Preparation

I learned this summer that a hospital operates in a constant state of preparedness.  Yet, even as you are prepared you will simultaneously never be prepared.  Pages would go out overhead and to your personal pager for the following situations: Level 1 (trauma), T-10 (most severe trauma), code blue (cardiac arrest), STEMI (heart attack), Stroke Alert, and Rapid Response (a dramatic change in patient status).  Each of these things demanded a different sort of preparedness.  An overhead page is accompanied by a chime that I will never forget the sound of in my entire life.  It is a Pavlovian response when that bell is heard, instantly you grab your pager and turn your ear toward the overhead speaker.

The strangest moments I experienced this summer were while waiting at the main Emergency Department desk or upstairs at the T-10 room as we waited for the trauma patient to arrive.  The charge nurse would generally have a vague description of the situation (gender, age, and a brief description of the incident).  However, "motorcycle collision" or "motor vehicle collision" can have varying levels of intensity.  As I waited at that desk, in front of the trauma rooms, there is nothing in my life that could have prepared me for what I would see.  I would wonder, will this person be dead or alive?  Will I see their internal organs today?  No sight really bothered me until the burn patient came in on one of my overnight shifts. That was a sight, smell, and experience that I will never forget.  I had never smelled severely burned flesh, but instantly I knew what it was.  Horrifying.  Yet I still had a job to do.

You can get all the training in the world, carry all the right supplies, yet, you can never really be prepared to do something until you are in the middle of it.  Then, you find a way.  Because you have to do it.  Because everyone in that trauma room has a job, including the chaplain.  I never once froze if I had a job to do, even in the most terrible trauma situations.  It only comes afterwards that you realize how unprepared you actually were.

Leaving

I have started processing and unpacking my summer CPE experience.  So here are some of my assorted and sundry thoughts.  

People leave the hospital in two ways, the front door or the back door.  The front door they are wheeled out, often carrying balloons and flowers, met at the front door and their car is pulled up by valet.  They are generally escorted by a beaming nurse and a gaggle of family members.   Success.  A battle has been won.  If they leave by the back door it is through the loading dock, picked up from the morgue by mortuary transporters in stiff dark suits, escorted by a grim faced security guard who would probably rather be somewhere else.   Loss.  All those life-saving interventions are for naught.

The family leaves in two ways too.  Either with their loved one or without.  It is this latter leaving that is the hardest part.  After a death occurs, the family is given some time to sit with their departed loved one.  They can say their goodbyes.  There is so much that goes on behind and during and after this leaving.

When the chaplain's office gets a page of a death, you really have no idea what you are walking into.  Sometimes we had a few minutes warning of an actively dying patient.  Often we did not.  Stopping by the nurse's station.  The death packet paperwork already spread out.  A nurse on the phone with the coroner's office.  All deaths are reportable.  Another nurse on the phone with the donor services agency.  Checking eligibility to bring life from death.  I wash my hands, walk into the room, peering around the drawn curtain.  There is a palpable absence in the air.  There once was one more soul in the room.   I stand awkwardly in this private grief.  I sometimes pray.  I sometimes do not.  I bring coffee, water, kleenex.  I will ask for consent to donate tissues.  I will ask for mortuary information.  I feel my heart strain in my chest.  This is not a daily part of very many people's jobs.

As the family prepares to leave I gather the last belongings into the plain plastic "patient belongings" bag and clip it shut.  With as much care as I can muster I hand it over, with it I hand over a piece of my heart.  They are preparing for a leaving.  They cling to these belongings as if they were still clinging to their loved one.  A watch.  A phone.  A wallet.  So much lost, yet, tangible items in hand make it seem unreal.  If they still have a phone, why don't they have a person?

I escort the family to the front door.  They are missing a branch of their family tree.  I return to the patient floor.  The body is bagged and tagged.  It is preparing for a leaving.  A patient transporter arrives to transport the patient for the last time.  All the way down to the windowless basement morgue.

The call to the mortuary is awkward.  Do you say "you can come pick up Mrs. Smith?"  Is she still Mrs. Smith? Or is she "The Decedent"?  I feel a responsibility to hold this person's humanity.  My last bit of patient care is to walk the death paperwork down to the morgue and place it on the counter.  I never took the elevator.  It felt like the honorable thing to do would be to use my own two feet for this last part of the patient's journey.  I always open the door to the cooler to check the tag on the body bag. I feel responsible for caring for this person, even in death.  I wish this person well, say a quick silent prayer for them in the cold of the morgue, among the stainless steel and tile and silent and cold companions.  They are not leaving.  They have already left.

New Tattoo

I got a new tattoo today!

By Julian Kates at White Lotus Tattoo, TOTALLY worth driving to Highlands Ranch.  An incredibly talented artist, he drew the design based on the nebulous verbal description I provided and brought to life to the idea that has been rattling around in my head for the last year.

I highly recommend Julian to anyone.  He has done tattoos for a bunch of my friends also.

God Shows Up

The sermon below is one that I preached at my home congregation, House for All Sinners and Saints on August 19, 2012.  

Audio Text: God Shows Up

Grace, peace, and mercy are yours from the Triune God.  Amen

I really struggled with this week’s gospel text.  I wrote an entire sermon about how the Gospel passage that we just heard pertains to Holy Communion, but I couldn't help to feel like there was more here.  So I kept writing.  Four more drafts.  I do think that a Eucharistic interpretation is a perfectly valid way to look at this text, but one could also approach it from an incarnational perspective.  A clear sign that God is present in the world and knows the fullness of human experience through the person of Jesus Christ.   In other words, God Shows Up. 

Yes, today’s Gospel is about Holy Communion, but I think that it points to something even beyond that, the promise that we affirm each time we take communion.  The Eucharist is the celebration that Jesus is the Word of God incarnate and that we are no more prisoners to sin and death.   The celebration that through Jesus all things were brought into being, and by means of his life, death, and resurrection, a new creation is born.  The language in today’s Gospel is clearly Eucharistic and can be seen as pointing to Holy Communion, and certainly all the pieces are there: the body, the blood, the blessing, and the promise…but what if there are other meanings here as well?  What if Jesus is talking about drinking in and consuming all of the promise of who He is? 

John’s gospel starts out with some very familiar words:

“In the beginning was the Word, and the Word was with God, and the Word was God…

Several verses later comes: “ And the Word became flesh and lived among us.”

The central claim of John’s gospel is that God chose to take on human form, in the person of Jesus.  And through the actions and words of Jesus, God can be known.  However, also running throughout the Gospel of John is a theme that the people could not see Jesus for who he is…the incarnate God.

Today’s Gospel reading is a prime example of this.  Those listening to Jesus ignore the first part of what he is saying, “I am the living bread that came down from heaven” to jump to the scandalous part, “the bread that I will give for the life of the world is my flesh.”  They argue among themselves, “How can this man give us his flesh to eat?”  In their disputing, they miss the best part of all, that the bread of heaven, the incarnate God, is right in front of them, and by taking in all of him, they will live forever.   

This got me thinking about where else I am distracted by the broken world and fail to see the promise of an incarnate God who refuses to be destroyed even by death.   Where else might we all do this?  One week ago I finished a ten-week chaplaincy internship at St. Anthony Hospital.  I was assigned to the Neuro and Trauma intensive care units.  My patients were some of the most ill in the hospital, and there were many, many hours that I spent just sitting with families in unimaginable pain, as they grieved what could have been and what was to come.  I was angry that young people, full of promise, were rudely taken from this world by car accidents, indignant that parents were outliving their children, and incredulous that in an instant, people’s lives could be changed forever by a single choice made by them or someone else.  I often found myself wondering where God was in all of this and the only thing that I could offer to my patients and their families…and myself…was that God Shows Up.  God knows suffering.  God is here.  And as the summer unfolded, so did my understanding of the incarnate God. 

I spent a fair bit of my summer accompanying families in the initial moments of their grief as they sat at the bedside of their recently departed loved ones.  In the minutes just before death and those immediately following, the presence of the Holy cuts so deep that it can be felt in your soul.   The palpable presence of something outside the bounds of this world is in the room.  And in the intimate moments just after a death, the absence of that person’s soul can be felt, as if carried away, but the room itself is still filled with the deep presence of God.  You could almost taste it, drink it in. 

As we take in all of Jesus, nothing can destroy us, even death. We can know that neither life, nor death, nor anything in all of creation can separate us from the love of God.  Because God is already among us. 

I think we are all like those gathered around Jesus, sometimes blinded to the truth that is right in front of us.  Blinded to the incredible promise of what God is trying to show us. We carry the burden of past mistakes and don’t see any way that we could ever be “good enough” again.   We built walls around our hearts when we have been hurt.  We get stuck in jobs where we aren’t happy and know that our gifts could be better used elsewhere, but we make a comfortable salary and it seems safest to stay right where we are.  We run relentlessly from one hobby to another trying to find that one thing that might make us feel complete.  We try to understand God’s will for us and in this vain attempt at control, we miss the incredible promise that is presented to us at the Lord’s Table, a living God present with us right here, right now, and forevermore.

The good news is that God keeps relentlessly pursuing us.  God knows that we aren’t all good, all the time, and yet…loves us unconditionally anyway.   We have a God who continues to offer Godself to the world, even to the point of death on a cross. 

God in Jesus came into the world not because we were good or because we deserved it or because we would understand why, but precisely because we needed salvation from ourselves.

         Like those who were the first to follow Jesus, we too live in our own little worlds and are sometimes downright oblivious to what God is doing right here, right now, in our midst.  God continues to show Godself, we just need to look up from what we are doing, step away from our assumptions about what things mean, and take some time to eat.  The Word became flesh and lived among us.  God in Jesus says, “Those who eat my flesh and drink my blood, literally consuming the totality of me, will have eternal life…”  God knows that try as we might, we will never understand the gift of life that has been given to us through Jesus Christ, yet it is still freely and continuously and abundantly given.  And God promises to continue to pursue us doggedly in the midst of grief and pain and distraction…and that is promising news indeed.  Amen.  

update on the most recent post

My mother told me today that she was very surprised that I did not show the "you are on the highway to hell" gentleman my full wrath and tell him exactly what I thought of him and his theology.

Somehow I was able to stifle the quick-to-anger part of my personality, probably through no doing of my own.  I'll pin that one on Jesus.

Maybe this means I am finally ready to act like a responsible, reasonable adult.  That's a funny thought.