Reading at Sundance Bookstore, November 15

On Thursday, November 15 at 6:30, I'll be reading from Brief Visits, my new book of sonnets about my ER volunteer work.  Here's the official flyer for the event.

If you're in Reno, please stop by, and even if you can't make it, please spread the word!

The Last Shift

Today I served my last shift as a volunteer lay ER chaplain.

When I was there Monday, a letter was being written to spiritual-care volunteers explaining that the department was being cut because of the sale.  I never got that letter this week.  When I went in today, the letters were sitting unmailed on my supervisor’s desk, although he told me he’d called everyone to make sure they knew.  “It doesn’t say much,” he said with a sigh as he handed me mine, and indeed it doesn’t: thanks us for our service, explains that the department’s closing, instructs us to hand in our ID badges.

“I need to say that this sucks,” I told him.  “The way this has been handled is terrible.”

He nodded glumly.  “We do many things very well.  This has not been one of them.”

I went next door to sign in, and then popped back into his office to ask him a question, but he was on the phone, so I went downstairs to the ER.  The first thing I usually do down there is to check the blanket warmers: I give out a lot of warm blankets, and I need to make sure I have my supplies, so for years now I’ve restocked the warmers at the beginning of each shift.  There’s one at each end of the rather large ER; usually the one farthest from the linen cart is partially full and I only need to carry a few blankets down there.  But today that warmer was completely empty, so I decided to roll the entire cart down to the warmer rather than trucking back and forth with armloads of blankets.

The cart is huge, taller than I am, and very ungainly.  It was difficult to steer; I couldn’t see over or around it and wanted to make sure that I wasn’t running over staff, patients or equipment, so I finally got in front and walked backwards, pulling and looking over my shoulder to navigate.  And then, all of a sudden, I saw my supervisor’s face, his eyes round with surprise, peering at me over the opposite end of the cart.

I’ve never seen him in the ER.  I thought maybe there was a patient emergency and someone had called him.  But before I could ask, he said, “What are you doing?”

“Restocking the blanket warmer.”

He frowned.  “We really aren’t supposed to do that.”

Bite me, I thought (completely unjustly; I’m just a volunteer and he lost a salaried position, so getting cranky at him makes no sense, except that he’s the one who’s there).  I’ve been restocking the warmers for over seven years, and I get grief about it on my last day?  “Look, I give out a lot of blankets, and it’s easier and faster for me to do it myself than to nag an overworked tech about it.”

He nodded.  He got that.  (Later I apologized for being cranky and he said, “It’s okay.  Letting people be cranky at me is about all I can do for anyone right now.”)  It turned out he’d come down to find out what I’d wanted to ask him, which was really very decent of him.

We chatted; he left; I kept rolling the cart.  A registration clerk spotted me and said, laughing, “Okay, you’re hired.”

“Actually, I’m fired,” I told her, and explained the situation.  She hadn’t known.  Nobody knew until I told them.  I didn’t tell many people, since everyone was busy, but I did have a long talk with a nurse sitting in the psych hallway, and I also mentioned the situation to the psychiatric social worker, another nurse, and a security guard, all of whom gave me spontaneous hugs.  “You’ve been here forever,” the social worker said, and the security guard said kindly, “With your gifts, you can go anywhere.”  Nice guy.

From my point of view, it was a somewhat slow shift, but a lot of people thanked me for looking in on them, and one couple recognized me from an ER visit last year.  And we had one extremely obstreberous patient who wound up in restraints and was threatening all kinds of violence to medical staff.  “Don’t go in there,” the nurse said.  “That patient doesn’t like women.”  But when I went in and identified myself as the chaplain, the patient started crying, and asked for prayer, and clung to my hand, and treated me to a long, heartfelt and incoherent life history.  Things went south again with medical staff later, but for a few minutes while I was there, that part of the hallway was a little quieter.  The nurse came in again to get vitals while I was there, and the patient said, “I’m talking to my chaplain now, and she trumps you.”  (I explained that actually, medical staff trump me.)  Somehow I don’t think identifying myself as a patient advocate would have had quite the same effect.  Still, I’ll go back as a patient advocate if they’ll let me, as soon as the new owners start accepting volunteer applications.  My supervisor says it’s possible that the new outfit will bring back some form of spiritual care, but I’m not betting on it.

After my shift, I went back upstairs, and removed my badge from its holder, and gave it to my supervisor.  I was pretty teary-eyed.  “Are other people having a hard time with this?” I asked him.  

“No,” he said gently.  “Not as much.  Or at least, they haven’t talked to me about it.  But it’s an individual journey.”  I find that a little hard to believe, since some of the other volunteer chaplains have been doing this much longer than I have.

I cried the whole way home.  Seven and a half years and 1,132 hours: that’s a chunk of my life that’s over now.  And I know I’ll find things to fill the void, but they haven’t arrived yet.

We’re going to a concert tonight.  Music will help.   On Monday, which would ordinarily be a volunteer day, we’re going to a movie.  I’ll keep myself distracted.  But this is a true loss in ways even I can’t quite put my finger on yet, and I ask my friends’ patience and understanding.

End of an Era

1: Background

My hospital has been sold.  All of the hospitals in this area – like so many hospitals across the country – are having terrible financial problems.  If my hospital hadn’t been sold, it would have had to close.  In everything else I say here, keep in mind that closure would have been worse.

The sale’s been percolating for many months.  At one point, it looked like we’d be sold to a particular company: I got online and checked out the websites of the hospitals in their system, and a number of them had spiritual-care departments, and when I spoke to my supervisor, he confirmed that they were sympathetic to spiritual care.  So we were happy.

But that sale fell through, and we were sold to another entity, and when I checked that entity’s hospitals, none of them had spiritual care departments.  And my supervisor confirmed that fact, too, and said it didn’t look good.

2: The Plot Quickens

A few weeks ago my supervisor told me that he had been fired and that there would no longer be a Spiritual Care Department.  He didn’t know what would happen to volunteer chaplains.

This past Friday, I passed his office on my way to sign in for my shift, and ducked inside to say hi.  “Anything new?” I asked.

“Oh, yeah.  There won’t be volunteer chaplains anymore.  The last date they can work is, uh . . . “ – he checked his calendar – “the 18th.”

“Of May?  That’s in two weeks!  We haven’t gotten a letter!”

“It will go out Monday.”

I felt like I’d been sucker-punched.  I reeled through my shift, fighting periodic tears, venting to a few staff.  One doctor I hadn’t even talked to came up to me (very unusual, but it was a slow shift) and said, “I just heard. I’m so sorry.  You guys are so important.  Please let me know if there’s anything I can do to help.”

I kept wondering aloud if there’d be some way for me to stay in the ED, maybe as a patient advocate, but everyone told me I’d have to talk to the hospital’s volunteer coordinator about that, and she was on vacation.  So I finished up that shift and came home in tears, heartsick and furious.

3: Big Picture

A lot of my anger was political.  My hospital is the only one in the area that still has in-house Spiritual Care; after the change, there won’t be any.  The importance of spiritual concerns in illness and healing is pretty general knowledge these days, and after seven and a half years of doing this work, I know firsthand how much prayer, comfort and conversation mean to patients.  I literally can’t count how many patients have wept in gratitude during my visits with them, how many of them have told me that they feel better just from talking to someone like me.   I may even have played a tiny role in helping save a life or two, simply by – for instance – offering suicidal patients a different perspective on their despair.  I know for certain that during the time I’ve been volunteering, ED staff have asked at least twice for more chaplains in the department.  Emergency-medicine people are the ultimate empiricists: they aren’t going to ask for something unless they know it works.

It absolutely infuriates me that this crucial aspect of patient care is being abandoned because it doesn’t meet a corporate bottom line.  There’s no billing code for prayer.  Over the weekend, I talked to a professional chaplain who confirmed that it’s not just us: Spiritual Care Departments are being dismantled, and chaplains fired, all over the country.  This is only one more indication of the country’s economic slough.  Once again, I’d rather see departments dismissed than see entire hospitals close, although I have to wonder if Spiritual Care actually has a positive effect on the bottom line that no one’s bothered to try to measure.

4: Also, It Feels Personal

So I spent a lot of the weekend weeping and raging, not just over the dismal swamp of healthcare in general, but also over my own loss.  In case it wasn’t already obvious, I love being a volunteer chaplain, and I think I’m good at it, not least because my somewhat spiky personality is an asset, rather than a drawback, in the ED.  It’s often very difficult for me to see progress in the classroom, and I’m often despondent about my writing, but after any given volunteer shift, I can point with certainty to places where I did good work and produced palpable results.  Losing that role felt like having a body part torn off.

And this loss comes close on the heels of many others.  Over the last five years, I’ve lost both of my parents, Gary’s father, two cousins, an especially beloved cat, and my church.  The world feels a lot thinner than it did five years ago, and (like so many other people), I’ve also suffered losses connected to the inexorable tightening of standards in the university and the church.  Five years ago, I believed I would one day be both a deacon and a full professor: now I know that I won’t be either, because the level of insane hoop-jumping required to reach those spots - a function of nationwide changes in professional expectations - simply isn’t anything I want to attempt.  These decisions are choices, of course, but I’ve heard a lot of anecdotal evidence that this kind of bar-raising is happening in many other fields as well, placing a lot of jobs out of realistic reach of people who’d be very good at them.  Losing my cherished volunteer gig at the hands of a faceless corporation isn’t quite the same thing, but it pushed some of the same buttons: the powerlessness any of us feel in a world of moving targets we can’t map or predict.

Let me say here that I am also very blessed, and know it.  I’m very grateful for everything I have in a world where so many people have so much less.  That doesn’t change the fact that I’m also grieving.

It was not a good weekend.  I sent wailing e-mail to three of my clergy, cried a lot, went through some PTSD-ish bouts of anxiety when I started wondering what I was going to lose next – I probably drove Gary nuts with my clinging – and, not to put too fine a point on it, was a mess.  To be fair, I also did research.  My supervisor had recommended that I move over to being a hospice volunteer, and I talked to a hospice chaplain who said that I’d be very welcome.

5: Cautious Optimism and Tentative Plans

Today was much better.  I talked to the hospital’s volunteer coordinator, who sympathized completely and gave me a huge hug; I once visited her and a sick family member in the ED, and she’s a fan. She said that I should indeed be able to remain in the ED as a “patient advocate.”  I’ll have to reapply, as everyone else at the hospital will.  I’ll have to be retrained.  I won’t be able to say the word “God:” she said there are very strict rules about that.  But I’ll be able to stay in a place I know, where people know me, and I’ll be able to keep helping patients.

She also told me that the last day for volunteer chaplains isn’t the 18th.  It’s the 11th: this Friday, not next.  I have one more shift.

Today’s shift was full and busy and confirmed, yet again, the value of volunteer chaplains.  I prayed with a newlywed whose spouse was on life support, and who thanked me copiously.  I prayed with a woman who wept in gratitude and squeezed my hand.  I cheered up a lot of people just by popping in and asking if they needed to talk.

The doctor who’d come up to me on Friday was working today, too.  I told her about the patient-advocate gig and said, “I could move to hospice, but I’d rather stay here.”  She smiled and said, “We’d rather you stayed here!” which of course made me feel good.

I saw another doctor and filled her in.  When I said, “I can stay here, but I can’t say the word ‘God,’” she rolled her eyes and said, “You have got to be kidding me.  Well, just do what you always do and call it something else.”

Exactly.  And again, lots of what I do – talking to people about advanced directives, giving out the number of the crisis-call line, calling shelters to try to find beds for homeless patients – doesn’t involve explicit mention of God anyway.  Preach the Gospel without ceasing; use words when necessary.  The trick now will be finding safely secular words.

When I went upstairs to sign out, I ran into a social worker who usually works in the ED.  I briefed her, and she said, “We’re going to need advocates, big time.”

So that’s sounding like a plan, but I won’t believe anything until it happens.  I have no idea how long it will take for the new volunteer training to happen.  In the meantime, I’m going to call hospice and check on their training schedule, since they only do trainings once or twice a year and I’d hate to miss out.  I’m hoping that their training will be far enough down the road that I can try the patient-advocate role first, see how I like it, and switch to hospice if it doesn’t work out.

Over the weekend, I got supportive, sympathetic responses from two of the clergy I e-mailed.  Today the third, my rector, called.  He told me that he always needs pastoral-care help in the parish, people to help with hospital and home visits.  So that’s another possibility.

I really do love the ED, though.  I love the clinical setting, the snippets of Cool Medicine I get to overhear, the sheer diversity of the department.   So I’m really hoping that being a godless patient advocate will fill the bill for me, although there will certainly be challenges.  Today – as happens fairly often – a patient recognized me from a previous hospital visit, and thanked me for praying with her then.  What will I do if that happens after the changeover and the patient asks me for prayer now?

“Point at the ceiling,” said Gary, my creative nondenominational pagan.  “Use the Voldemort strategy:  Pray to He-She-It Who Must Not Be Named.”  

Actually, I’d probably break the rules, say the G-word, and hope that no one called the cops.  But it’s going to be very interesting to see how all this works!

Unexpected Shepherds

Here's today's homily. The Gospel is John 10:11-18. After you read this, please do follow the link to the Times story and watch the video; it's disturbing, but also very moving.

*

As the video begins, we watch two men walking across a fenced field. The taller man, Secel Montgomery Sr., has put his arm protectively across the back of his companion, who asks in a puzzled voice, “Why are we here?”

“Why are we here?” Secel says. “We’re going back to the building.” 

“Oh. Where’s the building?”

“That way.” Secel points with his free hand. “See that yellow building all the way over there, with all those windows on it?”

“Way down there?” The smaller man sounds baffled and slightly alarmed. “That’s where we’re going?”

“Yeah!” Secel’s voice is kind, patient. “That’s your building!”

“We’re going to go directly there?” 

“Di-RECT-ly,” Secel assures his friend. “NON-stop!”

Secel’s friend has Alzheimer’s, and Secel is his caretaker. In addition to guiding his charge home from walks, Secel helps him eat, helps him make his bed and brush his teeth and shower, changes his adult diapers. Secel takes his job seriously, and when he talks about the work, he emphasizes the importance of relationship. “You have to bond with them,” he says of Alzheimer’s patients. “They have to trust you, or it won’t work.”

Now, let me ask you a question. Does Secel sound like a good shepherd?

Yes, he sounds like a good shepherd to me, too. And yet many people would be shocked to hear him praised as a good shepherd, because Secel -- and his patients -- are also convicted murderers. The men are inmates of the California Men’s Colony, where specially trained prisoners like Secel take care of fellow felons who have developed dementia. The video clip is part of a New York Times story about the challenges of caring for these prisoners.

I think that most of us, when we think of the Good Shepherd, imagine perfect, sin-free Jesus carrying adorable fluffy lambs. But in the California Men’s Colony, both the shepherds and the sheep have done terrible things. They have brutally taken life. They are part of a despised underclass in our society, a group many of us would think twice about trusting, a group often deprived of civil rights even after release from prison. In many states, for instance, paroled felons are no longer allowed to vote.

If the idea of a convicted murderer as a good shepherd shocks you, consider the following. According to Lutheran theologian Joachim Jeremias, first-century shepherds were also a despised underclass, sneaky trespassers who grazed their herds on other people’s land. Because shepherds often pilfered the herds they were paid to tend, it was forbidden to buy wool, milk or animals from them, because whatever they sold was probably stolen property. The Mishnah, Judaism’s written record of the oral law, said that no one should feel obligated to rescue a shepherd who had fallen into a pit. Deprived of civil rights, shepherds could not fulfill judicial offices or be admitted in court as witnesses.

In Jesus’ day, the idea of a Good Shepherd would have been every bit as startling, even scandalous, as the idea of a Good Murderer is now. Jesus was trying to shock his audience. The Parable of the Good Shepherd, like the story of the Good Samaritan -- another tale about a scorned outcast defying stereotypes -- is designed to make us rock back on our heels and reexamine our assumptions. Jesus acknowledges that some shepherds are very bad eggs, but he asks us to withhold automatic judgment. What really makes people good, he asks us: their social standing, or their behavior? Their past deeds, or their current ones? Who better to protect the sheep: the upstanding judge in town, or the stigmatized shepherd who lives with the flock? Which will the sheep trust more?

There’s a reason why we hear this parable during Easter, the season of resurrection. The story reminds us that nothing we have done, however seemingly shameful, is useless. Everything can be redeemed, made holy, used for healing. The parts of our lives we most want to hide may be what someone else needs to know to trust us. The places in our lives we most hate -– prisons literal or metaphorical, bottomless pits of despair or misfortune -– may be where we can best help people still trapped and suffering. This is the principle of peer support that has made 12-Step groups so successful. “They have to trust you,” Secel says, “or it won’t work.” And Jesus says, “I know my own and my own know me.” 

Here’s another example. Quite a few years ago, during one of my volunteer shifts in the ER, a registration clerk begged me to help a particular patient, a young woman taking Methadone to kick a heroin habit. The Methadone clinic had decreased her dose too quickly, and now she was in withdrawal, in tremendous pain, screaming nonstop. The clerk said, "Junkies feel so horrible about themselves, and I'm scared this kid will just go out and use again. Please go talk to her."

But when I went into the room, the patient wouldn’t even look at me, and the young woman’s mother, tight-lipped, just shook her head. I realized that because I was a chaplain, they expected me to shame or lecture them.

The second bed in that room held someone else from a stigmatized population: a burly biker with prison tattoos, including swastikas. He'd been brought in by a woman -- wife or girlfriend -- who looked as if she'd had a hard life of her own. The Filipino nurse assigned to the room wanted nothing to do with those swastika tattoos, and the relentless noise from the screaming addict was unbearable. It was a terrible room, and I found myself avoiding it.

And then I went by the room on my way to somewhere else, and heard . . . nothing. Silence, sweet peace. My ears rang from the lack of noise. I ducked inside and found the tattooed patient’s female companion leaning over the addict. She was giving the young woman a backrub. The patient, now quiet, had finally relaxed, and so had her exhausted mother.

"Thank you!" I said, amazed and grateful, and the woman smiled up at me.

"I'm a masseuse,” she said. “Massage really does help people calm down."

The screaming patient accepted that backrub because the other woman was a peer, an equal: someone else dealing with real or perceived staff judgments, someone who wasn’t going to lecture or shame or judge an addict in withdrawal. In that place, at that moment, she – not the highly trained medical staff or the well-meaning volunteer – was the Good Shepherd. “They have to trust you, or it won’t work.”

While I’m certainly not encouraging anyone to become a murderer or an addict – or even the consort of a swastika-emblazoned biker – the Good Shepherd reminds us that Good News begins not with status and success, but with the cross and the tomb. We are called to remember that God creates new life and light from death and darkness, from our places of pain and failure. Like Jesus displaying his scars to Thomas, we are called to be wounded healers. We are called to honor the lowest moments of our lives, and to reach out in love to those who live there still.

Amen.

Mass Casualty

The first I knew of the horrific crash at the Reno Air Races today was when my friend Arthur Chenin called me a little before 6:00 and said, "You should go back to the hospital." I'd only gotten back from my afternoon volunteer shift a few hours earlier.

I tried calling the ED to see if I was needed, but of course couldn't get through, so I threw my scrubs and ID badge back on and just drove down there. The ED itself was like something out of Breugel: More staff than I've ever seen in the department, because everyone had been called in, and much, much more seriously injured patients than I've ever seen in the department. As I commented later to Gary, the place made ER look like Sesame Street. I've never seen that much blood. The doctors all already had thousand-yard stares. One of them spotted me, plucked at my sleeve, and pulled me into a room where a patient was surrounded by at least five staff members, and somebody was saying "the CT looked really bad, we should go on to the next person," and I left that room and spotted a staff chaplain and asked him what to do and he told me just to go around letting people know we were there, but I couldn't get into any of the rooms because the beds were circled by so many medical people, and anyway those patients weren't conscious or in any shape to ask for chaplaincy services. I did speak briefly to a fellow in one of the minor-injury rooms -- he had a cut finger -- who, with a buddy, was watching the disaster coverage on the news, both of them wide-eyed, and I introduced myself but they didn't need anything, and I warned them that they'd probably have to wait much longer than usual to be seen, and they said, "Of course, of course, don't worry about it. Thank you for talking to us."

So I left again, spotted another staff chaplain, and followed her into the waiting room, thinking to find family members there, and indeed there were dazed and bruised and bloodied people, and other people frowning down at cell phones, but the staff chaplain and the nurses had it covered, so I went back into the ED and asked what I should do and someone said, "Go downstairs. They're setting up waiting areas for the victims' families in the auditoriums."

I went down there. I helped move tables and chairs around. Dietary was bringing in beverages and snacks, so I ate some myself, thinking I might need my strength. Various other chaplains wandered in: hospital chaplains, hospice chaplains, law-enforcement chaplains. I think every chaplain in Northern Nevada had converged on the place. We stood around chatting, and a few family members and other bystanders showed up, and we chatted with them, but at any one time, there were more chaplains in the room than chaplainees, and that was before a phalanx of smartly uniformed Trauma Intervention Program volunteers marched through the door.

To be sure, I heard my share of horrors. Several people said, "Body parts were everywhere." Someone said, "I had to step around brains." Someone said, "I saw a shoe with only a foot in it." Lots of survivors' guilt: "I heard a voice in my head telling me to get out of there, and I did, but now four of my friends are in the hospital." "I got up to go to the bathroom, and when I came back, my box wasn't there anymore." I talked to someone who saw the pilot as the plane crashed: "You could tell he was trying really hard to wrestle that plane away from the grandstand and back towards the tarmac." I talked to two people who said, "We were on either side of our buddy, and a piece of metal came flying towards us, and he got hit and we didn't." I talked to someone who knew one friend was dead and didn't know about other friends; I talked to several people who had loved ones in surgery ("Oh, he got off really lightly, he only lost a finger, he'll be fine"); I talked to people who didn't actually know if their loved ones had been brought to this hospital and were desperately trying to get information.

Most surreal moments: 1) The snippets of Brahms' lullaby that came over the PA twice, alerting us that babies had just been born in the midst of the carnage. 2) The Code Blue that came over the PA for a room in the ED. Every emergency responder in the hospital's already there: you need to call a Code to summon them?

I told the people who came to the auditorium to take good care of themselves, told them to watch out for signs of PTSD (repetitive thoughts, nightmares, etc.), told them that clergy and therapists and journaling can help. I listened a lot. But, for the most part, there was nothing for me to do that fifty other people in the building couldn't do as well or better, so after three hours, I left.

As selfish as it may sound to put it this way, here's what I learned from this experience:

1. I've always wondered if I could handle trauma. After tonight, I think I could.

2. I must really like being a chaplain, because I wanted to do more tonight, not less (not, God knows, that I don't mourn and grieve the occasion).

3. In a mass disaster, every helping resource in the area shows up, and I trust those resources will continue to be available to everyone touched by this horror -- and the psychological toll alone will be huge -- in the coming months. So, weird as it sounds, the work I did during my much quieter afternoon shift today seems more important, because those folks weren't on the news. Nobody else was rushing to their side. The suicidal patient who sobbed and hugged me and was so grateful for prayer didn't have every chaplain in northern Nevada showing up to offer help. My weekly conversations with ordinary ED patients are (usually) much less dramatic than the ones I had tonight, but they're also less redundant.

Which is all a way of saying that my quiet little niche is fine with me, thanks.

And now I'm going to have a very delayed dinner. Rice Krispie Treats and peanuts just don't count as a meal.

Why God's Love Matters

I'm cross-posting this from Facebook, because I think the question's important.

*

Last night, my friend Chris Coake, motivated by his intense dislike of Pat Robertson, posted some quotations from Jillette's new book about atheism. You can find that post, and responses to it, here.

My rather forceful dislike of these quotations (which imply that Christians are pathetic losers who need imaginary friends because they don't have real ones) resulted in a conversation in which Chris posed this question: "Why, exactly, is the love of Christ/God so valuable to people of faith, and not to atheists?"

There are all kinds of answers to that question, and other people have addressed it more thoroughly than I can, and my own answers change according to my mood and circumstances. But for me, right now, the answer can be summed up in two words: social justice.

Look around. There are a lot of people in the world who aren't loved by other people: prisoners, addicts, mental patients, the poor. Look at all the hatred that gets spewed on Facebook itself, not to mention a whole lot of other places. The kind of Christian faith I admire and try to practice -- because there are many versions I don't -- is predicated on the core belief that God loves everybody, and therefore we're called to love everybody, too. Even people we don't like. Even people we'd rather hate. Even people who hate us. Even -- oh, honestly, you can't mean it? -- Pat Robertson. (Insert gagging sound here.)

Jesus loved everybody, and made a particular point of loving the people the rest of his culture hated. Lepers. People with despised ethnic/tribal identities, like Samaritans. Women. The unclean, the untouchable, the stigmatized, the scapegoated. Jillette's quotations suggest that if we have the love of our family and friends, we don't need God; Jesus spoke out quite forcefully about the fact that people who remain within the cozy cocoon of their families and friends are barricading themselves against the broken, hurting world we're all called to help heal. Sure, we're called to love our families and friends, but we're also called to love "the least of these," the people who make us really uncomfortable, the people we've been told to have nothing to do with, the people we'd rather ignore. We're called to love everybody, like Jesus did. That's the whole point.

It's worth noting that even he didn't get there right away. It was a process. My favorite character in the Bible is the Samaritan woman -- despised both for her gender and her ethnicity -- who asks Jesus for healing for her daughter and, when he declines (because she's not the Right Kind of People), stands up for herself, very cleverly, and gets the blessing after all. She's the only person in the Gospels who argues with Jesus and wins, and she's a stigmatized minority. You go, girl!

The Christian story reminds us that radical love isn't easy, and that it will get you killed in, oh, three years or so if you really practice it. (MLK Jr. and Oscar Romero are more recent reminders of that fact.)

Now, to try to address some inevitable objections: can the non-faithful love this way? Sure. People who do this work as part of faith communities often have a lower burnout rate, though. And are there people who call themselves Christians who don't love this way? (Hi, Pat Robertson!) You betcha. But they aren't the only Christians out there, even if they want to make you think they are. (As a person on the left, I believe that the Christian Right is the Christian Wrong, even though I know the Christian Right considers the Christian Left the Christian Left Behind.)

As for God's love not mattering to atheists, well, I personally believe it's what sustains all of us even if we aren't aware of it. You're free to disagree.

And those lonely, pathetic people who need to believe that God loves them because nobody else does? Are you going to make fun of them? Really?

Let me tell you a story.

Many people reading this know that I volunteer as a lay ER chaplain (and if you're reading this on the blog, rather than on FB, you've probably already heard the story). One evening many years ago, I knocked on the door of a room and heard a soft, "Come in." Inside, an emaciated man hooked up to IVs lay on a gurney. When I told him I was the volunteer chaplain, he started to cry.

"No, I visit everybody here," I told him. "My being here doesn't mean you're dying. Don't be scared!"

"That's not why I'm crying," he said. "I am dying. I'm dying of AIDS, and fifteen minutes ago I was praying for God to send me a sign that he still loved me, and then you walked through the door. You're a sign from God."

He needed God's love precisely because other people had stigmatized and isolated him, but what reassured him of that love was a flesh-and-blood person, not an imaginary teddy bear. My friends who work with prisoners have lots of similar stories. God calls us to love everybody; surprisingly often, that's simply a matter of showing up.

Okay, I'll stop now. I'm sure I haven't persuaded anyone who didn't already agree with me, but well, Chris, you asked. For evidence that other people are on this side of the issue, rather than Pat Robertson's, check out The Christian Left and Seminary of the Street.

Today's Keeper

Among volunteer chaplains, it's axiomatic that even one good visit a shift means it was worth coming to the hospital that day. Some volunteers say all their shifts include a visit like that. Mine don't -- some shifts are dull, and some are exhausting and infuriating -- but today's did.

A nurse told me a psych patient had asked for a chaplain. The patient brightened when I introduced myself. "I'm glad you're here. I've been waiting for you. Can I ask you a question?"

"Of course."

"Why's God letting me suffer like this?"

Oh, man. Theodicy 101. "I don't know. I do know that it's okay to ask questions, and it's okay to be angry. You can yell at God. God can take it."

The patient nodded. "That makes sense. That's a good enough answer for me."

I relaxed, since that particular subject usually gets a lot more complicated. "Would you like me to pray with you?"

"I don't know how to pray."

"That's okay; I do. It's kind of what I do around here." The patient laughed, and I offered my standard-prayer-with-personalization (you can find my Hospital Prayer 101 post here).

By the end of the prayer, the patient was crying. That happens pretty often, so I'm used to it. When other people have prayed over me, especially for healing, I've sometimes cried too: there's something about a) knowing that your concerns have been heard and b) handing them over to Somebody Else that tends to release the floodgates.

I handed the patient some tissues. "Here, you can keep the pack. This is something else I do around here."

The patient laughed again. "Can I tell you something?"

"Of course."

"That prayer moved me more than any prayer I've ever heard."

"Thank you!" I said, floored. Patients often say "that was a nice prayer" or even "that was beautiful," but I'm not used to superlatives.

"May I have a hug?"

"Of course," I said, and hugged the patient, and then moved on to the rest of what was a fairly chaotic, and intermittently crappy, shift. But it was okay. I had my keeper. It mattered to someone that I showed up today.

Please note that I'm not claiming any special skills here: I think any chaplain who walked into that room would have had the same effect, since the patient was clearly primed and eager for the visit. But I'm selfishly glad that I was the one who was there. It's also axiomatic among volunteer chaplains -- and volunteers in general -- that we get much more than we give.

Little and Big

Here's today's homily; the readings are 1 Kings 3:5-12 and Matthew 13:31-33, 44-52.

I'm preaching again in two weeks, at the St. Stephen's reunion. I've rarely, if ever, had to write two homilies this close together, and I have deep respect for people who do this every Sunday.

*

In November 1998, Esquire published a cover article by Tom Junod about Fred Rogers, host of the beloved children’s television show Mister Rogers’ Neighborhood. Junod’s immensely moving profile includes this story:

On December 1, 1997 . . . a boy . . . told his friends to watch out, that he was going to do something "really big" the next day at school, and the next day at school he took his gun and his ammo and his earplugs and shot eight classmates who had clustered for a prayer meeting. Three died, and they were still children, almost. The shootings took place in West Paducah, Kentucky, and when Mister Rogers heard about them, he said, "Oh, wouldn't the world be a different place if [that boy] had said, 'I'm going to do something really little tomorrow,'" and he decided to dedicate a week of the Neighborhood to the theme "Little and Big." He wanted to tell children that what starts out little can sometimes become big, so they could devote themselves to little dreams without feeling bad about them.

The really big news this week is the horrific massacre in Norway, which seems to be everywhere we look, inescapable and omnipresent. Our Good News this week, our Gospel reading, is about really little things, the seemingly insignificant items we can so easily overlook: the mustard seed that grows into a large, life-giving shrub; yeast, invisible when stirred into dough, that transforms it into the miracle of bread; a fine pearl, grown from a grain of sand, that’s worth more than everything else in the market.

The Kingdom of Heaven, Jesus says, dwells in and results from these really little things. Fred Rogers was an ordained Presbyterian minister, and I have a strong hunch that he was thinking about this Gospel passage when he planned his week of “Little and Big” programs.

Jesus is speaking metaphorically, indirectly. As usual, he doesn’t tell us everything, but forces us to figure things out for ourselves. From this morning’s metaphors, here are a few things we can figure out about the Kingdom of Heaven.

First, it requires patience. Mustard seeds don’t become large plants overnight.

Second, it requires faith. You won’t plant the mustard seed unless you believe it will grow. You won’t look for the pearl unless you believe the market contains things worth finding.

Third, it requires discernment. Here’s a jumble of stuff in a market stall: souvenir t-shirts and plastic fridge magnets and 100% genuine local handicrafts made in China, and hey, the merchant’s offering a special sale on paste-glass rhinestones, five hundred for ninety-nine cents, and over here, almost hidden in a corner, is a small, round white thing with smelly bits of oyster still clinging to it. What are you looking for, and what will you buy?

And finally, attaining the Kingdom may require sacrifice, both of wealth and reputation. Dude! You can get five hundred of these pretty paste-glass rhinestones for ninety-nine cents, and you’re selling all that you have to buy that little smelly round white thing? Are you nuts?

A firm grasp on history helps with all this. Just as that large shrub started out as a tiny seed, famous King Solomon started out as “a little child” in the midst of “a great people, so numerous they cannot be numbered or counted.” We most easily discern the Kingdom of God, then, when we look both forward and back.

In fact, the Kingdom is everywhere around us, and also, Jesus promises, within us. Because our really big news is so often about atrocity -- Norway, 9/11, Columbine -- all of us need to cultivate the discipline of seeking out and tending the Kingdom, the Good News that starts out really little, usually where no one else is looking. It might show up, for instance, in a stable, in an obscure corner of an occupied territory, in the form of that weakest of creatures, a newborn human infant.

But that was two thousand years ago. If the Kingdom is everywhere, invisible and omnipresent as yeast in bread, where do we find it now?

With luck, all of us have many answers to that question. Here are two of mine.

First, I firmly believe that we become citizens of the Kingdom, helping to create and maintain it, when we perform even the smallest acts of mercy and charity, loving our neighbors as Jesus commands us to do. The really big bad news, the horror we see on TV, is often the work of people who’ve used terror and violence to tear huge holes in creation. It’s easy for us to despair, to believe that nothing can fix these gaping rents. Certainly we cannot do so by ourselves. But each tiny act of kindness is one stitch, repairing those holes, and enough small stitches will mend even the most tattered fabric.

Some of you know that I volunteer as a lay ER chaplain. On Friday, I helped an elderly man eat his lunch, cutting his turkey for him because he couldn’t do it himself. That tiny act couldn’t fix what happened in Norway, but it made me –- and him -– feel better. It kept me focused on what I can do instead of on what I can’t, and it reminded me that even the smallest kindnesses are infinitely valuable to those they help. When any of us feed our neighbors, we expand the Kingdom, giving despair and atrocity a little less growing room.

Here is my second example of finding the Kingdom in something small and easily overlooked. A few years ago, my husband and I spent a week in Honolulu, staying in one of the garish Waikiki mega-hotels. We love to snorkel, and before flying to Oahu, we’d read guide books describing the best snorkel spots on the island. Most, because they’re in the guide books, are overcrowded tourist meccas.

Our first morning on the island, we strolled along the Waikiki beach until we reached a small park, a series of pocket beaches separated by jetties. On a whim, we asked one of the lifeguards, “Hey, any good snorkeling around here?”

The lifeguard pointed two jetties over. “There. The fish love the rocks and the coral.”

We walked over to the tiny beach he’d indicated, donned the snorkel gear we’d brought along just in case, entered the water -- and found ourselves in heaven. The water was crystalline, filled with brilliantly colored fish, so numerous they could not be numbered or counted. We watched schools of angelfish, butterflyfish, yellow tang. We stayed there for hours, hovering above endless parades of fish. We saw no other humans. This little beach wasn’t in the guidebooks. All of our fellow snorkelers had rushed to the tourist meccas.

We returned to our pocket beach every day. It never failed to delight us, to create deep joy. We didn’t sell everything we had to keep visiting it –- although airfare to Hawai’i can feel like that –- but we did forego a host of more famous, high-profile attractions.

Coral polyps, as most of you probably know, are very small animals. Coral reefs take even longer to grow than mustard plants do, and like mustard plants, they support an enormous diversity of life. If Jesus had been a snorkeler, I’m sure the Gospels would include some parables about reefs.

I’m home in Reno now, but that little reef is still inside me. During the really big news from Norway, I’ve found myself revisiting it, cherishing its fragile peace and beauty. In the midst of horror, it comforts me. May all of us find such Kingdoms, and help others find them.

Amen.

Dangerous Woman

Today was my first volunteer shift at the hospital since Mythcon. It was good to be back, but I guess my reputation as a wannabe social worker -- which is what a former spiritual-care supervisor always called me, in some exasperation -- has solidified. When I checked in with the ED case manager to see if there was anyone I should see first, he said, "No, the social-service cases are all gone."

Ha!

So I didn't get to research special-needs AA meetings today, or call shelters to get beds for homeless patients, or hand out business cards for our local crisis hotline to single parents struggling with employment issues. My most weighty visit was with an elderly patient who was having trouble communicating, but who managed to croak out "Food!" I alerted a nurse, who ordered a food tray. When lunch appeared -- turkey and stuffing, Thanksgiving in the ED -- I cut up the turkey and helped the patient eat. It reminded me poignantly of doing the same for my father.

Near the end of the shift, I did a quick sweep of the ED waiting room, which is part of my official territory (although, as usual, no one there needed my services). I jotted down the number of people I'd spoken to, since we have to keep a census of each shift, and was heading back into the department proper when a security guard snagged me. "Hey, Susan, hey, c'mere a minute, okay?"

I know most of the security guards pretty well; they're some of my favorite people at the hospital. This guard, whom I'll call A, took me gently by the arm, swung me around so I was looking directly into one of the ceiling-mounted security cameras, and said into his walkie-talkie, "Hey, B, I think I've found the security threat. Is this her? Hey, B, look at your camera! Is this her?"

"Yeah," came the crackling reply. "That's her."

"What the heck?" I said.

A was laughing. "B saw you on the cameras and told me there was a suspicious woman walking around writing things down."

"Why would that be dangerous?"

"Beats me." A shrugged and went off to respond to some other situation, hopefully one more deserving of his attention, and I went back into the department to finish my shift.

We now have a spiffy new ED with private rooms for each patient, but some of the rooms in our old quarters had three beds per cubicle, with only thin cotton sheets between them. In the old digs, a nurse once came up to me, laughing, and said, "Hey, y'know that lady who asked you for prayer in Room 12? I just brought meds to the patient next to her, and that patient whispered, 'One of your nurses is sneaking around praying over people!' I said, 'Ma'am, that's our chaplain. She's supposed to do that. It's her job.'"

As far as I know, that's the only other time I've ever alarmed anyone in the hospital. But I was really curious about the writing-as-terrorist-threat issue, so after I signed out, I stopped by the security office. When I knocked on the door, I heard A, inside, call out, "Hey, B, it's the dangerous woman!"

B was rather embarrassed, and couldn't really explain why I'd worried him so. "You were walking, and then you stopped dead and wrote something down, and I thought, 'I need to find out what this is, even if it's none of my business.'"

"But what could it have been that would have been dangerous?" I asked him. As Gary pointed out, I'm hardly the only person in the hospital who carries a clipboard and takes notes.

B didn't answer. "You could have been drawing plans for how to take the place out," A said cheerfully. I showed B my notes to reassure him, and then noticed something odd in the office next to his.

"Why do you guys have naked store-window mannequins in here?"

Actually, only one mannequin was naked. The other was wearing a t-shirt and a cardboard smiley face. "They're to model the new hospital t-shirts," A said. (Gary's theory was that the guards use these things to practice pat-downs.)

"Can I take a picture? I gotta get a picture of this." I took a picture, and they admired it, but we agreed that I probably shouldn't post it anywhere online, in case someone decided to magnify it and somehow acquired HIPAA-protected info, like the identity of the mannequins. So you'll just have to use your imagination.

I suspect B took some more teasing from his co-workers after I left. Poor guy! Better for him to be over-zealous in his duties than not careful enough.

An Extended Metaphor

Greetings from sweltering Albuquerque, where the locals are praying for rain and those of us staying at this hotel are praying for reliable wifi (which I think I've finally found in a public area) and decent coffee (the acquisition of which required a hotel shuttle ride to a Starbucks this morning). The conference is great; the hotel's more than a little wonky.

I've been doing some knitting here -- finished a pair of socks for Gary's mom -- but I miss weaving, as much for its psychological and cultural resonance as for its physical pleasures. Weaving's been a very potent symbol since people started doing it, of course, so my thoughts on this subject probably aren't remotely original, but I wanted to get them down anyway.

My novice understanding of weaving, or at least of the weaving I've been doing, is that a cut or broken weft thread is no big deal: you just use another piece of weft and keep going. In fact, the fabric's more interesting the more varied the weft is. But if one of your warp threads breaks or is cut, you're in big trouble, because that's the structure that holds everything else together.

On an individual level, the weft is the variety of our life: the different things we do, the different places we go, our varied friendships. The warp would be whatever we consider our bedrock, the things it would be crisis to lose. For some people, that means job or career; for others, it means social status; for most of us, it includes both our core beliefs and our most significant relationships.

On a larger level, the weft is the huge diversity of life and cultures through time; the warp is God, gravity, thermodynamics, whatever we think of as the glue that holds everything together.

Often, though, we don't think about the glue. In weaving, there's a style -- often seen in rugs and tapestries -- called weft-faced weaving,, where the weft is so closely packed together that you can't see the warp threads at all. This would correspond to a life or creation so full of day-to-day processes and routines that the warp -- the underlying structure or ordering principles -- never gets thought about, and effectively becomes invisible.

We become aware of the warp in two circumstances; either when a warp thread breaks (when we lose one of our foundations) or when the weft thins out, becoming less densely packed and revealing the underlying structure.

In chaplaincy, it's axiomatic that people facing The Big Stuff -- disease, disability, death -- are usually engaged in some kind of theological reflection (even if they don't recognize it as such) and welcome company and guidance. The Big Stuff, losing your health or your mobility, or facing the end of your life, or watching a loved one die, can feel like the breaking of a warp thread. Everything's falling apart. A good chaplain (or any other friend or advisor) can try to help the person re-envision this: No, your warp threads are still there, but you have to work with different weft now.

That quintessential chaplain's question, "So how are you getting through this?" asks the person to examine and name warp threads: friends, family, faith, whatever. The warp is what keeps us going, what allows us to continue into the future, or to imagine a future at all.

Hospital patients also engage in theological reflection, though, because they're lying flat on their backs and, often, have so little else to do. Their daily routines are temporarily absent. They aren't going to work or school, doing housework or gardening, chatting (as much) with friends. In other words, their weft threads have thinned out to the point where they start asking, "Hey, so what're those other things under there?" For some people, illness is the first opportunity they've had or taken for this kind of exploration, for the examination of their lives' deep structure.

That's as far as I've gotten with the metaphor, and people who know more about weaving than I do can probably say more about how one repairs broken warp threads. But I do think this metaphor shows why weaving has always been such a powerful image.

Thoughts, anyone?

The Train

I was at the hospital today when "Code Triage Standby" came over the loudspeaker. This means, more or less, "get ready for a possible mass casualty." No one knew what had happened, but I checked the news on my BlackBerry and saw this story, which many of you have probably already heard about. Our local ambulance company gave the accident their highest emergency rating, and we heard that 150 people had been injured; although we knew the worst injuries wouldn't come to our hospital, we still expected a fair number.

As it turned out, the Code Triage Standby was cancelled, and we wound up getting only one patient. The most severely injured were airlifted to trauma centers; the most minimally injured were treated at the scene, which is about an hour from us. The paramedics who brought in our one patient told us he was the last person to be transported.

He had very minor physical injuries too, even though he was only one car away from the collision, but he was very shaken up. He'd felt the heat and smelled the smoke from the fire, and he helped carry another passenger -- someone much more severely injured, who wound up being airlifted -- away from the burning train. That person's blood was on his clothing; he repeatedly described the injuries. When he asked me for prayer, he wanted to pray for the other passenger.

He cried while we prayed. So did I. I told him to be sure to ask for help coping with this when he gets home. He has to take another train to get there; he was worried about getting back to the Amtrak station, whether they'd honor his ticket.

I'd never want to get on a train again (and it's not like Amtrak ever runs on time even without a huge honking disruption). I kind of hope Amtrak puts him on a bus, or, better yet, buys him a plane ticket. The accident wasn't their fault, but still.

The accident's really weird. How the heck do you run into the fourth car of a train? How do you not see the train? As Gary pointed out, most drivers of smaller vehicles who get hit by trains do so when they're racing across the tracks when the train's coming and don't make it in time, but in that case, they're hit by the front of the train.

The truck driver's dead, so I guess we'll never know, unless an autopsy turns up interesting toxicology. Gary said, "What do you want to bet he was on his cell phone?" but I dunno. Even if you're on the phone, how do you not see a train? It just doesn't make sense.

I've now, as of today's shift, volunteered 1,000 hours in the ER. I wish that milestone had been marked much, much less dramatically.

Deja Vu

At the hospital today, I saw a patient who looked so much like my father -- same bushy eyebrows, same eyes, same hair -- that I almost started crying in the room (and did cry after I left: I hid in a back storeroom for a few minutes and sniffled). These days, I'm pretty good at comforting myself by remembering that I carry my parents inside me, but the shock of seeing those familiar features made me realize, quite painfully for a few minutes, how much I miss having them walking around in the world.

The department was exceptionally busy today. In two hours, I offered chaplaincy services to seventy-four people, and that was just patients, friends and relatives within the ED proper (lots of large family groups today, which always drives up the census). I visited the internal waiting room, but never even got out to the main waiting room. This meant that I didn't have much time to be sad, which was probably good.

A later visit, though, pushed the same buttons: a young woman sitting at her elderly father's bedside, weeping in worry and exhaustion. I gave her a hug and told her that I know how hard it is to be in that position. She seemed to appreciate the empathy.

Do I really want to be sitting next to my father's hospital bed again? Well, no. But I miss walking into any old room and finding him there, eyes twinkling.

Another volunteer chaplain's working from five to nine tonight. If his evening's anything like my afternoon, he'll have a very busy shift!

The End of the World -- Again

So yeah, no Rapture. Not, mind you, that I expected it, but I feel sorry for all the folks who gave away their life savings or whatever, and now have to figure out a Plan B. A friend of mine commented the other day, "Oh, I'd be one of the people left down here, but that's okay, because I really wouldn't want to spend eternity with the others." I agree with him whole-heartedly. This is another way of saying, I guess, that we all get the heaven we deserve.

In any case, I spent all morning at church, but not planning for Judgment Day. It was a "getting to know you" session for those of us from my old church to meet some of the people from my new church. We shared bits of our history -- most of these intensely moving -- and wrote a group prayer at the end. (This was a quintessentially Episcopal document which, in the thanksgiving section, included the phrase "Thanks for postponing the Rapture.")

Because the session had been advertised as four hours long (and indeed ran that long), I brought knitting, a pretty new scarf I'm working on. Knitting's the only way I can survive marathon meetings, even when they're fascinating. At the end we were chatting about the Ministry Fair tomorrow, and I said, "So is there a knitting group here?"

The rector, sitting next to me, turned to look at the scarf and said, "There is now." So I'll attempt to drag myself out of bed early enough tomorrow to go to the Ministry Fair with a sign-up sheet and clipboard to see if anybody else wants to get together to knit.

In other news, I'm about fifty pages into this phase of the revision. If I can keep going at this rate, I should indeed have the book done before Mythcon, although I wouldn't be surprised if a snag somewhere slows me down.

My first short shift at the hospital went fine. My tally at the end of the two hours was a whopping 59 -- which is about average for a four-hour shift -- so my hunch that two two-hour shifts will let me visit more people may indeed be true. I don't think the numbers will always be that high, though. The ER was extremely busy, and lots of people asked for prayer, but there was no one with whom I had to spend a lot of time, which translated into lots of visits, because I was able to keep moving. If there were fewer people in the department, or if more of them had deeper needs calling for longer visits, the numbers would be lower (not that my supervisors really care: it's not like we have a quota or anything, but they do want us to do basic bean counting).

It was strange being there during the week, when the hospital's so much more populated! Signing in, I said hello to no fewer than three staff chaplains. I asked if I should still respond to non-ER codes, and was told, "No, we'll do it." In a way that's a relief, and in a way it feels like a bit of a demotion. Since the professional chaplains respond to all codes, I'll probably be playing a much smaller role even during ER codes: get there first, provide whatever comfort I can, and stand aside when the professionals show up. When my sabbatical ends I'll have to go back to working Saturdays, though, which means they'll probably want me on codes again (if only because an on-call staff chaplain can take longer to arrive than someone already in the building).

As the most recent shift showed, however, there will still be enough to keep me plenty busy. And a lot of patients love being visited by volunteers; they're moved and fascinated that people just like them do this, and ask lots of questions about whether they might be able to do it, too. We're an important part of the hospital ecosystem.

Last Long Shift for a While

As previously advertised, one of my adjustments during my sabbatical will be to break my four-hours-a-week at the hospital into two two-hour shifts during the workweek, rather than doing it all at once on Saturday (the only time I can manage during the academic year because of teaching and meetings). Shifts can run long anyway; last week I was there for five hours. I usually take a meal break, but visiting patients can be hard on the feet -- I do a lot of standing and walking -- and of course the work's sometimes, although not always, emotionally draining.

Today's shift, the last four-hour one before the new schedule, turned into four-and-a-half because there was a code just as I was about to sign out. (I think the staff chaplain who's usually there on Saturdays must be on vacation, because I was the only spiritual-care person who responded to the code, although it turned out the family didn't really want me there. The nurses were doing a fabulous job taking care of them, as well as the patient.) Then it turned into almost five, because a visually impaired visitor needed help finding a room -- so did I, since I barely know that part of the hospital! -- and then, just as I was leaving through the waiting room, a relative snagged me, angry over not being able to go back and visit a patient.

Sometimes it's hard to get out of the building.

It was a good shift. I had interesting conversations with patients. I helped someone who's feeling very isolated brainstorm about possible support systems. I saw cute kids and visited with fascinating older folks; I love hearing their stories! Quite a few people both asked for prayer and responded positively to it. The patient who coded didn't die. The work was smooth and steady -- busy but not too intense -- until the overtime stretch.

Still, it was really good to get home, take a shower, and curl up with a cat for a few minutes. Now I'm going to go downstairs and make a pot of tea. Then I hope to settle into rereading the rough draft of the novel, which I indeed finished last night, so I can start figuring out the billion and one things I need to fix.

That End of the Hall

The ER where I volunteer has a particular set of rooms often used for psychiatric cases. They feature things like steel shutters that pull down over equipment panels, so someone who's acting out can't destroy medical gizmos. Even without such special features, the staff tends to cluster the psych patients close together so that sitters -- staff charged to watch them -- and/or security have only one area to cover.

The rooms were lively today. One patient kept begging to use the cell phones of passersby, and ultimately got into a yelling match with a doctor while security guards and nurses looked on. (It's hard to say who was more frustrated, the doctor or the patient.) Another patient wound up in four-point restraint. "One arm up, one down!" the nurse instructed the security guards who'd be trussing up the patient. She later told me that if both arms are down, the patient can still head-butt someone who, for instance, is changing an IV. If one arm's down at the patient's side and another's over the patient's head, movement's much more restricted. And then we had a frequent flyer, someone notorious in the department and whom I've met at least twice over the last few years, who had already been in two other times this week.

Psych patients have to be medically cleared before they can be sent to psych hospitals (and have to wait for beds to become available in those facilities). They also have to be evaluated by a psychologist, psychiatrist or psychiatric social worker. These individuals aren't dedicated to one department, or even one hospital. They're on call and float among all the hospitals in the area, which means that it can take hours for them to show up.

When you add all these factors together, some psych patients wind up being held in the ER for forty-eight hours. This would be nearly intolerable for any patient, but psych patients are, by definition, already emotionally unstable. Nobody likes waiting in an ER; psych patients are probably less able to handle long wait times than anyone else, and they wind up with the longest wait times of all.

Let's do a thought experiment. Imagine an average citizen who isn't already depressed, paranoid, or feeling violent towards self or others. Maybe you're picturing yourself; maybe you're picturing someone you think is better adjusted than you are. Now, stick this person in a small white room. Deprive this person of all clothing and other personal possessions -- since just about anything you can imagine could conceivably become an instrument of destruction -- and give your patient a humiliating hospital gown instead. Outside the door, park an aide or nurse who peers in at regular intervals.

Your patient will be given food and warm blankets, and may even have a private bathroom. A chaplain may stop by for a chat. Doctors and nurses will show up for a medical evaluation early on, but after that, no one can tell the patient how soon the person performing the psych evaluation will arrive, because no one knows. Once the psych evaluation has taken place, no one can tell the patient how soon a bed will be available at the facility across town. Once a bed opens up, it's anyone's guess when transport will show up. If the patient wants to leave, she or he will be told, "No, you're on a legal hold." Everyone will try to be as nice as possible, but if the patient starts getting cranky, the attitude of the staff is likely to go downhill fast. In most cases -- for reasons I don't entirely understand myself -- the patient won't have access to whatever medication he or she was taking (or not taking) at home. And all of this could go on for up to two days.

At the end of those two days, is your average citizen feeling depressed or paranoid yet? Fighting an urge to scream at people? Looking for things to throw?

Yeah. I thought so.

This system would drive the sanest of us bonkers, and the people subjected to it are already fragile. It stinks. Patients and staff both hate it, and too often vent their frustration on each other as the easiest accessible targets. Patients don't understand why they can't get their meds: they're in a hospital, aren't they? Providers don't understand why patients can't be more reasonable, and resent bad behavior even when that behavior's a symptom of the condition for which the patient is seeking treatment. It certainly doesn't help if the bad behavior involves attempted violence to staff. Even patients (psych or otherwise) who've walked into the hospital tend to start getting rebellious after ten or twelve hours; people who've been brought in against their will are even more unhappy.

Nobody was happy today. I usually like psych patients, but I found this bunch as exhausting as everyone else did (although my heart breaks for our frequent flyer, who's a very sad case). I was on the fringes of a staff kvetch-fest that featured people offering passionate rants about how much they hate dealing with psych patients. They want to be sympathetic; they try to be sympathetic. But they're overworked and have a million other urgent tasks to perform for patients for whom the ER is the front line, not a way station.

"The system's broken," I said. "It's like taking somebody with a broken leg and saying, 'Okay, we're gonna make you stand in a corner for forty-eight hours, on your broken leg, and we're not gonna give you pain meds.'"

People laughed. "That's pretty good, for a chaplain," said one of the docs. (We chaplains are a slow bunch, but we catch on eventually.) A case manager said, "You're right. The system is broken. Can you think of ways to fix it? Would you work on that?" (I think she was being serious, not sarcastic, although I may have missed some nuances in the general haze of fatigue and exasperation. Gary's response, when I told him about this later, was, "Are they paying you a consulting fee?")

"I think what we need is a dedicated psych ER," I said, "and that won't happen." The case manager sighed, nodded, and walked away.

Actually, we don't even need a dedicated psych ER. We do need a few ER staff who are dedicated to psych patients and who'll attend to their needs as quickly as everyone else attends to the purely medical cases. And, most of all, we need a ton more community mental-health resources. If we had those, some of these patients wouldn't wind up in the ER at all, and others would have more options about where to go post-ER.

None of that's going to happen, either, not in this economy. Those kinds of services are the things that get cut when money's tight. (And I've done enough research to know that the conditions I'm describing aren't limited to our area.) And, of course, many psychiatric patients can't pay for their care, which makes everything worse.

One patient today wound up being discharged, a huge relief for everybody. The frequent flyer asked me solemnly if I loved Jesus, and when I smiled and nodded, sang me a song he wrote about being friends with God. Then he rolled over to take a nap, which was probably the most sensible way for him to spend his time. I don't know what happened to the patient in restraints. For all I know, he and the frequent flyer are still in their respective small white rooms, all these hours later, frustrating a new shift of medical staff.

Really, there's got to be a way to do better by these folks. The question is how to do it without spending extra money. If anyone has any idea how to answer that, please let me know.

Easter

Happy Easter.

Last night I attended the Great Vigil, which never fails to move me. The transition from darkness to light is beautiful. This is the first Great Vigil I've attended which used a cantor -- a young woman with a lovely voice -- and that added to the power of the service.

One of the things I loved about my old church was how much of the sanctuary had been handmade by parishioners or former clergy; the altar and roodbeam were carved by a former rector, and the stained glass windows were designed by a former parishioner and cut and assembled, under that parishioner's direction, by a group of people in the congregation who met once a week for many months to work on the project. That happened long before I arrived, but I always loved the story.

Many people in my old parish moved to our mini-cathedral downtown. This is a gorgeous building, but to me it's always seemed like an uncomfortable worship space: too formal and too large, not human-sized enough for me. The church I attend now is on a more comfortable scale (larger than my old church, but smaller than the fancy one), but won't win any awards for aesthetics. The walls are cinderblock with glass bricks scattered throughout to let in light; the floor's linoleum. And above the altar hangs -- may I be forgiven for saying this -- one of the most unappealing Christus Rex crucifixes I've ever seen. It's huge, shiny, and looks like ceramic; light emanates from behind it. To me, it's always looked like a particularly hideous nightlight someone bought at a yard sale. (Last night I was sitting next to our bishop's wife, and she giggled when I said that.) One of the advantages of Lent and Holy Week, from my point of view, was that this excrescence was veiled.

At the beginning of last night's service, I couldn't see it at all, because everything was dark. But part of the blaze of light preceding "He Is Risen!" -- the high point of the service -- came when someone flicked the switch to turn on the nightlight. We were in the dark with just candles, and more candles were being lit, but all of a sudden . . . there he was, the Savior, glowing from the wall in all his ceramic glory.

I got a lump in my throat, and acquired new and grudging respect for the nightlight.

After the service, I told the rector about this. Looking a bit pained, he said, "That piece was hand-carved by a parishioner. It's wood."

"It's wood? It looks like ceramic!"

"It needs to be stripped and refinished."

"Yes, please. Strip and refinish it so it actually looks like wood. I think that would help a lot."

Whether that ever happens or not, I'm now a lot fonder of the thing than I used to be: not just because of the Easter moment, but because the crucifix was a labor of love by someone who belonged to the church.

I didn't go to church this morning, since the pastel-and-Easter-egg scene always makes me itch. Instead, I pigged out on smoked salmon for breakfast, a special Easter treat, and then went to the hospital. It was a pretty good shift; at least one family was actively glad I was there, and I had nice conversations with several staff members. Also, I've discovered a pastoral rationale for going to Hawai'i: it's actually useful at the hospital. Today I had a patient going into surgery who was in pain and very frightened, but I noticed that her husband was wearing a Kaua'i cap, and we had a lively conversation about their trip to the island that distracted her from her pain for a few minutes, and gave me material for a guided visualization exercise later on, when her pain came back.

Let's hear it for tropical islands.

Hands

You're one of the oldest patients I've ever visited, but -- alert, friendly and bright-eyed -- you look much younger than your years. When I ask if you'd like prayer, or conversation, or a warm blanket, you opt immediately for the blanket. "I'm so cold!"

The ER's nearly always cold; staff rushing from one spot to another warm up quickly, while patients shiver. The blanket warmer's one of the most valuable pieces of equipment in the department, even in summer. And although it's technically spring now, snow covers the ground outside, with more forecast for this evening.

So I fetch a blanket for you, and you beam when I spread it over you. You ask for a prayer, then, and I hold your hand and offer one. "I know Jesus is with me," you say when I've finished. "A few years ago I was here and I was just freezing, but then I felt someone holding my right hand. I turned to look, and no one was there! But my right hand was so warm, even though the rest of me was cold."

I love stories like this; they're one of the reasons I volunteer at the hospital. For all the pain and tragedy that fill the building, there are also small, improbable miracles (and sometimes larger ones). Hard-headed, empirically-minded ER staff don't bat an eye at these tales. Whether they believe them literally or not, they know their patients do, and anything that helps a patient feel better is welcome medicine.

Later, as I load more blankets into the blanket warmer in a chilly back hallway, a nurse greets me as she hurries by. Then she doubles back. "Hey, can I ask you a question? You're a chaplain, right? Don't you guys do that Blessing-of-the-Hands ceremony? Can anyone do that, or does it have to be a priest?"

"Any of us can do it," I say. Every October, hospital chaplains spend a week blessing the hands of any staff members who ask. In October, we're given holy oil to daub on caregivers' palms, and a printed prayer to recite. "I don't have the formal props we usually use," I tell the nurse now, "but I'd be happy to offer a blessing anyway."

So, standing in the dim hallway, I hold the nurse's hands. I give thanks for their skill, tenderness, and compassion; I pray for them to continue in strength and gentleness. The nurse beams, thanks me, and rushes away again. "I need to remind myself," she calls back to me as she vanishes around a corner.

"We all do," I answer to her disappearing back.

And then I go back to loading blankets, thinking about all the work done by the many hands here, and reminding myself always to be grateful for how we reach out to each other, and how the divine reaches out to us.

Vacation's Coming!

This time next week, our cruise ship will be on its way to Mexico. I can't wait! We now both own snorkels and wetsuits; corrective masks are on their way and should arrive Wednesday. Today I found the fitover sunglasses I'd misplaced -- they were wedged between the gearshift and the driver's seat in the car -- so we're just about all set.

I've ordered an MP3 of my mother's message: it wasn't very expensive, and I prefer that to fooling with cables. (Thanks again, Danielle! So good to know that service is out there.)

As of today, I've volunteered over 950 hours at the hospital (950.5, to be precise). We had a code, but the patient came back quickly, and I pray he'll do okay in the ICU. Otherwise, my most memorable visit of the day was with a sneering atheist -- a bit like my father, but with much less pleasant manners -- who lectured me for several minutes about how all religions are based on guilt, about how religion is just an addiction, and about how religious people just want to kill anyone who doesn't share their views.

I commented that if religion's an addiction, it's healthier than heroin or meth. He ignored that. When he got to the homicidal believer part, I said, "Y'know, I'm religious, and I'm not trying to kill you, am I? I've never tried to kill anybody. I've never even wanted to kill anybody."

He ignored that, too. It's a source of continual amazement to me that people who a) don't share my faith, and b) are actively hostile to my faith, nonetheless a) believe that they know more about what I believe than I do and b) blithely disregard whatever contrary evidence I'm providing by standing in front of them.

"All religious people only want to kill nonbelievers!" Yes, that's why the hospital chaplain just asked if there's anything she can do to make you more comfortable.

I guess it just goes to show that non-religious folk can be every bit as closed-minded as the believers they're berating. Although, really, when I started volunteering six years ago, I expected much more of this kind of thing (as my father's daughter, I learned to get ready for long, detailed arguments whenever the word "God" popped up). In all that time, only a handful of patients have been nasty, which is really pretty remarkable, when you consider that anybody in the ER is having a very bad day. What amazes me is how polite almost everybody is, regardless of spiritual background. Still, this guy could have used some courtesy coaching from one of our well-mannered Satanists.

Small Piece of Good News

In the middle of running errands this afternoon, I stopped by the hospital to see if my supervisor was in. He was. I asked if he's had a chance to read the ER Sonnets manuscript yet (I gave it to him in December), and he said he's about halfway through it. He likes the poems and sees no HIPAA problems.

That was a big relief, and bodes well for the ultimate fate of the project.

Conversations

Grim and determined, you race through the ER hallways, your hospital gown flapping open behind you, until at last you have to stop. You're ringed in by three nurses, two techs, a chaplain and an ER doc, with security on the way.

"Please go back to your room," the nurse says.

Panting, you stare around, eyes wild. "I have to use the phone! She wouldn't let me use the phone! She said --"

"We'll bring you a phone," says the charge nurse, "but you have to go back to your room, okay?"

A tech's trying to tie your gown. You swat her away. "We can't have you naked out here!" the ER doc says, keeping her voice cheerful and friendly. "That won't do!" You've stopped near the ambulance bay; as people walk by, the doors whoosh open, flooding the corridor with freezing air.

"How about a warm blanket?" asks the chaplain. "I'll get you a blanket. It's cold out here."

"Let's go back to your room." That's your nurse again. "You can get warm there."

You allow yourself to be cajoled back into your bed. By the time you've lain down, security's shown up, two brawny men and a young woman in blue uniforms, all donning blue latex gloves. "I need a phone!" You're hollering now, fists clenched and body rigid. "I need a phone! You said you'd --"

"Here it is." The charge nurse appears with a cordless phone and punches in a complicated series of numbers to get a dial tone. She hands it to you. You hit random keys, scowl at the phone, and shake it. The charge nurse has left; so have the two male security guards.

Your nurse, who's been standing guard outside, comes in now; she and the chaplain manage to coax a dial tone from the phone. You dial again, but your face fills with despair. "Nobody there."

The chaplain hears a tinny recorded message blasting from the phone. "I think it's an answering machine. You can leave a message."

"Leave a message," the nurse echoes. "At the beep."

You take the phone back, wait a few seconds, and start talking. "This is your friend. You need to take care of my things! I'm going to be gone for a while. You have to help me. Good-bye."

The chaplain wonders if anyone will hear this message, or be able to make anything of it, but leaving it seems to have calmed you a little. You're still cold, though, so the chaplain fetches a warm blanket, and then three more, and piles them on top of you. You huddle underneath. Your fingers, when they touch hers, are icy.

"Mommy!" You're staring at an empty spot beside the bed. "Mommy, don't leave me! Take me with you! Take me to heaven! Please don't leave me! Mommy!" The chaplain, who lost her own mother recently, swallows past a lump in her throat. Is this a deathbed visitation? But you look much too young to die.

As the nurse and guard watch from the doorway, you stretch out beseeching hands, and then fall suddenly into a doze. Just as suddenly, you startle awake. Fixing your eyes on that same stretch of air, you keep talking. "Mommy, why are you just standing there? I want to come with you. Mommy!" That last is a drawn-out wail; tears streak your face.

This sleep-wake cycle happens several more times. The chaplain holds your cold hand as you babble to your mother, and then brings yet another blanket. You thank her for it, poiitely, your eyes for once focusing on her rather than on your invisible visitor. Then you fall asleep again.

But this time, when you wake up, something's different. You squint up at the chaplain. "Where am I? How did I get here?"

The chaplain and the nurse explain that you're in a hospital, and why. You don't remember coming here, even though it was your own idea and you got here under your own power. Head cocked, you listen to the explanations, and then sigh. "This is scary. Not remembering."

You roll over in bed. You're facing the place you were talking to before, and sure enough, your eyes focus on that same spot. "Mommy, what are you doing here?" You shake your head. "You know I miss you." You reach up with one arm, hand curving as if cradling someone's head, and then bring your hand down again. When your hand's a few inches from your face, you stop and gently kiss an invisible cheek or forehead. "Mommy, you know I love you. But you have to leave me alone now."

Then you roll over again and go to sleep: a more natural sleep, this time, one that lasts a while. The security guard has left, and the chaplain leaves now too, smiling at the nurse still sitting next to the door. As the chaplain walks down the hallway, she hopes that she has just watched a transition from seeking death to welcoming life, and she hopes that you will not see your mother again -- except in tranquil memory -- for a very long time.