Oftentimes in my job as a chaplain I get called to do what is called a "family consultation." Typically this experience is when the medical staff needs to discuss end-of-life goals and/or advanced directive decisions with the family and think it would be beneficial for a chaplain to be present to provide comfort and support. The family is often asked a myriad of difficult, complex decisions about what kind of care to provide for their loved one. Do we intubate? Do we perform a tracheotomy? Would you like comfort-care to be given? Do you want us to resuscitate your loved one if they experience cardiac arrest?
The family is often at a loss as how to respond; either they don't fully understand the questions or what implications the decision will have, or they struggle emotionally with having that power and being asked to decide about what is next for their loved one. In those times, my presence as a chaplain is important because we offer compassionate support. However, we are often viewed by the families as a source of spiritual authority. "Oh he's the chaplain; he'll know what we should do." A visit that was about my offering compassionate presence suddenly becomes an encounter where I am asked for advice. "Chaplain, what should we do? What would you do?"
As someone at odds with himself spiritually, having this position of spiritual authority foisted upon me makes me feel deeply uncomfortable and anxious. If I am asked what I would do or what I would want, then I will offer an honest opinion of what my wishes would be. However, in many of these visits it becomes a strange, uncomfortable moment of spiritual advice. "What should we do? What would God want us to do?" Today, I was called to one such visit and I fell into this all-too-familiar yet all-the-same uncomfortable moment. My insides churned a ulcerous batch of stomach acids as I was asked what "we should do as Christians." Unfortunately, many religious people view the discontinuation of care as "giving up." If you are not doing everything you can to preserve your loved one's life, then you are giving up on them and effectively killing them. Omission of action is viewed as something sinful in itself.
It is a cringe-worthy moment when you are conscripted by a family to be a source of spiritual authority and power. I find it alienating. Why are you asking me? I don't know...
For those of my friends who are in the clergy, aspire to be, or conversely if you serve in the medical field, be mindful of the power that is ascribed to you simply on the basis of your role as pastor, minister, chaplain, doctor, etc. Our roles are not our identities, but they do inform them. Be conscious of that when you enter the room and are put into areas of difficult ethical decision-making. All we can do is be compassionate and mindful, absorb the shock and anger, and reflect statements previously made that reinforce what they've previously indicated as their desire for their loved one.
I'm sure that some of you have been on the other end of this encounter: you were the family member who had to make a difficult decision regarding care. Drawing from that personal experience is a boon in your service to others and will help you connect to people at the human level. For those who haven't experienced this yet, just remembered that you are invoking the divine presence so avoid the easy, cloying temptation to play God or even God's representative. You cannot know God's will, but you can pray, offer compassionate words, and reflect God's mercy.
Anyway, crazy times ahead on this shift. That is all.
Wednesday, November 26, 2014
Sunday, October 12, 2014
Homesick
"For mine is a rugged land but good for raising sons- and I myself, I know no sweeter sight on earth than a man’s own native country…." The Odyssey
Since moving to NYC, I have struggled continually with homesickness. This feeling has been a surprising one, as I do not normally get homesick or feel overcome with waves of nostalgia. After attending my friend's wedding, it felt like I was hit square in the face with a sledgehammer. I was filled with a longing to return home, to be with the people I love and care about. However, as I reflect often on this sensation, I cannot help but wonder if I am missing home or missing the past. I am surely missing my friends and family, but is it simply that I miss them or that I miss the way our relationships used to be?
I often struggle with a desire to be certain: certainty about my sense of self, certain about where I am in life, certain about spirituality, etc. I often crave stability, to know the ground underneath my feet. I miss the easy familiarity of my absent friends, my absent home, my seemingly absent life. New lands are often the loneliest to explore, especially without structures naturally conducive to making friends like school. I find myself challenged often by that craving of comfort and security, which is why I miss home so much.
I have recently been reading Paul Tillich's "Courage to Be." It is a philosophical gem. Tillich argues that the courage to be is the willingness to affirm oneself in the face of nonbeing- the anxiety of nonexistence. This anxiety manifests itself in three ways: anxiety of fate/death, anxiety of emptiness/meaninglessness, and the anxiety of guilt/condemnation. Anxiety is different from fear in that fear has an object. You are afraid of death, darkness, killer clowns, etc. Anxiety is more pervasive and encompassing. You do not have anxiety of experiencing death, but you have anxiety about after death, the idea of no longer being. That is the central tension of existence: all existence is becoming, but it is also finite and destined to end. All things must end. As conscious beings, we struggle with the anxiety of nonbeing, of this inevitable end. Life is about constant change, and the constant challenge to perennially accept this change.
If you know me, or can at least inference from what is written above, then you know that this challenge is not easily met. I often desire a static universe-constantly fixed- over the the one that began with a bang and will end in a whimper. I think we all feel the desire to return to our rugged lands, a place settled sweetly in the countries of our past. However, if there is one thing I am learning, it's that one way to combat the anxiety of fate and meaninglessness is to hold gratitude for both the past and the present. A friend recently posted on Facebook the other day "Share life with others when you are able. You never know when you will find yourself alone and need those memories to help you through." I have found this often to be the case. When I return each day to the lonely islands of my heart, far from the rugged lands of my youth and man-childishness, I remind myself of these good times so as to assuage my anxiety and combat feelings of regrets over past decisions, mistakes, errors, and so on...
My hope is that by remembering to be grateful for those whom I love, to be grateful for the air in my lungs now and the dexterous motor functions of my hands that allow me to type this message, I will learn to be comfortable with discomfort and have peace with the challenge of constantly accepting change in a world that is always changing, a me that is always changing, and persons all over whom are always changing. I hope you can encourage me in this as well as I press forward.
Since moving to NYC, I have struggled continually with homesickness. This feeling has been a surprising one, as I do not normally get homesick or feel overcome with waves of nostalgia. After attending my friend's wedding, it felt like I was hit square in the face with a sledgehammer. I was filled with a longing to return home, to be with the people I love and care about. However, as I reflect often on this sensation, I cannot help but wonder if I am missing home or missing the past. I am surely missing my friends and family, but is it simply that I miss them or that I miss the way our relationships used to be?
I often struggle with a desire to be certain: certainty about my sense of self, certain about where I am in life, certain about spirituality, etc. I often crave stability, to know the ground underneath my feet. I miss the easy familiarity of my absent friends, my absent home, my seemingly absent life. New lands are often the loneliest to explore, especially without structures naturally conducive to making friends like school. I find myself challenged often by that craving of comfort and security, which is why I miss home so much.
I have recently been reading Paul Tillich's "Courage to Be." It is a philosophical gem. Tillich argues that the courage to be is the willingness to affirm oneself in the face of nonbeing- the anxiety of nonexistence. This anxiety manifests itself in three ways: anxiety of fate/death, anxiety of emptiness/meaninglessness, and the anxiety of guilt/condemnation. Anxiety is different from fear in that fear has an object. You are afraid of death, darkness, killer clowns, etc. Anxiety is more pervasive and encompassing. You do not have anxiety of experiencing death, but you have anxiety about after death, the idea of no longer being. That is the central tension of existence: all existence is becoming, but it is also finite and destined to end. All things must end. As conscious beings, we struggle with the anxiety of nonbeing, of this inevitable end. Life is about constant change, and the constant challenge to perennially accept this change.
If you know me, or can at least inference from what is written above, then you know that this challenge is not easily met. I often desire a static universe-constantly fixed- over the the one that began with a bang and will end in a whimper. I think we all feel the desire to return to our rugged lands, a place settled sweetly in the countries of our past. However, if there is one thing I am learning, it's that one way to combat the anxiety of fate and meaninglessness is to hold gratitude for both the past and the present. A friend recently posted on Facebook the other day "Share life with others when you are able. You never know when you will find yourself alone and need those memories to help you through." I have found this often to be the case. When I return each day to the lonely islands of my heart, far from the rugged lands of my youth and man-childishness, I remind myself of these good times so as to assuage my anxiety and combat feelings of regrets over past decisions, mistakes, errors, and so on...
My hope is that by remembering to be grateful for those whom I love, to be grateful for the air in my lungs now and the dexterous motor functions of my hands that allow me to type this message, I will learn to be comfortable with discomfort and have peace with the challenge of constantly accepting change in a world that is always changing, a me that is always changing, and persons all over whom are always changing. I hope you can encourage me in this as well as I press forward.
Thursday, September 25, 2014
Complementary
I had the great honor of taking part in a wedding this past weekend. Every facet of the event was absolutely beautiful. I think this was so not only because of their impeccable taste (despite their obsession with lavender honey as a flavor), but because they are a beautiful couple. At the wedding mass, the priest highlighted a common theme in their relationship as a sign of their matrimonial harmony: they complement each other. They cover down on each other's desires, shortcomings, needs, wants, peccadilloes, etc.
As I reflected on their special day over this week, a number of thoughts occurred to me. Fortunately for all of you, I won't be sharing all of them here. One thought that has been turning over in my head is this idea of finding someone complementary. It is often said that opposites attract, but what if it's more like the cogs clicking in a wheel, the way a key slides into the groove of a lock, the pieces of a puzzle fit together? I've never been one for kismet, destiny, fate, or whatever. I don't think I believe in soulmates or anything of that nature, but I was challenged to reconsider that this weekend. Do we meet people in our lives for whom our souls long for? Is that possible? If so, I would like to think that's because something is missing.
I don't mean to say that you're an incomplete person if you don't meet someone or fall in love. That would be absurd. If you're looking for someone to "complete" you then I think you probably need to finish completing yourself. That being said, perhaps we look for someone who complements us because we cannot cover down on every matter of perception, being, and understanding in this universe. We need an alternative heart, an alternative perspective on both our own lives and on the nature of existence. We need a counter-testimony to how we witness the bend of life's river.
You can share values, goals, interests, passion, and/or physical chemistry, but perhaps our soul longs for a complement because we long to experience our lives through the perspective of another. Not only that, but we long to do it from an intimate perspective, one we understand even if we cannot understand ourselves. What better to seal this complement than through a bond of trust and love? As my friends go forth into this world hands clasping tightly to one another, I hope that they continue to not only be one, but to be two in one. I hope that they share a counter-testimony to one another, an alternative perspective to the wonders of this life. And I hope that I find the same, and you all as well who are also looking and waiting keenly for their complement...
As I reflected on their special day over this week, a number of thoughts occurred to me. Fortunately for all of you, I won't be sharing all of them here. One thought that has been turning over in my head is this idea of finding someone complementary. It is often said that opposites attract, but what if it's more like the cogs clicking in a wheel, the way a key slides into the groove of a lock, the pieces of a puzzle fit together? I've never been one for kismet, destiny, fate, or whatever. I don't think I believe in soulmates or anything of that nature, but I was challenged to reconsider that this weekend. Do we meet people in our lives for whom our souls long for? Is that possible? If so, I would like to think that's because something is missing.
I don't mean to say that you're an incomplete person if you don't meet someone or fall in love. That would be absurd. If you're looking for someone to "complete" you then I think you probably need to finish completing yourself. That being said, perhaps we look for someone who complements us because we cannot cover down on every matter of perception, being, and understanding in this universe. We need an alternative heart, an alternative perspective on both our own lives and on the nature of existence. We need a counter-testimony to how we witness the bend of life's river.
You can share values, goals, interests, passion, and/or physical chemistry, but perhaps our soul longs for a complement because we long to experience our lives through the perspective of another. Not only that, but we long to do it from an intimate perspective, one we understand even if we cannot understand ourselves. What better to seal this complement than through a bond of trust and love? As my friends go forth into this world hands clasping tightly to one another, I hope that they continue to not only be one, but to be two in one. I hope that they share a counter-testimony to one another, an alternative perspective to the wonders of this life. And I hope that I find the same, and you all as well who are also looking and waiting keenly for their complement...
Friday, September 12, 2014
No Words to Say
A new blog for new times! So I started a chaplain residency program at a hospital in Brooklyn and have taken some time to settle in. Not only is it a new job for me, but a new city as well. I have been waiting to start a new blog since I began, but I was so busy with other things that I haven't had the time. Now that I have a free moment, I thought I would share some things from my first duty shift.
On my first duty shift, I received the page of all pages. I'm sure that many in the profession would call it the worst page you could get. In the middle of the night, I cancelled the blaring notification ringing from the duty pager and called the extension. "Hello Chaplain, this is Labor and Delivery. We have a fetal demise." There is an instant sinking feeling that comes with those words "fetal demise." I think the word that best describes the sensation would be dread, but that may be too melodramatic of a term. Fetal demise; turn the phrase over in your head. At our hospital, it is the phrase we use to describe babies that are stillborn. In my opinion, it is a cold, clinical term meant to create distance between the user and the reality of the situation. You find that a lot here; "expiration" instead of death, "procedure" instead of surgery. Sometimes they are appropriate as they minimize the risk of alarming the patient and increasing their stress levels. However, there is a sanitary notion behind it, as though it sterilizes the perception of an uncomfortable reality.
Upon hearing the page, I immediately went to Labor and Delivery, which was a mistake. My personal anxiety and discomfort with such cases in addition to a general unfamiliarity with this hospital's patient-care protocols coupled for disastrous results. Here, the chaplains are the ones responsible for filing the paperwork regarding burial arrangements in cases of fetal demise. We guide the family through the process of deciding whether they want a private burial, a public burial, hospital disposal, etc. We then file the paperwork as well. My first call was a complete fiasco. I botched the paperwork due to only having a cursory knowledge of the system, then one of my supervisors had to return to the patient and bring up a loss that was still fresh in the patient's mind. I think that despite not being terribly busy, that was one of the most stressful duty shifts of my life.
When I got to the room, I had no words to say. Language is so crucial in providing care to patients. As noted above, it can provide illumination or it can insulate us from discomfort. The words we say and the actions we perform matter to the patient. With that in mind, what language is appropriate in this instance? The loss of a child is perhaps the most egregious one a person can suffer. It seems to fly in the face of the natural order of the world. Parents are not supposed to bury their child; their child is supposed to bury them. I don't think I've ever encountered a situation where I felt words couldn't be more insufficient. As I reflected later on, meditating both on my mistakes and on the general nature of the situation, the thought occurred that words are often utterly insufficient. Words in such encounters are rarely remembered unless they cause harm. What is remembered is positive presence. I carried my fear into that room, and I think it showed. This limited my ability to project a positive presence, which in part led to my later mistakes. What I often forget is to have grace, not just for others but for myself as well. By remembering to have grace, we also remember that we are insufficient. Our language, our actions, our intentions are insufficient in the light of truth. By remembering that, we allow ourselves not to be overcome by fear, but instead find courage and thereby increase our ability to provide compassionate presence.
Therefore, I hope that you remember to find grace for yourself this day so that you may also find the courage to live decently in this world. Remember that sometimes there are no words to say, just a compassionate presence.
On my first duty shift, I received the page of all pages. I'm sure that many in the profession would call it the worst page you could get. In the middle of the night, I cancelled the blaring notification ringing from the duty pager and called the extension. "Hello Chaplain, this is Labor and Delivery. We have a fetal demise." There is an instant sinking feeling that comes with those words "fetal demise." I think the word that best describes the sensation would be dread, but that may be too melodramatic of a term. Fetal demise; turn the phrase over in your head. At our hospital, it is the phrase we use to describe babies that are stillborn. In my opinion, it is a cold, clinical term meant to create distance between the user and the reality of the situation. You find that a lot here; "expiration" instead of death, "procedure" instead of surgery. Sometimes they are appropriate as they minimize the risk of alarming the patient and increasing their stress levels. However, there is a sanitary notion behind it, as though it sterilizes the perception of an uncomfortable reality.
Upon hearing the page, I immediately went to Labor and Delivery, which was a mistake. My personal anxiety and discomfort with such cases in addition to a general unfamiliarity with this hospital's patient-care protocols coupled for disastrous results. Here, the chaplains are the ones responsible for filing the paperwork regarding burial arrangements in cases of fetal demise. We guide the family through the process of deciding whether they want a private burial, a public burial, hospital disposal, etc. We then file the paperwork as well. My first call was a complete fiasco. I botched the paperwork due to only having a cursory knowledge of the system, then one of my supervisors had to return to the patient and bring up a loss that was still fresh in the patient's mind. I think that despite not being terribly busy, that was one of the most stressful duty shifts of my life.
When I got to the room, I had no words to say. Language is so crucial in providing care to patients. As noted above, it can provide illumination or it can insulate us from discomfort. The words we say and the actions we perform matter to the patient. With that in mind, what language is appropriate in this instance? The loss of a child is perhaps the most egregious one a person can suffer. It seems to fly in the face of the natural order of the world. Parents are not supposed to bury their child; their child is supposed to bury them. I don't think I've ever encountered a situation where I felt words couldn't be more insufficient. As I reflected later on, meditating both on my mistakes and on the general nature of the situation, the thought occurred that words are often utterly insufficient. Words in such encounters are rarely remembered unless they cause harm. What is remembered is positive presence. I carried my fear into that room, and I think it showed. This limited my ability to project a positive presence, which in part led to my later mistakes. What I often forget is to have grace, not just for others but for myself as well. By remembering to have grace, we also remember that we are insufficient. Our language, our actions, our intentions are insufficient in the light of truth. By remembering that, we allow ourselves not to be overcome by fear, but instead find courage and thereby increase our ability to provide compassionate presence.
Therefore, I hope that you remember to find grace for yourself this day so that you may also find the courage to live decently in this world. Remember that sometimes there are no words to say, just a compassionate presence.
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