On Tuesday, the famous cancer patient’s DPOA (durable power of attorney) was discussing her care with the doctors, one of whom estimated that the end could be three to five days away, so I was quite shocked when I saw Wednesday morning that she was gone. Such a short time ago, we were having long, delightful conversations, and she was utterly, fully alive.
That day, I went to see the woman from the soup kitchen, as I do every day. I arrived just as the social worker as leaving and found my friend worrying about her benefits and where she will live. Before I left, I encouraged her to rest and to focus on her body for now—to offer love and care to it, at which she rolled her eyes.
“Did you just roll your eyes at me?”
She nodded and smiled a smile of great satisfaction.
“OK, good. That tells me you’re feeling a little better.”
Her doctor told me he is hoping to get her out of the ICU and into another unit where she can start to do physical therapy. He said that every day she is in the ICU, she loses five percent of her body mass—I imagine this is true of anyone—and that her chances of leaving the ICU alive diminish.
That was also Ash Wednesday, when we got to go around “imposing” ashes on those who wished to receive them. When the woman at the front desk for the operating rooms saw the little container in my hand, she immediately made an announcement over the public address system and staff members lined up for this brief ritual. It was touching to see the trusting look in people’s eyes as I dipped my thumb in the ashes and made a cross on the person’s forehead, while saying, “Remember that you are dust, and to dust you shall return.” You can also say, “Turn toward God, and believe the Good News.”
One woman in the waiting room wanted ashes and also instructed her small grandson to approach me, but he looked terrified and backed away. “You don’t have to,” I assured him. “We have freedom of religion in this country.” In the course of the day, serving as an “extraordinary minister,” I offered ashes to 36 people, both patients and staff.
Imposing ashes was so satisfying that I briefly considering becoming a priest, but then I remembered that you don’t get to smear ashes on people every day even if you’re a priest, and also that ladies can’t be priests. On my way home, I saw someone on the bus with black stuff on her forehead and thought, “Ha! I know what that means.” I never would have even noticed it before, or if I had, I would have been mystified.
On Thursday, Anita pulled me aside to discuss a chart note I’d made about the woman from the soup kitchen. It was for the visit where she was fretting about her benefits, during which she’d insisted on writing down her social security number for me, even though I kept telling her I’m not a social worker and also that her SSN was already in her chart. But, lo and behold, the SSN in her chart was different, so I put the one she gave me in my chart note, which turns out to be prohibited because the charting system is insufficiently secure. Also, Anita thought my note sounded more like a social worker note than a chaplain note.
I felt a little defensive at first, but it all came out all right. Anita watched me delete the note, which made me feel like a five year old, but then I was instructed to put the note back, just minus the SSN, and the managers said it was not a question of being in trouble, just an educational thing, and that there was no need for me to apologize to the social worker, but that it would be good if I spoke with her in person to clarify about the SSN. I did that, and she asked me to send it to her in a secure email, so that information actually was welcome, just not in the charting system.
I asked about one other thing I’d put in the chart—was that OK? The manager of the spiritual care department thanked me for asking and told me how she would have handled that piece of information. I thanked her and said I would add that to my treasure trove of learning for the day. (Only to quote other members of the care team in my note if it pertains to spiritual care for the patient.)
I also did joint visits with a peer on Thursday because my supervisor, Anita, told her that I’m particularly good at reflecting back what I hear and that she should observe me in action. That was flattering. However, I thought my peer also did a great job in her visits. She created a very nice, relaxed, leisurely mood in the room, and I thought she did a perfectly fine job of reflecting what she was hearing. When I told her that, she said she had made a point of doing it because I was watching.
We had no classes or groups this week, just seeing patient after patient, so I tried to be relaxed and unhurried and reminded myself repeatedly to be present in just this moment. Nonetheless, I was exhausted at the end of every day, which reminded me that Sayadaw U Tejaniya says if you’re getting tired while being mindful, you’re doing something wrong. You’re using too much energy. Next week, I will see if I can make my attention lighter, more buoyant, less focused.