Wet Fleck

At my paying job, a handful of new chaplain positions have been posted, one full time and two per diems. I heard from two of my CPE peers about their potential interest in these jobs, one of whom has since talked with my boss on the phone. When I was hired, it was for one on-call shift per week, which soon became two, which is one too many. Ever since getting back from school in March, I have felt exhausted, and would love to return to working just once per week. I’m not going to bring it up, but if it is offered, I will accept with alacrity.

For school, we are required to meet with a spiritual director monthly. They said this can be a spiritual director per se, but it can also be our therapist. I see my therapist monthly just in case, but nothing in particular has been coming up, and when I saw her in March, she said she wondered if she’s actually doing me any good. I skimmed the write-up on what we’re supposed to discuss with our spiritual director and decided it wouldn’t be fair to try to force my sessions with my therapist to conform to that when she is already having doubts about the fruitfulness of our time together. I know a woman who is an actual spiritual director and who is a delightful person, so I decided to call her up and maybe just to see my therapist as needed instead of monthly, so as to not pay both a mental health professional and a spiritual health professional.

But I made a copy of the write-up for me and my therapist to discuss, and when I finally read it a bit more closely—not word for word, of course—life is short—I saw that it actually does dovetail nicely with stuff one might discuss in therapy, and my therapist said, when I saw her early in April, that she liked the idea of having some sort of explicit plan.

There is a palliative care patient on one of my units I had not visited once because he speaks Cantonese, and 100 percent of the time, Cantonese- and Mandarin-speaking patients don’t want spiritual care. Lining up an interpreter to confirm that fact can seem like too much work, so I had never laid eyes on this fellow, who has been in the hospital for months. I decided to go see him, and when I finally reviewed his chart, I saw that his family rarely comes to visit him and that it seems to other care team members that he is terribly lonely.

I found him lying in bed with his eyes closed, looking somewhat like a sad little egg, but when I spoke quietly to him, he opened his eyes right away and looked steadily at me as I chatted away in English. His expression didn’t hint at any emotion in particular. The energy emanating from him was extremely quiet and peaceful.

The next time I worked, I called an interpreter in the morning and left a message saying that I know this patient doesn’t want spiritual care, and I understand that he is hard of hearing and also confused, but I felt that I should at least try to talk with him. At the appointed hour, I went to his room and found him in the same posture as before. Again, he opened his eyes right away, and I started talking to him, saying that I knew he couldn’t understand me, but an interpreter was on her way. I said, “Do you speak any English?” He said something in response, but his voice was so quiet, I couldn’t get what it was. He had to repeat it five times and I had to put my ear four inches from his face before I understood: “A little bit.”

The interpreter came and I told the patient that I’m the chaplain for the unit and that I wanted to say hello to him. I asked if everything is OK and he said, via the interpreter, that it is. I asked if there’s anything he’s worried about, and he said there isn’t. I asked if he considers himself to be spiritual or religious and he said he does not. I said I want to make sure he doesn’t feel lonely or alone. He had been looking steadily at the interpreter until this point, but when I said that, he turned his head and looked warmly at me. I asked if it would be all right if I came to visit him once or twice a week, though the interpreter won’t usually be there. He said yes to that.

As we left, the patient’s roommate said, “That was nice. I couldn’t help but overhear. That was really nice.” The interpreter was also looking at me with a very kindly expression, and I felt good about the whole thing. I’m going to ask the interpreter if she can teach me how to say in Cantonese, “Just saying hello. I hope your day is going well.”

Later in the day, there was a request in the electronic charting system to go see a patient on the medical-surgical floor. Since my colleague whose unit that is (the one who moved my desk) wasn’t working that day, I went and found a patient facing end of life and in immense distress—crying and afraid. Her mouth was full of some kind of gunk and she was coughing. To understand what she was saying, I had to bend over her, bracing myself for a wet fleck of something or other to land on my face or my glasses (though better my glasses than my eyeball). I noticed my own distress arising, and found myself offering more words than I usually do, which was due to my own discomfort.

This patient was not religious, but had a quirky set of things that are meaningful to her. When I asked what she takes refuge in, she immediately named a TV show and described a particular episode. Maybe the best thing I did in that visit, which was about 50 minutes long, was to ask if I could put my hand on the patient’s hand—she said yes—and then if I could put my other hand on her forehead, which I hoped might be comforting; that was all right with her, too.

I felt sad when I left her, and as if something profound had happened. I will need to do some self-examination to become more aware of my attitudes towards death and end of life so that I’m not projecting onto others my own sense that it’s terrible to die and to say goodbye to the people we love most. (But isn’t it, sort of?)