Monday, January 16, 2017

Not Amused

Several days ago, a nurse interrupted my visit with a patient to gently point out that I had totally overlooked a sign on the outside of the patient’s room explaining what PPE—personal protective equipment—was required. There was a droplet hazard. I was supposed to be wearing a mask and eye protection. I put on the PPE immediately asked the nurse, “Should I freak out?” She said no, just to be sure to wash my hands with soap and water after leaving the room rather than using gel. Afterward, I asked her, “Uh, what does he have?” Fortunately, merely the flu.

Last week, we did our mid-unit self-evaluations, which involved displaying genograms we’d created—this was a fair amount of work—and presenting a two-page analysis of family dynamics, along with sharing what we’d written about our peers and our supervisors. In the middle and at the end of every unit, we have to describe our relationship with each peer, and offer at least one sentence of affirmation and one sentence of critique for suggested growth. Each person gets 45 minutes for his or her whole presentation, and there are five of us, so it is quite a long afternoon, but helps us to know each other better, while doing all of the preparatory work helps us to know ourselves better. I brought in a few family photographs, which people seemed to enjoy, including of the band my Great Uncle Ivan was in. I said that, like me, he was a trumpet player and had goofy hair. My colleagues easily picked him out.

We have brought onboard three new interns who will be doing a part-time unit of clinical pastoral education for the next several months. They are going to take some of our on-call shifts, so we are especially pleased to have them.

I have a patient who is chronically distraught over the end of his marriage, which occurred two years ago. I told him about my own recently ended romantic relationship and how I have been noticing the interplay of thoughts, emotions and physical sensations. Jodie said approvingly, “Good use of self.” She is no longer my supervisor, but her office is right next to the student office, and she is nice about hearing brief reports or commiserating with difficulties.

At the end of the visit, after the patient said maybe his wife will come back and maybe they’ll go to counseling, I said, “Or maybe she’s done with the relationship.” He got really angry and said loudly, “I don’t believe we’re ever done with a relationship. How can she be done with 17 f*cking years of her life?” I told him I wasn’t comfortable being spoken to that way and that I was going to leave. “I’m sorry,” he called after me.

“Don’t worry about it,” I said. “In about three seconds, I’ll have forgiven you, and I will see you again. We have a relationship.”

Jodie’s brow creased over the “Maybe she’s done with the relationship.” She said he
s not ready to hear that, even though it’s been two years. Or, as I think of it, I got too far out ahead of him. I think I also got invested in his relating to his difficulty some other way than how he was relating to it. I probably wanted him not to be devastated over his loss because I don’t want to be devastated over mine. For what it’s worth, another chaplain who has seen this patient several times didn’t think there was anything wrong with what I said. He said he has told the patient the same thing more than once.

Jodie also thought I should not have told the patient not to worry about what he’d said, and should have let his apology stand, in hopes that he might make some connection between his behavior and how it affects others. She said that saying “Don’t worry” sort of negated his apology. Instead, I could have said, “I hear your apology and thank you for that. We will meet again; we have a relationship.”

I visited a patient who treated (that might not be the right word) a lump in her breast with natural medicine. Now her cancer has metastasized to her spine. I led her in a guided meditation that put her soundly to sleep, a welcome result. One might say that she should have gone to a doctor immediately and done whatever he or she said to do, but other patients refuse chemotherapy and go on to live with stage four cancer literally for decades, so you never know.

I arrived at work this past Friday afternoon to start my on-call shift to find Sam, without whom I would not be in this program, and another colleague in the student office. The latter reported that she had just been with a patient who is having a hard time; she asked me to visit this person if I had time. Like an improvising musician picking up on a bandmate’s riff, Sam suddenly and quite loudly sang-shrieked, “Having a hard time!” I thought that was extremely funny and said, when I was done laughing, “That was very entertaining for your peers.”

“For one of them,” corrected our colleague.
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