Thursday, June 30, 2016

On the incarnational nature of chaplaincy

A.Kumm-Hanson, Iceland 2016
My work as a chaplaincy is intensely incarnational.  By this, I mean I continually encounter God in the flesh.

"Incarnate" has latin origins, "in" mean into and "caro/carn-" meaning flesh.  It has theological connotations in the Christian belief system, but we usually only speak about a God incarnate around the time of Christmas, with Jesus as a newborn baby. It is uncomfortable to think about God as a human body. A body that sweats and eliminates and requires food and water.

As a hospital chaplain, I am never removed from humanity in all its bodily manifestations.  I see what the body is capable of doing to repair itself, and all the ways that it can fail. I smell the sharp metallic smell of fresh blood. I smell bodily odors of every kind.  I smell the earthy smell of birth and the earthy smell of death. I hold the hands of patients who are swollen with IV fluids, with a gentle touch so that I do not exacerbate their edema. I stroke the foreheads of newborn babies, with skin so soft they don't yet seem made for this world. I use my brain, certainly, but chaplaincy is primarily the use of my body.

Walking into a room and meeting another person wherever they are. To show up and shut up and be present. To move through the human desire to say something to make it all okay and just be. To be a reflection of God-in-flesh to those who are suffering.

Also, my patients reflect God to me. People who are dying share visions of angels and whispered messages from the hereafter. Patients who are undergoing intensive rehab therapies after a stroke speak of wrestling with God in the dark hours like Jacob and emerging with a limp, but having touched God.

Chaplaincy is not a cerebral ministry of long hours spent in a pastor's study in preparation for preaching. It is holding hands through bed rails and wearing isolation gowns and being willing to literally stand in suffering with God's beloveds. It is not about translating Hebrew or Greek from ancient texts, but about translating scripture into something now that matters to the mother who is delivering her stillborn child or the son losing his father to cancer.

The theology of the cross is particularly apparent to me in my hospital work. This theology holds that God's love for all of creation is most clearly seen in the act of dying on the cross.  That God did the most human thing of all, which is to die. The theological conviction that shapes my ministry as a chaplain is that God knows what it is to suffer and to die, and there is no place that God is unwilling to go, even death. This is good news for all of us who feel immersed in suffering, our own or that of others.

Because to be human is to be made in God's image and to carry God's likeness.  We are the incarnate God to one another.

Tuesday, June 21, 2016

Adventures in the Icelandic Emergency Medical System

I am currently on my honeymoon in Iceland. As part of our adventure, we decided to go caving. We explored a cave that had been created by a lava flow, that was approximately 1km long and easily accessible. We were provided with helmets and headlamps

And our guide led us through a beautiful cave. We crawled, scooted & shimmied through stunning formations of lava. On my way out of the mouth of the cave to the car, I stepped into a hole that went up to my thigh. I caught myself with my hand. I heard a crack, but didn't think too much of it. 

By the next morning, my finger looked like this:

Bent, purple and swollen. We arranged an online consult with a physician service in the USA called Dr On Demand, through our insurance company. I FaceTimed with a Dr in Maryland who instructed me to go to an Icelandic emergency room based on pain in a specific area of my hand, the "snuffbox", or navicular area. This is a bone that has poor blood supply and doesn't heal on its own without intervention. So off to the ER we went. 

Just to make sure, I contacted an Icelandic RN via 1700, which is a non-emergent way to get a medical consultation. This was a Sunday, so the only place I could get x-rays was the hospital. 

Reykjavik has several large hospitals, but the ER is located at the main branch. I walked right in and a triage nurse assessed my hand immediately. I completed paperwork in English and another RN did additional manipulation of my hand. I was sent upstairs to the "minor injuries unit." A triage RN asked me if I needed an ice pack and pointed out the location of a water cooler. I waited about 45 min, then was taken back to meet with a doctor. 

Perla, the doctor, put us immediately at ease. She ordered X-rays & said she would order a CD also that I could provide to my USA doctor.  A tech took the X-rays, and I was sent back to the ER and received a CD of the images almost  immediately. We waited for awhile longer while my X-rays were read. 

Diagnosis, probable Scaphoid Fracture. The doctor stated that I would be receiving a cast and would need to be re-examined & re-casted when I returned home once the swelling went down.


A nurse took me in for casting and explained that she was unsure how my rigid cast would work with a long flight. The Dr consulted a specialist about this, while I waited for the cast to harden. 

Once my cast was complete, we checked out with the cashier. I thought this would be the scary part. Most US health insurance doesn't cover international care, although it's possible to be reimbursed. 

Total cost for three hours in ER, X-rays, physician and specialist consult, casting, CD of imaging, and English transcript of records? 

Only $530 for this "uninsured foreign national." 

Plus I was given personal discharge instructions & follow up care required by a physician. 

I experienced nothing but care, respect and concern from phenomenal nurses & physicians who spoke flawless English. I received high quality care for a reasonable cost. I'm not sure why ER care in the US is so expensive. 

Monday, June 13, 2016

On heterosexual privilege

Last week I did something that I am not proud of. I got into a social media spat with a friend of a friend about why the shooting in Orlando was a hate crime.  I linked to a description of hate crimes and hate groups as identified by the Southern Poverty Law Center . And I texted an apology to my friend for instigating a fight on her Facebook feed. Then I went to the gym and lifted heavy things to direct my anger somewhere. Because nothing makes me more indignant than when I am trying to explain privilege to someone who refuses to listen.

The thing about privilege is that its really hard to understand when you have it. By way of example, I have white skin. This privileged status affords me a huge number of advantages. They are as far reaching as seeing people with white skin on television, having teachers and professors who look like me, and having a "white sounding name" on my resume.  These privileges are as small as being able to purchase bandaids and underwear that are called "nude" and also match my skin tone. My privilege allows me to drive or walk pretty much wherever I like, or shop in stores without being scrutinized. I don't even have to think about white privilege, because it is intrinsic to my experience. You can learn more about white privilege in this article by Peggy McIntosh, Unpacking the Invisible Knapsack.

Heterosexual privilege functions in much the same way. Because I identify as a member of the LGBTQ community, my status as a member of an oppressed group, this difference is particularly marked to me.  I am only able to speak to a very small window of this experience. I defer to my friends and colleagues to speak more fully about what it is to identify as transgender, genderqueer, or the intersectionality of what it is to be a person of color who also identifies as LGBTQ.

I've been really frustrated by the inability of the media and of many people to claim the Orlando attack as a hate crime. The main argument that I'm hearing is that "all crimes are hateful, particularly gun violence." 

This is not exactly incorrect, as I would say that a crime in which an innocent person loses their life is indeed hateful, but it doesn't instill fear like a hate crime does. Hate crimes are intended to terrorize a group of people & instill fear in their very existence. 

It is a profound example of heterosexual privilege that the fact that this shooting occurred in a gay club is so easily erased. 

I find myself troubled by cisgender & heterosexual people co-opting the phrase, "we are Orlando." Because, no, you are not. 

You don't know what it's like to need a sanctuary club where you can dance with  same gender partners. 

You don't know what it's like to have strangers glare & shout at you in public for holding the hand of your partner. 

You don't know what it's like to be looking over your shoulder while walking together or glancing around to see who is around before kissing your partner in public. 

You don't know what it's like to be misidentified as sisters. 

You don't know the chore of coming out repeatedly.

You don't know what it's like to have your life sexualized and fetishized by heterosexual men. 

You don't know what it's like to be in fear.

You can stand alongside us, but your privilege allows you to leave. 

So please don't erase this as a hate crime committed against the LGBTQ community.  

On being queer and being safe

I came of age in the 90s. I knew I was queer around the same time that Matthew Shepard was brutally murdered in Laramie, Wyoming. And Wyoming is not that far, geographically or ideologically, from where I was raised in Montana. This was before widespread usage of the internet and way before the age of social media, so this publicized case was the only example I had of being gay.

At the time, I didn't know anyone who was gay (or at least I didn't know anyone who was out of the closet). I had no gay teachers or friends. Later on, a lesbian couple would begin attending our church with their daughter, but this was after my own realization of my sexual orientation. This was before "It Gets Better."  Ellen DeGeneres had come out on network television, but to a teenager in Montana, the idea that you could be accepted and even loved for who you loved, was about as realistic as living on the moon.

As a teenager, I visited an exhibition of the AIDS quilt in my hometown. Panel after panel, sized to represent graves, stretched out through the university arena. My classmates whispered in hushed voices, "they died of AIDS because they were gay."

The only image I had of what it meant to be gay was death. Brutal murder at the hands of homophobic monsters. Death by disease. Death by suicide. Death by being ostracized out of families, churches, communities. I knew that if I was going to survive, I needed to not be gay. I needed to bury that part of myself. I decided that if I couldn't be straight, I would have to be dead. So I was going to be straight.

There have been consequences for me. Depression and anxiety and pain. Bad choices. After a long time, I began the coming out process because I couldn't slowly die while living anymore. It was many small steps, and continues to be a path I walk rather than a switch that I flipped.

I have celebrated marriage equality in the capital building of Minnesota. I have marched in pride parades. I've spoken publicly about what it is to be queer, a Christian, and to be human. Just one week ago, I married the love of my life in a ceremony with over 200 of our friends and family present. I have been filled with life.

And yet, just a mere seven days after I professed my love to my wife in front of my nearest and dearest, I was reminded again of death.  That queer lives matter less than the lives of other people. That hate is real. That homophobia was not vanquished just because we can get marriage licenses and health benefits. That the fear that sometimes knots in my throat when I hold hands with my wife in public is well founded. A fear of being attacked. I have found sanctuary in gay clubs. I could have been in that club, along with any of my friends. The difference between a hate crime and other crimes is that hate crimes are intended to stoke fear in groups of people for being who they are. This attack in Orlando gives me pause when I think about attending my city's Pride festival this year. I will be looking over my shoulder and will be on guard for anyone or anything that feels threatening. I am not a child anymore, but that child in side of me who fears for her safety and her life is still there. 

I don't have a solution. I don't really have words right now. I need allies to speak the truth about the events in Orlando, that these events were not perpetrated by an Islamic Extremist, he was a homophobic sociopath. I need allies to attend to my safety and those of my community. I need allies to continue to create safe spaces for all youth to feel loved, but especially queer youth, because the world can be cruel.