Wednesday, October 31, 2018

Halloween Self-Portraits

I took these during a recent power outage.

(Click photos to enlarge.)

My Boss's Excellent Plan

My cohort at school has a number of things to do before jukai—Zen ceremony for receiving the precepts—next March. Besides the two lineage charts that I finished while I was at school in August and sewing our rakusus, we have to write about each of ten precepts, each of the Three Refuges, each of the Four Commitments, and each of the three Zen Peacemaker Tenets. We decided to do the writing as a group, taking three days for each item: one to read about whatever it is, one day for contemplation, and one for writing. It’s nice to know we’re all focused on the same thing, in all our various locations.

The final task is to make a piece of art or writing representing our own lineage, which doesn’t have to be literal. That is, mine won’t be a PowerPoint with Howie appearing right above me and Howie’s main teacher, whoever that is, appearing right above him. Rather, this is something that honors all of the people who guided or inspired us on our spiritual path. Mine will probably start with the first dharma book I ever read, which was Who Dies? An Investigation of Conscious Living and Conscious Dying, by Stephen Levine.

Early in September, I went to the first session of a class on palliative care at the Truly Wonderful Medical Center that will meet once a month for about a year. Our teachers are an interdisciplinary team of four women: a chaplain, a physician, a nurse and a social worker. One of my peers from Clinical Pastoral Education is in the class, along with two of my co-workers. The day was utterly superb, including a wonderful talk by a pioneering palliative care physician. Even lunch was wonderful. I figured it would be a sandwich and small bag of potato chips apiece, but it was a lavish spread of chicken, lasagna, brown rice and vegetables, along with two kinds of salad and three dressing choices, with cookies for dessert. I still don’t eat sugar, but I stuffed myself with salad and lasagna.

While reviewing charts at work one day, I read earlier chaplain notes saying that a certain patient had sneered and been rude and answered questions in a “sarcastic” manner. While thus engaged, I could hear a patient shrieking loudly from his room that he needed help, help! The fact that no one rose to assist him immediately suggested that he might have been shrieking off and on for hours. Then I realized that the shrieking and sneering, sarcastic patients were one and the same: now I was definitely going to visit this person.

I entered the room to find the patient staring at me with a forbidding, even angry expression. He looked as if he didn’t intend to say a word, or if he did, it was going to be a discouraging word. I said cheerfully, “I know you don’t enjoy chatting with chaplains, but I just thought I’d stop by and see how you’re doing.” At this, his expression changed completely. He smiled and looked me in the eye and said, “Actually, I do enjoy chatting with chaplains, but I’m [outrageous religion guaranteed to offend any chaplain]!” At this, I raised and extended my hands, palms up, as if to say, “Go figure! Fine with me,” and then he told me that he expects to die soon and that he’s at peace with that. It was quite a powerful visit. I was impressed by his equanimity, and also suspect that this kind of acceptance can come and go, so I asked who will be with him on this journey and was glad he has company.

This was on an oncology ward that I normally rarely visit. I now go to various campuses and various units per what my boss thinks needs covering, and can end up almost anywhere. That day I ran into a meditation friend of mine who is an oncology nurse. It was the first time I’ve ever seen her in the hospital. Three observations about the oncology ward: care team members are much more often in patients’ rooms than they are on other units. Ditto family members and friends. And that people facing the end of life are more likely to get right to the point. When I approached one woman’s bed, she immediately stuck out her hand to take mine.

The first day of the palliative care class awakened a desire in me to be part of a palliative care interdisciplinary team, as our teachers are, or like my oncology nurse friend and her co-workers, and it kind of threw into relief how much that seemed to be lacking at my paying job.

A few days later, I was thinking about this and got more and more aggrieved as I mentally detailed how poorly we’re being treated by our boss, how much we’re being excluded, how little we’re being valued, etc. That’s why the palliative care class is so great: it’s a chance to spend a whole day with a like-minded bunch of people. It’s also why serving at County Hospital is so wonderful. There almost always are two or more chaplains there—sometimes six or seven—and our supervisor is usually there. In between visiting patients, we hang out with each other and it’s fun.

As I told myself my victim story over and over, I felt worse and worse. Finally, I remembered who is responsible for my feeling like part of the team: me. I had vowed never to attend a team meeting now that we per diems weren’t being paid to join in, in order to show my boss how terrible her new plan was. However, if it’s important for me to feel like I’m part of a team, and if I’m entirely responsible for that, what actions could I take? There are many. I could schedule lunches with my co-workers. I could periodically send an email to the group. And I could go to the meetings, even if I’m not paid for doing it, and even if it causes my boss to think her plan is perfectly fine.

Wednesday, October 10, 2018


(Click photo to enlarge.)


Late in August, I went to see Emily in hospice for the first time. It was great to see her. (Oh, right, I had vowed not to make an in-person visit, but I finally broke down.) She looked well, I thought, with her eyes very clear. She told me about a day when she realized she didn’t know where her call button was. Worried that she might need assistance and not be able to summon it, she tried yelling for help. When this did not produce results, she began to sing “Swing Low, Sweet Chariot” at the top of her lungs, and to yell, “Jesus, take me!” This caused a staff member to arrive very soon and to scold Emily: “You’re scaring the other residents.” (Emily grumbled to me, “She didn’t even ask what was bothering me.”)

I went from the hospice to have tea with my school peers who live in the Bay Area. We meet at a place near the Haight called The Center, which has astronomically expensive tea and very agreeable ambience.

The next day, I was in the ED at County Hospital when a “900” was called over the PA, a severe trauma, in this case, a stabbing. I stood outside the young man’s room in the resuscitation unit and thought about how shocking it must be to be suddenly punctured by a knife or a bullet.

I also visited three people in the psych ward. I enjoyed these visits during CPE, and I enjoy them at County Hospital. (I never get to visit the psych ward at my paid job.) For one thing, these are always referrals, so I can directly ask the person why he or she wanted to see a chaplain; in the course of normal rounding, that question would not make sense, since the patient probably didn’t want to see a chaplain. I asked a couple of these patients their thoughts on how they might reconnect to their sense of the sacred, leading right away to interesting discussions. One person wanted to be issued a Bible upon leaving the hospital so he could hit Mormons over the head with it.

In another unit, a patient said that she was feeling short of breath. Any number of times I have given the nearest nurse a message from a patient only to be told that the patient’s nurse is such-and-such person, which I interpret to mean, “Not my job. Why are you bothering me?” So on this occasion, I tried to telephone the patient’s nurse and when I found the number out of service, I finally mentioned the patient’s SOB to someone else at the nursing station who leapt up and said, “Don’t wait on that kind of thing! Tell anyone!” Later I apologized to her, and she said, “Yeah—ABC: airway, breathing, circulation. That kind of thing anyone can help with.” Now I just need to figure out how to tell when someone is having ABC problems.

Here’s an interesting thing I learned that day, from a homeless patient: that it is better to sleep during the day and be up during the night, because it’s warmer during the day, and people can keep an eye on you and your stuff, but you have to be careful not to sleep through mealtime at the soup kitchen, since food is mostly not available at night. (Later on, I  learned that you should also try not to sit down in the closely guarded territory of a  drug dealer. This was told to me by a patient who was severely beaten, ending up with at least one broken limb, when he made this mistake.)

The next day, I went to work for the first time at our brand new hospital. I was away on moving day and couldn’t even figure out how to get to the chaplain office, which is one of the few things remaining in the old hospital next door. I had to call my boss to have her explain how to get in there; even the security guards thought the whole place was sealed off. I’m pretty sure I was the only soul in the entire building, and it was creepy. I decided never to be in there at night. When I went back to the new hospital, the first thing I did was ask the security guard how I would explain to emergency personnel exactly where I am. I could just picture a security guard or police officer saying, “Oh, no, there couldn’t be anyone in there,” while I’m being murdered.

It also appeared that there was no bathroom available in the old building, nor a time clock. In the new building, the cafeteria is closed on weekends, so I ended up eating at a kiddie table in the lobby, because if I’d punched out for lunch in the new building and walked back to the chaplain office to eat, that would have used up a lot of my 30-minute lunch period.

We per diems had been told in the past that if we attend work meetings on days we don’t work, we’ll be paid for them. That day, we got an email saying we’re still welcome to attend work meetings on our days off, but we won’t be paid for them, which made me feel rather less welcome. I started to feel somewhat ill used, but remembered an exercise we did at school, where we told a partner about a time when we were victimized. (As it happens, I told a story about something my boss said during orientation a year ago.) When my partner told his story about being mistreated by a professor in his graduate program, I felt indignant on his behalf, and a feeling of connectedness arose between us. When I told my story, I could feel, similarly, that my partner was a little bit outraged on my behalf.

Then we were instructed by our teacher—Fleet Maull, who co-founded the first prison hospice program—to retell the same story, but taking responsibility for everything that had happened. It was interesting to see that, even though I had considered the fault to be entirely my boss’s, it was easy to retell the story explaining how it was my fault that things happened as they did. What was even more striking was how the connection between myself and my partner changed, deepening noticeably and taking on a sweet feeling, very different from the feeling of being connected by anger.