Sunday, December 03, 2017

Oxygenated

Early in November, Ann Marie and I went to Open Studios, followed by dinner at Los Jaliscos. She was wearing her customary floating layers of orange and silver and red, and enormous pieces of jewelry, including a ring one third the size of a baseball featuring the image of an insect. All of this dazzled the artists. Periodically I explained that I myself had dressed in navy blue from head to toe so as to be an effective backdrop.

Another day, Ann, Tom, Ann’s friend Jill and I saw Daniel Handler’s play Imaginary Comforts at Berkeley Rep, preceded by lunch at Au Coquelet. Jill is a very cheery soul, and helped Ann with the driving from Sacramento. I love these afternoons at the theatre, a gift from Ann.

One Friday afternoon, I took a walk with Anita, my ex-CPE supervisor. I was planning to have dinner with Karen that night, but she hadn’t confirmed yet. Anita and I made our way to Balmy Alley and enjoyed the murals, and then we were both hungry, and I was still unable to reach Karen, so Anita and I decided to go ahead and eat, which we did at Heung Yuen, where F. and I used to go. I ate all of my substantial entrée, and a few bites of what Anita left of her entrée, plus half an order of pot stickers. Then I got a message from Karen saying she’d be at my door in a few minutes!

Karen and I went to Udupi Palace, a vegetarian Indian restaurant, where she observed mournfully that I had done with Anita exactly what she and I were supposed to do together: eat and go for a walk. I told her I’d have a little snack while she ate, but ended up ordering—and eating—a second full dinner, after which I felt extremely ill, followed by five straight days of diarrhea. During that time, the heat was broken in our apartment building, so I spent several days huddled in bed underneath all of my blankets, waiting for my intestines to settle down.

On Wednesday, I called my mother and she said you’re not supposed to let diarrhea go that long—that you can get dehydrated and end up in the emergency room. Who knew? She ordered me to go to Walgreens and get some Kaopectate or Immodium AD. I dragged myself over there and back; I had to sit down to rest on the way home. Back at home, I took both Kaopectate and Immodium AD to be on the safe side, which worked so well and so immediately that three days later I was wandering my neighborhood looking for prunes.

Late in November, I went to Michigan to visit my parents and sister for Thanksgiving. Right before I left, I submitted my application for school—a two-year low-residency program that will afford the exact 48 units I still need for board certification, if they let me in.

My visit home was nice. I spent a lot of time with my parents, and my sister came over twice, and I had lunch with Amy at Seva. Ginny was not feeling well on the day we would have gone to Café Zola. My parents made a wonderful Thanksgiving dinner: roasted chicken, dressing, two kinds of gravy, Waldorf salad, baked lima beans with olives, biscuits, Mama Stamberg’s Cranberry Relish (as well as cranberry sauce from a can, for those who don’t care for Mama Stamberg’s), and chocolate-chip cookies for dessert.

After I returned from Michigan, I felt super-crabby for several days—maybe too much MSNBC, which I only get to watch every six months, or maybe my brain got dried out on the plane. In class Wednesday night at County Hospital, we talked about trauma exposure and self-care and Clementine mentioned that since we deal with so much death and loss, creating something can be powerful: making art, gardening, writing, playing music, cooking.

She and I had a one-on-one and I told her about a patient I visited who had gotten a terrible diagnosis and had been wailing loudly off and on for weeks, per what I heard from another caregiver and certainly during much of our time together. After I left her room, I felt worried that I’ll get what she has. This has not really happened before, and Clementine said it was a flag—perhaps a signal that my self-care needs adjusting. She has stressed to us that self-care needs change over time. I don’t want to be the chaplain who is burned out or suffering from trauma exposure, but the latter, at least, cannot be avoided. As it was explained to us in the class at Sati Center, if you work around those who are traumatized, you will experience secondary trauma, just as surely as you will become warm if you stand near a fire.

On Friday at County Hospital, I visited a patient who was very cheerful, who said she was fine: “The universe takes care of me if I take care of my universe.”

As I was leaving the hospital at the end of the day, I came upon a man pushing a cart full of empty water bottles and singing to himself in an exceedingly merry fashion.

“You’re in a good mood. What’s your secret?”

He turned to me, and I saw how cheerful and relaxed his face looked. He explained, “I don’t want to be a grumpy old man. I want to be a happy old man. I realized that the difference between my very worst day and my very best day was my attitude. Also, I don’t believe in problems. I believe in inconveniences, which might be small or large. God solves problems.”

Still thinking about effective self-care, I decided to actually cook something other than cereal for the first time since June, 2016, and immediately felt more optimistic. Yesterday I made lentil-potato-tomato stew, while listening to music, and it was really nice. I have not had enough opportunities to listen to music lately, which is something that brings me joy. (Two favorite new songs: Radiohead
’s “The Tourist (new to me, anyway) and Janelle Monae’s Tightrope” (her solo version). The former is so beautiful and the latter is so infectious. What a lovely voice she has. I was surprised to hear some ukulele at the very end, which she mentions, saying the name of the instrument in such a sweet way.)
 
Speaking of optimism, Nancy Gibbs used this wonderful phrase in an essay in Time magazine (soon to be partly owned by the Koch brothers) about the state of our nation: “The expansive, oxygenated opportunity of optimism.” Outstanding use of Os.

Fire Circle

Early in November, nearly all of my clinical pastoral education cohort got together at the house in Berkeley where one of us lives. We brought food and ate and talked and, toward the end of the evening, sitting in the dark backyard around a fire, did a circle where each person got a chance to check in.

Another day, I got together with my CPE peer Nellie for lunch at Xolo in downtown Oakland followed by a trip to a store called Sagrada Sacred Arts, tea at Crepevine, and a visit to a bookstore. A couple of days later, I had lunch at Green Chile Kitchen with Mason, one of my two peers in my first unit of CPE in the summer of 2016. That was delightful.

My next day at work, I set out to have explicitly spiritual discussions. Early in each conversation, I said, “I want to know how I can support your spiritual well-being.” My first shift or two, I felt overwhelmed by the number of patients on my three units, but since these are all units where patients stay for a long time, and since Carolina and one of the CPE students also visit people in these units, and since a “spiritual” conversation takes a much shorter time than my normal kind of conversation, I’m now wondering if I’m going to run out of patients to see.

I’m finally starting to memorize some of the questions we use for taking a basic spiritual history, and I’ve gotten in the habit of checking the charts for an entire unit before picking out patients to see, in part to see if Carolina visited the person very recently. I also notice where the person lives: is he far from home? And marital status: is she married, single, widowed, divorced? This is just a snapshot, with much more to be learned, but someone who lives in San Francisco and is married is in a different situation from someone who is widowed and has come to the hospital from far away.

At County Hospital a couple days later, I continued to tinker with my approach. Mentioning the wish to support the patient’s spiritual well-being first thing seems to constrain the conversation a bit too much, so I started by asking how the patient was coping with his or her hospitalization, and then brought up spiritual well-being soon after that.

A couple of patients just ignored that question completely. One was screaming at the top of his lungs that someone had stolen his boots and that he wanted to leave the hospital immediately. After yelling for five minutes, he apologized quietly when the boots were discovered in the closet in his room. Another patient seemed taciturn and angry at first, upset because I wouldn’t go across the street to get him a soda; later he asked me for money. But then he started telling me all about his life and his relatives and was smiling when I left. A great thing about this work is that the gratification, or lack thereof, comes immediately.

At the hospital that day, I attended a session on dealing with difficult patients, part of a series that emphasizes the emotions of health care professionals. There were four presenters, including Clementine, who supervises us chaplains. Another was a trauma surgeon, who said his own inclination is never, ever to give up. However, he said he often has a frank talk with a patient where he claims he says, “I can do this, this and this, or I can withdraw support, and then you’re going to die.” I was wincing a bit at that. I learned in my first unit of CPE that we never “withdraw care” or “withdraw support.” We transition to a different type of care. And I hope he does not announce so baldly that the patient will die. Or am I wrong to hope that?

I pictured how I might conduct such a conversation: “I can do this, that and the other procedure. The recovery will be long and difficult, and I can’t guarantee how much function you’ll get back. This is for you to weigh out. These procedures will be hard on your body, there will be pain afterward, and the recovery period may be months. At that point, you may be able to do most of the things you enjoy, or you may not. However, it is your choice whether or not to have these treatments. It is perfectly reasonable to decide not to have them, in which case we would focus on making sure you are comfortable and free of pain. Your remaining life span would then be measured, probably, in weeks to months.”

While I was embedded with the palliative care team at the Truly Wonderful Medical Center, I noticed that they always referred to life expectancy in such terms: weeks to months, days to weeks, minutes to hours.

Yes, I think I don’t like the idea of anyone saying to someone, “Your other choice is that we can withdraw care, and then you’re going to die.” I hope he doesn’t literally say that.

Anyway, one reason I mention the presentation is that there was a second doctor there who said that it can be wrenching to care for patients in very difficult situations, including because there can be disagreements among care team members. However, he said, not caring is not a good alternative, because caring is what makes this work satisfying.

A Rock in the Stream

Late in October I took a walk in Golden Gate Park and had Thai food with a hospice nurse I met during clinical pastoral education.

I worked on a Sunday and had a one-on-one meeting with Jacqueline, during which she offered zero words of affirmation and many, many criticisms—such as of nearly every line of one of my chart notes. When she was snippy during orientation, I brooded about it for five days and briefly, angrily, considered quitting the job.

Her name came up at a dinner party full of chaplains that I went to several days after our one-on-one. When I said that she had said something mean to me, the person I was talking to said, “Yes, everyone who has ever worked for her says the same thing.” I said I couldn’t decide whether to protest vigorously or tactfully share my feelings with her or just do my best to ignore it. I said I was leaning toward the latter. The person I was talking to said, “Yes, you could just let it go by.” I was glad to have that option affirmed, since I’m terrified of confronting her.

In our meeting, I kept waiting for that moment when my stomach would clench and I would feel afraid, but it never happened. Not because she didn’t say anything critical—she said lots of critical things, but since I was actively waiting for them, they didn’t have any particular effect. I noticed her escalating as the nearly two-hour conversation went on, and I also noticed her subtly trying to set me and the other per diem against each other. She finally got to the point where she directly announced that she can feel annoyed by me at times, and then she quickly apologized, as if to suggest she’d gone too far. In the moment, it seemed a bit disingenuous. I got the feeling that she wasn’t sorry at all, but had apologized just to underscore that she had said something that could cause offense. But I am fresh from 15 months of CPE and constant discussion of feelings, so mentally I was like: OK, you sometimes have such-and-such feeling.

Also, I can see the truth in some of what she said. I do like to know what’s considered right and what’s considered wrong so I can do what’s right. When she pointed that out, I said, “Yes, that’s true. I’m an Enneagram One.” She said, “I don’t know … I’m also an Enneagram One, so I think it’s something more than that.” This I recognized as her trying to shake my confidence or make me think there’s some deep, dark, unfixable thing about me. I also recognized it as likely correct and not a cause for self-flagellation: I have my stuff that I’ll be addressing forever, which I came by honestly. So does she, and so does everyone else.

Besides saying some things that were true, she also said some helpful things. She is a good educator. I actually left our meeting feeling inspired (but also a little bit glad that we’re only going to meet every other month; I’m also glad for all the kindness and affirmation we receive at County Hospital). Jacqueline said she doesn’t want to tell me, “This is right and this is wrong.” She wants me to figure out how to think about things to come to my own conclusion. (I believe my parents had the same plan 50 years ago, and it didn’t work then, either.) It will be good for me to try to do that.

She also really does not want chaplains sitting around chatting with patients about whatever is happening in their lives or even about what they are feeling. She said we are the only people who provide actual spiritual care—that not even the hospital priests or Eucharistic ministers do that, truly. She said there are lots of people who can provide emotional support, but that a genuine spiritual care provider is like a “rock in the stream.”

This has been my issue all along: I do shy away from pestering people about religion and spirituality, because I enjoy sitting around chatting with all sorts of people, because it seems rather personal and private to discuss with a stranger right off the bat, and also because there’s part of me that still thinks a chaplain is a religious zealot and therefore someone to avoid. Even though I am one! Ugh. Jacqueline said not to tell patients, “We offer spiritual care and emotional support,” because emotional support is something I should be embodying all the time and not something optional for someone to request. So there is much to learn and practice. I’m going to be a much better chaplain for my time in this job.

On my very next visit, I skipped the part about emotional support and said I was there to provide spiritual care, period, and was surprised at the depth of the discussion that immediately ensued.

Wavelet of Joy

I went to County Hospital on a Friday afternoon quite some weeks ago now to work a shift that included a fairly long visit with a patient which I wrote up afterward for one of the two verbatims we have to do during the course of our training as volunteer chaplains. It was the first day I really felt I belonged there, and I also felt one of those little wavelets of joy that I count on to let me know I’m still on the right track.

Online, I saw a story about a police officer who was severely injured while in the line of duty, and in the background of the accompanying photos, I saw County Hospital, where he was being treated. I also saw an even more horrendous story about a three-year-old brutally attacked by his own father, a tech executive, and realized that that child was probably right then also at County Hospital or at the Truly Wonderful Medical Center. Maybe one of the new batch of CPE students was this child’s chaplain.

I was excited to return to the Very Fantastic Medical Center for my second shift. The pager was quiet during the day, so I went to one of the three units Carolina and I share and saw three patients. Two of the visits were long and very satisfying. The third was short; the patient was resting and said she had all the resources she needed to practice her religion. Later I was sitting in a charting room with big glass windows, and she walked by and waved and smiled. As at County Hospital, I had my first sense of really belonging there, and sent my boss a gushing email telling her that I love my job and thanking her again for hiring me.

One of the long visits was with a patient who was initially sort of belligerent. When I said we offer spiritual care and emotional support, she said, “Are you saying you think I have emotional problems?” She was waving around a pair of glasses missing one earpiece which periodically flew out of her hand. I must have answered that question correctly, because two minutes later, she said, “You look like Meryl Streep. Actually, you’re better-looking than she is. Her face is too narrow.” That’s officially my new favorite patient. Obviously one with some sort of visual impairment, but very charming. Toward the end of our time together, she asked if a chaplain could visit every day. I said I work only once a week, but would she like a chaplain to visit the next day? “No!” she answered. A relative at her bedside interpreted: “You’re her chaplain. I could see it in her eyes after you started talking to each other.” That made me wish I could be there every day.

Per my boss, I’m going to find out if religion or spirituality is important to patients, and if so, whether they have the resources they need, but I’m also reminding myself that it is the relationship that heals, and that it is attuned conversation and emotional presence that build that kind of relationship. This means I need to be in touch with my own emotions. Accordingly, this is now an explicit part of my sitting practice, sort of combining meditation and therapy.

I start with ten minutes of metta practice, and then, per Sayadaw U Tejaniya, I notice if I can feel my body. If I can, I’m present. I inquire if the most noticeable sense experiences are pleasant, unpleasant or neither. I inquire if I like or dislike these experiences, or neither. It’s interesting to notice how the latter two move in tandem and how they don’t. In fact, that’s extremely important to notice, because we assume that we will dislike things that are unpleasant, but it’s not actually required. Having an experience that is definitely unpleasant but realizing that one isn’t unhappy about it is liberating.

Anyway, I next inquire if I’m having any particular emotion, and if so, what I would call it, where I feel it, and how it is behaving. Is it thick, wispy, contracting, expanding, stationary, traveling elsewhere in the body? That is my practice lately, these questions over and over and over, and I’m noticing that it’s getting easier to feel my emotions when I’m with patients, which I think helps the connection on a subliminal level, but also affords clues as to what the patient might be experiencing, at least as a starting point.

I never got an email thanking me for applying for my dream job and letting me know I’m not qualified for it, but I finally heard that an offer was being made to another candidate, one who is new to the hospital. I would have been thrilled to get that job, but it would have made the next couple of years way too busy. Meanwhile, I’m settling in more and more at my current hospitals, and can now picture myself staying indefinitely.

Two years ago, I told myself that if my employer laid me off, I was going be a hospital chaplain, and now that’s what I am.

Enjoying Wildlife in the City

I believe this is a rat, but you can hardly tell, huh?


 (Click photo to enlarge.)

Wednesday, October 18, 2017

Snippersnapper

Yesterday was my very first day as an actual paid staff chaplain. It went pretty well. I spent the first couple of hours at the office where Rebecca, our administrative person is, doing the last of orientation. I thanked her for a couple of things she said when I was doing CPE that were helpful to me. One was when I announced to my supervisor, “I’ve thought of another good reason I can’t be a chaplain: I’m an introvert.”

Rebecca, working away at her desk nearby, said, “Every chaplain I know is an introvert.” Objection overruled!

Rebecca also mentioned one day how much exercise chaplains get walking around the hospital all the time—that it’s a healthier job than some.

Rebecca said she wanted to thank me in return for teaching her how to center herself—I had not realized I had done such a thing—and also for being an inspiration in regard to mindful eating. She said she periodically attends mindfulness training classes at work where they talk about mindful eating. She said it never really sank in until she saw me having lunch one day and thought, “Mindful eating: There’s someone doing it.” She said that ever since then, she has been paying much more attention when she eats.

I took the shuttle over to my own campus and spent the day fielding pages to the on-call pager and dispatching requests. I saw only three patients, including one who was going on comfort care, meaning that death was imminent.

The air was smokier than it has been all week, and even in our windowless chaplains’ office in the basement, I could smell it. After an hour of sitting at the computer mid-day, my chest hurt, my eyes were burning, and I had a headache. At the end of the day, I spent another hour in that room. It no longer smelled like smoke, but I still got a headache. I hope it’s not going to be a chronic problem, something to do with the ventilation. I gather that even if you can’t smell smoke, such as from the North Bay and Santa Cruz wildfires, there can be yucky stuff in the air, so maybe it was that.

I punched out at 5 p.m. and went on standby, but lingered in the office until near 7 p.m. to see if any pages would appear. Nursing shift change is at 3 p.m., and my colleagues say most requests for an immediate visit from a chaplain turn up by 5 or 6 p.m. The likelihood of being paged after that is less. I spent that time typing up notes, figuring out how to print, and devising a method for tracking my daily stats—the number of minutes we spent doing this, that and the other. Late in the day, I realized I had forgotten to check one source of chaplain referrals and was relieved to see that there was only one request, and it could be handled the next day.

I walked home and made dinner, marveling that I was still on the clock, yet in my own kitchen with my own cat. I didn’t get paged during the night.

Today I had some stuff to do in regard to health insurance: check my latest notices from Covered CA, pay my monthly premium, and follow up on getting both forms of insurance that I had earlier in the year to authorize the mammogram I had in January, which in itself has been an absorbing little project. I am so grateful to have health insurance, but applying for it and dealing with it have been ongoingly stressful—so many weird little details. Fortunately, the people at Covered CA are excellent at what they do and very helpful.

I got a notice from them several weeks ago saying there was a discrepancy between what I’d reported as my income and what the computer said. I called and we agreed that I would upload some documents pertaining to my CPE stipend. I did that—with difficulty—and two weeks later got the exact same notice again. I called back, and this time the person said there is nothing in their system that tells them that documents have been uploaded. You have to call and say, “I uploaded some documents!”

So I told her, “I uploaded some documents!” and she went and checked them right then and said everything was fine—except that now that I had no verifiable income, I qualified for Medi-Cal instead of Covered CA, which is fine with me. A couple of days later, I got a call from a Medi-Cal worker and told her about my new job. She somewhat sternly told me that if my income from my new job is what I predict it is, I do not qualify for Medi-Cal (which is also fine with me, since it wasn’t something I was seeking in the first place).

Today I yet again got that notice from Covered CA saying there is a discrepancy in regard to my income. The other day, I tried doing my annual renewal online, but could not convince the system that I was never in foster care. So I called today and explained the whole thing to another helpful person. Whoever hired the people who answer the phone at Covered CA truly did a fantastic job. This person updated my income per what I think it will be, said not to worry about the foster care thing, and said he had gone ahead and renewed my insurance; I just need to choose a plan.

I’ve been feeling sorry for myself because my insurance has such a massive deductible that I don’t dare use it unless I really, really need to. I decided today to go look at the other options. Maybe that low-premiums / high-deductible plan is for some young whippersnapper that I no longer am. There are certainly some other choices, but I wasn’t sure how to proceed because I’m not sure what the various plans cover, exactly. This caused me to remember the big stack of documents Kaiser has mailed me over the past several weeks that I have not looked at. Possibly if I were to peruse those documents, I could make a better choice about next year’s plan. Mainly, I just hope I don’t inadvertently do something that causes my insurance to vanish.

Though if that did happen, County Hospital serves people with no insurance at all, and their doctors are one and the same as the doctors at the Truly Wonderful Medical Center, so the care would actually be superb; you just might have to sit in a clinic waiting room for six hours before getting it. I used to do that when I was in my 20s and didn't have insurance. However, it would be disingenuous of me now to rely on that safety net meant for others. I can pay for health insurance, and I am happy to have the opportunity to participate in a pool of insured people.

Oh! I always thought “whippersnapper” just meant a young person. It actually means “A person regarded as insignificant and pretentious” or “An unimportant but offensively presumptuous person, especially a young one.” But why? Oh, because of this: 1665-75; probably blend of earlier whipster and snippersnapper, similar in sense. All right, that clears that up.

Monday, October 16, 2017

Burning-Hot Coins and Slippery Rocks

I have finished reading The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures, Anne Fadiman’s superbly written, riveting account of Lia Lee’s medical travails, and, for comic relief, have started Zen Confidential: Confessions of a Wayward Monk, by Shozan Jack Haubner.

He writes: “You deal with your shit in Zen by sitting with it. By breathing right into it. You don’t try to ignore it with pleasant thoughts or lofty ideas, and you don’t try to bury it with solutions. You deal with it, you work with it, one breath at a time. You hold it right there, in your hara, or breathing center. You don’t try to breathe it out; you don’t try to breathe it in. You keep it suspended in your diaphragm like a burning-hot coin. Your problems won’t change; only you can change. That’s the point.”

That reminded me of what Ezra Bayda wrote about trying to figure out what work to do—that he finally concluded that he just needed to sit with his anxiety about it, and after he did that for long enough, an idea came to him.

One skein of recent worry runs like this: What if I go to school for two years and then can’t get a job in San Francisco? Will I be able to find any job whatsoever at age 58? Today I was going to call my friend who worked for many years as a recruiter to ask her this, but then I remembered about the sizzling coin, and dropped the reminder to myself in the recycling bag instead. While my friend might actually have some ideas about this, in the end, the question can’t be answered in advance and answering it isn’t the point. Learning from my experience is the point, however haltingly, and however often I seemingly have to learn the exact same thing once again.

This doesn’t mean that I should go to school and work as a chaplain, of course, which points to another chronic worry: How do you know what to do? I really appreciated that CPE kept me from having to think about this for 15 months, but now CPE is gone and I’m back to having to feel my way across the river on my own, one slippery rock at a time.

One thing to consider: What is my motivation? In these periods of unease, fear and the desire for security and certainty loom large. Even though this fits nicely with my generally anxious temperament, I don’t want to spend the rest of my life lurching from one seemingly safe haven to the next. Ultimately, there is no such thing, and I also will feel disappointed in myself if I do that.

(However, I’m also not saying I’m going to mail my keys to my landlord and go live on the sidewalk with Hammett, trusting that all my needs will be met.)

The path toward chaplaincy does afford continual personal growth. Wanting to grow and learn seems like a pretty good motivation.

I had dinner with Sam last night at Eric’s and learned that perhaps the thrill of working for the complaint department could wane over time.

Closing for today with this little prayer from the Peace Pilgrim, which I say aloud almost daily, and which sometimes seems like enough and sometimes doesn’t seem like enough:


Live in the present,
Do all the things that need to be done.
Do all the good you can each day.
The future will unfold.

Sunday, October 15, 2017

No Teasing

Yesterday morning brought clear blue skies and a complete lack of smoke in the air—a welcome surprise. Charlie and I went for a walk through our neighborhood.

I found this written note in my pile of little pieces of paper and I’m going to keep it until I remember what it means:
“Louise = bad with medical. Katrina = good with medical. Doesn’t like to be teased.”
What on earth does that mean? I don’t recognize either of the names.

This morning also featured blue skies and clear air, just as welcome as they were yesterday, but I am in a state of unease about my path forward. I really do not want to go to school, for one thing. In 1998, the question I asked myself, which led to 18 lucrative but not particularly fulfilling years in a cubicle, was, “How can I weasel my way into a tech job without getting any more education?”

During the past year of doing CPE, I assumed I would go to school starting next year, because I believed that chaplaincy was the answer to the question, “How can I support myself doing something that seems worthwhile?” and school is required for board certification.

But now I’m remembering that, before that, my question was, “What kind of job can I do that takes place in a hospital?” I ruled out being a physician, nurse, OT (occupational therapist), PT (physical therapist), ST (speech therapist), or administrative assistant. That left just one choice: chaplain! I moved toward this several times and then backed away when I remembered how much religion would be involved. I still feel uneasy about the religious aspects.

Today I got a call from Sam and was reminded of another job that takes place in a hospital: complaint department! It appears that, each year when the CPE program finishes, a few graduates go to work there, where they are welcomed for their unique skillset.

Several times it has crossed my mind that I might like to work part-time doing tech support. I like sitting in front of a computer. I like assisting a variety of people with whatever is bothering them. Today it strikes me that working in the complaint department of a hospital might be just the thing: I could sit in front of a computer, use my chaplain skills, talk to different people every day, and not have to go to school. I would also not have to continue to deplete my savings at a nauseating rate, which I’ve only been doing for a month but already don’t like.

I told Sam about my troubles with Jacqueline and at first he said it sounds like she is really suffering and that he thought I should confront her and tell her how her words make me feel. This struck terror into my heart. But after I told him a  couple of things she said, word for word, he said, “Hmm, do you think there could be any truth to that?” and, “Oh, just ignore her. Let that roll off your back.”

Friday, October 13, 2017

The Dorky Duckbill

On Wednesday, I walked over to County Hospital through the smoky air and spent the afternoon seeing patients. Jacqueline, over at VFMC, shared with us during orientation several things she’s not a fan of. One is chaplains stopping by to see patients “just to see how you’re doing.” It sounds like she wants her chaplains to confirm whether the religion listed for the patient is correct, find out if that religion is helping the patient—I’ve never heard anyone say it isn’t—and inquire if there is any religion-related support the patient needs, such as a Bible, which often is requested. She has an actual flowsheet for pastoral care conversations.

OK, then. I tried this out and it certainly does make conversations shorter, and resulted in even more walking, as I went to fetch Bible after Bible. Before you can be certified as a chaplain, you have to log 2000 post-CPE clinical hours. Possibly by the time I’ve done 2000 hours, I’ll have settled into approaches that are satisfying to me and also meet the job requirements.

On Thursday I stayed inside all day due to air quality issues. When I looked out my window in the morning, there was a layer of haze between me and the rooftops several blocks away. When I opened a window to see how things smelled, ash started blowing in immediately, and it smelled very smoky.

Today I stayed in most of the day, too, wondering if I was being overly wimpy. In the late afternoon, I went out to do a couple of errands. I ran into one of my fellow County Hospital volunteers. I was outside for only 30 minutes, and came home with a headache and irritated throat, and smoke-stinking clothes that had to be put into the laundry basket right away.

I have ordered a budget HEPA filter and some N95 masks, but who knows how long those will take to arrive? We are fitted yearly at work for an N95 mask. There are two general kinds. Thanks to that, I knew exactly what to order.

Tuesday, October 10, 2017

Eggplant

On Saturday, one of my CPE peers came over. I’ll call her Nellie. We had a really nice day together. She visited with Hammett, and we walked over to Scarlet Sage and on to Papalote for burritos for lunch. We went to Dog-Eared Books and came back to my place for tea. In the evening, Tom and I went to Eric’s, Chinese food at Church and 27th St., for dinner. We had pot stickers, eggplant and cod. Everything was incredibly delicious, really fresh and lovely.

Nearly a year after breaking up with F. (that is, him breaking up with me), I’m finally starting to get some helpful insight into the matter. Basically, I want him to behave in a different way so that I don’t have to have certain feelings, primarily that of longing. I haven’t been able to fathom why he doesn’t feel the same way. Doesn’t he miss the remarkable togetherness we had? (Quite some time ago, at this point.) No, he does not, because he refuses to feel longing; he prefers to feel angry. How he feels is based on how he sees things; how I feel is based on how I see things. There is no way for me to affect how he sees things. There wasn’t when we were together, and there certainly isn’t now. There is nothing I can do about that.

I realized that I have this little mound of grief, with notes of regret, guilt and occasionally anger, that I may have to carry forever. Once I accepted that, it was a short hop to tonglen: being willing to shoulder all of the bad feelings left from this relationship, and to wish for F. to be entirely free of them—there’s no sense in both of us feeling bad. A couple of days after I began to practice tonglen—“May I take upon myself all of the sorrow from this breakup; may F. be happy and at peace”—I noticed a new sense of separation between us which for the first time felt good instead of bad. It felt clean and peaceful.

I usually forget about tonglen practice until I’m desperate, but it is quite powerful. It is a way of turning toward difficulties rather than trying to make them go away, and it affords a bolstering and inspiring sense of doing something noble.

However, about the time the sense of separation arose, I began to consider how much of this pile of suffering might be self-inflicted and therefore optional. Maybe some of it is unavoidable, and this I will willingly carry with me, but probably a lot of it is due to how and where I deploy my attention. As the Buddha taught, grasping causes suffering. Theoretically, I could have figured this out two days after the breakup, but it always goes the way it goes.

Yesterday I went for the fourth and final day of orientation for my new position as staff chaplain at VFMC, along with my wonderful co-worker, Carolina, who I like more every time I see her. That will happen very rarely, since we are going to work on different days. The night before, I kept smelling smoke, and when I woke up in the morning, I learned that there are a lot of wildfires burning north of here. My apartment, where all the windows were closed, was smoky, and the hallway outside my apartment much more so. Outside the air was hazy. Even deep in the bowels of the hospital, in the basement, it smelled like smoke.

A few times yesterday, my new boss, Jacqueline (not her real name), spoke to me in a rather withering manner, which caused a knot of fear in my gut, and which I well remember from last summer. She spoke to Carolina in nearly the same tone, and I know it’s not personal. The person I feel for most is Rebecca, the administrative person, who I know is regularly criticized and scolded. It may be partly the difference between a hospital that is basically corporate and one that is a teaching hospital affiliated with a university. There’s quite a different feel.

However, I must admit that Jacqueline’s bordering-on-rude observations were not entirely off the mark. I am detail oriented and risk averse. I am an Enneagram One, and I like to do stuff right, and in order to do that, I have to know what’s right. Unfortunately, the kind of question I am most urgently moved to ask is exactly the kind of question that can annoy Jacqueline, so I guess this is an opportunity to figure out how to draw upon my own authority.

I also see the parallels with F.: I want my boss to act in a different way so I don’t have to have a knot in my gut. But that is outside my control, and it’s not reasonable to expect only good things to come my way. After having been affirmed constantly at TWMC (a teaching hospital affiliated with a university), being treated as if I’m a loser is hard, but I am grateful for the memory of that extravagant kindness, and also for currently being treated extremely well by Clementine at the County Hospital (also a teaching hospital affiliated with a university).

What they call “self-supervision” in CPE is called for here: how can I be a chaplain to myself? I can figure out creative solutions, such as taking the unpleasantness itself as my object of attention.

As for the job at TWMC, I haven’t heard anything. The online listing has now disappeared, so the application period appears to be over.