Change of Shift. Carnival of Hope. Spa Day.

AC has posted a terrific edition of Change of Shift, the biweekly nursing blog carnival, over at Protect the Airway. My three favorite posts are Marcia's story about leaving a haunted workplace, Blue's beautiful tribute to the many people who took care of her during a long hospitalization, and Marisapan's heartbreaking farewell to a prison patient. But there are many other wonderful posts, too. Head on over for a look! (And AC, thanks for including me!)

Speaking of blog carnivals, today at 5:00 is the deadline for this month's Carnival of Hope. Send me your stories of light in the darkness!

I'm feeling a little lighter myself today, after being completely decadent yesterday. I got up very very very early for my 8:00 appointment with my primary-care doc . . . but at 7:30, just as I was about to leave the house, the phone rang. PCD was ill, so I've rescheduled for January 2. So I sat and chilled out at home until it was time to go to my therapy appointment, where Beloved Therapist once again urged me to see an actual shrink to discuss meds adjustments. BT thinks some sort of multi-drug cocktail is in order. This idea horrifies me, but BT says it shouldn't. I told her I'll think about it if my mood doesn't improve (as it usually does) in January.

In the meantime, we talked about the whole depression-as-invisible-illness problem, and she showed me a fascinating book by a doctor named Daniel Amen, who's used brain-imaging studies to show that conditions often considered purely psychological are physical as well. Among other things, depressed brains don't look like normal brains. Intellectually, I knew that, but it's nice to have pretty pictures to back it up. Amen's website makes me a little nervous, though, because it's so clearly commercial; I know the guy has to make a living, but his site still pushes my pseudoscience buttons. Sure enough, it looks like people who know more than I do agree with me about that. I still like the brain pictures, though.

BT gave me many pats on the back for being so good about exercise; I've been worse this week, but she still says that I'm one of her only patients who makes exercise a priority. So after our appointment, I hied myself to the health club, where I'd been planning to go anyway. When I walked in, I saw a list of available massage appointments, and grabbed one.

I wound up staying at the club for four and a half hours. I soaked in the whirlpool, sat in the steam room, swam for forty-five minutes, baked myself in the sauna, showered, and then had an hour-long massage. Aaaaaaah! Spa day! Bliss!

My massage therapist is applying to nursing school, and told me that the first massage therapists were nurses, because massage is so effective for pain relief. I hadn't known that, but it made sense.

After Spa Day, Gary and I went out for pizza (cheeseless, in my case) with friends. Then we came home and watched an episode of Rome. It was a very nice day.

Today's to-do list: Grading. Shopping. Picking up Gary's relined jacket from the fancy-fur place. Working on Carnival of Hope.

First Shelter Sighting!

I have a history of learning writing news from the internet before my publishers have told me about it. In 2000, for instance, I learned that my story "Going After Bobo" was going to be included in Gardner Dozois' Year's Best Science Fiction: Eighteenth Annual Collection when I found a Table of Contents on the net during a routine ego-search. Gardner hadn't even sent out contracts yet, and didn't realize that the TOC had been posted. He was very startled when I e-mailed him about it.

So last night, I decided to see if I could find any information about my third novel, Shelter, which is coming out in June. Imagine my surprise when I found the book on Amazon Canada. Imagine my even greater surprise when I saw that the novel was being published in trade paperback, rather than the hardcover I'd expected.

After a flurry of panicky e-mails and phone calls this morning, I've determined that all is well. The book is indeed coming out in trade paper, but my editor Patrick -- who didn't realize that a final decision about publishing format had been made yet, and was as startled as I was to see the Amazon Canada page -- assures me that this is A Good Thing. Shelter's a huge book, 576 pages, and in trade paper, it will be more affordable for more people, and will (we hope) sell better to the big chain bookstores. And I'll still get reviews and library sales, especially since Tor's doing a four-color bound galley. Patrick assures me that the book's getting positive attention, rather than being sidelined, which was what the change of format originally made me fear. I'm still having a bit of trouble overcoming my "hardcovers are more prestigious" bias, but I'll get over it. My agent, who's an avatar of calm and reassurance, tells me that I should be happy, and she knows what she's talking about.

Patrick also reports that the cover looks much better in real life than on a computer screen. On the computer, it's hard to see that what looks like white space is in fact covered with a subtle blueprint, and that the windows of the house are circuit boards. I figured this out last night by tilting my laptop screen for greater contrast, but Patrick says that those details are clearly visible on the printed cover. I'm happy to hear it, since the book is indeed science fiction, rather than a Victorian ghost story (which was my initial impression of the cover).

Here's the back-cover copy for the galleys:

The three basic human needs are food, water . . . and shelter. But in the late 21st century, compassion is a crime. You can get your memories wiped just for trying to help.

Papa Preston Walford's world doesn't allow for coincidences. Accidents. Secrets in the back of closets. Or the needs of his own daughter.

Meredith Walford has reason to seek shelter. She needs protection from the monsters in her mind, in her history, in her family. And the great storms of a changing climate have made literal shelter imperative.

When a cutting-edge, high-tech house, designed by a genius with a unique connection to Meredith, overcomes its programming to give shelter to a homeless man in a storm, from its closets emerge the revelations of a past too painful to remember.

In the world of Susan Palwick's Shelter, perception is about to meet reality, and reality has mud all over it. The truth won't make you happy, but it may just make you whole.

This isn't what I would have written, but I've learned that cover blurbs are about marketing, not about accurate plot synopsis. If this copy sells books, more power to it.

Walking the Dog: Addendum

Driving home from work tonight, I heard a piece on NPR's All Things Considered by a cancer care nurse, Jeff Curl. One of Curl's patients, named John, had both depression and cancer, and John's comments about the two illneses resonate with my post Walking the Dog. He talks about how when he just had depression, his family thought he was lazy and didn't want to get up and work; but when he got cancer, previously judgmental relatives suddenly started being kind to him, and strangers bought Christmas presents for his kids.

It's a moving audio essay, and you can listen to it here. Or you can read a slightly longer, fuller print version here:

I think a part of him was relieved to be dying. He had endured a tremendous amount of physical discomfort battling his lymphoma —- pain caused by tumors growing throughout his body, all of the lab tests and intravenous lines, the excruciating fatigue and dangerously low blood counts that come with a transplant.

Yet despite all he had suffered through the course of his cancer, it was easier than the burden he had carried all those years from his other disease.

In personal depression news, today the friend who gave me my lightbox stopped by my office to chat, and asked how the lightbox was working. I told him that I think it is working, but that I'm still having a tough time at the moment (as almost always happens at the end of the semester). It made me sad to have to say that; I wanted to be able to tell him, "Yes! The lightbox has fixed everything! I feel 100% better!" On the other hand, it was really nice that he asked.

Tomorrow I see both my therapist and my primary-care doc (for my quarterly meds-management appointment), so we'll see if they think I need to have the meds situation evaluated by an actual shrink. I hope not. I'll try to convince them that this is just the time of year, tra-la-la. I truly do always feel immensely better on January 1, so with any luck, that pattern will hold this year.

Part of my melancholy at the moment is that my last classes were today, which is a happy moment but also, always, a weirdly anticlimactic one. Now it's all over but the grading. And the shopping. And the planning courses for next semester.

But tonight, we watch DVD TV: namely Rome, which we just started and are warming to after the first four episodes. The first two were pretty lurid, even for HBO (and even for Gary, who has a far stronger stomach for this stuff than I do). It's a gorgeous and fascinating show, but if you're squeamish about blood, guts, and full frontal nudity -- of both genders -- you may want to avoid it.

Nursing Theater

UNR's winter commencement was last Saturday, and the paper carried this story about the top nursing graduate:

"In addition to intelligence and self-assurance, Jamie Souba has another quality that will make her a great operating room nurse.

"'She has beautiful eyes,' said Peg Farrar, one of Souba's instructors at the University of Nevada, Reno's Orvis School of Nursing.

"'In the operating room, everyone is wearing a mask and all you can see are their eyes,' said Farrar, who was Souba's faculty mentor. 'You have to help people who are usually pretty scared, and you can't see all the usual facial expressions. You can't even touch patients because you have to keep your hands sterile, so you have to use your eyes to reassure them.'"

Reading this article made me think about something I'd only realized subconsciously: the extent to which good nurses very deliberately use body language, gesture and tone of voice to communicate with patients. In the ED where I volunteer, I've heard burly male nurses, people who might otherwise be intimidating, soften and lower their voices to reassure helpless patients. I've seen small female nurses adopt hands-on-hips fighting poses when dealing with confrontational patients. I've watched nurses switch from working a code (all business, emotions suppressed, each movement as economical as possible), to comforting a frantic family member (empathetic expression, arm around shoulder, voice that radiates compassion) -- and back again, all in a matter of seconds.

Good nurses, I've decided, have more than a little in common with good actors. They know how to use their entire bodies to reinforce their words, and they're exquisitely aware of the impression each gesture and intonation will produce in their audience. I've read several nursing-blog posts whose authors made rueful comments about deserving Academy Awards for their performances: for pantomiming concern when all they felt was exhaustion, for projecting calm when inside, they were panicking.

There's a lot to be said for knowing what people need and delivering it, even when it may not be 100% sincere. I've met some nurses who are excellent technically, but who simply can't adjust their self-presentation to circumstances: nurses who talk to frantic family members exactly the same way they talk to other members of the code team (noting with clinical detachment, "oh, yeah, these numbers are off the chart, really bad"), or who maintain a machine-gun conversational style even when patients are terrified and need to be spoken to slowly and softly. These nurses aren't bad people: in many ways, they aren't even bad nurses. They're admirably authentic, but they aren't good actors. And medical crises often call for good acting, rather than authenticity.

I've learned to recognize when nurses are acting, and I think many patients and relatives recognize it, too. But that's okay. We all appreciate the performance. I doubt that nursing schools including acting techniques in their curricula, but maybe they should.

Grand Rounds! Carnival of Hope Reminder!

This week's Grand Rounds is up! Head on over for the weekly best of the medical blogosphere.

And please remember that the deadline for this month's Carnival of Hope is coming up fast: this Thursday, two days from now, at 5:00 PM PST. Please e-mail me your submissions!

An Excellent Sunday, Despite Exhaustion

Yesterday, to my great relief, went fine. (And I slept well last night: hallelujah!)

Church, with Brecht

As planned, I went to the 8:00 church service, where one of our deacons -- who's also a theater instructor -- gave a very moving homily about how difficult it is to be good in a broken world. He discussed Bertold Brecht's The Good Woman of Setzuan, in which three gods come down to Earth looking for a good person. They find a prostitute named Shen Te who does everything she can to help her neighbors, but who's so disillusioned by the process that she has to create a hard-hearted, calculating male alter-ego to survive. Our deacon just finished directing a production of the play, and one of his students, in costume, delivered one of Shen Te's monologues. The play concludes by asking the audience how it's possible to be good, and ends with the line, "There must be happy endings: must must must."

Our deacon told us that when the three gods come to earth looking for good people, they're looking for us.

Any regular reader of this blog will guess how much this moved me, especially given how frustrated and angry I'd been about the state of the world yesterday morning. The homily broke me wide open; it was one of those mornings when I sobbed through church, although a lot of that was probably just sleep deprivation. As happens so often, I showed up for the service feeling weary and cynical and then heard exactly what I needed to hear: a message that affirmed the reality of light without denying the reality of darkness.

This is why I love Christianity, at least as it's practiced in my parish: it doesn't simplify or sugar-coat anything, but it also insists that realism needn't be synonymous with despair.

And after church, also as planned, I got in forty minutes of swimming, which always makes me feel better.

Assisted Living, with Ukeleles

When I got back from the health club, I sat down to make Christmas packages for the assisted-living service: three of Gary's ginger cookies in a baggie, wrapped in red cellophane, tied off with red curling ribbon attached to a World Market animal ornament. Gary took the photo at the beginning of this post, showing some of the ornaments, which were all different and really funny. The seahorse and hedgehog were my favorites. Wrapping the packages made me feel Christmasy for the first time this season.

Three of us from church came to the service: I officiated -- if that's the right verb for someone who isn't ordained -- and two friends played their ukeleles (they're from Hawaii) and led us in singing Christmas carols. The Mormon Tabernacle Choir we weren't, but it was great fun. Six people from the facility came, five residents and one staff member, which makes it one of the larger services I've done there. I think everyone really enjoyed both the music and the Christmas favors, and there were nine packages for nine people: perfect!

A new lady had come, rather shyly, and asked if she could join us. Of course I said yes, and also assured her that she could take Communion (our parish's written policy on this is that anyone who loves God and seeks a deeper understanding of God is welcome at God's feast). At the end of the service, when everyone was picking out packages, the newcomer chose the purple seahorse ornament, with great delight, because purple is her favorite color. "I never would have guessed that I'd get a purple seahorse today!" One of my regulars took the hedgehog, and told us that her English grandmother had a pet hedgehog when she was growing up in the Midlands. Another regular picked one of the bird ornaments, and said that she wants to come back as a bird after she dies. So the favors turned into an opportunity for grace and some personal stories.

I also found out that the staff member who joined us is a UNR student whose boyfriend volunteers in the same ER I do. Small world!

Hospital, with Trail Mix

After I'd dashed home, grabbed dinner and changed into the Magic Shirt, I went to the hospital for my ER shift. It was pretty calm while I was there. The place was becoming much livelier when I left -- we were starting to get hammered with ambulances -- and if I hadn't been so tired, I might have stayed longer, but at that point, I could hardly see straight. I'd gobbled down some trail mix halfway through the shift; I often have a snack just to sit down for a few minutes, but this time, the calories definitely helped me keep going.

Before my shift started, I had a nice conversation with one of the staff chaplains and another volunteer, someone who finished CPE and volunteers about five hundred hours a week. I mentioned the recent chaplaincy controversy over at PlainViews, and the staff chaplain rolled his eyes and said, "Most board-certified chaplains know how helpful volunteers are. Sometimes you guys are the right people for the job in ways we aren't." I'd already known he felt that way, but it was nice to hear it.

During the shift itself, I spent a lot of time with a psych patient who's facing a number of scary challenges, and who mainly needed someone to hold her while she cried (which was about all I had energy for last night). She brought out the best in the staff: everyone was very compassionate to her and concerned about her. I think most ER staff really do usually feel this way, but they don't always have the time and space to show it. Listening to staff expressing their sadness at her situation helped me, because it was another reminder -- on a day that had begun with my desperately needing such reminders -- that most people really do want to make crooked roads straight, and try to accomplish that however they can, and get as frustrated as I do (or as Brecht's Shen Te does) when they can't, when systems or circumstances defeat them.

When I got home from the hospital, Gary said, "So you made it? You're still standing upright?" I was, but not for long!

In Which We Feel More Rickety Than Usual

Today's Gospel reading is Luke 3:1-6, which includes the famous passage from Isaiah:

"The voice of one crying out in the wilderness:
'Prepare the way of the Lord,
make his paths straight.
Every valley shall be filled,
and every mountain and hill shall be made low,
and the crooked shall be made straight,
and the rough ways made smooth;
and all flesh shall see the salvation of God.'"

This is one of the reasons I have so much trouble with Advent. We hear this passage every blessed year, and every year I think, "Oh, yeah. That promise was made thousands of years ago, and are we even close yet?"

It doesn't help that today is Human Rights Day. I won't go into the United States' dismal current record on this -- there are enough bitter, cynical, nay-saying political blogs out there, and I don't like reading them and certainly don't want to write one -- but then again, you probably don't need me to, because you've all seen the recent story about how the U.S. locks up more people than any other country, right? We have 5% of the world's population, and 25% of its prisoners. Go, us.

It doesn't help that I live in Nevada. I love Nevada, really, but it has a generally dismal social-service record. This morning's paper included this story about the state's Mental Health Court:

Defendants in mental health court participate in a yearlong program in which the state pays for rent, therapy and medication until they are deemed capable of living outside the court's supervision. Fewer than 20 percent are arrested again.

On the one hand, that's a very heartening success record, and this program actually costs less than locking people up. (To learn more about mental-health issues inside prisons, see this post at Anxiety, Addiction and Depression Treatments.) But because Nevada's mental-health services are otherwise so poor -- in the state that consistently has one of the country's highest suicide rates -- it also means that the best way to get help here, if you're severely mentally ill, is to commit a crime.

What's wrong with this picture?

Okay, I know: it's not like there's ever any lack of bad news. My thinking right now is colored by the fact that I spent most of yesterday fighting off a migraine, got no exercise, got the bad news about my friend last night, and woke up at 4:00 this morning, after roughly four-and-a-half hours of sleep. Today's one of my marathon days: church, followed by a communion service at an assisted-living facility, followed by a four-hour hospital shift. I love doing all that, but having it all on one day is exhausting even when I've had enough sleep.

So as I lay in bed, staring up into the darkness, I came up with a plan. I almost always go to the 10:30 service, because I like the music. But this morning I feel like quiet, and since I'm up so early anyway, I'm going to go to our 8:00 service, which doesn't have music. That will give me time to swim before I go to the assisted-living facility.

Because that (very small) service is monthly, this will be our Christmas celebration. Two friends from church who can actually sing are going to come along to sing Christmas carols. Yesterday, Gary baked ginger cookies, at my request, and I went to World Market and bought some cute animal ornaments; at some point today, I'm going to make up little gift packages with cookies and ornaments to give to the people at the service. That will probably make me feel better.

Then I'll shoot home, grab a quick bite to eat, and head off to the hospital. We'll see how that makes me feel: it's impossible to predict!

And if I can't sleep well tonight after all of that, I'm really in bad shape.

Good News/Bad News

My father's home from the hospital, and seems to be doing pretty well. He's not feeling great, but he has visiting nurses coming by, and housekeeping help several times a week also.

I just got a call about the friend who had brain surgery on Wednesday. None of his friends had heard the biopsy results, which were supposed to be back yesterday, and everyone was nervous. And yes, it's bad news: an extremely aggressive kind of brain cancer (GBM Grade IV, for you medical types). The surgeons think they got it all -- which is something -- and he'll be starting chemo and radiation in a few weeks, with possible clinical trials in the interim.

He's home now, three days after brain surgery, and sent out a long, funny e-mail to friends and family. Amazing.

The Magic Shirt

This is the pattern of the scrub top I wear to the hospital. When I started volunteering as a chaplain, I wore street clothes, usually in fairly subdued colors. For a while, my standard outfit was entirely black, although I wore bright jewelry with it. Then, a year ago this past October, I went to get my free-to-volunteers flu shot at the hospital. There was a scrubs sale outisde the auditorium where the flu shots were being given. I saw this top and fell in love with the fabric, and I've worn it to every shift since then.

The first time I wore it, I was heading into the ER when one of the registration clerks started teasing me. "Oh, look at you! You're wearing scrubs now!"

"Yeah," I said, "I've gone native."

The clerk laughed. I think some staff find it annoying that I wear scrubs, as if I'm trying to look like a medical professional when I'm not. And patients do sometimes mistake me for a nurse, although some of them -- usually the ones begging for pain meds -- did that even before I started wearing scrubs. (Drug-seeking patients are an enormously fraught subject for ER staff. I've read agonized blog posts by people who dismissed Patient X as a drug-seeker, only to discover that the person was suffering from some genuine, hideously painful ailment. My own definition is simple: drug-seeking patients are the ones who keep begging me for Demerol even after I've said, "I'm sorry, but I'm the chaplain, so I can't help you with that.")

I don't care if my scrub top annoys other people, though, because I love it so much. The colors are gorgeous, and to me, the hearts and suns and moons and stars are all images of creation, reminders of the glory of God. Lots of patients have complimented me on the shirt. One gentleman, who was very enthusiastic about astrology, wanted it buy it from me so he could hang it on his wall. (I didn't sell it to him, but I gave him the name of the company, Cherokee, so he could buy his own. If I were a better Christian, I suppose I'd simply have given it to him.) And several times now, the shirt has had a very salutory effect on somewhat, ah, colorful patients.

A few weeks ago, I walked into one of our critical-care rooms and asked the nurse if I could visit a particular patient. "You don't want to talk to him," she told me. "He curses every other word."

Actually, cursing bothers me much less than it seems to bother many of the medical staff, or even the patients. Whenever someone at the hospital apologizes for cursing in my hearing, I say, "If God really minded bad words, we'd all be charcoal briquettes by now." But the patient was deep in conversation with someone else, a friend or relative, so I decided to come back later.

Before I could get back to that bedside, though, I saw the patient being wheeled to radiology. When he saw me, his face lit up. "Oh, what a pretty shirt! I love the colors!"

Now, that's not very blasphemous, is it?

A few weeks before that, we had the mother of all screamers in the ER. It was a busy night, and all the rooms were full, so the patient was on a gurney in the hall: struggling against four-point restraints and a chest strap, hurling very high-decibel expletives at everyone in range as a nurse with nerves of steel tried to start an IV, and as a cast of other characters -- me, several security guards, and a few other nurses and techs -- tried to calm her down.

"Ma'am," I said, "can you please be quiet? There are a lot of people here who don't feel well, and they need to rest."

"I DON'T F***ING CARE!"

"Ma'am," said one of the nurses, "there's a sick child trying to sleep in that room right there." (There wasn't, but the nurse told me later that this ploy sometimes works with obstreperous patients.)

"I DON'T F***ING CARE! YOU F***ING PEOPLE CAN'T DO THIS TO ME!"

One of the techs decided to use reverse psychology. "You just don't care about anybody else, do you?"

"I DON'T F***ING HAVE TO LISTEN TO THIS! LET ME OUT OF HERE! I WANT OUT OF THIS F***ING PLACE!"

The husband of another patient came barreling out of a room across the hall. "Lady, my wife has a migraine, and she doesn't need to listen to you! Would you just shut up?"

"I DON'T F***ING CARE! LET ME GO! LET ME UP! HELP! HELP! HELP!"

This went on, and on. And on. We stood around helplessly, racking our brains for other strategies. And then, mid-scream, the patient raised her head (not an easy task, with all those restraints), saw me standing at the foot of her gurney, and said in a perfectly normal, conversational voice, "Oh, and I like your shirt!"

The nurses, techs and security guards all turned and gaped at me. I gaped at the patient. I'm pretty sure we were all thinking the same thing. What in the world? The patient, oblivious, drew in a deep breath and resumed her screaming. "LET ME GO! YOU F***ING MOTHERF***ERS CAN'T DO THIS TO ME! I HATE IT HERE! LET ME F***ING GO!"

Okay, so the magic shirt only worked for a few seconds. (Haldol and Ativan ultimately worked much better.) Still, they were a very welcome few seconds.

During another recent shift, I introduced myself to a patient who cocked her head, squinted at me, and said, "You don't look like a chaplain."

"Really? What do chaplains look like?"

"They don't wear scrubs."

I told her the story of finding my magic shirt, and we talked about why she was in the hospital, and about her job and family. At the end of the conversation, she smiled and said, "It's good that you don't look like a chaplain. It makes you less threatening."

Amen to that!

My magic shirt has faded now, from over a year of washing and ironing. (I never iron anything else, but ironing the magic shirt is a pre-shift ritual.) It's not nearly as pretty as it used to be. But that's okay, because I have it on good authority that Santa's bringing me another for Christmas.

Funny Classroom Conversation

Yesterday in my fiction class, we workshopped a story about the Four Horsemen of the Apocalypse having lunch in a dive bar. It was a fun story, but the author hadn't identified the Horsemen explicitly, instead relying on their personalities and conversation to clue in the reader. Several people in the class were annoyed, because they hadn't been able to figure out who these characters were. One student, in particular, was a little grumpy about being left in the dark, although others -- including an older female student who's Muslim -- really enjoyed deciphering the clues. In our discussion, I pointed out that the author had automatically limited his audience by relying on cultural knowledge that not everyone has.

Author: But I thought everybody knew about the Four Horsemen of the Apocalypse! You hear about them on Republican talk radio all the time!

Grumpy student: Well, I'm not Christian, and I don't listen to Republican talk radio!

Me: I am Christian, and I don't listen to Republican talk radio.

Female Muslim Student: I'm Republican, but not Christian.

Watch those stereotypes crash and burn!

RCoDG: The Logo Challenge!

After I posted my "gold star award" yesterday, it occurred to me that gold stars are really awfully generic. I mean, everybody uses them. So then I thought I should try to come up with a specific Rickety Contrivances of Doing Good award (my friend's health club would definitely get one), and from there, it didn't take me long to decide that this blog needs a logo.

Which leads to the question: Just what the heck does a Rickety Contrivance of Doing Good look like, anyway? My initial idea was to find a picture of some sort of Rube Goldberg machine performing a good deed -- feeding a baby bird, maybe -- but that's probably too complicated for a logo (and I couldn't find anything in Google images that even came close to what I wanted). Then I started looking for pictures of broken-down or dilapidated robots doing nice things: no go. Gary found this picture of a makeshift doggy wheelchair, which is awfully cute but won't quite do for a logo, either. And with any existing image I'd be using a lot, there'd be copyright issues.

So, two questions:

1. What should the logo look like?

2. Is there anybody with drawing skills out there who's willing to take a stab at it? I think this one's beyond my modest artistic ability. My nephew's very interested in, and skilled at, graphic design, so I may ask him if he's willing to figure something out, but I'd love to hear ideas from other people, too.

Thanks!

Also, brief medical updates: My friend came through the brain surgery, although there won't be biopsy results until tomorrow. And tomorrow's also when my father's coming home from the hospital.

The Chaplaincy Debate: A Voice of Reason!

Over at PlainViews, the volunteer-chaplaincy debate continues. The Rickety-Contrivances-of-Doing-Good Gold Star Award goes to Mark Grace (how's that for an appropriate name?), the Director of Pastoral Care & Counseling for Baylor Health Care System, who says:

"I'm the director of pastoral care in a large, faith-based health care system in which spiritual care volunteers have increased the reach AND the quality of pastoral care that our chaplains provide to the patients and family members served by the 16 hospitals in our health care system. Furthermore, repeated research in a wide variety of helping disciplines that offer services MOST like those which chaplains offer has demonstrated conclusively that, for about 80% of individuals in need of care, nonprofessional helpers are as effective as professional helpers.

"I cite this statistic to every new group of volunteers who train in our system –- as I did when I developed a large volunteer program in a regional public hospital in the East.

"I do so for two reasons –- one is to affirm their capacity to successfully carry out the divine call we share with them –- to offer themselves in compassionate service to the spiritual needs of others. The second is to stress to them how MUCH they assist our chaplains to increase the effectiveness of their ministry by focusing on the approximately 20% of individuals who desperately need the services of a professional chaplain."

Hurrah! You go, Mark Grace!

While other professionals in the debate have spoken in favor of volunteers, this is one of the most straightforward and least defensive responses I've seen. Grace also says quite bluntly that the anti-volunteer contingent is driven by fear.

You can read his full response, and others, here.

A Most Excellent Rickety Contrivance

A friend of mine has just been diagnosed with a brain tumor, and will be having emergency surgery tomorrow morning. Tonight I called to wish him and his wife luck; they both told me that they feel like they're "levitating" on all the prayers people are offering for them.

Among other things, this will be a major financial drain, so they're doing everything they can to cut expenses. A few days ago, my friend's wife filled out a form to cancel their health-club membership. The form asks the the reason for the cancellation, and she told the truth: explained that her husband has a brain tumor and that they can't afford the membership on top of medical expenses.

The next day, someone from the health club called her and said, "We want to give you a scholarship."

She's incredbly grateful, because she knows she's going to need the stress relief of exercise during this ordeal. I started crying when she told me about it. She said, "You don't expect a corporation to come through like that, you know?"

Right. Exactly.

Grand Rounds, and Another Dad Update

This week's Grand Rounds is up over at The Antidote. Thanks to Emily DeVoto for including me, and for her kind words about my writing.

In other medical news, my father's still in the hospital (no longer in MICU, though), but sounds -- and seems to feel -- better. Today he's seeing a physical therapist who'll help him with walking. Mobility's been a big issue for him, so I hope this helps.

Also, I added a new sidebar link, to Dolittler, a veterinary blog, which I found via Fat Doctor.

Enjoy!

Monday Miscellany

1. Last night's hospital shift was low-key and satisfying, neither too busy nor too quiet. A lot of patients requested prayer, which always makes me feel useful, and I also got to do a bit of Girl-Detective stuff: going online to help a patient find an AA meeting, helping medical staff try to track down the family of a patient who couldn't communicate very well. The staff hadn't been able to find ID or anything containing phone numbers in the patient's personal effects, but I spotted a doctor's note written on a prescription pad and said, "So if this is the patient's doctor, maybe we can get info that way?" I don't think that lead ultimately panned out -- although the staff did finally reach the patient's family -- but the medical folks thanked me and pursued it, so I felt as if I'd been of some value. And I got the chance to pass along a compliment: last week, the spouse of a patient in very bad shape, someone who'd been in the hospital before, sang the praises of a nurse who'd been kind, competent and caring during a previous crisis. That nurse wasn't working last Sunday, but was last night, and I remembered to share the story. I think it made the nurse feel good. I know it made me feel good.

2. Speaking of chaplaincy, today my friend Claire e-mailed me this New York Times article about workplace chaplains. It includes some moving chaplaincy stories, and also mentions Storm Lake, Iowa, where my friend Inez lives with Rickie the Wonder Dog and her two cute cats.

3. Speaking of two cute cats, I submitted my cute-cats-pix post to Carnival of the Cats, where Harley and Figaro are now in good company with many, many other adorable cats. We got your fur fix right here!

4. Speaking of blog carnivals, please don't forget that the deadline for the next Carnival of Hope is Thursday, December 14 at 5:00 PM PST. December's theme is "light in the darkness." Please e-mail your submission to SusanPal (at) aol (dot) com, and please remember that I'm looking for personal stories. I've been getting a lot of submissions from slick, semi-commercial "inspirational" blogs, and while some of those posts are worthwhile, that blog genre in general makes me a little nervous. I'd really love to have more material from just plain folks, you know?

That's it for now. Have a good Monday!

The Kingdom in the Chaos

Of all the seasons of the church year, Advent's my least favorite time to preach. The readings just don't appeal to me. Every year, though, I wind up doing at least one Advent homily. I was originally supposed to preach next Sunday, but the person who was scheduled for tomorrow needed to switch -- and when I looked at the readings, I realized that I'd preached on them three years ago as a guest homilist at another parish. So this is an old, very slightly recycled homily. I hope the references to 9/11 (which was more recent three years ago) won't seem too dated. When I reread this, I liked it too much to change a lot of it, especially since Advent scriptures are always such a struggle for me. That may be a sorry combination of vanity and laziness, though.

The Gospel is Luke 21:25-36.

* * *

“There will be signs in the sun, the moon, and the stars, and on the earth distress among nations confused by the roaring of the sea and the waves. People will faint from fear and foreboding of what is coming upon the world, for the powers of the heavens will be shaken. Then they will see the Son of Man coming in a cloud with power and great glory.”

Happy New Year!

Today is the beginning of Advent, the first season of the church year. Advent is when Christians are called to prepare for the arrival of Christ. During these four weeks, we get ready to celebrate Christmas, the festival that marks Jesus’s first arrival on earth 2,000 years ago. But Advent also reminds us to watch for the Second Coming, the one that hasn’t happened yet: the scary one that will be preceded by all kinds of chaos.

I always find Advent a disjointed, disquieting season. On the one hand, we have Jesus arriving in a cradle in first-century Judea. On the other hand, we have Christ arriving in a cloud, at some undetermined date, in the middle of storms and earthquakes. Advent makes me feel torn between the distant past and the unknowable future. Advent asks me to connect Incarnation –- the beginning of Jesus’ life –- with Apocalypse, the end of the world as we know it. Advent makes my head hurt.

And most of us have enough headaches right now. With Christmas scant weeks away, we find ourselves in a frenzy of shopping, wrapping, mailing, baking, decorating, making lists, checking them twice, fighting for parking spaces at the mall, and collapsing in exhaustion when we get home. We already have more chaos than we can handle. Contemplating apocalypse simply isn’t something that most of us want to add to our holiday to-do lists.

And, just to contribute to the confusion, does anyone else think it’s pretty weird for Jesus to compare the end of the world to a fig tree? “Look at the fig tree and all the trees; as soon as they sprout leaves you can see for yourselves and know that summer is already near. So also, when you see these things taking place, you know that the kingdom of God is near.”

So people fainting from fear and foreboding is like a tree putting out new leaves? How does that work, exactly? Jesus’ parables are usually a little puzzling, but this one seems extreme, even for him. How can distress and destruction, storms and earthquakes, be compared to the joyous springtime budding of trees? How are those two things even connected?

Once again, we’re being handed a headache. We’re being torn between two apparently contradictory images.

One is an image of death. The other is an image of resurrection.

One is a description of Good Friday. The other is a description of Easter.

I can just picture Jesus smiling and saying, “Do you get it now?” Jesus links these two images because Jesus himself is the link between death and new life. Jesus makes that connection because he is that connection. Jesus reminds us that rebirth cannot happen unless death has happened first. He reminds us that a new world cannot come into being unless the world as we know it has first been destroyed. He reminds us that when things seem craziest and most chaotic, that is when we are actually closest to the Kingdom. Jesus did come in a cradle, and he will come in a cloud, but he also comes to us now, every day, because the Kingdom isn’t simply some future event. As Jesus reminded the Pharisees, a mere four chapters before this morning’s reading from Luke, “The Kingdom of God is within you.”

Worlds end all the time. The world as we know it ends whenever a loved one dies, whenever we move or change jobs or go to war, whenever we go through periods of pain and turmoil. As Jesus says in this morning’s Gospel, “it will come upon all who live on the face of the whole earth.” Chaos comes in all kinds of forms: personal, local, national. I’ve been through times like that these last few years; so has St. Stephen’s; so has the Episcopal Church. These are the times when the sea and sky are raging; when there’s too much to do and not enough time to do it; when every time the phone rings, it’s bad news. Good people are taken for no reason, and bad people triumph. There’s too much loss and too much pain. Hope seems very far away; grief overshadows everything. All the fig trees have been blasted, and we don’t know if they’ll ever bud again. These are our Good Fridays, when all we can do is hang on and wait for Easter. And this is when the Kingdom is closest to us, because every other defense has been stripped away. This is when Christ appears, in clouds and other disguises.

Several years ago, Episcopal Life printed a story about the relief mission at St. Paul’s Chapel in New York City, which became a refuge for rescue workers and volunteers after the September 11 terrorist attacks. According to priest Lyndon Harris, New York became “unfrozen” after the tragedy. “I saw a glimpse of the Kingdom,” Harris said, “people working together in loving relationships. That glimpse of the kingdom will haunt me for the rest of my life.” After a relief worker hurt his leg, an elderly black woman who had heard about the injury caught a bus to Ground Zero. She struggled into St. Paul’s and gave the worker the cane she used to walk. Then she left. (Note 1)

Vincent Druding, who kept a journal of his own volunteer experiences at Ground Zero, tells a similar story. He had been working nonstop for five days, and he was exhausted. He wanted very badly to go to a mass being held that evening, but realized that he had missed it. And then “a nameless priest in a white robe” appeared, in the middle of a chaotic supply area, and offered Druding the Eucharist:

Here, amid the nonstop movement and clutter of bodies and buildings, amid the constant acrid smell of smoke and smog, amid the signs reading “Warning, high levels of asbestos here!” amid the dozens of workers who seemed always on the verge of breaking down in tears, amid the steady flow of sobbing civilians who toured the place where their loved one lay entombed, amid the constant sounds of machines, crashing metal, and sirens, amid all the destruction and death -- here was a pocket of peace. Here, Christ was present, not only among us, but now, again, inside me. (Note 2)

In the heart of chaos, Vincent Druding found himself standing before the Son of Man.

The chaos following September 11 was among the worst our country has ever experienced, but we survived it. We lived through all that grief and loss and sorrow, with the help of a lot of people working together in loving relationships. We lived through the end of the world. Most of you probably have your own stories like this: tales of personal apocalypse, terror and tragedy you thought would destroy you but didn’t, because love and help arrived in ways you could never have anticipated.

Advent reminds us to keep watch for the unexpected arrival of Christ. If we focus too narrowly on Jesus’s arrival as a baby in a cradle, we may not notice Christ’s arrival as an elderly woman with a cane. We may become blinded by our own clouds of distraction. And we may forget that we, too, are called to bring Christ and the Kingdom to others, to embody hope in the heart of chaos. For Christ has already come. Christ is present, not only among us, but here, now, inside each one of us.

Happy Advent.

Amen.

Notes:

1. Michelle Gabriel, “New York Thaw: Days after Sept. 11 provided ‘glimpse of the Kingdom’,” Episcopal Life, September 2003, 19.

2. Vincent Druding, “Ground Zero: A Journal,” in Philip Zaleski, ed., The Best Spiritual Writing: 2002 (HarperSanFrancisco, 2002), 66.

Extemporania

When I first started volunteering as an ER chaplain, what made me most nervous was the pressure of composing extemporaneous prayers: of coming up, on the spot, with something that sounded lucid, graceful and compassionate.

That may seem odd. I'm very comfortable with most kinds of public speaking. I'm a college professor. I preach at church. I'm extremely verbal -- too verbal, according to some people -- and I'm a writer. And, after all, one of a chaplain's primary jobs is to pray with people who want prayer. So off-the-cuff composition shouldn't be a problem, right?

And yet, for quite a while, it was. There are two reasons for this. The first is that I'm new to the church, and prayer language, especially public prayer language, doesn't come easily to me. (Nor, I suspect, to many Episcopalians: we are, after all, "God's frozen people.") For most of my life, public prayer has made me squirm, and I've often had to suppress the fear that the person praying was about to start juggling rattlesnakes. After I started going to church, well-meaning friends would sometimes ask me to say grace before meals: this always mortified me, producing instant prayer's block.

The second reason is that I know I sometimes talk too much, and I was afraid that if I became too comfortable with spontaneous prayer, I'd never shut up. This is also why I always preach from a printed text: if I tried to preach off the cuff, the poor congregation would be stuck in the pews all morning. Limiting myself to four printed pages is an act of mercy for everyone involved.

Well, I got over all that. After two years as a volunteer chaplain, I'm now comfortable praying with patients. For one thing, I've developed my own toolbox, phrases I use in almost every prayer. They're mine, but at this point, they're also familiar territory, so I don't have to invent everything from scratch. I'll use a preexisting prayer -- usually the Lord's Prayer -- if a patient asks for it, but personalized prayer means much more to most people.

I've also discovered that praying with patients is nothing like saying grace. At least in the homes where I eat, most of the other guests look as self-conscious and embarrassed about the whole grace thing as I feel. But hospital patients who ask for prayer really do want prayer (although sometimes their friends or relatives look uncomfortable), and when they thank me for praying with them, I can tell that they're speaking from their hearts. Prayer truly makes people feel better.

And, oddly, the hectic environment of the ER makes the whole process less pressured. Certain kinds of formality simply aren't possible when you're standing next to a beeping monitor and liable to be interrupted any second by someone who's arrived to draw blood or check vital signs. Some medical staff will wait for me to finish a prayer, but most won't (and this is completely appropriate). Most of the phrases in my toolbox can be used as endings, and I've learned to wrap up prayers very quickly indeed when a doctor or x-ray tech shows up.

Through a combination of training and experience, I've developed a set of tips, strategies and guidelines for praying with hospital patients. I offer them here for anyone who may find them useful.

1. Don't pray unless asked. This was the number-one rule in my training: chaplains don't impose anything on anybody.

2. If a patient or relative does request prayer, ask, "What are we praying for?" Medical concerns aren't always foremost: sometimes people will ask for prayers for family issues, for financial problems, or for other patients in the room who are suffering more than they are. Pet owners may fret about finding care for dogs or cats during a hospitalization. Youngsters with athletic injuries are often worried about whether they'll be able to finish out a season, or play again at all. Several patients have asked me to pray for world peace. And even when medical issues are first on the list, it's important to pay attention to how the patient voices those concerns. Some want pain relief. Some want courage and strength in uncertainty. Some want miracles.

This is where things get tricky, because praying with someone for something that almost certainly won't happen -- "a spontaneous remission of my metastasized stomach cancer" -- is bad pastoral care. If that outcome doesn't happen, the patient's faith could be damaged. The same holds for patients who want to pray for lottery winnings or specific football outcomes (and I've gotten such requests). If I suspect that the patient is praying for something that probably won't happen, or trying to use God as a vending machine, I pray for acceptance of God's will and for "the best possible outcome." I'll also often include a phrase about how God always heals, but not always in the way we expect, reminding the patient that even when a physical cure isn't possible, emotional comfort and healing are.

The most difficult prayer requests I've gotten are from elderly people who want to die. "Please, God, take me, I want to die, why won't you just take me, Lord?" In these cases, I always pray for acceptance of God's will.

3. Don't assume that patients who ask for prayer are Christian. I always ask "What's your faith tradition?" or "What kind or church do you go to?" Obviously, if a patient says "I'm Jewish" or "I'm Wiccan" or "I'm not religious, but a prayer right now couldn't hurt," I avoid specifically Christian language. A few weeks ago, I was asked for prayer by the Muslim and Buddhist friends of a sleeping Mormon patient. Even when all the people involved are Christian, asking about their tradition may help me prepare for how they'll respond. Catholics usually close their eyes and wait quietly for the prayer to end; Pentecostals interject fervant exclamations of "Yes, Jesus!" or "Thank you, Lord!" The first time that happened, I nearly jumped out of my skin -- Episcopalians just don't do this kind of thing, donchewknow -- which probably didn't reassure the patient.

4. Do pray for everyone involved in the situation. I always pray for guidance and discernment for the patient's doctors and nurses. If family or friends are there, I include them (by name, if possible). I offer thanks for anyone who's come to the hospital with the patient; I'll often say something like, "And we ask special prayers for [patient's spouse/parent/child], because sometimes it's harder to be the person at the bedside than the person in the bed." This almost always elicits nods, and sometimes tears, from both the patient and family members.

5. Do use humor when appropriate. I once had a patient who'd broken both arms -- one of which required surgery -- in the process of chasing a pet bird. (Note to self: While trying to put Tweety to bed, do not climb on top of tall, unsteady furniture.) When the patient and spouse asked for prayer, I included prayers for the bird and for the trials of pet ownership; this made the couple laugh, which was very much one of the things they needed at that moment.

This set of guidelines may seem daunting; I suspect it would have made me more nervous if I'd read it two years ago. But after a while, the process really does become smoother. It just takes practice, like anything else.

On Thanksgiving, Gary and I went to the house of a friend whose father is a minister. Even though he was there, she asked me to say grace. I had a panicky moment of the old stomach-clenching, self-conscious embarrassment, but then I thought, "Come on, you do this all the time at the hospital." So I bent my head and prayed.

Afterwards, one of the other guests said, "That was really nice. Was that extemporaneous?"

Maybe I've finally gotten the hang of this?

"If You Choose, You Can Make Me Clean"

Today is World AIDS Day. To observe this event, I'm posting a homily I preached on February 16, 2003, because it includes a story I told about our friend Michael, who died on Mother's Day, 1996. Gary and I didn't know Michael very long, but I still think about him all the time.

This is a very localized, personal story about a disease that's become a global epidemic, but it's the story I have to tell; and maybe what I say here applies globally, too. To offer healing, we have to risk relationship, however complicated and chaotic that relationship may become.

The Scripture readings are 2 Kings 5:1-15 and Mark 1:40-45.

* * *

“If you choose, you can make me clean.”

Today’s Gospel and Old Testament readings are about choices, and about the risks that come with those choices. These stories are about people who choose to ask for healing, and people who choose to offer it. The person who asks for healing risks rejection. The person who offers healing risks relationship.

Without treatment, leprosy is a terrible disease. It causes numbness in the face and extremities, which become injured and deformed. Today, we can cure leprosy, and we know that it’s not especially contagious. But first-century lepers were social outcasts. They had to live in isolation, for fear that their defilement -- both physical and spiritual -- would infect others.

The word we translate as “leper” in the Bible is actually the generic term for a number of skin diseases. In the thirteenth and fourteenth chapters of Leviticus, God commands that people with such conditions be brought before the priests, who will determine the exact nature of the illness and decide if the patient must be sent into permanent quarantine. Even if someone had been cured of a skin disorder, that person was still considered unclean until purified by a priest. This cleansing involved ritual decontamination, not just of the patient, but of clothing and living quarters. Only after all of this had been done could the leper be accepted back into society.

These elaborate rituals are the context for today’s readings about Elisha’s healing of Naaman and Jesus’ healing of the leper in the Gospel of Mark. In both stories, the cleansing ritual is radically simpler than Leviticus says it should be. Naaman, despite his illness, has a great deal of social status; the nameless leper in Mark has none. But both of them have faith that God can cure them with only a wave, or a touch, of the prophet’s hand. Both choose to ask for healing.

The difference lies in what they do when their request has been granted. Naaman, told by Elisha to wash himself in the river Jordan, pouts but obeys. The leper in Mark, commanded by Jesus to be silent about his healing –- and to present himself to the priests for the ritual cleansing described in Leviticus -- blithely ignores both orders. Giddy with restored health, he shoots off his mouth, and Jesus finds himself mobbed by other people who want healing.

These two stories aren’t just about decontamination; they’re about decorum. They’re about the patient’s relationship with the community. Naaman, who has a social reputation to lose, plays by the rules, and when he gets the healing he wants, he politely offers Elisha presents. The leper in Mark doesn’t play by the rules. He’s already a social outcast; he has nowhere to go but up. And so he behaves in a way that makes life more difficult for Jesus. He can’t be bothered with decorum, because he’s just gotten his life back.

As disciples of Christ, we are called -- among other things -- to include outcasts and to heal the sick. Cleansed in the waters of baptism, we, too, are commanded to offer cleansing and community to those whom others consider unclean: the poor, the ill, the imprisoned and the improper. We are called to love people who create either physical or social revulsion in their neighbors. The leper in Mark reminds us why this is so difficult. The people we help don’t always behave the way we want them to afterwards. They aren’t always decorous. If we choose to make them clean, our own lives can get a lot more messy.

When my husband Gary and I, not yet married, lived in New Jersey, we had a neighbor named Michael who lived two floors above us. Michael had AIDS, and his doctor had told him that he had to get rid of his cat. Cat waste carries a disease, toxoplasmosis, which is harmless to most people but can be deadly to anyone with a compromised immune system. Michael couldn’t clean his beloved cat’s litterbox, because it was too dangerous to his health.

Gary and I knew that AIDS, like leprosy, is much more difficult to contract than many people think it is. We weren’t worried about catching anything from Michael, and we wanted him to be able to keep his pet. So we offered to clean the litterbox for him. It wouldn’t be that big a deal: an hour or two a week. Right?

Wrong. Michael, it turned out, didn’t just have AIDS: he had the world’s most impossible personality, and he was absolutely starved for human contact. When Michael hugged you, it felt like he was never going to let go. He told us every detail of his life; he wanted every detail of ours. He pounded on our door in the middle of the night when he was in pain. He pounded on our door first thing in the morning, even when he wasn’t in pain, to raid our refrigerator for breakfast. When Gary and I got engaged, Michael complained that Gary should have gotten me a flashier ring. When Michael was in the hospital, he called to demand that I bring him Godiva chocolates. “You can’t say no,” he told me. “I’m dying of AIDS.” Michael had no decorum whatsoever.

But he also gave us gifts and left messages on our answering machine to tell us how much he loved us. He cheered me on through the process of getting my Ph.D. He insisted on paying for a limousine to take me and Gary to our wedding, and he asked if he could give a toast at the reception. He was too sick to give it; he had to go home. But he had a friend read it for him, and it was beautiful.

He could be wonderful. He could be horrible. You never knew which side was going to come out. He had a habit of begging us to take him to parties we were going to, because he was lonely. But if we did take him along, he often wound up doing something totally socially unacceptable. Because his illness left him so little privacy, he seemed to believe that he had a perfect right to invade other people’s. Once, at a party given by Gary’s boss, Michael searched the hostess’s medicine cabinet and gleefully told me and Gary -- and the other people standing near us -- what medical conditions she had.

Michael and I had quite an argument after that little incident. “Michael,” I told him, “if you keep acting like this, you won’t get a chance to die of AIDS, because somebody’s going to kill you first!”

Gary and I loved Michael, but we also fought with him, ranted about him to other friends, and sometimes found ourselves avoiding him. What we had offered as a simple act of cleaning turned into a messy, complicated, demanding relationship. We didn’t handle it perfectly, but our lives would ultimately have been poorer if Michael hadn’t been in them. He could be absolutely impossible -- but if we had it to do over again, we’d still choose to clean his cat box.

“If you choose, you can make me clean,” the leper says. And Jesus, reaching out to touch the untouchable, says, “I do choose.” What he gets to choose is whether to be caring; he can’t choose how the person he cares for will respond. Jesus risks relationship, not knowing if that relationship will be easy or exhausting, decorous or difficult. He does what he knows he can do, even though he doesn’t know what the leper will do in return.

What he gets is a mess: the news spreading all over the place, and so many people clamoring for a piece of what the leper got that Jesus can’t even go into town openly. But I have a very strong hunch that if Jesus had it to do over again, he’d make the same choice. I think he’d still touch the untouchable. I think he’d still choose love, however messy it might become.

What do you think?

Change of Shift. Pats on Back.

The latest Change of Shift is up over at Fat Doctor. Thanks for including me!

In writing news, I'm almost done with the Fate of Mice galleys (and a good thing, too, since they're due tomorrow). I also have to respond to a long marketing survey by tomorrow. This is stuff I thought I'd get done over Thanksgiving, but didn't.

I've canceled my classes today to give myself more time; I always build a little slack into the course schedule in case I'm felled by the flu -- which I haven't been this year, hurray! -- so we can still get everything done. And I don't think my students are heartbroken.

My mood's been unaccountably low since Sunday; maybe that's just a delayed reaction to last week's stress, but whatever it is, it's both unpleasant and annoying. After four days of feeling like I've been hit by a truck, I need to remind myself that I've also gotten some very nice compliments this week. So, at the risk of sounding like I'm bragging, I'm going to list them.

* Karen Joy Fowler wrote a lovely blurb for The Fate of Mice; this will join similarly lovely blurbs from Pat Murphy, Jo Walton, and Sheila Williams.

* My friend Inez passed along some kind words from her brother-in-law, who taught my story "Gestella" in one of his classes and said it generated quite a bit of student discussion. (Given the polarized response that story has gotten from some readers, I can just imagine!)

* I received unexpected e-mail from the rector of a local church, who not only enjoyed The Necessary Beggar, but used it as a sermon illustration last Sunday.

Also, rereading The Fate of Mice has been a good experience. It's always nice to look back at one's own work and decide that it doesn't suck.

And on that note, back to the galleys!

Tip for Aspiring Writers #249

Do not ask your Local Author to read your unpublished manuscript.

Yesterday when I got to work, I found a small padded mailing envelope in my mailbox. It contained a floppy disk and a note from someone who'd seen a story about me in the newspaper and wanted me to read her novel. "I realize you are very busy, but if you could find the time, I would forever be in your debt."

This kind of thing happens to me quite often, although I'm hardly a household word and have never gotten within a hundred miles of a bestseller list. I've had people bring me manuscripts in shoeboxes. I get e-mail from folks who want to know if I'll critique their 1,200-page fantasy trilogies. I sometimes meet people at parties who want to know if they can send me their stories, or their children's stories, or their next-door-neighbor's second cousin's stories.

My answer is always the same: Sorry, but no. I only read the work of current students.

I wrote a note to yesterday's Aspiring Writer explaining this, and advising that if she wants a critique of her work, she should either take a writing class or join a local writer's group.

Why do I only read the work of current students? There are two reasons: a) I'm being paid for it and b) It's very literally all I have time for. I'm sorry if this sounds harsh, but it's the honest truth. Come on; does anyone walk up to a surgeon at a party and say, "Hi, I know you're busy and all, but I was just wondering if you could whomp out my appendix, for the heck of it, for free?"

Reading and critiquing manuscripts is a lot of work. It's not something anyone can do well in five minutes. Reading the work of my current students takes nearly all of my reading time and energy, and sometimes it's difficult for me to get to everything they give me. (One of my current students gave me a story manuscript -- an unassigned piece he'd written on his own -- weeks and weeks ago, and I haven't read it yet, although I really do want to. I swore I'd get to it by Thanksgiving, and then I got derailed by my father's crisis. This weekend, I promise!) I have very little time for pleasure reading. I'm woefully behind in my field. I got books for my birthday in September that I really want to read, but haven't yet, because I simply haven't had time. I just agreed to review a new book on Tolkien, because I really want to read it and know that I'll only make the time if I have a deadline and an obligation. I don't have time to read the published work of award-winning authors I consider friends.

So no, I'm not even going to try to make time to read the unpublished work of strangers.

I suspect that often, the psychology of aspiring writers (and some of them will even come out and say this) is "But my work's brilliant! If I can just get the right person to look at it -- someone who's published, someone with connections -- then I'll finally get my lucky break, and the literary world will benefit from my genius."

That may be true. Really, I hope it is true. But if it's true, the happy discovery will have to be made by someone else.

So where does Aspiring Writer find that "someone else"?

In writing classes, or critique groups run by local writing organizations.

See, here's the thing. What you want is a group of people who are committed to your work and will spend time on it. You'll get that in a class because the professor's paid to teach it, and because responding to other students' work is a course obligation for your peers. You'll get it in a critique group because the other Aspiring Writers are as hungry as you are: they'll respond to your work because they want you to respond to theirs. It's an implicit contract.

And responding to other people's work is essential. It's much easier to see the flaws in other writers' stories than in your own, because you have more distance. But once you've gotten practice at analyzing other people's work and helping them figure out ways to fix it, you'll be able to transfer those skills to your own writing.

The key factor here is duration. The average class lasts several months; good critique groups can stay together for years. You want to find people who'll get to know your work over that length of time, who'll be able to tell when you're getting better (or worse) because they've seen your earlier writing and have a basis for comparison. Writing's a process; no one learns it overnight. You need readers who'll be with you for the long haul.

I tell my students to be very wary of weekend writing conferences, the ones that bring in Big-Name Writers to share gems of wisdom, and sometimes even to read manuscripts. These events can be a lot of fun, and you may even learn useful things, but the psychology of the attendees often seems to be, "If I can just get into the same room with Big-Name Writer, either some of BNW's genius will rub off on me, or BNW will recognize my inherent genius, and my struggles will be over."

It doesn't work that way. You're far better off working with Obscure Writer for several months in a class than spending a few hours with BNW at a weekend conference.

I also tell my students to be very wary of how-to-write books, especially of the "How to Write a Novel in Ten Easy Steps!" genre. If novels could be written in ten easy steps, everyone would be writing them.

Writing is an art, not a science. It's hard work. It's a discipline. There aren't any shortcuts. Anyone who promises you a shortcut is lying, peddling snake oil. There are a lot of snake-oil salesmen out there. Be very wary of them.

Addendum:

Gary has reminded me to warn you about one common species of snake-oil salesperson, the so-called "agent" who charges a reading fee to evaluate manuscripts.

Legitimate agents don't charge reading fees. Legitimate agents take a percentage -- usually fifteen to twenty percent -- of actual sales: they don't make money unless you publish. And, guess what: legitimate agents usually have more work than they can handle, which means that you generally won't find them handing out business cards at weekend writing conferences. I'm not saying it couldn't happen, but I am saying to be careful.

Do your homework, please. At the very least, google the person's name. Ask who this agent's other authors are, and find out if they've actually published books with reputable presses.

True story: I once got ecstatic e-mail from a former student announcing that she'd gotten an agent. When I googled the person's name, the first thing that popped up was a page of warnings and horror stories from a website for aspiring writers, talking about how this individual charged reading fees and then never delivered on promises.

Reading fees are almost always suspect, unless they're associated with literary contests . . . but some of those are suspect, too. Do your homework.