Marc 7, Verbatim 0 or how I learned to stop worrying and watched someone’s last breath

Today I presented my final verbatim for my current unit of CPE. I’d be lying if I wasn’t excited about the verbatims being over but I’d also be lying if I wasn’t a tad sad about it. Turns out, I actually LIKE doing verbatims.

My final verbatim was about a visit I had a few weeks ago with a family. The patient was a teenager who had suffered a gunshot wound. I picked this visit to write about because a) it was kind of weird and b) I wanted to receive feedback on how I minister to families. When I walked to the patient’s bedside, I entered a strange and hostile family dynamic that, in the words of my supervisor, “even the most experienced chaplain in the world wouldn’t have known how to deal with effectively.” The only true effective way was to divide and conqueror. Sadly, I was not reading my book about the post-Alexander the Great empire, so the military metaphors failed to enter my mind. I did a decent job with the patient, I failed with the parents, and – all in all – I learned a lot. You might be shocked to realize that when you actively dislike someone, your ability to provide pastoral care actually diminishes – especially if you don’t realize what your gut is telling you. I know, shocking stuff, but it’s actually harder to notice than you realize. Even subtle feelings can cause strange conversation dynamics. Even with my summer CPE unit almost over, I still have a lot to learn.

So, after spending an hour today reliving my visit with a family containing people I disliked and having myself grilled over some of my issues, I found myself being summoned via pager. I was called to visit a family I met with the day before. A rather youngish man was being disconnected from life support. The family was lovely – I grew close to them rather quickly – and I was able to provide some spiritual and emotional support. I watched Last Rites be performed (and also learned why I’m glad my tradition has only a few sacraments – there’s more to comfort care than just performing the ritual!) and learned a lot about a beloved family man. The family was withdrawing support with the expectation that he would die rather quickly. But… he didn’t. He lingered. I received a page to stop by after class, before the end of my work day. After my verbatim – where I got angry and attacked a father – I found myself, face to face, with a father who was about to die. I entered the room, stood with his family, and talked with them. And then, rather soon, the man’s state changed. His breath slowed down. His family said their last goodbyes and encouraged him to finally go. And then he took his last breath.

I have never seen someone take their last breath before.

I stood with the family while the doctors performed their final checks. I stood with the family as they cried and expressed how heart broken they were yet how relieved they were that he was finally gone. I held the family when they needed it. And then I gave them their space and hugged them goodbye.

It’s been several hours since I saw the patient die and every time I think I’ve come to terms with it and processed the experience, I realize that I haven’t. I really don’t know what to feel at the moment. I feel sad. I know I’m grieving. I know I witnessed something unsettling. I also know that I did some good and I know that I was able to do Christ’s work even though I never read a psalm, never said a prayer out loud, nor did I read any bit of the gospels. But I think what gets me is the fact that the family, even before I entered the room, wondered if the patient was hanging around because I wasn’t there. The family said, several times, that the patient was waiting for “this spiritual man” who “he knew would bring comfort” to be there before he left. The patient’s wife hugged me and said the same thing as I left. I have no idea what to make of that. Maybe it’s true; maybe it was a fluke of fate. I don’t know. I really don’t know. But it was a truly beautiful, moving, and heavy thing to be told. I’m not sure what it all means yet. I’m not sure if I really believe what the family told me. It’s just too…awesome; too powerful; too unlike how I see myself. I almost feel as if I was given a responsibility in that moment – a responsibility that I don’t understand nor do I truly even know what it is that I’m suppose to do. But I do know that something wild happened. And I know I did some good. But I’m still just blown away with being called to be there, at that moment. Just… blown away.

On Call

I have just begun my “first” night being on-call.

Actually, that’s not totally true. I’ve had one night so far but this is my first “real” on-call event. Because Weill-Cornell does not have a major emergency trauma center, our on nightly on-call schedule is a tad different than other hospitals. Rather than being on call for a night (and having to “sleep”/work at the hospital), we instead are on call for an entire week. I began tonight at 9pm and I will be on call through 9am tomorrow morning. I will also be covering the 8pm Friday to 9am Monday morning (while also working 9-5 on Sunday). The trick will be in actually falling asleep and not waking up every few moments believing that my beeper is “about to go off.” I think I’ll be fine though. My first night on-call, earlier in the month, I received a call at 3:30 in the morning (but I was able to pass it off to a catholic priest). But, with my luck, I just might have to go in every night this week. I hope not though.

My last few days at the hospital have been going well. I feel that I’ve plateaued in the amount of reflection I’m able to do about myself. I’ve learned a lot. I’ve discovered quite a bit of growing edges about myself. I think I’ve got a lot of work to do. But the energy I’ve been using to reflect on myself has been disipated. I’ve felt it move into other areas of my work, specifically my interactions with patients. I’m taking more risks, experimenting more, and seeing what works. During these last few weeks (less than 3 – can you believe it?), I think my main goal will be working on how I provide pastoral care to those where death is fast approaching. I tend to be ineffective at the “life-review” process that death can cause and I also tend to avoid asking the questions that really force a person to reflect on their death. What do they find meaningful? What are they hopeful for? What gives them meaning even in the face of death? They’re tough questions but good questions. And they are questions, when I’m confronted with death, that I tend to just avoid. I’ve got to work on that.

But besides that, I can feel CPE winding down. I have one final verbatim to do (on Friday) and then my final evaluation. It’ll be weird not getting up and going to the hospital. It will be weird not seeing my group every day, talking to them, having lunch with them, and learning with them. It will be weird not having to walk into rooms and talk to folks about their spiritual and emotional lives. But that doesn’t mean that my work as a chaplain is going to end. The more I’ve practiced it, the more I realize how often I will now being using it. And the opportunities for pastoral work are endless. I’m starting to understand while some supervisors in CPE tend to say that everyone, no matter their religion, profession, spirituality, or whatever, should take CPE. It’s actually a pretty amazing thing.

Operational Smashational Theology

I can’t believe that I just completed my seventh week of CPE. The week was, probably, my hardest week “academically” but not emotionally. The kids in the PICU were in good spirits, with most there for post-op monitoring. No one yelled at me. No one paged me during the day I was on call. I did have to pray at the bedside of one woman who was actively dying and I did run into my first experience trying to minister to a family where the mother and father were not on speaking terms, but none of that really bothered me. I did have a cold through much of it so trying to talk to people without coughing was a bit of a challenge. Luckily Sudafed/Muscinex are a hell of a drug.

Academically, however, I had two verbatims, I had to plan an interfaith service, and I had to write a paper about an aspect of my operational theology. After reading my seven page paper out loud, I was then grilled on it. It was tough but not totally uncomfortable. I noticed that I spent most of my time responding to questions with my eyes looking down or away from the people I was speaking to. I felt a tad vulnerable so my response was to disengage from eye contact. I found that experience to be a little neat because, even though my body language was uncomfortable, I actually could tell exactly what I was doing. Every time I broke eye contact with a person, I knew I was doing that. I wasn’t able to stop myself from doing that but I could at least note what I was doing. I’m getting much better at parallel processing on the fly it seems.

Folks described my paper as a little heady, so I was grilled in an attempt to see how my operational theology was tied to my experience. I revealed some things to some folks, people understood me a tad better, and I made a few folks feel sad. To be quite honest, I’m a tad happy that none of what I wrote/or said is going to be forwarded to my candidacy committees. It was emotional but I learned a lot so, all in all, I had a good time.

One of the many things that stuck out at me was that people experienced my writing as something completely different how they experience myself in real-life interactions. Where they found my writing to be harsh, they all said that they experienced me as a very kind and tender person. Where my paper seemed a tad cold, they said that I’m the exact opposite of that. Ever since they mentioned that, I’ve been pondering what that means. If I am a kind and tender person (and I think that I am – too many people tell me that for me to discard it), how do I write in that way? Do I talk about rainbows and puppy dogs? Or is my inner spirituality tougher than that – reflecting the spiked leather jacket I use to wear? Is my outside persona a mask for what I really am? And is my operational theology at odds with my tender personality?

The idea behind the whole exercise was to see if what we profess matches with our thoughts, our actions, and our developing pastoral theology. There was no right and wrong answer (and there can’t be since every individual’s theology belongs to them). I’m not sure if my operational theology matches my pastoral presence but I’m hoping it gets there. My theology begins in a place of brokenness because that’s where faith found me. But it isn’t the only place where faith can be found. So one of my life-goals is to, somehow, create space for theologies that start from somewhere else. I’m not sure how to do that yet but, well, I’ll figure it out somehow.

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.