Diamonds and Stones -

On Monday I had a feeling to check in on a patient I hadn't talked with in a couple of months. I went to her chart to get her phone number. A big red box, marked "deceased" popped up before I could even get to her number. She passed away in September, and I just learned. 

As well, a patient in the hospital, who has been at death's doorstep for a week, was finally allowed, by his family, to pass. 

Tuesday I received a call from a hospital asking for some support for caregivers as they had a traumatic death in their emergency department the previous evening. And they needed to vent. 

Last night at 3:40am, I made the mistake of checking my phone. My sister had sent me a text earlier in the night about a friend dying. The friend was my patient. 

When I woke for real, I had a group text from a client's brother stating that his sister's tumor was cancerous, yet she was healing well from her surgery. 

Just a few minutes ago I received notification that another patient had passed away, yesterday morning. 

And that's just a few of the deaths and imminent deaths I've been a part of this week. 

Some days are diamonds, some are stones. 

What a week, what a damn f'ing week. 

The Need for Chaplains -

 I love my job/career/life-choice as a chaplain. I cannot imagine doing anything else. I love serving my patients, their families, and the caregivers who are dedicated and committed to giving the best care they can to those they likewise serve. 

It's been a busy several months - caregivers were on adrenalin highs for several months, as was the world, with a multitude of initiatives and ways of showing support. And yet as caregivers tire, so does the public, and now we're dragging, exhausted, without evening applauses and caregiver parades, no healthcare provider discounts (and I tell you, they made a differences), and we still go home to families who are likewise burnt-out and dragging. I have cried more than once in the past month - who chaplains the chaplains? 

I spend as much time with caregivers as I do patients and their families. This is a fundamental part of my job. In fact, not only do I serve at my facility, I also am doing my best to support caregivers system-wide, particularly at the site where many of our toughest CoVid cases go. 

Enough said, and yet there are still institutions (people) who think chaplains are not necessary, that in this day when religion is waning, there is no need for religious rituals and conversations. However, when someone is in a health crisis, they are likewise in a spiritual crisis (not religion, although people rely on the beliefs, or non, of their religious and spiritual perspectives). "Oh God" can be a curse or a prayer, and I've seen this over and over again, and a listening ear, a quiet moment, a nod, permission to share, is so very very necessary.

This article, from one of the organizations I have my certification through shares a perspective examining the words stating there is no need, yet likewise validates the need, for healthcare chaplains, now more than ever. 

Count chaplains in, not out! Now more than ever, chaplains are needed on healthcare teams    _____   "Our role is to care for anyone -- patient, family member or professional and clinical colleague -- who is suffering, feeling overwhelmed, hopeless, and alone." -- Eric J. Hall _____ As the leader of a national chaplaincy organization, I am baffled by the opinion that chaplains are becoming irrelevant. This statement during this pandemic when chaplains have become more necessary than ever is simply a cover to remove chaplains from employment.   A discussion I had with an administrator indicated that because people are not going to "church" there is a diminished need for chaplains. It's true that many churches across the country were growing empty even before COVID-19 caused them to close their doors. But the flight from organized religion does not mean people are throwing the baby out with the bathwater. Many faith communities doing online worship and tracking their viewers are seeing significant number of "attendees" who they can tell are not members of their community. Thus, lots of people who have not participated in worship before now are seeking it out. We saw the same phenomenon post 9/11. Large numbers of people turned to faith and religious practice in the time of uncertainty to find connectedness and meaning. So where do these people find that connection and community today? Chaplains fill that role for many.   As chaplains working in emergency, trauma and other healthcare settings across the country can attest in this time of COVID, people in existential crisis long to make sense of what's happening to them and their loved ones whether they have God or a religious tradition to guide them or not.   I want to address the misconception that chaplaincy is only a valid ministry in the context of faith, and that as organized religion declines in importance, chaplains become less relevant to healthcare systems and therefore a resource that can be eliminated from the budget. This is not the time to count chaplains out. Now more than ever, leaders in healthcare should count them in!   If they have learned anything from the experience of our hospital systems overburdened by suffering and death, health care leaders must surely see the value of treatment protocols such as palliative care and hospice when curative care is deemed futile. Dr. Diane Meier, director of the Center to Advance Palliative Care, makes this point when she says, "Our first and foremost job is to identify and relieve sources of suffering. And particularly in the COVID-19 environment, where all available treatments are experimental and variably accessible, our first obligation is to provide psychological, existential, and spiritual support to people who are understandably terrified."   I direct the Healthcare Chaplaincy Network. For us, professional chaplaincy is about "caring for the human spirit." Our chaplains work alongside first responders and EMTs, integrated in hospice and palliative care teams, and collaborating with doctors, nurses and other medical professionals in ICUs across the country. Our role is to care for anyone -- patient, family member or professional and clinical colleague -- who is suffering, feeling overwhelmed, hopeless, and alone. When the human spirit is assailed by too much sickness, too much misery, and too much death, our chaplains are there to offer comfort through presence, listening, and support, sometimes joining in with our prayers and often with our tears. We are trained to wade into the midst of human suffering, to recognize spiritual distress in our fellow human beings, to promote healing even when there is no cure, and to affirm the value of life even in the face of certain death. This is what we mean by "caring for the human spirit." And this is why, now more than ever, chaplains are needed on healthcare teams that are providing curative care, palliative care, or end of life care. Chaplains should be counted in, not out!   For administrators wanting to cut the costs of doing business, I say do not cut your chaplains! Take a lesson from hospice, in which spiritual care for the dying is federally mandated, or from palliative care in which it is a best practice the world over. If you are looking for ways to increase emotional support for your frontline clinical staff or seeking to address burnout among your physicians, hire more chaplains! We are trained to do this work. Many of us have indeed been preparing our entire professional lives to rise to the challenge of such a moment in time as the one we are facing right now.   Count chaplains in, not out. And then count on us to work side by side with the other professionals on your teams, providing care for every needy human spirit we encounter. If you would like help finding professionally trained and certified chaplains to join your teams, email me at EJHall@SpiritualCareAssociation.org and I will put the resources of the HealthCare Chaplaincy Network and the Spiritual Care Association to work for you. The needs are critical and the solution is at hand.   --Eric Hall Reverend Eric J. Hall, DTh, APBCC, is President and Chief Executive Officer of HealthCare Chaplaincy Network, Inc. and the Spiritual Care Association. He is also Chancellor of the SCA University of Theology and Spirituality. Hall also serves as pastor of the Eastchester Presbyterian Church and the Lincoln Academy for early childhood learning. Formerly, he was the founder, President and CEO of the Alzheimer's Foundation of America. He can be reached at EJHall@SpiritualCareAssociation.org.   * See https://www.pewforum.org/2019/10/17/in-u-s-decline-of-christianity-continues-at-rapid-pace   ** See https://acphospitalist.org/weekly/archives/2020/04/08/3.htm

Anxiety and Self-Care -

 

Anxiety - 'Tis the Season!

 

I had simple sinus surgery a year ago, and it didn’t work! So after more than 2 months of dealing with a sinus infection (and trying every feasible remedy), I had full-blown sinus surgery 2.5 weeks ago.

These past few months have been tough knowing I would need to face this reality, and I will admit, being sick, not sleeping, and anticipatory anxiety has gotten the most of me. Not sleeping, over/under-eating, easily irritated and equally irritable, difficulty concentrating, and continually asking “why me” and thinking about how defective I am, and searching “sinus surgery” on Google.

Please tell me that you have done similarly when avoiding the inevitable! And Google is the worst education tool when anxiety is involved!

Well, surgery it was, and while it was really horrible, I’m 2.5 weeks out, and healing! Imagine that! And all those things I worried about – I can’t even remember them, and yet all those behaviors I adopted – now I need to break those habits!

The  below thoughts have helped me step out of my emotional self and rationally think through what I’m anxious about rather than letting the anxiety control me. I hope, particularly this season, these will be of benefit to you.

“We don’t fear the unknow, we fear the thought of the unknown.”

“The worst bullies you will ever encounter in your life are your own thoughts.”

“Is there something I can do now to relieve my concerns for tomorrow?”

“Filling my mind with good thoughts means there is no room for bad thoughts.”

“The doctor knows what he’s doing.”

“What if things work out?”

“Ommmmm.”

“You are bigger than what is making you anxious.”

“Worrying doesn’t empty tomorrow, it empties today.”

“I give myself permission to be anxious, and then I give myself permission to move forward.”

“Nothing is permanent, not even our troubles.”

And lastly – “Just breathe.”

More tomorrow - 

 

Many Reasons to Give Thanks -

 Ecclesiastes 3 always comes to my mind this time of  year. I stitched this version into a wall-hanging that is on the wall in my office:

 There is a time for every season and every purpose under heaven.

A time for family and friends,

A time for happy memories and thankful hearts.

A time for traditions kept and blessings shared.

We have many reasons to give thanks.

And of course, this version, written by Pete Seeger and sung by The Byrds imprinted Ecclesiastes 3 in my mind:

Photo Triggers - Shame -

 My brother's birthday is today. He's 58 years old. As is custom with the Walker siblings, we'll post photos of us and the birthday person through the years. As I was looking for something to share, I found these. And the memories came flooding back - and not all associated with these pics, this situation, is good. 

I was born in Jan, my sister, 18 months later in July, and Brett came a couple of months before I turned 4. My father was getting a son! My mother had given birth to Sheri and me in the Maternity Home in Rigby, and Brett followed suit (interestingly, 2 other cousins were born at that same time, and they all made the local news). 

I'm pretty sure he was born in the morning, and if I remember correctly, I was sleeping in my parents bed, with my Jensen grandparents, when the call came that we had a baby brother, and Sheri and I jumped up and down on that bed, we were giddy with little girl anticipation. 

My father was so excited! He wanted to make the "pick-up" for Brett and Mom extra special, so with Mom's encouragement, Dad took us to Idaho Falls to buy winter coats for 2 little girls. I would imagine that my mother asked Dad to get us something warm, something that would fit us all season, and coats that were practical. 

Well, my father seldom did anything practical first - pretty first, practical second. And we ended up with these lovely "fur" coats, that were cream colored with brown highlights. So warm, fuzzy, pretty; Grandpa said we looked like 2 little Eskimo's.  

And here is my memory - 

Being so proud of that new coat, so proud of Dad for picking matching coats for us, and feeling so fancy standing in the sunlight getting our pictures taken. 

Meeting my baby brother for the first time, just being taken in by the beauty of this new being, and at nearly 4, feeling a sense of time. 

My mother - so upset with my dad for not buying practical coats. Didn't he know these would get dirty so fast, that they wouldn't be valuable playing in the snow, and for sure they'd wear out before the season was over. 

I felt shame. Shame because I was happy in my new coat, and yet I knew that what we had and what Mom wanted were not the same, and sorrow for my father who didn't follow Mom's directions, and sorrow for Mom who couldn't see the pride in my father's eyes as he showed us, and baby brother, off. 

And I remember then knowing I had to make a choice between protecting my mother or protecting my father, feeling the angst in my belly, and knowing I would always have to choose between practical/Mom and pretty/Dad. And wondering if I would ever be able to make either happy. If a pretty fluffy coat and a brand new baby boy, couldn't do, what would? 

Mom's "pretty" typically sat on a shelf or behind closet doors, only to come out for a special occasion, if at all. Hoarded, almost, because, in her words, "I seldom had anything nice." Practical, frugal, careful, cautious, scared - all words that come to mind when I think of choices and my mother. 

Dad's "pretty" was always on display, and he was often chastened for spending too much money or time on nice, or having something out that may be broken or be seen as prideful. Adventuresome, creative, risk-taker, considerate - all words that come to mind when I think of choices and my father. 

As I've been cleaning and sorting at Mother's house this past month, this has been reinforced over and over. The closets and shelves still speak this same story - Dad's on display; Mom's behind closed doors. 

Yet the trigger - the story - the beautiful coats - the sense of pride and pretty and shine - deflated that day, with shame and guilt and inadequacy taking the place of delight and beauty and self. And to this day I dance in both worlds, and often feel the emotions of that little girl, over and over and over again. 

Sheri and I were so different in personalities, that just the fact we are in these photos in our coats, with the same dresses on, pants on, shoes on, is a miracle. 

And aren't those little corsages with Christmas ornaments and bells just darling?! 

Sinus Surgery - Again -

 I've had sinus infections for most of my adult life, and prior to that I blamed it all on allergies. My first memory of a really bad infection was as a newly-wed with an infection that would not go away. It was fall, and so bad, that my in-law's volunteered to pay for an x-ray and treatment. 

Over the years I've blamed the infections, particularly because they hit either in September or January, on students - public school, college, or even my students as I taught for so many years. My sinuses began aching about the time all other students began getting the sniffles - I figured they were worn down, sharing germs, getting used to the environment, and I was the recipient of their "not staying home when sick" gifts. 

Sadly, over the years my infections have continually gotten worse and lasted longer. They vary from sneezes, to blowing, to gagging, to coughing and coughing and coughing, to crazy headaches. I've tried all types of antibiotics, natural remedies, even chiropractic manipulation to get rid of these. Nothing has helped. 

Last year I finally reached out to an ENT, Kirt Beus, for his perspective. I've seen an ENT before, but really hadn't had much different info from my regular doc. Beus, however, was aggressive - from an in-office CT scan showing highly inflamed, swollen, and damaged sinuses, and offering every non-surgical remedy available. 

And when they didn't work, he suggested balloon sinuplasty, not as invasive as full-blown surgery. In-office, shorter recovery time, and a 90% success rate. 

Sadly, the surgery worked, but the surgery was painful (only local anesthesia), and recovery was horrid, thanks to steroids, which I now know make me go crazy - literally. 

And I've been fine, great even, until Sept. 5. And boy, I was slammed, and I haven't been able to get all the way back up. I can talk over-the-counter meds, best cough syrups/remedies, cough drops, hot or cold humidity, antobiotics, and the benefits (ha) of sleeping on 2 pillows for 2 months! 

I'm tired of snot! Particularly post-nasal drip. Not my favorite!! 

So back to Dr. Beus I went, and now, 4 weeks later, I am scheduled for sinus surgery - via scope, for this Friday, November 13 (thankfully, Fri. 13's are my lucky days). 

This is a 2 hour surgery, with a lengthy recovery time (2-4 weeks), and I've heard, pain on pain on pain. 

Thankfully, working from home in the days of CoVid are possible; I'm not going anywhere; we're not doing anything for Thanksgiving, and with Gov Herbert's mandate, our social distancing begins tonight and ends on Nov. 23 with my 10 day doctor's appt. to remove packing and . . . . 

I'm a little/quite concerned; I'm not happy, nor am I extraordinarily healthy after having my health compromised for so long. Yet I'm hopeful. 

And away I go - to take my 3rd CoVid test since Sept. 7. Yuck yuck yuck.