I want to float, not dive

7239cf715db990fa2babb5c00ec962e1.b2c7dcabcd02d6b1a207e0dffe7b5242.jpgNot quite ready for the day.

I have my tea and mouse is keeping me company.  I kinda want to be all on top of it and hit the ground running, but today I just want to ease into it.  Like when you are going swimming in the early morning and you slip slowly into the still waters, trying not to make a ripple.  You are one temperature and the water another and the change from one state to another can be a welcome shock, but not first thing in the morning.  Late in the afternoon, in the heat of the summer, you welcome it, along with the other swimmers. But early in the morning, you move slowly into the depths.

And today I have patients to see and meetings to attend and driving to do between one place and another,  all within certain times, all seemingly crowded together. There are notes too. Notes to say what I did and how I met the goals already written.  “Patient will transition through the end of life process with peace and serenity.”  ” Patient received pastoral presence and silent prayer.”  Today is like most days, but today I want to slip into it slowly and purposefully, not reactively. I want to slip into the sacred and let it support me as I go,  I want to float, not dive.

 

Exhaling into death

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It occurred to me yesterday morning that I have been fearful of the role of full-time hospice chaplaincy for two main reasons.

The first is that I thought I might get burnt out ministering mostly to folks who are actively dying and their families, that the nature of unavoidable death without the affirmation of life might not be there. That without the balance, I would eventually tip over and absorb too much of the grief and not enough of the life.

If you are on my hospice list then you are most likely dying.  Some folks get better with hospice care and no longer qualify for it, but mostly, folks die.

Here is the other point. Frankly I didn’t have confidence that my spunky little self was cut out for the solemnness of the gig.  I met a ton of ministers and others who felt called to hospice while I was in seminary and CPE, and they tended to be very peaceful, calming, and reverent.  I am mostly irreverent and have a quirky sense of humor.  I am also naturally charismatic and sometimes find it difficult to tamper that gift down. I don’t mean to say that I am all that and a bag of chips, but I have that funny personality that is highly interested in others, connects easily to strangers and for the most part, is authentic.  What you see is what you get.

I didn’t think that my calling was to hospice.  I figured it was to helping people with addictions, and homelessness, and hospital type stuff.  I love hospital chaplaincy and did well in training with the cases where it was messy.  Messy with bells and whistles going off.  Messy with theological issues.  Messy with emotional responses.

This is what I discovered.

In the hospital, death is there and is often sudden.  Unexpected.  As chaplain you need to have your spiritual tanks filled because you respond to some deep stuff. People are plugged into machines, the heart is monitored, beeps and alarms go off. People rush in and rush out trying to save the patient. The main purpose of the medical team is curative,  everybody jumps in at the code to save the life and the chaplain holds the sacred space.

A 17-year-old wraps their car around a tree and the family comes to the bedside, faced with issues of taking him off life support or organ donation.  The baby’s heart isn’t working and he has to be medevaced to Children’s hospital.  You are called to take someone to see their loved one in the morgue after death from an overdose and you lead them to a cold room, generally far away from the rest of the hospital, and generally underground.   Shock is the response to sudden and unexpected death.  It is surreal at times.

Death comes unexpectedly and on the emotional intensity scale of 1-10, 10 being full on, you give spiritual care and support, holding the sacred space for the family and the patients.  It is a fast inhale, like when you are being startled and you quickly hold your breath for dear life, hoping death will not take it.   And sometimes you go from emergency to emergency and you have to be there, one patient emergency after another.  All of you, present and with The Divine because you are the symbol of the sacred in the moment.  It is exhausting, but I was good it.  I can hold my breath for a very long time.

In hospice, it is like a long and cleaning exhale.  Death is not unexpected, it is unavoidable, for the most part.  There are folks who struggle with accepting death, their own or the death their loved one.  Hospice is provided only if there is a medical indication that curative medicine will no longer help.  To be on hospice you have to have a terminal diagnosis with death imminent, generally less than 6 months.   Hospice is when death has knocked the door has opened.

And with the exhale, it seems that the tension of intensity , the holding your breath against sudden illness and unexpected death,  is released. The emotions are still there, but not as tense.  The grieving process has begun.  The emotion has moved from the shock of not accepting that death has come,  to sometimes welcoming the relief from suffering that death sometimes brings.

In this place, with patients and their families, my true self can be present without filtering.  Not to say that I was fake in my other work.  I was authentic, but I feared that I could not be authentic in hospice full-time.

Well I seem to be wrong. This calling fits like a glove.

I can hold the space sometimes  and relieve the tension by bringing life back into the room of the dying.  “Tell me a little bit about your loved one” I say.   I can get the story telling started because I am genuinely interested in the life of the patient.  Family members get that. They can feel it  and respond by sharing the life that their loved one lived.  Granted I am still new at this type of gig. But if I can be my true self right from the get go, then I am pretty optimistic about it.  All things will sugar out with time. I am hopeful this calling will get sweeter.

 

 

Bennies

Bennies.

Not what you are thinking though.  I am thinking healthcare and insurance benefits.  I just spent the past couple of hours signing up for them and I am the lucky one.  

Lucky because my new employer offers a whole host of benefits which include medical, dental, vision, long and short-term disability. Then there is also insurance for credit fraud, benefit plans for lawyers, pet insurance and then the pre-tax, directly from your paycheck savings account.   There were 24 different areas to pick from.  I made my picks and I will be paying 3.8% of my gross pay for insurance per month with a potential of 1.43%  of the gross in costs for healthcare.  That is about 5% of my gross.  And that is affordable access to healthcare.

This new policy  will kick into effect 90 days from my hire date and I can breathe a bit easier.  I say that with the silly notion that large employers are keeping watch at the current health care payment fluster cluck.   I will be sorry to say goodby to the current coverage I have, but I am the lucky one.

I have been covered for the last year and a half on Mass Health, the Bay States version of the Affordable Care Act,  also known as Obama Care. In graduate school I was covered under a student health plan that basically covered very little.  When I graduated I was able to get onto the public coverage and because I was still training for chaplaincy, I didn’t have an income. As in I didn’t have a job.   The coverage was basically free to me and every medical expense was covered and 99% of my medications.   I could pick up my thyroid medication and instead of a 20.00 co-pay, I paid out 1.75.  One dollar and seventy-five cents.  Less than a cup of tea.  Even my Epi-Pen was free because of Mass health and the CVS pharmacist found coupons to make up the difference.

I totaled up my health care costs based on billing submitted by my providers and it came out to about 78 thousand, of which only a small fraction was paid out to the hospitals and doctors, but under contract, I was not billed.  I benefited from Mass Health profoundly.

Health maintenance is critical for me to be engaged in the larger community.   In order for me to work full-time, I have to keep self-care in the foreground.   That means that I have to put the needs of my body, mind and spirit before the needs of others.  I can not sacrifice me to serve others, I must serve myself first so that I can be there for others.   If I don’t take care of the vessel, I can not sail.

I am not unique on this. We all need to have good, not adequate, but good health coverage. By we, I mean all of us.  Good prenatal care, infant child wellness, preventative care, emergency care and end of life care, including hospice.   If we see the Dr. before the issue gets bad, or get our teeth cleaned on a regular basis or take the medications we should, then can you imagine what good would come from it.  More of us could do the work we are called to do.  More of us would take care of things before those little things become disabling.

So the issue then becomes: are we entitled to good health care?

If we look at the greater good, what is good for all of us in a society, then yes.  People do better when choices for care are available and affordable.   Society does better when the populace is healthy and can engage in the workforce.  Businesses run better when their employees are healthy. Our economy can grow when the population is healthy. Our country can focus on other issues if this one can be solved.

Looking at the costs billed from providers; hospitals, Dr.s and procedures like labs, I was shocked at the difference between the charge and what was paid out.  A blood test with a full metabolic panel was over 568.00 while the provider was paid 40.00.  It is like going to Savers and seeing a cashmere 4 ply designer sweater priced at 5.99 when you know that it retailed at over 400.00 and it probably cost 50.00 to grow, harvest, spin, dye, knit, ship, and stock at the store.

So here is the long-winded idea.  I got the sweet deal in insurance last year and now I continue with a sweet deal though my new job.   But I shouldn’t be the only one.  We should all have the ability to access affordable health care.  For the benefit of the individual and society as a whole.

 

 

I am not a preacher

imageBlizzard

Well, not really. At least not yet, there is very little wind. Certainly not huge gusts that make the trees creak.  There is heavy wet snow  and walking home tonight was lovely in a surreal kind of way.    The ambient light created from street lights, and glow from the nearby highway, gives everything a pink and orange edge.  The sun set hours ago and I swear it is so light out I took the photo without a flash.  I miss the dark deep of a North Country snow.  The stillness I crave in the storm is dispersed with sounds of cars unaccustomed to driving on greasy roads.  Just say’n.

Yet my joints don’t know the difference. My hips hurt and I am a bit gimpy. Which I expect with a good-sized Nor’easter.  Yesterday was worse than today and no amount of hot tubs, gentle stretches or over the counter meds help.  I didn’t leave the house and spent most of the day up in my studio working on a pattern draft and playing with Mouse.

Today I mustered and got myself to Church and was treated to validation of my calling.

On Fridays and Saturdays many of my preaching buddies are working on sermons and programs.  Not me. I was grateful for that yesterday.  I love to write and I love the exegesis required for a good sermon, but I don’t like preaching.  I don’t like reading scripture in front of people. Here is another secret: I don’t really like participating in a service.  It is too much like organizing a play  in which you are both the director and the actor.   Plus you gotta know the script. Which given my dyslexic way of thinking and the way the words often tumble out in the wrong way, I get anxious.  So instead of  being in the moment and getting my worship on, being totally connected, I am uneasy.

Not so when I speak extemporaneously in a AA meeting, or in a one-on-one in a hospital setting.I can pray at the bedside of the dying and the injured without notes.  I can expound ad infinitum while being authentic and I won’t remember exactly what I said, or the way I said it.  I just know that when I connect with people in that way, the spirit shows up.  I can give a testimony, tear up and get an amen.  But be the pastor in a congregation every Sunday?  Nope. Not me and not my call.

Melanie, our Priest at St. Paul’s has the gift.   Today she did a baptism and when she was pouring from the silver (historic) pitcher to the font, she stopped abruptly and exclaimed “Wait! This isn’t water.  This is the wine!” Talk about being baptized into the blood of Jesus, which would have totally  ruined the beautiful baptismal dress of the candidate. She then got the correct silver pitcher, but the water was too hot.  Trying to make sure the water wasn’t too cold, which might have produced a cry of anger, someone had brought the water to a boil and it was still scalding hot.  Melanie then called for colder water and several folks scrambled to get some.  She was able to turn a potential disaster into an epic win for the preacher.

And I got to be present instead of being anxious and it didn’t matter that my hips were killing me and that I was chilled and kept my coat on during the service or that I had my clunky blizzard boots on.  I was reminded that I had a Sunday of friends and worship and that my gifts of ministry are just that; mine.  Different from what is sometimes expected, but valid all the same.

I was hoping to go into work tomorrow, yup was looking forward to it, but got an email that we will have a snow day.  Whoop Whoop.  Here’s hoping we actually get some decent snow.

 

 

How do you tell a Mob Boss to quit smoking?

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I had a great conversation with Mum yesterday.  We were talking about politics and ethics and social justice. We talked about those that reach out to everybody and those that for what ever reason, push those that are different away.

And that lead to a bunch of family stories most I knew and this new one I had never heard. Grandaddy was a surgeon here in Boston and was one of the first in the world to successfully open the chest cavity to do either lung or heart surgery.  His main thing was lungs and he was one of the first to connect the effects of smoking to lung disease.  Mum said that when President Eisenhower had his heart attack, Grandaddy was flown out to Denver as part of the medical team.  That story did not surprise me, I grew up hearing stories about some of his patients that were heads of state, famous actors and the like.  These were pre-Hippa days, and often the family would receive gifts from “grateful patients”.

That was a category.

Pointing to a crate of oranges, “Hey Mamie, where did this come from? ” Or looking at the delivery of giant flower arrangements, “who sent these?”  “A grateful patient Dearie, a grateful patient.”

The story I didn’t know was about that time when he operated on big time Crime Boss Raymond Patriarca and there were detailed cars parked outside of the house for a week or so.  Mum said the cars were FBI or CIA.  I am not so sure about that.  “We had to lock the doors, and we never locked the doors” said Mum.  “We couldn’t go anywhere until it was over”.

What was the issue?  “Well I guess there would have been an issue if Patriarca didn’t make it off the table.  It was life and death you know.” Mum quipped.

I guess he didn’t discriminate.  He treated everyone about he same.  Gave me lecture upon lecture about smoking and I am sure he gave that same lecture to the Mob Boss.

This is what I know about Grandaddy. He was a diehard Republican who I argued with during the Ronny Ray-gun years. At family dinners, we would get going about it until Mamie felt it was going nowhere and would say, “My, the battleships are a lovely shade of gray this year”.  He taught me to fish, to gut that fish on the spot, to chop wood and to how to stack it.  He told me that I could do anything if I put my mind to it.  He once sent me a letter at camp impressing upon me how important communication was.  He had his secretary type it for him.  I wish I had kept that letter.   He was human like the rest of us.

What I did see was that he pumped his own gas, but he drove a Saab.  He talked to the guy behind the Dunkin Donuts counter with the same intent as international guests at his table.  He impressed upon me to never think less of someone doing manual labor, for we all should do what we can with the gifts we are given.  If he had to go out at night, he often wore his PJs under his suit because he liked to get his sleep.

He was a product of his generation, born in 1901 and in Peru Nebraska.  He was motivated to do something after watching the fall out from the 1918 flu.  and the Great White Plague.    He didn’t get everything right, but he did instill the notion that one should find their purpose and do it. His was fighting Lung disease.  He literally saved lives, and from what I remember and what I have learned, he never checked to see what the patient’s background was; religious, economic, political or otherwise before he operated.  We all bleed red.

I would have liked to have been a fly on the wall then he lectured the Boss about quitting smoking.  He could not help to give that lecture to anyone at anytime. He was asked to speak at my 6th grade graduation and I was mortified when he gave the no smoking lecture to the whole school.  I picked up smoking because it was so rebelous.  He once hauled me into his clinic and took a chest r-ray just to scare me.  I didn’t work, I was hooked anyhow.  I smoked ciggs off and on for years and still dream of them.  But I smile now when I see how his efforts in the early days paid off and for the most part, people understand the risk of smoking.

I guess he knew that the addiciton of smoking does not discriminate, neither does lung disease.  It does not care if you are rich or poor, black or while, Christian or Mulim, gay or straight.  He did the work he was wall called to do Mob Boss or not.