engaging dialogue with you on almost every facet of who you are.  But when it does happen, you feel seen and heard and known in ways that are exhilarating, refreshing, infatuating, stirring, motivating, comforting, and, simply amazing.

Now, the thing is--one can experience the most amazing connection in the world.  But, if there is not a choice and commitment to partnership and love, then it also remains just that--the most amazing connection of a lifetime.  

So, it remains to be seen, whether that sort of thing is sustainable for a lifetime--or whether it just marks the most incredible and irreplaceable memory of a lifetime.