12 weeks; 25 lessons . . . my summer in CPE

Greetings, friends.

As the ink dries on my final self-evaluation, presented just this morning, I rejoice in part by sharing this list with you.

I send appreciation to my CPE cohort group (and our supervisor) for sharing laughter, tears, and learning, and for serving as draftreaders of this post.  Appreciation also to the many incredible SLH staff members with whom I’ve had the privilege of working.  Big thanks to my beloved support team who have helped me through this experience in many ways–you know who you are.  And finally, I offer gratitude, wonder, and respect for the patients and family members I’ve had the honor of companioning these past weeks.  Prayers and blessings to all.

Much love,

j

Hospital surgery corridor 12 weeks; 25 lessons (and colleagues, I’d love to hear YOUR lessons as well.)

1. Moving toward any situation, there’s what you expect.

Then there’s what you see.

And then there’s what there is.

Sometimes there is a lot of space between those things. 

 

2. GSW means gunshot wound. MVC is short for multivehicle collision. And STAT is classical Latin for get your butt down here right now.

 

3. People make decisions about me and who I will be to them in seconds.

Sometimes less. Some of that is what they project from without. Some is what I project from within. And amid the projections, there is a circle of space in which I have control over a part of my image. Herein lie power and identity, service and sacrifice. Who am I willing to be for you? How will I move to do that?

 

4. When grief finds you, you can cry. Or, you can not cry. Both choices might change things.

 

5. Your religion matters, even if your denomination is tiny and has an unusually long name.

I never understood as a patient or parent why I was being asked to share my religion upon admission, and I have hesitated more than once to even try to explain that I am a Unitarian Universalist. At one visit to the local children’s hospital I hemmed and hawed, explaining, “probably ours isn’t even one of the choices.” The admissions clerk replied smoothly, “No, we have that. I’ll put it right in.” That was a small moment, but it was one of great hospitality, and I remember it clearly amid a day that is otherwise mostly a blur.

From the medical side of things, I can now tell you that we ask not so we can report your hospitalization to your church (you would need to ask us to do that) or to sort or classify you in any particular way. We ask because your faith and its rituals are important to your life, and that makes them important to your healing.

And who knows—your local UU chaplain may be ready and waiting to talk with you. So make your presence known. Consider that pre-admission faith statement to be part of your ministry, to yourself and to the world.

uu_oval_car_sticker_im_a_unitarian_universalist

6. The most intimidating spaces I walk into are the ones where I will be alone with myself.  Yours are probably different, but if you can identify the scary places, you will hold a key to changing both frame of reference and behavior.

 

7. I feel the sting of failure acutely. And then I reliably reflect, stand up, and keep going. From here on out, we’re calling that success. Which in CPE language means “good enough.”

 

8. Editing means loss. So does stepping forward. So does simply continuing to breathe. In the formation process, you chisel and sculpt and free from the rocks a new version of yourself. And you will, inevitably, leave pieces of yourself on the cutting floor.

 

9. On a related note, it can be scary to move out of draft form. To use periods rather than commas. To bid farewell, walk away, close the door. There is beauty in openness; there is honesty and integrity in closure. The boundaries of this work require both.

Goodbye

10. Moments are shared, bonds are formed . . . and then, as attends the work of all caring professionals, it is time to let them go.

The place between life and death has been called the thin space, the valley, the hinge, or the knife edge. Whatever words we use, it is a privilege and an intimacy to be invited into it.

As chaplains, our walk through this space with you is often short in duration; then we commend you back into your wider communities of care, trusting in your combined strength and resources, and in the Whatever-Is. There are next steps, but we will not know about them. I find God in that mysterious unknowing.

And I root for you still.

 

11. You took hundreds of risks today, some tiny, some larger. You’ll take hundreds more tomorrow. Which ones did you notice?

 

12. I am constantly surrounded by blessings. And sometimes that bounty feels like too much to take in, and I’m tempted to push them away or live at the edges, with words like “earn” and “deserve” echoing in my mind.

I haven’t figured out why it’s ok to have so much. And I cannot know that things will be the same tomorrow. This means it’s possible and even understandable to meet extreme generosity with shame or fear.

And yet, I find a lived answer to this every Sunday. I love the ancient liturgy, and I wonder if the most powerful words within it are “given for you.” I subscribe to a faith with generous love at its core. Might holding that truth in my heart mean learning to be fearless about receiving?

Deeply grateful . . . and fearless.

 

13. If you’re tempted to say something stupid, try not talking. Truly. There are events for which the solidarity of silence is the only reasonable response.

 

14. I have told myself for a very long time that I “don’t do well with blood.” I can now tell you, post trauma center, that when it comes to the physical realities of bodily fluids, blood is only the beginning. There’s also vomit, sputum, cerebrospinal fluid . . .

As it turns out, I can handle more than I thought I could, in the moments where “handling it” is what is needed. Blood running down the wall? Alrighty then. Wound vac at the bedside? Ok. But later, post-fluids, what needs processing are my feelings. Life in the trauma bay is a buy-now, pay-later endeavor for care providers. I choose to pay later in a way that affirms life and hope, and that means remembering that good stewardship of resources begins with my own emotional and physical energy.

 

15. People are often not sure what a chaplain might be for. Nor a Unitarian Universalist. Explanations can be invitations, obligations, or apologies. They can also be opportunities.

 

16. There is both magic and danger in the spaces between us. When I walk into your patient room, or come into the trauma bay as a fellow staff member, we are immediately negotiating and sharing power. We might also be mediating God.

 

17. I would rather scrub floors or skip meals or, on some days, cut off fingertips than ask for help.

Even when it matters. Especially when it matters.

I hope to continue challenging this tendency in myself. In the meantime, I pray that the realization inspires a more generous pastoral awareness—the reluctance to request or receive assistance of any kind is not uncommon in our congregations, and it presents challenges around concepts of covenant and care.

Support

 

18. Holding the hand of a dying person will encourage you to touch your faith. Holding the hands of fifty dying people will demand, instead, that you challenge it.

So do it. Lean in to the questions. Despair, even—can it be faithless to cry out into the expanse of space My God, My God, Why if Jesus did just exactly that? And to notice that that the question goes unanswered?

Wrestle. Observe.  Acknowledge, get mad, throw anything you need to overboard . . . and then, return to what is simple. To what you know about living and meaning and this moment. And find with the darkness and the questions and the numbered, labored breaths the faith that will carry you forward. It is, now, a faith fit for the valley . . . a faith worthy of the sacred steps you will take holding so many other hands.

 

19. I do not know why bad things happen. I just know that they do, and that sooner or later, some of them will happen to you. And when they do, I hope that you let yourself fall, as Rev. Kate Braestrup advises, and, when you’re ready, that you notice what catches you. That you can number each blessing, each piece of grace and beam of love as it finds its way to you. Comfort and solace amid the Very Worst.

You don’t have to call that God . . . but you could.

 

20. Sincere affirmation opens many doors.

 

21. Food does not heal sadness.

Like the children’s story We’re Going on a Bear Hunt, the fundamental truth of grief is that we can’t go over it, we can’t go under it, and we can’t go around it. We have to go through it.

For me, despite many attempts, chewing has not turned out to be an instrinsic part of the healing process . . .  and even so, the hospital cafeteria offers surprisingly good meals and its staff engage in a cheering ministry all their own.

Bon appetit.

Slice of apple pie

 

22. People will tell me they are “spiritual, but not religious,” in any of the ways that people say this, approximately 500 times between now and when I’m ordained.

And infinitely more times after that.

I have come to accept this. And believe that my task is to see it as an invitation to exploration, using language, symbols, and values that hold meaning for the individual. This will be how we do faith in this time . . . and it’s actually not a bad place to start.

 

23. Both/and isn’t just seminaryspeak. It is an invitation to find oneself within the complexity of life, where things are rich and ambiguous and multivalent.

This way of looking at things can be deeply uncomfortable—it offers none of the easy answers of either/or. It also offers possibilities and hope that remain obscured within a two-dimensional view of conflict.

Developing the emotional range and creative tools to live into ambiguity, and to encourage others to explore it with us, is one of our most important tasks as religious leaders. It is risky, deeply countercultural, and requires the use of imagination and prophetic voice. And it just might offer a future in those spaces where the horizon seems the darkest.

 

24. The fact that a thing needs to be done does not mean that the thing is mine to do. Sometimes simply taking care of my own square is an act of love and faith.

 

25. Some days, it is worth planning an outfit around your shoes.

(Any day you spend working in a hospital is one of those days.)

 

Ballet flats

on mothering from afar

Watermelon slice

There are watermelon slices sitting, in an alchemy that somehow encompasses both rotting and drying, uncovered in the fridge. Perhaps they’re from the one I bought 10 days ago, green and heavy and slightly lopsided. I forgot we had it. For me, this summer, the kitchen is just something that came with the house.

It’s morning now, and silent, but a riot of color, lent by stains I can’t identify and toys I don’t recognize, shouts from the oak floorboards of the kitchen and living room. I pick my way across, alone with the sunrise on that rarest of weekdays—no work, no hospital rounds, no trips, no sitters, no guests. Just me, here. Present in the company of my family, in the comfort of my home, but no one else awake.

I’m told that lunch yesterday consisted of chicken nuggets with peanut butter sandwiches on the side. A pair of shoes is missing. Soeren’s shoulders are sunburned. And Silas’s hair has gone from supernova to rock star to Laura Ashley model (on, it should be noted, the girls’ side). The compliments he gets from women have shifted from adoration of his cuteness to envy of his mane.

I am determined to trim that mane today, because last night as he talked to me, I sometimes couldn’t see Si’s eyes . . .

Or is it because yesterday, he used a long-fingered hand to casually sweep the surfer-white curls from his forehead as he addressed me, and was suddenly not four, but fourteen? I sat, transfixed, taken, awed, horrified. How magical and terrible that you must become something so separate and strong and unpredictable. How audacious of you to do it here before my eyes. How practical of you to do it, mostly, while I am not watching.

I’m cutting it, I tell you.

You will be four again. And perhaps, my blond-curled babe, I will forget that even now I can’t quite know you.

And Soeren. Your eyes, ever changing, now look like sea glass. You are so tan. And so tall—another few inches and I will be able to rest my chin on the top of your head. And you might let me, in the stray moments, in the same way you acquiesce, with a soft smile, to being hugged, or toweled, or tickled. I don’t wonder, yet, if it’s the last time for thoughtless cuddles . . . but I can see the wondering coming, ambling toward us on the winding, unpaved lane of growing up.

All of this—the changes, the surprises, the tallness—they would be happening, all the same, if I were here. But the inexorability of the process, when remembered, comes anew as a shock and a revelation. Because, at the heart of things, we mothers still think that growing up should not happen without us.

I don’t want you to keenly feel my absence. Wishing you pain for the benefit of my ego is too big of a burden for either of us to bear. But I do wonder what it means that my lack of everyday presence is not a tragedy. That you, my children, appear to flourish anyway.

Perhaps the lesson is that the real loss is simply mine. I miss kisses. Whispers. Small gifts with four or six or eight legs, or petals, or staples. The creak of the porch swing. Domain over the kitchen sink.

What does it mean that I never wanted that kind of household eminence—don’t want it still—but I ache as I type this?  Not enough to turn back, or quit, but enough to know, for sure, that there is indeed a cost.

Enough to add fervor to my prayers that “ok” comes in all shapes, that love comes from lots of places, that enough is enough is enough, whoever’s providing it.

My faith tells me there is no hell, but amazingly, that doesn’t touch the fear of damnation here, on this earth.

Not by others. They could condemn me or my choices—maybe they do—but in the final estimation, it’s not any person’s judgment that frightens me.

What I’m afraid of is bigger and deeper, a theological matter for our time. The final judge will be the limits of each 24 hour day and the reality of opportunity cost and the truth that to love is on some level to leave your heart lying helpless.

In the face of that, I wish–I wish us all, in fact–comfort and peace and strength for the journey.

-j

Absolution for the working mother

My love for you would break hearts
It does. It has–
I would know.

But not as a sun on a leaf through a magnifying glass
Or a portrait drawn from a single sitting
Or an unbroken line of oatmeal mornings and chocolate chip cookie afternoons.

I see you in the dappled light of moving tree branches
And candid photos
In full color, not sepia
Real and shining
And part of a true story–

Part.

The rest told in mudpies and milkshakes
served to other mouths
Footprints cleaned by other hands
The laundry, the sink, and the bathrooms
that say Daddy’s Rules

You laugh, and I hear you;
You laugh when I don’t hear you.

I know this.

And I smile
and swallow
and pray
That word,
balm to souls
who always knew
you can’t really have it all

Enough.

Just let it be enough.

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on the road (OR, what I’m NOT learning in CPE this summer)

Image

I’ve been having some trouble with my commute.

Kansas City, with no functional, centralized public transit system, is a city of freeways.   It has byways and beltways, bridges and merges, and, as I lately am painfully aware, near-misses and sheer miracles. Also, it’s summertime, which means construction. And my schedule at the hospital often means a choice between driving at the height of rush hour or sacrificing precious hours I could spend with my family.  Or, you know.  Sleeping.

Additionally, I have discovered something: there is a lot that we take on faith in rush-hour highway commuting.

You do, anyway.  I, on the other hand, just haven’t been able to get with the rhythm. Not lately.  I want more information, you see. What is that car going to do? And that one over there? Andohmygoshthere’s a huge truck in my way and an entire lane obscured from view. And he’s braking and she’s coming over and I have to move right now but I can’t and

 

This is new. I have spent a total of seven years making some version of an urban highway commute, but until now, I never noticed the rules.

You probably haven’t either—we drive largely with our bodies, and if you’ve been lucky, there’s likely been no reason for your head to become overly involved.

Suddenly, though, I’m as a stranger in a strange land on these roads I’ve traveled for my entire adult life.  And that means the rules have become as obvious as they are impossible. And they go like this:

Make a plan. Pick your opening. Use your turn signal (this one’s a bonus for non-assholes and those who like to minimize their risk of collision). And finally—and, it should be noted, swiftly—make your move.

I’ve been struggling with all of it.  In fact–particularly on those mornings when I cross the Missouri river, take the short ramp that connects one highway with another, and then, in the space of about one minute, merge across FIVE lanes of rush-hour traffic to take a left exit–I find myself remembering days of carefree lane-changes like I’ve lost the Golden Age of Driving.

I’m sure commuting “back then” wasn’t as magical as I’m making them seem in my mind  . . .  but I do know that things were different.

Because then, I wasn’t skittish.

Because then, I wasn’t scared.

 

As it turns out, being at the scene of a major accident 36 hours before starting CPE may have had some effects. Especially when stressed. And tied to both a commute in the morning and a midday trek between hospitals. And when absolutely, bone-wearily tired.

But each day, I get up and do it again. And most evenings, I am confronted by the dreaded onramp at Metcalf and 435. Right at 5 p.m.

The main thing is, I can’t ever get on it—there is no space for me, with cars overhanging the intersections for more than a mile before the onramp, people cutting in, and two lanes merging into one just in time to fly into six other lanes (that’s on ONE side, my people) which are moving or not moving as impatience and construction and rush hour dictate.

So that’s happening, or rather it’s not happening, and it’s been taking me 90 minutes on alternate routes to travel home.

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on second thought . . .

Meanwhile, I’ve been wanting to explain to you about CPE—what I see, what I hear, how I hold those things in the charged moments, and what I do later with what remains.

I’ve been wanting to share some of the messiness in hopes that you might also see the magic.

I’ve been hoping to communicate, somehow, my fledgling understanding of what all of this means in the larger process of growing into ministry.

 

But I’m not ready yet.

 

So I won’t tell you that I’m learning about ministerial authority when I claim my space in the trauma bay, or work alongside the medical team, or stand in front of an altar in a chapel not my own.

I won’t assert that I’m learning about God in every patient room, about my faith every time I record a name in the “death book,” about myself in the moments that I spend on my knees in the chapel.

I won’t describe how I’ve learned patience in the refraining from clobbering, or perseverance in the wanting to quit.

And I will say when I struggle as hard as I have been lately with theology . . . in fact, with life . . . it’s challenging to decide whether I’m assigning meaning out of truth or out of need.

Which means that perhaps it’s suspect even to link these things.

So I won’t try.  No point.  Not yet.

Instead, I will just tell you this:

I’ve been doing CPE.

The experience, taken in total, has been one of the hardest things I’ve ever done.

I fight several battles every day. And while my toughest opponent is myself, what I’m learning is how to stand my ground with everyone else.

And that when I do that, even by myself, I am not alone.

 

And today, my people, I got on that road.

The one that leads to my home.

There were just as many cars as before.

There was no magical open space.

But then I made one.

Out of a possibility.

I hooted.  And cheered.  I made it home in 45 minutes.

And I am going–in the same way that I will definitely hold hands and invoke Spirit and be present–to do it again tomorrow.

-j

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finding Jesus on the first floor

I first considered taking a unit of CPE a couple of years ago.

It was 10% because I thought I might want to be a chaplain.  It was 90% because I didn’t want to be a minister.

CPE seemed like a perfect solution, because I knew that it stood between me and ministry any way you slice it.  So, if I hated it, then probably that scary “calling” thing would return from whence it came. And if I loved it, then perhaps I could find an easier way to chaplaincy than the current Unitarian Universalist path to ordination allows.

What I envisioned doing, after all, was about patient care. And there are lots of ways to do that. The majority of which don’t require a deep understanding of denominational polity or skills in congregational conflict resolution.

In short, why seminary? And, more to the point, why ordained ministry? I just wanna be there for people.

 

Next month it will be two years since this particular brand of insanity began in earnest . . . and in those two years of Trust the Process (and Fight the Process, and Kick the Process, and . . . ), I can tell you that the answers to the above questions are so much deeper and richer and more complex than I ever imagined.

And also, after the last three weeks, I can tell you something else.   About CPE.

 

It is not about patient care. 

Professional chaplaincy mostly is, but to be in that role and present in a way that is simultaneously simple and delicate and risky and generous . . . you gotta go through the stuff above. The ministry stuff. The formational challenge, and the time, and the struggle. The arduous path that initially seems unrelated to the end result–it cannot be skipped.

And meanwhile, I have discovered that this—my mandatory summer of crisis and opportunity—it, too, belongs to the formation process, and all its deep mysteries, and not to the world of healthcare.

I expect I’ll say more about that soon.  Or someday, at least.  I’m really in it, at the moment, and that means, for now, that I’m not sure from one day to the next if there will be anything left over after I complete task 1.  Which is to simply be.

In the meantime, though, I will tell you something else.

If what I really wanted were a continuous focus on patient care, I have discovered a role that actually does this:

[whispers . . . ]

It’s the CNAs.

This is a stock photo. Not a patient photo. Everybody breathe.

 

These people, at their best, are the moving hands and walking feet of Jesus in these tiled hallways.

The doctors or the administrators or even the accountants may well be God.

But Christ is somewhere else.

These weeks, I’ve seen Him in the whispered joke in a patient’s ear as her bed is wheeled down a too-public corridor, in bringing a quiet, determined dignity to tasks that otherwise offer a patient precious little, and in the touching and talking and being human with a person in a bed or a line or a wheelchair who is, first and foremost, a human, too.

 

And I am so grateful for this reminder.

 

We are humans, all of us. As professionals, and as patients, we deal with this reality—our frailties and our incredible possibility— in every moment. Some of us are ignoring it, some of us acting it out in one hundred small ways . . . and some of us struggling to remember how we might connect with our humanity once again.

The institution is not human. The procedures are not human. But this hospital . . . that insurance company . . . this government . . . it is made up of and designed and remembered and carried on and implemented by people.

j

Insurance Forms

Things feel so big, the dealings so impersonal, the daily workings so unalterable, that it’s hard to see, at first glance.

So look again.

 

I am continually inviting myself to do this, too.  And when I do, I wonder:

What if we made it our number one job each day to remember that we aren’t a role or a title or a degree, not really? And that the one across from us, with the hair the color of your sister’s, or freckles, or dimples, or a gold tooth, and a look of fear or dread or hope or resignation—that person isn’t a patient or a stroke victim or a financial concern, not really?

What if we truly remembered this, with each phone call or e-mail or data input task:

I am a human being, here to serve other human beings–in love–and this entire institution exists, whether it knows it or not, to fulfill that mission.

 

Here. Now. In this very moment.

Whatever I believe in most deeply, my hands and my heart belong to it.

And whether I intend to or not, I serve that spirit with my every breath.

Please, God . . . let it be love.

-j