Saturday, June 25, 2016


This past week Samantha was out of the office. I assumed she was taking vacation, but overheard her in our open-plan office saying something about when she would return “from leave,” which suggests she may have something going on in her life that is making her cranky. In any event, I was happy we’d be getting a break from her and that her boss, Jacqueline, would be teaching our class sessions, which are Tuesday and Thursday from one to five p.m.

In class Tuesday, Jacqueline was saying something about the Google calendar we use and I asked her if some recent on-call trades would be reflected there. She asked, “What does that have to do with what I’m talking about?” Sheesh. I submit that there are nice ways to say things and mean ways, and that that was a mean way. In the 18 years I spent at the large corporation that laid me off in January, I can’t think of a single occasion of blatant rudeness (except for the time I walked away from the fellow who was insisting that I go through the kitchen door before him; I apologized later). I’ve only been in clinical pastoral education for, as of yesterday, three weeks and have already lost count of how many times someone has spoken in a rude, angry or impatient way. (However, I did make a mental note not to depart from the topic at hand in the future.)

When the day was over, I asked Andrew if I could walk to his shuttle with him, and on our way up the hill, I asked, “Is it just me, or are these people jerks?” He said, “It’s you and me both” perceiving it that way, and added that it’s well-known in seminary circles that this is the culture of CPE: it’s supposed to be spiritual boot camp or something, he said. I can’t fathom how being harsh with students is supposed to teach them how to be empathetic caregivers.

When I got home, I called Naima, my mentor, and she was able to speak right then. She said three or four times that she is very sorry this is happening, but also suggested that I stop focusing on my instructors and consider what I can learn from this situation. She said that CPE is just plain hard—it’s hard for everyone at the beginning. She reminded me that the time I spend directly being supervised is a fraction of the whole experience, and that I’m there to learn pastoral skills (how to provide spiritual or contemplative care). If that is happening, that’s the main thing, and that is happening.

I went that evening to Howie’s just to serve as the greeter, and complained to him about my experience, and he looked pained and asked, “Where’s the love?”

Jacqueline did say one helpful thing on Tuesday, which is that we might get to the end of the summer and conclude that a hospital ministry is not for us, and that is fine. She said, “There are many different kinds of ministries you can have.”

On Wednesday, I had a 60-minute one-on-one meeting with her, at which I expected to be further offended, but it was actually very helpful. I scribbled down lots of notes. I had figured that I’d hang around the hospital and be friendly and listen to people as best I could, and that if I had to, I’d say prayers or otherwise proceed in a religious or spiritual context, and that that would basically be it, but what is really required is quite different. It’s about learning to figure out what others are feeling, which depends on being able to figure out what I’m feeling, and to learn conversational techniques that are not about solving problems but about allowing people to explore their own issues and to place them in a meaningful context (which could be a religious context) that may suggest solutions. Offering reassurance seems like a really nice thing to do, but it’s not the goal here, as it does not recognize what the other person is feeling. In fact, it does the opposite. It says, “Don’t feel that way” and can leave the other person feeling alone and unheard.

We lately read the first half of Being Mortal: Medicine and What Matters in the End, by Atul Gawande (which I had read before; it’s excellent) and now we’re reading The Skilled Pastor: Counseling as the Practice of Theology, by Charles W. Taylor. I’m finding his chapter on verbal responses very helpful. A key skill is paraphrasing what we’re hearing. He says that paraphrasing is the most important skill discussed in the book “because it is the one that contributes most to both [patients]’ exploring and [caregivers]’ empathy.”

We do a lot of role-playing in class, giving each other honest feedback afterward; plus we will write five “verbatims” this summer, in which we try to recount, sentence by sentence, a conversation we had with a patient, and what we were thinking during the conversation. We will go over these in class, as well. Having to do this should improve our ability to recall what was said, along with how well we pay attention in the first place. As someone or other said, you can’t remember what you didn’t hear in the first place. Jacqueline might have said that.

I was on call again on Thursday and slept much better this second time. There were no pages during the night, so I got 10 hours of sleep and had time to meditate for 45 minutes the next morning, plus you get the next day off, so I am having a three-day weekend.

I am feeling much, much better now that I’m back to getting pretty much all the sleep I need. At first, I felt so terrible both physically and emotionally, and also disoriented and overwhelmed. I literally felt dizzy now and then, but with each passing day, I feel more present in my body and can attend to my posture and how I’m using my body, a la the Alexander Technique, so that I feel more comfortable and more at ease. I’ve only been at this for three weeks, but so far I’m not brooding over patients’ problems after the day ends. For one thing, it’s my practice to try to be present in this moment, and for another, this is obviously a heavy thing to do, with great potential for compassion fatigue, so I feel it’s my responsibility to enjoy everything that can possibly be enjoyed. This is happening naturally as I can’t help but appreciate that I am not lying in a hospital bed. I can go outside. I don’t have cancer.

On Thursday afternoon, we had quite a good class with Jacqueline. Maybe Tuesday was hard partly because she didn’t know us at all. By Thursday, she knew us better, and the mood was friendly. She gave us a useful presentation on the art of conversation and we saw the movie The Sea Inside, about a quadriplegic, played by Javier Bardem, who wishes to end his life. Samantha had said firmly that we ought to be able to delve into a patient’s deepest beliefs in a first conversation, but Jacqueline said that this kind of intimacy may take several conversations to develop, which sounds much more realistic. However, the average patient in this hospital is there is for only three or four days, so a very deep conversation might not happen that often, but I’m enjoying meeting tons of new people, including nurses. I had a riveting conversation with a patient who is Buddhist and Christian and who recounted in vivid detail a couple of mystical experiences, as well as a very meaningful dream. I don’t take any credit for that beyond the symbolism of the chaplain title. “You’re a chaplain? You’ll want to hear about this!” Also, I had time to listen.

Today I met my walking friend at CafĂ© La Boheme for tea, and then Tom and I had El Salvadorean food in Berkeley and went to Berkeley Rep to see For Peter Pan on her 70th birthday. Ann didn’t join us for this one. The play was short, about 80 minutes, with no intermission. When it starts, an old man is dying in a hospital bed. Monitors are beeping, he has an oxygen tube in his nose, and his five adult children are gathered around him. (Hmm, seems like I’ve seen this somewhere lately … ) The oldest child played Peter Pan in a theater production when she was a child. The first half of the play seemed kind of flat, but in the second half there is a dream sequence which I found magical and quite moving.
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