Saturday, April 22, 2017

Dazzlingly Lovely Flower

The next morning, a physician said something to me in the palliative care rounds meeting that initially was quite jolting. He said, “I’m not comfortable with you as a chaplain.” I spoke up for myself in what I thought was an appropriate manner, and the physician clarified that he was merely saying that, while Delia was on vacation, he felt unequal to the task of mentoring me, since he is not a chaplain. I saw that I had projected onto him, which I acknowledged in the moment, and the interaction ended in a relaxed, agreeable mood.

However, possibly that very day, I accompanied the palliative care team to visit a woman in the ICU, and after we left, her relative joined us outside the room to share some bad news he had gotten about another family member. I said I’d be happy to return to offer emotional support. He broke in to say excitedly that he had been hoping emotional support was available, but instead of letting him talk, I finished what I was saying: I talked over him. As with visiting the wrong patient, I felt embarrassed afterward and again feared that the palliative care team will think I’m incompetent. I comforted myself by remembering how our new supervisor asked me to do joint visits with him. He said, “I heard you’re the all-star chaplain, and also that you’re good with the charting system.” Nice to think someone is saying good things about me.

One day at work, I went to a very interesting panel discussion about how care team members respond emotionally to patient requests to exercise the End of Life Options Act.

It has now been four months since F. left me, and the pain has abated noticeably. Particularly since starting the palliative care rotation, I’ve hardly had time to think about him, but it does occur to me that the relationship itself, like a person, was subject to sickness, old age and death. I think of us as having been a dazzlingly lovely flower that bloomed for a whole year, but then wilted, became ugly, fell. No one thought this was going to be a good relationship, including me, but it exceeded expectations. My mother said once or twice, “That worked out better than I thought it was going to.”

This past week, the palliative care team visited a woman, not much older than I am, who is dying and terrified. She loves God, but wonders where he is. The physician in our group talked to her at length, in Spanish, about end of life choices. I would never have been able to conduct this conversation myself in Spanish, but could understand pretty much everything the doctor said (less so the patient). After we’d been with the patient for about 30 minutes and the meeting was maybe winding down, I asked the physician to ask the patient what she would say to her own child if her child expressed that she was scared and felt God had abandoned her. The conversation ended up going in a different direction, but I think that might have been an interesting question. Or maybe it would have been too theoretical and too complicated for someone feeling so frightened. However, just saying, “Of course God loves you!” seems useless, which none of us did say.

One day, I went to a meeting with a palliative care doctor, a patient’s wife and his grown children. The situation was quite dire, and the wife periodically wept. Meanwhile, one of the children talked and talked, throwing out possible plans and ideas. After about an hour, the imbalance between the grief at one end of the table and the verbalizing at the other seemed so glaring that I asked if we could just sit together silently for a few moments. I said, “Maybe we can take a few moments to notice how it feels to be having this conversation about your husband, and your father.” We did that, and then the meeting drew swiftly to a close.

The doctor said afterward that he had been trying to think of how to end the meeting, and that he never would have thought of doing something like that. He said, “Just like that: poof! The meeting ended.” I liked that the idea arose very naturally, as if on its own. That makes me feel I can trust my intuition.

Late this past week, a woman from Zen Hospice came to the hospital, which I guess she does every now and then. She attended rounds and thought a certain patient sounded like a great candidate for the hospice. After rounds, she and I went to see the patient together. She did all the talking and I observed. She described what Zen Hospice is like and what services are available there, and finally asked the patient, “Does that sound like somewhere you would like to go?” The patient said he did want to go there, and the woman said she would go start the paperwork; he could go the very next day.

But the very next day, he was dead. I couldn’t believe it, but then realized he had spent his last day thinking he was going to go somewhere wonderful, and maybe that is just what he did.
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