Unrise (Rather Than Sunrise): September 9, 2020

Here are two photos I took on that day. One is of a lobby in one of the hospitals where I work. It looks like it's night, but it was about 2 p.m. 

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Drumming Class

One day while I was sitting on a unit not my own, a nurse approached and asked, “Are you a chaplain?” She explained that one of her patients was reporting shortness of breath in response to her heart medication, but the RN wondered if the patient was actually having panic attacks associated with the anniversary of the suicide of her daughter. I agreed to visit the patient. Before I finished my charting, a physician came and asked the same thing, and told me the same story about the same patient. She added, “Shortness of breath is not a symptom normally associated with this medication.”
 
I went to see the patient, who was friendly and welcoming. Just as our visit began, her bedside RN gave her a new medication and warned, “This is the last resort.” The patient told me about the difficulty she’d been having with her prior medication and explained that if she had the same problem with this medication, she would have to have surgery.

After we’d been talking for 10 minutes or so, I said, “I understand something terrible happened at this time of year two years ago. I don’t know if you feel like talking about it.” The patient then told me the story of her daughter’s life, becoming tearful several times. Sometimes, as she looked into space, I imagined she was seeing the tiny face of a precious girl decades earlier.

Near the end of our 80-minute visit, I asked who she could talk about her child with and learned that she did not have a confidante. At the conclusion of our time together, during which I mainly just listened (and during which the patient did not experience any shortness of breath—maybe she was able to avoid surgery?), I expressed my sorrow at the loss of her beautiful child, and mused, “I imagine the anniversary has some impact. I don’t know what it would be, but I would think there would be some.”

The patient thought for a moment and said, “Yes, that’s probably right. Maybe I’d better go back to therapy or find a group.”

I reported a bit of this to the patient’s bedside RN, who seemed pleased, and I also felt pleased.

At the end of September, 2020 (a year ago!), I had my first COVID test, not administered in regard to Job One, but as part of onboarding for Job Two. It was pretty unpleasant; a stiff little plastic brush was stuck quite a ways up my nose. The result was negative.

Tom began leading his students in stretching each day via Zoom, which he reported was a popular offering. One day, after the end of stretching class, a loud, very repetitious noise commenced. When I called to ask, “Now what’s happening?”, Tom brightly replied, “Drumming class!” That evening, I called back to say that I had been impressed with his students’ mastery of drumming.

“I’d say they have tested out of drumming and don’t have to practice any more!”

My first day at Job Two arrived. You have to complete a screening each day before going in any building, answering the now-familiar series of questions, but your temperature is never taken, unlike at Job One. The day was chaotic, with calls, pages and electronic requests for spiritual care flowing in. When the next chaplain arrived, I had to turn over about six things I hadn’t been able to get to.

On October 8, 2020 (almost a year ago!), Duckworth and Marvin turned seven months old and I was finally able to find ten minutes to complete their microchip registration online.
 
Several months before the pandemic began, three friends and I had begun to co-facilitate a Buddhist meditation group in the Tenderloin under the auspices of the San Francisco Night Ministry. When the group had to stop meeting per social distancing, we began using that same time of week to check in via Zoom, and at this point, we have become fast friends. Late in October, one of us who lives in both Northern and Southern California came to town and we decided to meet, spread far apart, in the room where our meditation group had been meeting.

When the cab driver dropped me off in front of the building, he said, “Be careful.” Seconds later, a man came up to within about three inches from me and said, “How you doing?”

Seeing my three friends was wonderful and did not prove to be a superspreader event.

Around that time, I met with a committee for board certification as a chaplain (via Zoom), and did not pass. You send in a big pile of stuff, including 31 essays. The idea is that you will demonstrate your competency in each of the 31 areas in writing and/or via your conversation with the committee. I was asked to do more work on six of the competencies, and make a subsequent appearance.

At an orientation session prior to our committee meetings, someone at the national organization told us that if we didn’t pass after our first appearance, we should not take it as a “No” but as a “Not yet,” and she added that people routinely say the additional work they had to do was worth it, so when I got the news, I was perfectly gracious, and I resolved to have a good attitude about the whole thing, although sorrow soon set in: Ugh—I was so looking forward to this process being over.

Have you ever had someone important die and, for moment after waking up in the morning, you don’t remember it, and then you remember it? It’s as if the person has died all over again. This happened with my board certification. The following day I woke up and thought, more or less, “Another beautiful day! Isn’t it wonderful to be alive!” And then: “Oh! I didn’t pass my thing!”

One thing that made me feel better was the utter shock of everyone I told this to, and another was that three of my friends / colleagues also didn’t pass, including one whose MDiv is from a very fancy school and who started his own religious community after graduation. Apparently there was a huge crop of candidates, so there may have been inexperienced committee members, or even people serving for the very first time. Maybe committee members new to this process didn’t want to be the ones to let a psychopath slip through. Also, this was over Zoom, whereas these interviews formerly were always in person, and maybe that made it harder for the committee to get a good sense of the candidate.

In due time, I received my written report from my committee and found some disturbing things in it; for instance, the committee said they weren’t sure about the care I offered a Hmong patient, as written about for such-and-such competency. I looked at my essays and saw that I did not write anything a Hmong patient for that competency, but I did for a different competency—so which one did I not pass? There were three things like that, so I sent a note to the coordinator, and she got in touch with my committee. One of my committee members wrote back, “Well, whichever competency it was, we think such-and-such.” That seemed rather cavalier to me.

I convened a group of three of the four of us who didn’t pass, and invited several chaplains in the pipeline right behind us, so we could share what about our experience we thought might be helpful to each other. I typed up notes from this session and sent them to the CPE educators I am personally acquainted with; they were warmly received.

I started to not feel good about the whole thing, partly based on my own experience, but considerably more so in regard to two of my friends who were explicitly given a hard time for not being Christian. Finally, and somewhat on impulse, as is my custom, I sent a note to the organization saying I was feeling unenthusiastic about continuing with this process—could I maybe speak with someone who could restore my trust in this organization? I ended up having a very helpful conversation with someone who agreed that my committee had been rather flippant. As for understanding which competencies I actually needed to address, she said, “Maybe these are the competencies the universe wants you to work on.” I decided to assume that was the case.

The Great Outdoors (COVID Version)

Ah, beautiful!

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COVID Overview

I can’t remember what I’ve said about this so far, but to recap how COVID affected life at the hospital:

One of the first things that happened was that employees were instructed to use one particular entrance, and visitors to use another. (This made my own process of getting into the building about ten minutes longer.) We began to have to answer a series of questions when arriving, and to have our temperature taken every time we entered the building.

Visitors were restricted. This has ebbed and flowed over the months. At many times, the restrictions have been so stringent that the building has seemed quite empty. This has been a considerable hardship for patients, and is often mentioned by them.

Employees from the beginning have been required to follow social distancing guidelines: staying six feet away from others as possible; frequent hand hygiene; wearing of a mask when not eating; eating preferably done in the cafeteria, where tables have been placed far apart and many chairs removed. There are signs everywhere with instructions about social distancing and PPE usage. Plexiglas appeared here and then there. At times, people were seen carrying buckets around the hospital, wiping down high-touch surfaces.

Chaplains are considered essential employees and have reported to the hospital the whole time, whereas our manager, administrative person and one or two others began working from home in March (of 2020, this is) and have rarely or never been seen since.

At first it seemed there would be no effect on my income, and in fact, there seemed to be a double financial upside in that I was not traveling nor taking days off work in order to travel. However, after a while, the pandemic began to cause budget problems for the hospital, partly because elective and non-urgent procedures were put on hold to leave room for a surge of COVID patients, which to date has not happened in San Francisco, at least not in the hospital where I have been working for the past few years. Many workers have been forced to take time off (this might entail using PTO; I’m not sure, since this does not apply to me, since I am a per diem and do not have PTO), and retirement and early retirement have been encouraged. As mentioned here, I began to have fewer shifts than before, which is what led to my seeking and (fortunately) getting Job Two.

As for our actual work, from the beginning, we have placed new emphasis on staff support. Chaplains do not go in the rooms of COVID patients. If we are called to care for such a patient, it is done by telephone or video. I think this largely to preserve PPE and perhaps to put as few staff members as possible at risk. Because visitors are so restricted, chaplains have been more important than ever when it comes to emotional support of patients. There is sometimes a balancing act, as we try to stay six feet from patients and keep visits as brief as possible, while maybe being the only person there, besides the bedside RN, when a patient’s final hours are approaching. We want to keep ourselves and others safe, but not leave someone who is dying alone, or leave a frightened single visitor alone.

The supply of PPE has been uneven. At times, employees were asked to put their used N95 masks into special bins so they could be cleaned and reused. This didn’t seem to go on for long, and is not happening currently. However, rather than being fitted this year and last for N95 masks that come in at least two different sizes, we are now being fitted for one-size-fits-most models that I suppose are cheaper. In my case, I think the fit was better with the sized masks.

The first time I reported to work after San Francisco’s shelter in place order (which was a week or so later than my colleagues did, because that was also Hammett’s final week), I made sure my father and sister had my important financial information. However, I didn’t feel frightened of going to work, and I have never felt scared at work, though once or twice, at one job or another, I have walked by a whole series of rooms containing COVID patients and kind of thought, “Holy moly.” I do find I don’t want to stand around right outside such a room for long.

The hardest part has turned out to be when one of my very own colleagues has been sloppy about social distancing, which occurs exclusively at Job One, and the second hardest part was early on when people in my neighborhood weren’t wearing masks and/or allowing six feet when I thought they should be.