One day at my paying job last August (yep), I had an unusual number of very long visits, including one early in the day that was 95 minutes long, and one at the end of the day that was 100 minutes long, which took me well past my normal stopping time. In both cases, I couldn’t figure out in the moment how to get out of the room; there was no obvious pausing point. I felt like I’d had two visits with Scheherazade. However, getting out of a room is something I can actually do, as long as I remember and am determined: “I’m sorry—I will have to go in about five minutes. Is there any last thing particularly on your mind?”
As I wrote my chart note for the last visit, I realized that my ex-boss would scold that it looked more like the note of a social worker, and I wondered if that had anything to do with how utterly exhausted I felt when I got home, plus that whole evening, and the whole next day.
I wondered if I should be trying to make my visits true pastoral conversations, or is it inevitable that many conversations will have nothing to do with the patient’s religion or spiritual practice? I believe the answer is yes: I should be mindful that I am a spiritual care clinician, and people are going to talk about whatever they need to talk about. It is also very clear to me by now that if I’m going to find out what’s really going on with someone, patience is required. It can take an hour to find out what is really on someone’s mind on a given day.
Late in August, the group of people who are in the chaplaincy program in Santa Fe and who live in the Bay Area met for tea. Afterward, I attended a small and congenial vipassana meditation group in the Castro for the first time. I decided that I would attend regularly, but have not been back since.
My knees had been killing me since June, unprecedented both in duration and the intensity of the pain. About that dance party after the talent show at school: One knee was giving me particular trouble at that point. While dancing, I did not notice any pain, but the next day, I very nearly could not walk at all.
I saw the wonderful chiropractor again after I got home from Santa Fe, and continued to do what he said to do, and at this point, my knees are basically 99 percent fine, as long as I do my exercises every day. My mother, who has had two knee replacements, worried that it might be time to see an orthopedic surgeon, so I did. He said that my basic problem is that I’m aging. He also said that the amount of degeneration does not correlate with the experience of pain. Some people have horrible degeneration and little pain, while others have the opposite. As for my particular knees, he said he could do surgery, or inject steroids, or I could find a set of exercises that keep pain at bay and do them faithfully. Basically, he validated the approach of my chiropractor, and he agreed that when there is pain, it’s something to do with the kneecaps.
At my paying job, I was thrilled to see that a doctor had pasted a few sentences from one of my chart notes verbatim into her chart note. I ran and told my boss.
Once upon a time, if we called a priest to come during the night, we were required to be present to act as the priest’s host and chart what he did. This was under my former boss. Late in her tenure, she changed her mind and said we could just call the nurse to confirm that the priest had visited and make a note of it in the patient’s record. Our new boss has instructed us to go back to the original procedure, and I was getting ready to feel disgruntled about it when I remembered that it is absolutely moot. We used to be attached to a church that actually would send priests over at 3 a.m. to provide Anointing of the Sick (formerly known as Last Rites). Now that we have moved to the new hospital, we are attached to a church that won’t even answer the phone after 5 p.m.
Early in September, Tom and I went to see his mother, Ann, in Sacramento. It was a gorgeous day, and it was nice to be with Ann, as always. The following day, I went to see Carol-Joy in Novato, for lots of eating and card playing.
Monday, January 20, 2020
Friday, November 22, 2019
Shiki Shiki
In August, I went to Santa Fe for a chaplaincy intensive at school, one of two required each year, and the final one of the two-year program. I went a couple of days early so I could see friends. I spent a day with my Episcopalian priest friend and his mother and nephew. We had lunch at a diner, went to the Georgia O’Keeffe museum, and had sushi for dinner. The next day, my friend M. and I had breakfast at the Counter Culture Café and then went next door to the rock shop, where she bought me a lovely larimar pendant, to remind me of school and of Santa Fe. It will also remind me of M., a tremendously kind and gentle soul.
The chaplaincy intensive, besides being wonderful because it was a reunion of my splendid cohort, was the most powerful yet, with mini-courses on power and privilege, and eco chaplaincy. A Native American man led a prayer circle on a very hot, sunny day; we stood outdoors for about an hour at high noon. No one keeled over, though a person or two had to kneel. Then we did an exercise where we broke into small groups, and had to put cards labeled with various events into what we thought (often incorrectly) was the proper chronological order. Several of the events were ghastly, like Native Americans being invited to a celebration and deliberately fed strychnine.
The final evening, we had “cultural sharing”: a talent show, with many dazzling skills on display. There were several very accomplished musicians in the room. My cohort is huge on group projects, so we had prepared extensively for this. We were the final act, which began with one of us going up front to invite the audience to participate in the gentle movement exercises she claimed we had been doing together each evening. She invited the rest of our cohort to join her up front, to help demonstrate.
Her movements became slightly more animated and then all of a sudden Chaka Khan’s “Like Sugar” came over the PA—pre-arranged with the sound guy—and it became a wild dance party; everyone in the audience stood up to dance, too. (The official video for this song is delightful.) I saw Roshi dancing in the back.
But wait, there was more! One of us who happened to have the entire Heart Sutra memorized in Japanese rapped it while one of us beatboxed and the rest of us did our best to impersonate hip hop-style dancers, with intermittent synchronized movements we had rehearsed; we all waved our hands in the same way along with “shiki shiki.”
I believe I can accurately say we brought down the house. Afterward, a bit of icing on the cake, a student in the cohort after mine said I was her favorite dancer. Someone said there was going to be an after-party at one of the dorms. My peer the rap artist and I went over there and danced for an hour with maybe 15 other people.
It was a memorable evening, and I think the burst of joy at end of the talent show was welcome, because it had been a very heavy week, due to the curriculum and there was also a suicide, the spouse of a beloved staff member. Roshi led us in an impromptu memorial service, which was very somber and also comforting, doing this ritual together.
Back at home, the participants of the street retreat I had signed up for had a Zoom meeting to go over logistics. We were reminded that we were not to shower for five days before the retreat began. I asked if that included not brushing our teeth, and one of the leaders said it was up to me. He said he has done it both ways. (I did comply with the requirement not to bathe for five days prior, but decided that, since I’m paying a small fortune to a team of tooth-related professionals to keep them in my head, it didn’t make sense to take a break from dental hygiene.)
At County Hospital, I visited a young woman patient who had attempted suicide by drinking Drano—it is just never a good idea to drink Drano; it will not kill you, but there will not be one single day in the rest of your life when you will be able to forget that you did this—and also an older woman, diagnosed with mental health issues 60 years ago, who was worried about her SRO housing disappearing while she was in the hospital. This I only found out after about 20 minutes of conversation. After I left her room, I went to the nursing station and spoke with a social worker who advised me to call the patient’s case manager, because she did not have a social worker assigned. As I went off to do this, the social worker said, “Good luck.” Uh oh.
I did leave a detailed message for the case manager, whose outgoing message advised that he was actually a utilization manager, which sounded even less promising, and I asked the patient’s nurse to ask her doctor to request a social work consult. This is a new thing. It used to be that a given social worker was responsible for the patients in a certain area, but now a patient evidently only gets a social worker if a doctor requests it. But when does a doctor ever have 20 minutes to sit around chatting with a patient until her fears emerge?
Finally, I went back to the patient’s room and coached her: “If it were me, every time the nurse came in to check on me, I would say, ‘I’m worried about this, and I’m worried about that.’ I would express my worries, concisely, over and over, until I got the feeling someone was going to do something. Does that make sense?” The patient said it did, and that was all I could do.
I went back to the chaplain office and literally wept over these two patients, remembering the older woman’s incredibly sweet smile.
I was very surprised and relieved later that day to get a voice mail from the utilization manager saying he had gotten my message about such-and-such patient having such-and-such concerns, which he accurately stated, and he said he had passed all of this on to the social worker.
The chaplaincy intensive, besides being wonderful because it was a reunion of my splendid cohort, was the most powerful yet, with mini-courses on power and privilege, and eco chaplaincy. A Native American man led a prayer circle on a very hot, sunny day; we stood outdoors for about an hour at high noon. No one keeled over, though a person or two had to kneel. Then we did an exercise where we broke into small groups, and had to put cards labeled with various events into what we thought (often incorrectly) was the proper chronological order. Several of the events were ghastly, like Native Americans being invited to a celebration and deliberately fed strychnine.
The final evening, we had “cultural sharing”: a talent show, with many dazzling skills on display. There were several very accomplished musicians in the room. My cohort is huge on group projects, so we had prepared extensively for this. We were the final act, which began with one of us going up front to invite the audience to participate in the gentle movement exercises she claimed we had been doing together each evening. She invited the rest of our cohort to join her up front, to help demonstrate.
Her movements became slightly more animated and then all of a sudden Chaka Khan’s “Like Sugar” came over the PA—pre-arranged with the sound guy—and it became a wild dance party; everyone in the audience stood up to dance, too. (The official video for this song is delightful.) I saw Roshi dancing in the back.
But wait, there was more! One of us who happened to have the entire Heart Sutra memorized in Japanese rapped it while one of us beatboxed and the rest of us did our best to impersonate hip hop-style dancers, with intermittent synchronized movements we had rehearsed; we all waved our hands in the same way along with “shiki shiki.”
I believe I can accurately say we brought down the house. Afterward, a bit of icing on the cake, a student in the cohort after mine said I was her favorite dancer. Someone said there was going to be an after-party at one of the dorms. My peer the rap artist and I went over there and danced for an hour with maybe 15 other people.
It was a memorable evening, and I think the burst of joy at end of the talent show was welcome, because it had been a very heavy week, due to the curriculum and there was also a suicide, the spouse of a beloved staff member. Roshi led us in an impromptu memorial service, which was very somber and also comforting, doing this ritual together.
Back at home, the participants of the street retreat I had signed up for had a Zoom meeting to go over logistics. We were reminded that we were not to shower for five days before the retreat began. I asked if that included not brushing our teeth, and one of the leaders said it was up to me. He said he has done it both ways. (I did comply with the requirement not to bathe for five days prior, but decided that, since I’m paying a small fortune to a team of tooth-related professionals to keep them in my head, it didn’t make sense to take a break from dental hygiene.)
At County Hospital, I visited a young woman patient who had attempted suicide by drinking Drano—it is just never a good idea to drink Drano; it will not kill you, but there will not be one single day in the rest of your life when you will be able to forget that you did this—and also an older woman, diagnosed with mental health issues 60 years ago, who was worried about her SRO housing disappearing while she was in the hospital. This I only found out after about 20 minutes of conversation. After I left her room, I went to the nursing station and spoke with a social worker who advised me to call the patient’s case manager, because she did not have a social worker assigned. As I went off to do this, the social worker said, “Good luck.” Uh oh.
I did leave a detailed message for the case manager, whose outgoing message advised that he was actually a utilization manager, which sounded even less promising, and I asked the patient’s nurse to ask her doctor to request a social work consult. This is a new thing. It used to be that a given social worker was responsible for the patients in a certain area, but now a patient evidently only gets a social worker if a doctor requests it. But when does a doctor ever have 20 minutes to sit around chatting with a patient until her fears emerge?
Finally, I went back to the patient’s room and coached her: “If it were me, every time the nurse came in to check on me, I would say, ‘I’m worried about this, and I’m worried about that.’ I would express my worries, concisely, over and over, until I got the feeling someone was going to do something. Does that make sense?” The patient said it did, and that was all I could do.
I went back to the chaplain office and literally wept over these two patients, remembering the older woman’s incredibly sweet smile.
I was very surprised and relieved later that day to get a voice mail from the utilization manager saying he had gotten my message about such-and-such patient having such-and-such concerns, which he accurately stated, and he said he had passed all of this on to the social worker.
Monday, November 11, 2019
New Boss
When I was at school in Santa Fe in March, I submitted a proposal for a thesis based on my final project—learning about palliative care chaplaincy via volunteering at County Hospital—which was immediately approved: “Start writing,” said our congenial thesis mentor. Somehow, four months passed during which I could find only two days suitable for this activity, though good headway was made on both of those days. Finally, in mid-July, I spent a whole day rereading what I had written to date and sifting through the remainder of my raw material. By the time I figured I’d done enough work that I could responsibly return to goofing off, I had 44 pages of 60 drafted.
In October, I temporarily canceled the weekly sabbath and took a few days off from County Hospital so I could try to wrap up this project, which is a description of what I have experienced and learned at County Hospital, a review of academic literature on palliative care and spiritual care, and an examination of what from my Buddhist practice seems to be most helpful in this work, including things I have learned in the chaplaincy program in Santa Fe.
A couple of weeks before our mid-November deadline, my small group of students had its monthly meeting and I mentioned that I had written about various academic papers, but was worried that some of them were kind of old, and wondered if I should go find more, and more recent, papers. The mentor for my small group (different from our thesis mentor) advised just sending in what I had and letting the committee tell me what else is needed. That excellent advice turned six or eight planned work days into six or eight vacation days. Feedback will be coming in December, and then we have several weeks to make revisions.
Back in July (sorry for the zigzagging), I did a sleep study to see if sleep apnea was the cause of needing so much sleep. Evidently not, because I have only mild sleep apnea, and don’t need to use a CPAP machine.
Also in July, the new boss at my paying job started, taking over from the interim director. I was pleased to find that I really liked her (and still like her, nearly four months later). Normally, I automatically dislike anyone whose name is “New Boss,” and have been laid off in the past by at least one such person, so I was relieved. My new boss was formerly a physician, and also taught bioethics at a very prestigious university. She is smart, friendly, organized, warm, and obviously grounded in her own spiritual practices.
At the end of July, I went to Seattle for a lovely and relaxing weekend with my cousin and her family. Lisa, David and I went on a boat tour of Seattle’s locks system, which was fun, and that evening we all had dinner at my cousin’s.
Early in August, I walked over to Publico for a fish and chips burrito with my friend who has been diagnosed with dementia. Each time I said something about directions, he immediately asked a question about it:
“We’re turning right here.”
“We’re turning right?”
“We’re going to go straight after we cross the street.”
“We’re going straight?”
I’m sorry to say that I began to feel annoyed, but after I got home, I realized that my friend genuinely had no idea where we were going and that his questions likely masked an anxiety that is creeping up as he feels less and less oriented. We’d been going to Publico monthly for a few months, but that was not sufficient for him to remember anything about it.
I decided not to invite him to Publico again, and instead to ask if he’d like to have tea at a café near his house where he has been going for decades, and that when it got to the point that he couldn’t find that place, I would invite myself over to have a cup of tea in his living room. The following month, I suggested meeting at the café, and he said that sounded good, and we met there.
The very next month, I made the same offer, and he said, “Where’s that?” This café is on the very street where he lives, so I guess it is time to move on to just inviting myself over to sit in his living room.
In October, I temporarily canceled the weekly sabbath and took a few days off from County Hospital so I could try to wrap up this project, which is a description of what I have experienced and learned at County Hospital, a review of academic literature on palliative care and spiritual care, and an examination of what from my Buddhist practice seems to be most helpful in this work, including things I have learned in the chaplaincy program in Santa Fe.
A couple of weeks before our mid-November deadline, my small group of students had its monthly meeting and I mentioned that I had written about various academic papers, but was worried that some of them were kind of old, and wondered if I should go find more, and more recent, papers. The mentor for my small group (different from our thesis mentor) advised just sending in what I had and letting the committee tell me what else is needed. That excellent advice turned six or eight planned work days into six or eight vacation days. Feedback will be coming in December, and then we have several weeks to make revisions.
Back in July (sorry for the zigzagging), I did a sleep study to see if sleep apnea was the cause of needing so much sleep. Evidently not, because I have only mild sleep apnea, and don’t need to use a CPAP machine.
Also in July, the new boss at my paying job started, taking over from the interim director. I was pleased to find that I really liked her (and still like her, nearly four months later). Normally, I automatically dislike anyone whose name is “New Boss,” and have been laid off in the past by at least one such person, so I was relieved. My new boss was formerly a physician, and also taught bioethics at a very prestigious university. She is smart, friendly, organized, warm, and obviously grounded in her own spiritual practices.
At the end of July, I went to Seattle for a lovely and relaxing weekend with my cousin and her family. Lisa, David and I went on a boat tour of Seattle’s locks system, which was fun, and that evening we all had dinner at my cousin’s.
Early in August, I walked over to Publico for a fish and chips burrito with my friend who has been diagnosed with dementia. Each time I said something about directions, he immediately asked a question about it:
“We’re turning right here.”
“We’re turning right?”
“We’re going to go straight after we cross the street.”
“We’re going straight?”
I’m sorry to say that I began to feel annoyed, but after I got home, I realized that my friend genuinely had no idea where we were going and that his questions likely masked an anxiety that is creeping up as he feels less and less oriented. We’d been going to Publico monthly for a few months, but that was not sufficient for him to remember anything about it.
I decided not to invite him to Publico again, and instead to ask if he’d like to have tea at a café near his house where he has been going for decades, and that when it got to the point that he couldn’t find that place, I would invite myself over to have a cup of tea in his living room. The following month, I suggested meeting at the café, and he said that sounded good, and we met there.
The very next month, I made the same offer, and he said, “Where’s that?” This café is on the very street where he lives, so I guess it is time to move on to just inviting myself over to sit in his living room.
Friday, November 08, 2019
I Didn’t Freak
As I was leaving work early in July—after I was already on my bike and rolling down the street—I got a page requesting a visit for a patient right away, plus one later that evening, after she delivered her baby. I felt a little disgruntled at this order and pre-order of services: two after-hours visits for the same patient? How did she know she needed two? I turned back toward the hospital and went to see the patient. The nurse thanked me for coming, and said, “We’ll be paging the on-call chaplain later on.”
I said, “That will be me, because I’m on call all night. We are available during the night for emergencies.” I was hinting that being paged to offer prayers welcoming a well baby into the world would not be a good enough reason for me to be awoken from a hopefully sound sleep and to have to get dressed and return to the hospital.
The nurse said, “OK. We’ll page the on-call chaplain, then.”
I said, “That will be me, because I’m on call all night.”
After another loop or two of the same exchange, I asked the nurse if I could speak to her privately, and learned that the patient was going to be delivering a pre-term baby who was not expected to live. The two requests now made sense. The patient herself was quite young, and told me she was worried she would “bleed out” and die during delivery. I pulled the nurse aside again to ask if this worry was well founded. It was.
The patient told me that she did not want to see her baby, but did want him baptized if he was born alive. I agreed to baptize the baby if he was born alive, and I offered prayers for the well-being of the patient. I was now eager to be of service to this frightened young woman and told the nurse to be sure to page me later.
That happened after midnight. Back at the hospital, I found the patient in a relaxed mood. She had delivered the baby, already dead, and had asked for him to be brought to her; she had changed her mind about not seeing him. Per her worry that she would die during delivery, I expressed joy at seeing her, and she said, “I didn’t freak, because of your prayer.” That was a hugely gratifying chaplain moment.
I was not worried about seeing the pre-term child, because I have seen many pre-term children. However, when this one was brought back into the room, I realized this was something I had never seen before. The baby was perfectly formed, maybe 12 inches from head to toe, and black-red in color, which I learned is just the color babies are at that pre-birth age. The sight was disturbing. I felt a little weak in the knees and had to sit down for a moment.
I explained the Catholic church’s view of baptism, and offered the ritual as a naming ceremony rather than a sacrament. The baby’s weeping grandmother held the baby. By the time I was asked if I would like to hold the baby, I was happy to do that.
A few days later, I saw Kiss My Aztec at Berkeley Rep, which I had expected to be full of cheesy humor and/or annoyingly educational, but it was really wonderful—very funny, and with a refreshingly abrasive female lead.
When I visited my family in the summer, I shared the exciting news that I had bought a pressure cooker, and was dismayed when skilled questioning elicited the fact that I had bought a “jiggle top.” I know (now) that even a modern jiggle top has more safety features than the jiggle tops of yore, but decided that I would return this embarrassing item and get a second-generation pressure cooker.
One day during my visit I looked through my mother’s cookbooks to see if she had a pressure cooker cookbook, and indeed she did, by a woman who has written several of them. In early July, I went to Novato to see Carol-Joy. We had breakfast at Toast and dinner at a Thai restaurant. In between, we saw The Last Black Man in San Francisco. Carol-Joy mentioned that the community where she lives has begun hosting regular evenings where people can share for 15 or 20 minutes about themselves, a fun way for neighbors to get to know each other better. She mentioned a recent speaker, a well-educated food writer with a PhD. I screamed the name of the author whose book Mom has, and sure enough, it was her. She lives three doors from Carol-Joy! Carol-Joy told her about this coincidence, and she told Carol-Joy, “Next time Bugwalk visits, come on over!”
I said, “That will be me, because I’m on call all night. We are available during the night for emergencies.” I was hinting that being paged to offer prayers welcoming a well baby into the world would not be a good enough reason for me to be awoken from a hopefully sound sleep and to have to get dressed and return to the hospital.
The nurse said, “OK. We’ll page the on-call chaplain, then.”
I said, “That will be me, because I’m on call all night.”
After another loop or two of the same exchange, I asked the nurse if I could speak to her privately, and learned that the patient was going to be delivering a pre-term baby who was not expected to live. The two requests now made sense. The patient herself was quite young, and told me she was worried she would “bleed out” and die during delivery. I pulled the nurse aside again to ask if this worry was well founded. It was.
The patient told me that she did not want to see her baby, but did want him baptized if he was born alive. I agreed to baptize the baby if he was born alive, and I offered prayers for the well-being of the patient. I was now eager to be of service to this frightened young woman and told the nurse to be sure to page me later.
That happened after midnight. Back at the hospital, I found the patient in a relaxed mood. She had delivered the baby, already dead, and had asked for him to be brought to her; she had changed her mind about not seeing him. Per her worry that she would die during delivery, I expressed joy at seeing her, and she said, “I didn’t freak, because of your prayer.” That was a hugely gratifying chaplain moment.
I was not worried about seeing the pre-term child, because I have seen many pre-term children. However, when this one was brought back into the room, I realized this was something I had never seen before. The baby was perfectly formed, maybe 12 inches from head to toe, and black-red in color, which I learned is just the color babies are at that pre-birth age. The sight was disturbing. I felt a little weak in the knees and had to sit down for a moment.
I explained the Catholic church’s view of baptism, and offered the ritual as a naming ceremony rather than a sacrament. The baby’s weeping grandmother held the baby. By the time I was asked if I would like to hold the baby, I was happy to do that.
A few days later, I saw Kiss My Aztec at Berkeley Rep, which I had expected to be full of cheesy humor and/or annoyingly educational, but it was really wonderful—very funny, and with a refreshingly abrasive female lead.
When I visited my family in the summer, I shared the exciting news that I had bought a pressure cooker, and was dismayed when skilled questioning elicited the fact that I had bought a “jiggle top.” I know (now) that even a modern jiggle top has more safety features than the jiggle tops of yore, but decided that I would return this embarrassing item and get a second-generation pressure cooker.
One day during my visit I looked through my mother’s cookbooks to see if she had a pressure cooker cookbook, and indeed she did, by a woman who has written several of them. In early July, I went to Novato to see Carol-Joy. We had breakfast at Toast and dinner at a Thai restaurant. In between, we saw The Last Black Man in San Francisco. Carol-Joy mentioned that the community where she lives has begun hosting regular evenings where people can share for 15 or 20 minutes about themselves, a fun way for neighbors to get to know each other better. She mentioned a recent speaker, a well-educated food writer with a PhD. I screamed the name of the author whose book Mom has, and sure enough, it was her. She lives three doors from Carol-Joy! Carol-Joy told her about this coincidence, and she told Carol-Joy, “Next time Bugwalk visits, come on over!”
Sunday, August 04, 2019
Jack
2/13/2004 – 8/1/2019
My parents’ beloved cat has died.
In Jack’s final year or so, he spent most of his time inside, where he loved to sit for hours on one lap or another. Prior to that, my father says, he had two behaviors that were especially endearing: He would try to accompany Mom and Dad on their daily walks, either trotting along behind them or trotting a few paces ahead and periodically looking back to be sure the whole party was still together. (They could prevent him from following them by putting food out on the back deck; he would rejoin them for the end of the walk.)
Jack also liked to keep Dad company when he was working in the yard, either sitting nearby and watching Dad’s activities, or climbing up on downed tree limbs and using them as horizontal scratching posts.
Dad reports that Jack had a wide range of distinctive vocalizations, and that he and Mom were sure he often was trying to tell them something, but they were never able to learn more than a word or two of cat language.
Dad says that Jack was the most remarkably companionable cat he has ever known. “He was my buddy.”
Monday, July 15, 2019
Walking Like a Walking Person
Late in June at County Hospital, there were only two palliative care patients for me to see, so Clementine sent me to the ICU, where there were at least three horrible situations: a PVA (pedestrian versus automobile) accident that had resulted in brain death; a young parent accidentally caught in gang crossfire, also brain dead; the savage beating of a young woman.
I went into one room to find a doctor comforting the sister of one of the brain-dead patients. The doctor had taken the sister tenderly in her arms and was crooning into her ear. It was a tour de force of compassion, particularly given that the doctor probably has to do this five times a week. The sister was weeping, and then said, resolutely, “I’m going to let you do what you need to do,” by which she meant withdraw life support.
It’s impossible to know, but I wonder how it would have gone if the doctor had stood six feet away with her arms folded, saying, “There’s nothing more we can do.” Maybe then the sister would have yelled the words heard very often around the ICU: “Well, you’re not going to pull the plug! You’re not going to give up on her!”
One morning at the end of my 24-hour on-call shift at my paying job, I spoke to the person taking over. Fred asked, “How are you?” I said, “Oh, fine,” and then I added, “except for my right knee, which is killing me.” I’m not sure why I said that, and I expected Fred to say, “Sorry to hear that,” and that would be the end of the conversation. Instead, he said, “What’s the history of this problem? Where does it hurt?”
He told me that he had once been in an accident that had given him knowledge of such matters, and he hypothesized that my kneecap was being mashed against the joint. He said that when he had a similar problem, an acupuncturist treated the twin indentations under the kneecap known as the “calf’s nose.” This was helpful, but Fred figured there was no reason he needed to pay an expert to do this, so he went and bought his own acupuncture needles, boiled them in water, and stuck them in the indentations under his knee, with good results.
I was going to call my PCP the very next day for a referral to physical therapy, but when I thought about what Fred had said, it explained my symptoms exactly. Accordingly, I began doing quad stretches many times a day, and there was immediate improvement. A couple of days later, I went to have a massage, and my massage person worked on my right quads and suggested putting arnica gel on my knee, along with Tiger Balm and CBD oil, either spaced out or all at once. He said arnica is good for sore muscles, and the other two are good for inflammation, but via different compounds, so it’s worth it to use both. (Actually, all three are good for inflammation.)
Thus I found myself on the phone to the nearest marijuana dispensary, placing my very first order. I looked at their website before I called and couldn’t believe how many products they have. I explained that I wanted CBD oil without THC and the helpful employee pointed out various options and said she’d put my order in a bag for pickup. I’d thought I would have to provide my full name and address, or even show ID, but I only had to give my first name.
The next time I discussed my knee with Fred, he had more suggestions, including that I should go see the chiropractor in my PCP’s office, who Fred thinks is wonderful. I said, “Is he going to mess up my spine?” I had never in my entire life seen a chiropractor, but this one really is wonderful. Friendly and enthusiastic, he explained what was going on, released various frozen spots, and gave me some additional exercises to do at home. He said it was not in fact a case of my kneecap being mashed against the joint, but rather patella tracking disorder, due to a ligament that he said is slightly “lax.” He explained why stretching my quads helped. He said my focus does not need to be on growing cartilage but rather on lessening inflammation. My knee is not entirely better—maybe this is now a chronic situation of occasional achiness and stiffness—but it’s much improved and I can walk pretty much like a person who can walk.
I went into one room to find a doctor comforting the sister of one of the brain-dead patients. The doctor had taken the sister tenderly in her arms and was crooning into her ear. It was a tour de force of compassion, particularly given that the doctor probably has to do this five times a week. The sister was weeping, and then said, resolutely, “I’m going to let you do what you need to do,” by which she meant withdraw life support.
It’s impossible to know, but I wonder how it would have gone if the doctor had stood six feet away with her arms folded, saying, “There’s nothing more we can do.” Maybe then the sister would have yelled the words heard very often around the ICU: “Well, you’re not going to pull the plug! You’re not going to give up on her!”
One morning at the end of my 24-hour on-call shift at my paying job, I spoke to the person taking over. Fred asked, “How are you?” I said, “Oh, fine,” and then I added, “except for my right knee, which is killing me.” I’m not sure why I said that, and I expected Fred to say, “Sorry to hear that,” and that would be the end of the conversation. Instead, he said, “What’s the history of this problem? Where does it hurt?”
He told me that he had once been in an accident that had given him knowledge of such matters, and he hypothesized that my kneecap was being mashed against the joint. He said that when he had a similar problem, an acupuncturist treated the twin indentations under the kneecap known as the “calf’s nose.” This was helpful, but Fred figured there was no reason he needed to pay an expert to do this, so he went and bought his own acupuncture needles, boiled them in water, and stuck them in the indentations under his knee, with good results.
I was going to call my PCP the very next day for a referral to physical therapy, but when I thought about what Fred had said, it explained my symptoms exactly. Accordingly, I began doing quad stretches many times a day, and there was immediate improvement. A couple of days later, I went to have a massage, and my massage person worked on my right quads and suggested putting arnica gel on my knee, along with Tiger Balm and CBD oil, either spaced out or all at once. He said arnica is good for sore muscles, and the other two are good for inflammation, but via different compounds, so it’s worth it to use both. (Actually, all three are good for inflammation.)
Thus I found myself on the phone to the nearest marijuana dispensary, placing my very first order. I looked at their website before I called and couldn’t believe how many products they have. I explained that I wanted CBD oil without THC and the helpful employee pointed out various options and said she’d put my order in a bag for pickup. I’d thought I would have to provide my full name and address, or even show ID, but I only had to give my first name.
The next time I discussed my knee with Fred, he had more suggestions, including that I should go see the chiropractor in my PCP’s office, who Fred thinks is wonderful. I said, “Is he going to mess up my spine?” I had never in my entire life seen a chiropractor, but this one really is wonderful. Friendly and enthusiastic, he explained what was going on, released various frozen spots, and gave me some additional exercises to do at home. He said it was not in fact a case of my kneecap being mashed against the joint, but rather patella tracking disorder, due to a ligament that he said is slightly “lax.” He explained why stretching my quads helped. He said my focus does not need to be on growing cartilage but rather on lessening inflammation. My knee is not entirely better—maybe this is now a chronic situation of occasional achiness and stiffness—but it’s much improved and I can walk pretty much like a person who can walk.
Little Miracle Baby
One day late in June, I did a refresher for the two students I’d most recently trained at work in the use of the electronic charting system. I thought it might make more sense after they’d been using the system for awhile, and I could tell that some pieces of information were making sense to them for the first time. In the afternoon, the staff chaplains had our monthly meeting, and in the evening, Tom and I watched half of the Democratic Presidential candidates debate online. (That is, we watched the whole thing; half of the 24 candidates were debating.)
My right knee at that point had been hurting for about a week, which can happen if I slack off on my exercises, or perhaps for no discernible reason at all. I’ve been in physical therapy for this at least three times over the years. My father reminded me that the original injury likely was one I received at age 23 or 24, when I worked for PG&E, in the general construction department, when I fell off a telephone pole and got a lot of big slivers and also gave my knee a good thump. The co-worker supervising my pole-climbing practice said, after I fell, “Get back up the pole, Bugwalk!” Today I would say, “No, I won’t!”, but back then, I followed instructions, and fell maybe four times in a row. There was a worker’s comp claim, and it was determined that PG&E was at fault, and in fact permanently responsible for my knee, though I suspect if I called them up and asked them to pay for physical therapy, it would be an uphill battle.
Usually my knee feels better as soon as I get back to my stretching and strengthening exercises, and this time was no exception. In fact, my knee felt so much better that one day at work, I walked up the stairs from the second floor to my unit, on the tenth floor, with no ill effects. Accordingly, after lunch, I did the same thing again, and by the time I got to the tenth floor, I was in excruciating pain, which refused to budge, no matter how faithfully I did my exercises. The night Tom and I watched the debates, I could hardly walk. One thing that made it noticeably worse was sitting down; every time I stood up again, there was a sharp uptick in pain.
Once in a while, I get extremely dizzy, which I attribute to stress. Toward the end of Clinical Pastoral Education, I had three or four days in a row of dizziness, and the night Tom and I watched the debate, I suddenly got extremely dizzy just before bedtime. During the night, I sat up for some reason or other, and noticed that I still felt awfully dizzy.
At 2:10 a.m., my work pager went off: a dying baby was in need of baptism. I was genuinely afraid I was going to fall while making my way to work and end up in the ED myself, but somehow I got there, painfully folding my knees to get into a cab and painfully extracting myself again at the hospital. It was the worst possible night for the pager to go off: both sitting and standing were problematic.
The baby in question was one day old and had already coded (stopped breathing) at least once. The doctor had explained to his parents that he would not live. I performed the baptism and then I prayed for the baby, saying, in part, something like, “Of course we pray for a miracle, but if we can’t have the miracle we want, we give thanks for this miracle: that this baby is alive and breathing right this minute.”
Later I was kind of slapping my forehead over that: so often clinicians have to temper a family’s hope for a miracle—why on earth did I introduce the idea myself? Also, it was kind of stupid to give thanks for the breath of a baby when that baby was only breathing due to being on a ventilator, and would die once the ventilator was disconnected. However, the parents seemed comforted.
I spoke with the doctor while we waited for other family members to arrive to hold the baby for the first and last time. The doctor said that during his residency, 80 babies a year died. He studied how to help families with bereavement and learned that it’s important for family members to see the efforts to revive a patient who has coded. He talked about how, even if they know a baby will die, they give the baby a couple of days on life support, to give the parents a chance to start to come to terms with saying goodbye.
I asked him what he does to care for his own emotional well-being and he said that he doesn’t need to do this frequently, but now and then, it’s essential for him to go unburden himself to one of his two or three best friends.
Three days later was my next work day. I was sure the electronic health record (EHR) would say that the baby had died at the age of one or two days, but the baby was still alive. I went to visit, and found the baby doing well, with thrilled family members at his bedside. When I told a nurse this story, she cooed at the baby, “You little miracle baby!”
Update: this baby, who was “cold and blue” upon arrival at NICU went home “in good condition” a couple of days ago.
My right knee at that point had been hurting for about a week, which can happen if I slack off on my exercises, or perhaps for no discernible reason at all. I’ve been in physical therapy for this at least three times over the years. My father reminded me that the original injury likely was one I received at age 23 or 24, when I worked for PG&E, in the general construction department, when I fell off a telephone pole and got a lot of big slivers and also gave my knee a good thump. The co-worker supervising my pole-climbing practice said, after I fell, “Get back up the pole, Bugwalk!” Today I would say, “No, I won’t!”, but back then, I followed instructions, and fell maybe four times in a row. There was a worker’s comp claim, and it was determined that PG&E was at fault, and in fact permanently responsible for my knee, though I suspect if I called them up and asked them to pay for physical therapy, it would be an uphill battle.
Usually my knee feels better as soon as I get back to my stretching and strengthening exercises, and this time was no exception. In fact, my knee felt so much better that one day at work, I walked up the stairs from the second floor to my unit, on the tenth floor, with no ill effects. Accordingly, after lunch, I did the same thing again, and by the time I got to the tenth floor, I was in excruciating pain, which refused to budge, no matter how faithfully I did my exercises. The night Tom and I watched the debates, I could hardly walk. One thing that made it noticeably worse was sitting down; every time I stood up again, there was a sharp uptick in pain.
Once in a while, I get extremely dizzy, which I attribute to stress. Toward the end of Clinical Pastoral Education, I had three or four days in a row of dizziness, and the night Tom and I watched the debate, I suddenly got extremely dizzy just before bedtime. During the night, I sat up for some reason or other, and noticed that I still felt awfully dizzy.
At 2:10 a.m., my work pager went off: a dying baby was in need of baptism. I was genuinely afraid I was going to fall while making my way to work and end up in the ED myself, but somehow I got there, painfully folding my knees to get into a cab and painfully extracting myself again at the hospital. It was the worst possible night for the pager to go off: both sitting and standing were problematic.
The baby in question was one day old and had already coded (stopped breathing) at least once. The doctor had explained to his parents that he would not live. I performed the baptism and then I prayed for the baby, saying, in part, something like, “Of course we pray for a miracle, but if we can’t have the miracle we want, we give thanks for this miracle: that this baby is alive and breathing right this minute.”
Later I was kind of slapping my forehead over that: so often clinicians have to temper a family’s hope for a miracle—why on earth did I introduce the idea myself? Also, it was kind of stupid to give thanks for the breath of a baby when that baby was only breathing due to being on a ventilator, and would die once the ventilator was disconnected. However, the parents seemed comforted.
I spoke with the doctor while we waited for other family members to arrive to hold the baby for the first and last time. The doctor said that during his residency, 80 babies a year died. He studied how to help families with bereavement and learned that it’s important for family members to see the efforts to revive a patient who has coded. He talked about how, even if they know a baby will die, they give the baby a couple of days on life support, to give the parents a chance to start to come to terms with saying goodbye.
I asked him what he does to care for his own emotional well-being and he said that he doesn’t need to do this frequently, but now and then, it’s essential for him to go unburden himself to one of his two or three best friends.
Three days later was my next work day. I was sure the electronic health record (EHR) would say that the baby had died at the age of one or two days, but the baby was still alive. I went to visit, and found the baby doing well, with thrilled family members at his bedside. When I told a nurse this story, she cooed at the baby, “You little miracle baby!”
Update: this baby, who was “cold and blue” upon arrival at NICU went home “in good condition” a couple of days ago.
Cornbread Cake
In mid-June, I went to visit my parents and sister and Amy and Ginny in Michigan. I didn’t get to see my uncle because he was at his cottage up north. It was a lovely visit, doing all the things I enjoy doing there: hanging around with my parents, getting caught up with my sister, watching MSNBC (Rachel!), going to Seva with Amy and Café Zola with Ginny.
It was also nice to be with Jack the cat, upon whom my father dotes, worrying over his appetite, shopping for new kinds of food, cooking things Jack might like. I joked to a friend about my father saying, “I have bought these 95 kinds of food for Jack and have tasted them all. I think this one is the best.” That’s an exaggeration, but not by much. I told my friend that my father is an excellent cat father and that he’s like that with people, too. He goes well out of his way to care for those he has identified as being in his flock: Mom, his own children, other relatives, Jack the cat, and another person I have finally concluded is my half-brother, since we in effect share a parent.
During my visit, my father hosted a birthday celebration for me: pizza delivery and cake suitable for the person who avoids sweets. He has approached this problem different ways over the years. This year, he made a cornbread cake, omitting the cup of sugar the recipe calls for. It had buttermilk in it, and was moist and pleasing. As for frosting, he was thinking he would put cream cheese on it, and was wondering what might be added to the cream cheese. I suggested fruit-only preserves. He used strawberry and the result was wonderful—light and delicately sweet.
When my mother said later in the day that she could go for another piece of cake, my father said there should be plenty in the fridge, as he had had to test his recipe by making it more than once, of course.
Back at home and at work, I greeted a patient on a gurney in the hallway who turned out to have likely C. diff. From now on, I will wait until the patient is situated in his or her room and any instructions about precautions have been posted.
I was asked to visit a dying patient whose mother wanted someone to read the Bible to her. When I got to the unit minutes later, her nurse said, sounding shocked, that the patient had just died. When I went into the room, I saw the patient lying on her bed with her eyes wide open, and I got a tingling sensation all over my body. (A similar thing happened once before with someone who had just died: goosebumps on my shins.) I spoke directly to the patient, since the strong energy in the room made it seem she was still there in some sense.
I also visited a patient who has lived in his car since parting from his spouse two years ago. A nurse in the ED wrote in his chart note that patient was “inappropriately focused on needing to move his car.” Worrying about your car being towed is far from inappropriate if your car is also your home, contains all your possessions and is the thing that prevents you from having to sleep on the sidewalk or in a shelter. I swallowed the urge to send the nurse a message to that effect.
Finally, I visited a patient who had left the hospital a month prior with a newly transplanted organ and high hopes. Bad labwork had put him back in the hospital.
I went for a sleep study late in June, after having noticed that my sleep requirement seemed to have gone way up. Long ago, I was diagnosed with mild sleep apnea after a sleep study, and thought maybe it had worsened, accounting for what seemed like undue weariness—needing as many as 13 hours of sleep some nights, with nine hours a night, which I had considered a minimum, now insufficient.
The technician festooned me with wires and said that if I woke up at least 15 times per hour in my first two hours of observed sleep, I would then be set up with a CPAP machine to try out for the rest of the night. He had me try a few different ways of attaching a CPAP to my face, and said that 75 percent of people being studied end up qualifying to try the CPAP. If a CPAP was indeed needed, then I was looking forward to having one and enjoying more restful sleep, but I was hoping I wouldn’t need one—not to have the diagnosis, hassle or expense.
I caught myself waking suddenly from sleep at least three times soon after retiring, so I was sure the technician would be coming along with the CPAP, but he never did. As for improved sleep, that has already occurred, thanks to my new PCP, who, when she ordered the sleep study, also reminded me about proper sleep hygiene: no screens starting two hours before bedtime, taking magnesium in the evening, not lying awake in bed for more than 15 minutes.
I have been faithfully following these instructions, including that I take 500 mg of magnesium glycinate 90 minutes before bedtime. Maybe five or six times, I did get up and read in my dimly lit room until I felt really drowsy, which more than once took hours, and I felt lousy the next day, but now, as a rule, I fall asleep fairly easily and quickly, and sleep much more soundly than before. Nine hours, alas, really isn’t enough, but if I sleep nine hours on work nights and maybe 11 or 12 hours one night a week, and 10 or 10.5 hours the rest of the week, it seems to balance out.
It was also nice to be with Jack the cat, upon whom my father dotes, worrying over his appetite, shopping for new kinds of food, cooking things Jack might like. I joked to a friend about my father saying, “I have bought these 95 kinds of food for Jack and have tasted them all. I think this one is the best.” That’s an exaggeration, but not by much. I told my friend that my father is an excellent cat father and that he’s like that with people, too. He goes well out of his way to care for those he has identified as being in his flock: Mom, his own children, other relatives, Jack the cat, and another person I have finally concluded is my half-brother, since we in effect share a parent.
During my visit, my father hosted a birthday celebration for me: pizza delivery and cake suitable for the person who avoids sweets. He has approached this problem different ways over the years. This year, he made a cornbread cake, omitting the cup of sugar the recipe calls for. It had buttermilk in it, and was moist and pleasing. As for frosting, he was thinking he would put cream cheese on it, and was wondering what might be added to the cream cheese. I suggested fruit-only preserves. He used strawberry and the result was wonderful—light and delicately sweet.
When my mother said later in the day that she could go for another piece of cake, my father said there should be plenty in the fridge, as he had had to test his recipe by making it more than once, of course.
Back at home and at work, I greeted a patient on a gurney in the hallway who turned out to have likely C. diff. From now on, I will wait until the patient is situated in his or her room and any instructions about precautions have been posted.
I was asked to visit a dying patient whose mother wanted someone to read the Bible to her. When I got to the unit minutes later, her nurse said, sounding shocked, that the patient had just died. When I went into the room, I saw the patient lying on her bed with her eyes wide open, and I got a tingling sensation all over my body. (A similar thing happened once before with someone who had just died: goosebumps on my shins.) I spoke directly to the patient, since the strong energy in the room made it seem she was still there in some sense.
I also visited a patient who has lived in his car since parting from his spouse two years ago. A nurse in the ED wrote in his chart note that patient was “inappropriately focused on needing to move his car.” Worrying about your car being towed is far from inappropriate if your car is also your home, contains all your possessions and is the thing that prevents you from having to sleep on the sidewalk or in a shelter. I swallowed the urge to send the nurse a message to that effect.
Finally, I visited a patient who had left the hospital a month prior with a newly transplanted organ and high hopes. Bad labwork had put him back in the hospital.
I went for a sleep study late in June, after having noticed that my sleep requirement seemed to have gone way up. Long ago, I was diagnosed with mild sleep apnea after a sleep study, and thought maybe it had worsened, accounting for what seemed like undue weariness—needing as many as 13 hours of sleep some nights, with nine hours a night, which I had considered a minimum, now insufficient.
The technician festooned me with wires and said that if I woke up at least 15 times per hour in my first two hours of observed sleep, I would then be set up with a CPAP machine to try out for the rest of the night. He had me try a few different ways of attaching a CPAP to my face, and said that 75 percent of people being studied end up qualifying to try the CPAP. If a CPAP was indeed needed, then I was looking forward to having one and enjoying more restful sleep, but I was hoping I wouldn’t need one—not to have the diagnosis, hassle or expense.
I caught myself waking suddenly from sleep at least three times soon after retiring, so I was sure the technician would be coming along with the CPAP, but he never did. As for improved sleep, that has already occurred, thanks to my new PCP, who, when she ordered the sleep study, also reminded me about proper sleep hygiene: no screens starting two hours before bedtime, taking magnesium in the evening, not lying awake in bed for more than 15 minutes.
I have been faithfully following these instructions, including that I take 500 mg of magnesium glycinate 90 minutes before bedtime. Maybe five or six times, I did get up and read in my dimly lit room until I felt really drowsy, which more than once took hours, and I felt lousy the next day, but now, as a rule, I fall asleep fairly easily and quickly, and sleep much more soundly than before. Nine hours, alas, really isn’t enough, but if I sleep nine hours on work nights and maybe 11 or 12 hours one night a week, and 10 or 10.5 hours the rest of the week, it seems to balance out.
Sufficient Unto the Day Is the Evil Thereof
It ended up taking a week to dry out my apartment. I was left with (and still have at this moment) the various holes in my various walls and removed kitchen ceiling as previously described.
Like, here's my little hallway.
Here’s Hammett with the final dehumidifier.
And Hammett tenderly licking one of the fans.
Early in June, I got an email newsletter from one of the leaders of the street retreat I’ll be going on. He was reflecting on another retreat just concluded, and about how much help the retreatants had gotten from actual homeless people:
Street generosity comes in many forms. A woman in her 70s and who has been sleeping on park benches for decades, like a Bodhisattva walking through the hell realms with joy, quietly lured rats away from our sleeping area with scraps of food she had saved in her handbag.
Rats near the sleeping area?!?
Close on the heels of that alarming transmission, my mentor group met, including a person who had been on that retreat. She joined a few minutes late because she had spent the whole day in the ER dealing with a painful symptom that arose on retreat and lingered afterward. The retreat “did me in,” she confessed.
She also said that she spent too much time preparing, since you don’t need much: the clothes you’re wearing, a plastic bag in case it rains, one dollar. She said she wondered afterward why she had thought there was so much to do beforehand. She also said there was no overlap between what she worried about beforehand and what actually ended up being difficult (i.e., what she should have been worrying about). Encouragingly, she said everyone’s mala was different, so there is no need to fret about making the right kind.
Early in June, I went to the annual palliative care retreat in Marin, a fantastic day of seeing colleagues, meeting new people, eating, making art, singing.
By drawing myself a picture as I walked around my floor of the hospital at my paying job, I finally solved the mystery of why I have to turn 11 corners to go all the way around something that is basically a square.
Several weeks ago there was a half-time job for a palliative care chaplain at the Truly Wonderful Medical Center, where I did my Clinical Pastoral Education. That obviously was my job. I applied for it, and over the next couple of weeks, mulled over the pros and cons of taking that job versus staying where I am. Then I realized I had not been invited for an interview! This was a lesson in acceptance and humility. (I heard soon after that that a CPE peer of mine whose demographics are very different from mine had been invited for an interview. I’m pleased to say that, after about ten seconds, I was able to sincerely wish that he will get the job and that it will be a big success all around.) It was also simplifying: I guess I don’t have to try to decide whether to leave the Very Fantastic Medical Center or not.
And whether or not I have the title of “palliative care chaplain,” I am one. When I walked into the room of one patient, he said, “I was going to call for you! I would like to discuss what happens next, like my burial and so forth, and also what the spiritual meaning of this is.”
I said, “Would you like to discuss those things right now, with your family present, or another time?”
He said, “Right now. Please sit down.”
Once upon a time, I might have been flustered by that. I might not have known what to say or how to approach such a conversation. I might even—worst of all—have tried to install hope in the patient: “Maybe you’re not going to die!”
Another reason that conversation was great, from my point of view, was that the patient’s sister, who is very devout, mentioned a part of the Bible I actually recognized. “Matthew, chapter six,” I said, and we nodded and smiled at each other. That was extremely satisfying. That’s literally the only chapter of the Bible I would be able to recognize. It’s the one that, in the King James version, ends with my favorite line in the entire Bible: “Sufficient unto the day is the evil thereof.” I must have heard that in church when I was a small child and never forgotten it, because I have always known it. It means not to worry about yesterday or tomorrow. The Lord’s Prayer can also be found in that chapter, and the thing about the lilies of the field.
Like, here's my little hallway.
Here’s Hammett with the final dehumidifier.
And Hammett tenderly licking one of the fans.
Early in June, I got an email newsletter from one of the leaders of the street retreat I’ll be going on. He was reflecting on another retreat just concluded, and about how much help the retreatants had gotten from actual homeless people:
Street generosity comes in many forms. A woman in her 70s and who has been sleeping on park benches for decades, like a Bodhisattva walking through the hell realms with joy, quietly lured rats away from our sleeping area with scraps of food she had saved in her handbag.
Rats near the sleeping area?!?
Close on the heels of that alarming transmission, my mentor group met, including a person who had been on that retreat. She joined a few minutes late because she had spent the whole day in the ER dealing with a painful symptom that arose on retreat and lingered afterward. The retreat “did me in,” she confessed.
She also said that she spent too much time preparing, since you don’t need much: the clothes you’re wearing, a plastic bag in case it rains, one dollar. She said she wondered afterward why she had thought there was so much to do beforehand. She also said there was no overlap between what she worried about beforehand and what actually ended up being difficult (i.e., what she should have been worrying about). Encouragingly, she said everyone’s mala was different, so there is no need to fret about making the right kind.
Early in June, I went to the annual palliative care retreat in Marin, a fantastic day of seeing colleagues, meeting new people, eating, making art, singing.
By drawing myself a picture as I walked around my floor of the hospital at my paying job, I finally solved the mystery of why I have to turn 11 corners to go all the way around something that is basically a square.
Several weeks ago there was a half-time job for a palliative care chaplain at the Truly Wonderful Medical Center, where I did my Clinical Pastoral Education. That obviously was my job. I applied for it, and over the next couple of weeks, mulled over the pros and cons of taking that job versus staying where I am. Then I realized I had not been invited for an interview! This was a lesson in acceptance and humility. (I heard soon after that that a CPE peer of mine whose demographics are very different from mine had been invited for an interview. I’m pleased to say that, after about ten seconds, I was able to sincerely wish that he will get the job and that it will be a big success all around.) It was also simplifying: I guess I don’t have to try to decide whether to leave the Very Fantastic Medical Center or not.
And whether or not I have the title of “palliative care chaplain,” I am one. When I walked into the room of one patient, he said, “I was going to call for you! I would like to discuss what happens next, like my burial and so forth, and also what the spiritual meaning of this is.”
I said, “Would you like to discuss those things right now, with your family present, or another time?”
He said, “Right now. Please sit down.”
Once upon a time, I might have been flustered by that. I might not have known what to say or how to approach such a conversation. I might even—worst of all—have tried to install hope in the patient: “Maybe you’re not going to die!”
Another reason that conversation was great, from my point of view, was that the patient’s sister, who is very devout, mentioned a part of the Bible I actually recognized. “Matthew, chapter six,” I said, and we nodded and smiled at each other. That was extremely satisfying. That’s literally the only chapter of the Bible I would be able to recognize. It’s the one that, in the King James version, ends with my favorite line in the entire Bible: “Sufficient unto the day is the evil thereof.” I must have heard that in church when I was a small child and never forgotten it, because I have always known it. It means not to worry about yesterday or tomorrow. The Lord’s Prayer can also be found in that chapter, and the thing about the lilies of the field.
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