Category: CPE

Call me Mr. Padre

Today, I wore my collar while at the hospital for the first time.

One of the nice things about being Lutheran is the access to the accessories. Besides the stole and the cope, seminarians have access to quite a bit of the “traditional” clergy attire. My Episcopal friends are not so lucky. So, today, I decided to come to the hospital decked out in a black clergy shirt and a plastic collar. On the subway, I also donned my gray newsboy hat, my aviators, and my red chucks. Like one of my colleagues said, all I needed was a goatee and I could be “that” pastor. You all know the type I’m talking about. Luckily (or maybe sadly), aviators are not allowed in the hospital so I put my chucks aside, busted out my Ted Bakers, and went to town.

And I must say, I loved the experience.

My colleagues thought I looked nice. My supervisor called me Padre. I had to tell the story of Lutheran access to accessories several times. But besides the looks and support I received from my colleagues, I noticed that I seemed to take myself a tad more seriously and playful while I wore the collar. I had no need to worry about my authority as I was wearing it on the outside. Doctors recognized me, nurses who ignored me now took notice, and patients seemed to open up easily. No longer was just the word “chaplain” my entry way into the spirituality of those in the hospital. When I walked into the room, the patients saw spirituality and responded in kind. It was quite lovely.

There was one specific event where I feel, had I not been wearing my clergy shirt, a ministry opportunity would have gone unfilled. One of the Patient Care Directors on my floors asked me to see a patient who was dying. The food intake was being turned off and the family had been gathered for two days, waiting for the end. I walked into the patient’s room and began my speech. They all nodded along but it wasn’t long before I realized that they had very little idea what I was saying. They spoke Spanish. I spoke English. We both literally were not speaking the same language.

One of the family members came into the room and spoke to me. He spoke English and he pulled me out of the room to chat. I could tell that he was trying to push me out of the room (he revealed some family dynamics and his own personal religiosity that looked down on a chaplain being in the room) but I stood my ground and offered my services. As I turned to walk away, the spouse of the patient (who came out of the room to talk to a doctor) stopped me. Through a translator, the spouse asked if I was a pastor and asked if I could pray at the patient’s bedside. I said yes but I could only pray in English. The spouse did not hesitate for a minute and asked me to enter the room. So, there, in front of the patient’s family, I prayed. I acknowledge the harshness of the time. I acknowledge the pain that the family felt. I acknowledged that death was coming soon (though I went about that in a circular way – I need to get better at saying it more bluntly). I prayed with the family. I read Psalm 23 and Psalm 121. I offered my condolences. Some of the family cried; some just kept their heads bowed. But as I left, the spouse shook my hand and said “Thank you.” And I think he, and his entire family, meant it. If I had not been wearing a collar, I would not have been able to pray with them, there, at the bedside.

There is only five more weeks of CPE but I think I’ll wear my clergy shirt at least once a week. It is an experiment that I am having a lot of fun with. Maybe too much fun. This is CPE after all – there’s only so much fun that I should be having.

Walking with Marcs

I’ve had quite a trip since I wrote last; lots of things have happened. CPE has been very intense; I moved; I visited Ikea; I saw the Brooklyn Cyclone play; I wrote; I saw The Book of Mormon; I preached; and if putting together Ikea furniture was a requirement for ordination, I would be bishop by now.

I am exhausted.

I woke up an hour ago and all my joints hurt. My feet hurt. My spine hurts. My shoulders hurt. I don’t even really remember falling asleep last night. I know I laid down in the bed and then BAM, I was out. I didn’t hear the dog get comfortable. I don’t know what the cat did last night. And if there were any illegal fireworks in the morning, I missed them. I was gone like donkey kong.

CPE has been going well but it hasn’t been easy. The last ten days or so has been rough in the PICU. Many long time patients died. I was with one family for quite awhile over two days. I watched the mom and dad say goodbye and I did my best to comfort the entire family. But I made one big missed connection – I wasn’t able to connect with the mom. I wasn’t able to be the pastoral presence she needed me to be. She wanted me to be loud, to be controlling, and to distract her from the pain she felt. She wanted me to talk of miracles, of the power of God, of the restoration in the life to come. She wanted my theology to be brash and powerful. But that really isn’t me. I couldn’t create a sacred space that felt like it was running away from the reality around me. It’s not my theology nor did I have a set of tools that could turn off what I was feeling and what I needed in that moment. Although I did not know the child, I was mourning. I was feeling loss. I felt sad. And, try as I might, I couldn’t be an instrument of care only for the mom. I was ministering to an entire family (grandma, family friends, etc etc) where everyone (including me) needed a different presence, a different sacred space. I juggled but was never able to include the mom.

I know I failed to reach the mom because she called me out at one point. During a forty-five minute session of praying in tongues (which was a first for me), at one point she said that God wanted to speak to me. And she spoke, loudly and aggressively, criticizing my Lutheranism, my faith, my presence, and everything about me. At the time, I fumed. I got angry. But I kept it in check. I let her say her piece. She felt better afterwards while I did not. It was an interesting experience to have.

Most of my CPE experience has been similar in emotional impact as the death of that child. I’ve met people with loved ones are dying, children who are suffering, parents who are so angry that they no longer want to speak to anyone. CPE has been going well but it is really emotionally draining. The workload has increased. I’m sitting with patients longer. The required readings are a tad excessive. And the group analysis portion of the whole thing can get downright silly. But I really do enjoy my group mates. They really are the best. I don’t think it would be going quite as well for me as it has unless they were with me. Thank God for that.

Part of also why I’m so tired is that I moved. I’m no longer in Astoria but am now back in Washington Heights. The move went well – much better than I expected. We currently only have about 1/4 of our stuff in boxes. Our new apartment is filled with lovely new Ikea furniture. The apartment actually has windows (I can see the sun sometimes!). We’ve literally moved on up. But with the moving, the unpacking, and the shopping – my body, my brain, and my soul is just exhausted. And it shows. Yesterday, I preached at Trinity Long Island City. The gospel reading was Matthew 11:16-19,25-30. It is a weird little text where the context is left out of the scripture reading for the day. The epistle reading was that famous bit in Romans where Paul wrote about not doing the things he wanted to do. I preached mostly on the gospel reading but I wasn’t happy with it. I thought my presentation was good – my voice was strong, I wasn’t nervous, and I tried looking at the audience. But, while in the pulpit, I realized a few things. My transitions were weak. My main points were too buried. And what I really should have preached on, I spoke too little on and left to a snippet at the end. And halfway through the sermon, in the back of my head, I asked myself, “who am I really preaching to? Is this to them or to me?” I’m not sure the answer to that question yet. But I think the conflicted nature of my sermon is a reflection of just what’s going on in my soul right now. Everyday at CPE, I’m confronted with suffering. Everyday, I see something that shocks me. Everyday, I learn the story of a lovely person who fills me with joy. Many times, the only thing that really seems to keep me going is the presence of Christ’s wounded hands and pierced side. Holding onto that allows me to enter the next hospital room, walk to the next bed side, and confront the next image of the fact that we live in a broken world. If I didn’t have that, I really don’t think I could keep doing this.

And then there were five

Yesterday, we lost one of our colleagues.

One of the six, our fellow CPE summer student, had to leave the program. Due to their schedule and some things that came up, they just weren’t able to invest in the program fully and finish it up. It was all quite sudden and I was surprised by it. I completely understand why they withdrew (if I was in their same shoes, I would have done the same). And, like them, I wouldn’t have known exactly what CPE required until I actually tried it. But, even with the rationalization and the understanding, I was still very sad about it. I like the person quite a bit. Everyone in the group seemed to connect with them in a different way. And, for quite awhile, yesterday afternoon, I just felt down.

Right after we learned of our fellow student’s withdraw, we participated in our regularly scheduled process group. Our overall supervisor is a leader in a type of program (I am forgetting the name of it) where people explore their feelings, in the moment, and no one is suppose to be left alone. I think one of the goals of this type of experience is to get into better touch with what we feel and what it means to explore and be in those feelings (be they emotional or physical). We’re not suppose to explain away things. Like my supervisor says, we all know how to explain things. Ever since we were little kids, we are always asked why we did something or “explain yourself young man/woman!” And for those of us in seminary, explaining is what we do. But exploring is different. Trying to feel and be with yourself in the moment is different. This system, when explained, can easily sound like some silly new agey feeling talk (“You’ve just got to get in touch with your feelings, man!”) but it really isn’t. In the context that it is used (training chaplains to walk with people in their pain and hurting), being able to explore our feelings allows us to help people explore theirs. Instead of explaining away what people are feeling, or trying to uncover the hidden reasons why someone feels that way, we’re instead being trained to walk with people and live with them in their moments. What are they feeling? How are their feelings limiting what they’re able to do? How are their spiritual resources? What gives them meaning, hope, and connection in this time of need? Where are they at?

I like to uncover things. I like to ask questions and see if something that is unsaid is really the driving force for another’s emotions. I like to create thoughts and explore those thoughts. But I struggle with meeting people at their moment of feeling. That’s basically my current major learning goal for the rest of the summer (including all the other ones that I’ve mentioned!). Let’s see if I can crack this teapot during the next seven weeks.

Get your Pray On

I like to think I’m a praying kind of individual. Before I go to bed each night, I say a set. I’ve been known to take a few moments and say prayer in the middle of the day. When I need to calm down, I repeat the Lord’s Prayer over and over. When I hear of a friend struggling or suffering, I’ll shoot off a prayer. Now that I’m a seminarian, when I enter a room, I’ve become a designated prayer. At first, it was difficult but it’s been getting easier. I’ve even made a learning goal this summer to become more comfortable with extemporaneous prayer. I’m going to start reading prayer books regularly. Before you know it, I’m going be the quickest prayer drawer in the West.

But one thing I’ve struggled with during the last three weeks of CPE has been praying with patients. I don’t offer prayers often and I usually wait for a patient to request them. I’ve prayed with Jewish folks, Muslims, Greek Orthodox, Roman Catholics, Methodists, Baptists, Evangelicals, and Seventh Day Adventists. If I was playing prayer bingo, I’d be nearing a complete blackout. For non-Christians, I leave out the Jesus and tend to borrow their words. For “liturgical” traditions, repeating the Our Father or taking something from a Lutheran Prayer Book works fine. But for other traditions, I’ve struggled. I’ve had my prayers critiqued. I’ve had folks point out how my theology is “wrong” in my prayer. When it comes to traditions where the individual is an active participant in grace, my prayers seem to run into problems. My cries for God to do godly things runs into a dead end. They fail to bring comfort in the way that these patients ask for. Or, worse, these patients just assume I’m “catholic” and am a lost soul anyways so there’s no need to even ask me to pray with them. It’s frustrating.

When I run into this prayer confrontation, I tend to shut down. I’m not looking for pats on the back nor am I asking for a high five. I don’t want to be thanked (though that happens a lot). But I am a stickler when it comes to prayer. The theology might be off, the request might seem strange, and the whole thing might feel different and unfamiliar, but it’s a prayer. It’s a cry in the midst of human suffering. It’s a request for release, for mercy, for love, and for hope. It’s a hope for comfort, for release, for things to work out in the end. It doesn’t mean that it will work out that way – God’s will be done and all that – but, from my point of view, a prayer is the most human response possible to the presence of suffering. Before reaction, before restraint, before gasps, before retaliation, before resistance, there is a cry. And that cry is a human cry, even if it’s done poorly, feels silly, or isn’t in an understandable language. It’s a place where people not in the midst of your suffering can reach out to you and hold on. It’s what people just do.

I never expected to spend this summer working on my theology of prayer but it looks like that I’ll be struggling with that (and a million other things) during the next eight weeks. But thats okay – it’s why I’m here. And it helps that, on this Sunday, while packing up my apartment, my wife stumbled onto an old bottle of bad tequila. I’ve never met a bad tequila I didn’t like.

Lack of curiosity killed the CPE cat

Today, I presented my second verbatim at CPE. So far, I’ve been enjoying the verbatim process. I analyzed a visit, drew some conclusions from it, thought I did a good job, and then was shown that I had been triangulated, undergone some transference, and lacked a curiosity that would have helped with the visit. I did fine but I could have done better. For over an hour, we talked about what I could have done better and the group brought up things they struggle with that was related to what I had done. I had missed some important cues and part of my summer will be spent trying to hear those cues, get curious about them, and then see if the patient I am talking to has an image of God or any sort of spirituality that plays a role in what bringing them hope, meaning, and connection. I just hope that, during the next few days, someone will actually take me up on my offer to talk with them. It’s been two days of “no, I’m fine” or “I’m not into religion.” That can get old after awhile.

In other news, I witnessed something at the hospital on Monday that horrified me. It’s interesting because, of all the people I’ve seen, with all the tubes and medical devices, nothing had really thrown me for a loop yet. However, what I saw near the end of the day was just haunting. It’s an image that I’ve been carrying with me since and that still just hangs in the air around me. It doesn’t cause me to lose sleep or to stop talking with individuals. I’m still able to laugh, make jokes, etc. It doesn’t feel to be holding me back. But what I saw did truly frightened me in a new way. And, for the moment at least, I’m not trying to explain the feeling away nor am I trying to process past it quickly. Rather, one of my learning goals this summer is to try and stay with the feelings I’m having, to acknowledge them, sit with them, and bring them into the present. I have shared this image with my colleagues and mentioned my feelings about it – but I haven’t tried to process it away just yet. And I’ve discovered that, even though it repulsed me, I’m not really afraid of going back to the place where I saw it. I am taking time away for myself, but, in reality, I could easily go back to that place. By holding onto the feeling and the moment, I’m actually still able to function and live in all my present moments. What horrified me didn’t hold me back even though, four weeks ago, I would have told you it would. I keep surprising myself in very tiny ways.

I am a Jack of All Mainstream Christian Faiths; i.e. my first death on CPE

Yesterday, I was the day on-call chaplain at the hospital. My role was to be the emergency contact person for the hospital. If someone called the information desk and asked to speak to a chaplain, I would be their man (or I would farm it off to whoever is the chaplain assigned to their floor). If someone requested a Roman Catholic priest, I would call the local church. I would check the pastoral care request book and phone line every few hours. And my beeper would be set, ready to scream bloody murder at a moment’s notice.

My day started out fairly normal. I visited many different families in the pediatric ICU and various patients on other floors. I had a few long conversations but most were very short and didn’t last very long. Most were fairly polite. Not many conversations felt very theological – even the conversation with a man about how can someone believe in the midst of a suffering world wasn’t really a conversation; the man just wanted to monolog for awhile. A colleague had been the on-call chaplain the day before and their beeper barely beeped. I was hoping for the same.

My summer CPE group and I gathered after lunch to go over some IT stuff. None of our logins to access electronic medical records were working (way to go IT). But two of the students were unable to gather due to deaths that had happened on their floors. And as I sat at the computer desk and my supervisor called IT, my beeper buzzed for the first time. A number flashed on it. I called the number right away and a nurse answered. I told her I was the emergency chaplain on call and was calling the nurse back. The nurse thanked me for the quick response and then spoke the magic words: “We have a patient who is actively dying.”

I found out the patient’s name and their location. The pastoral care department does not make a guarantee to fulfill all religious faith/denomination requests (except for Roman Catholic) but the family did request an Episcopalian. I am not an Episcopalian but one of my colleagues is. He asked to tag team on the call with me. We gathered our things and head to the elevator. On the elevator, we went over our game plan and he showed me where in the Book of Common Prayer the rites at the time of death were located. We entered the floor, met the head nurse, and put on gloves and a gown. We were on a bit of an adrenaline high. We pulled back the curtain, entered the room, and saw an elderly patient’s daughter crying.

It wasn’t easy being in that room but I was amazed at how calm I was. We spoke various prayers. We spent time with the daughter. I was amazed at seeing how the rites and prayers affected the daughter and the patient. Tears flowed but calmness had more face time. Pictures were shared. And I think I saw the moment when the patient truly died but the machines said otherwise. The daughter seemed thrilled that we were both “Episcopalians” and, in the midst of grief, I decided it was best not to correct her. After forty five minutes, we left and made a promise to return later to check up on them.

We went upstairs and gathered with the other students. We all decompressed and told our stories. Lots of death and other painful situations dominated the conversation. We talked about the weight we felt. We named our emotions. We tried to get out of problem solving mode and just be in the moment as a way to center ourselves. I talked about how calm I felt – a calm that surprised and shocked me. In the midst of death, I didn’t know how I would react. But the very words I read from the BCP – words I never saw until that day – seemed to have a soothing effect on me. Just preforming the rite seemed to help. I felt slightly energized and ready to go into that room later in the day.

My colleague and I met again before the end of the day. The game plan was modified so that the true Episcopalian would take the lead. We entered the room and met more family. We prayed more prayers (the Litany on the anticipation of heaven was very nice). The prayers helped quite a bit again and, in the midst of suffering, I honestly felt like we did some good. It wasn’t perfect (we might have held onto silences a little too long) but I thought it went well. And I am really glad that I had the backup that I did.

I doubt this will be the only death that I see during my unit at CPE but it was no where near as scary as I thought it could have been. And even though it went smoothly, I do feel changed by the experience. A few months ago, I helped baptize a young newborn. Yesterday, I preformed the last rites for someone who had lived a long life. I’ve book ended life, so to speak. Now I just need to learn how to deal and minister to all those folks located in the middle.

A Passing Hello

Today, on my first full day on the floors (minus an hour tutorial on how to access and utilize Electronic Medical Records), I found myself heading to my first floor at 9:30 am. While walking and fumbling with some papers, a middle age man was following a nurse. Both were walking towards me. As we drew close, the man shouted “Hey man!” and waved. I looked up, unsure of who he was, and said “hello!” back. We both walked pass and he said “I get to go home today!” “That’s great! Be well!” I said back to him. It was only then that I realized who he was. I had briefly visited with him two days before. He was very tired and semi-sedated when I saw him. We had a very short conversation and he asked me to say a special prayer for him before he turned over on his side and fell asleep. He remembered my visit and seemed happy to see me before he left. That was pretty neat.

Overall, today was an interesting day. I spent most of my morning visiting heart patients and met quite a few characters. I then spent most of my afternoon in the PICU, introducing myself to families who I had yet to meet. I had three very interesting encounters. 1: a middle age woman was amazed that, while she was reading her daily prayer and studying the apostle Paul, I showed up – she offered to visit my future church some day. 2: I entered the no-man’s land of a family argument where my status as a prayerer was seen as an opportunity by one side of the family to barrage the other. 3: a mother who asked me, in the hallway, to pray for a miracle but not to tell the patient because the patient hates those things. When you visit with 40 people in one day, a lot of interesting things can happen.

I am staying up way past my bedtime and I really shouldn’t. Tomorrow I will be the emergency chaplain during the day. My duty is to man my pager and be ready to refer patients to chaplains (or priests or rabbis) as needed. And if there is an emergency and there is no one to refer the situation to, I am then their chaplain. I will be the page-meister. I should wear a superhero seal.

What am I feeling in the present moment? Guilt.

Today was an interesting day.

Most of today was spent in class – three students presented verbatims and we had an hour and a half “process group.” During process group, we work on connecting to what we are feeling, what is pulling us away from the group, learning more about ourselves, etc etc. After process group, and before the end of the day, the group would visit patients briefly. After my experience yesterday, I created a plan in my head on who I would visit. The PICU, my two other units, and a few specific patients were on my list. It would be a light day but a good day. I did planned to visit an individual I avoided yesterday. I met them on my first day on the floor and, after that experience, I just felt…unsure… of seeing them yesterday. While processing through my first day, I came to the realization that even though I only saw a few patients, I witnessed quite a bit of suffering and that it impacted me. I didn’t feel ready to see that again – I needed a few different experiences to center myself and return back to the places I went to on Friday. Well, at least that is what I told myself. Yesterday, I would walk by one specific patient’s room and notice the door was shut or nurses were in it or doctors were visiting. I allowed myself to believe that there wasn’t any time for me to stop by. But, in reality, I just didn’t want to go in there quite yet and I wasn’t able to push myself to go. But today was different. I had a plan. I was ready and willing.

But that patient wasn’t. I heard, right before process group, that the patient died in the morning.

At first, I felt anxious and wondered what the family was going through. During my time in process group, I mentioned feeling anxiety about knowing if the family was still there and what I would do. What role would I play? Would I be ready for it? But as the group continued, I kept internally examining what I was feeling. I didn’t say it out loud but, in reality, I was feeling guilty. I felt guilty for not visiting that patient and their family the day before. When I met them last week, I was informed that the family was looking to receive more pastoral care and support. They had been in the hospital awhile and I figured that I had many more days with them. But I didn’t and I felt like I let an opportunity step away. And the guilt led to feelings of shame. I really feel I should have made it to see them yesterday.

I do know that the family did receive some pastoral care. Priests were contacted and other chaplains – chaplains who are on staff or are on their fourth unit of CPE – visited and were there. Although the department is small, the resources are fantastic and I am sure that the family was taken care of. But I still feel down because I didn’t risk seeing that family yesterday. I thought I’d have more time with them but I didn’t. And that’s a fact of hospital life. I’m still getting use to the turnover of patients in the units. The long timers are the exceptions, not the rule. Even having patients staying three or four days isn’t normal on my floors. There isn’t really time to wait or to not visit.

Tomorrow and Thursday are days where I’ll be visiting patients all day. I’m not sure, yet, how that will go or how I will break up my day. On Thursday, I will be the on-call chaplain during the day and will be responsible for any emergency ministry needed. I’ll actually get to use my beeper. I’m back to 1983. This is, and will be, an interesting week of firsts.

Week One Done

Week One of CPE is done! 10 more to go.

This week went very well. It was mostly orientation and classes but, as I mentioned yesterday morning, I spent about an hour visiting patients in one of the units that I will be working at. Most of the patients were either asleep or being seen by nurses and doctors. However, I did meet four patients, and 2 family members. One patient had his wife there and I was able to visit with them with another chaplain. Another individual was just in so much pain, I couldn’t stay with them long. Another patient was very kind but didn’t need much help. And another patient didn’t even give me the time of day – when I walked in, announced who I was, the patient just put their hand up and shouted “PASS!” So I got a little bit of everything in that hour.

I learned a lot this week and meshed well with my group but, by 5 pm last night, I was exhausted. K and I visited an apartment (we’re moving this month), put in our rental application, ate some dinner and came home. I was able to play on the internet for about an hour before I passed out on the couch. At some point, I moved to the bed and slept till morning. I’m not a long sleeper but I needed that 10+ hours of sleep. I was exhausted. I have a feeling my friday nights are going to be like this for the rest of the summer.

Looking at the four visits, I’m trying to recall exactly what I said when I introduced myself. I remember mentioning my department and what we do but I don’t know if I called myself a chaplain or not. I think I did but I’m not sure. I’ve noticed that it takes awhile for me to get comfortable taking on a new title. At my field education site, it took a bit before I had no problem calling myself Vicar. Near the end of my time there, whenever someone would call me “Pastor Marc,” I was always taken aback. I almost wanted to butt in and say “oh hey, I’m not that quite yet.” But, this summer, even though I’m a student intern, I really am a chaplain. Just saying the word is going to be one of my projects next week.

The schedule for next week is to write a few papers, sit in class for a bit, and spend about 3.5 days visiting patients. I met some of the staff of the PICU and they seem very excited to have someone available to visit them during the week. I think, on Monday, I’ll be attending as many inter-disciplinary rounds as I possibly can. Medicine speak, I will master you.