Rip Current

I still remember the week. I was relatively new to the world of Chaplaincy, but confident in my practice. I remember the week because it helped confirm my calling. It was also one of the hardest weeks I’ve had in my professional career; laden with death, ethical dilemmas, and realities that changed the core of my theology. When colleagues asked how I was doing, I said “I’m feeling alright, actually; it is well with my soul.” And I meant it. In fact, I was doing better than alright. I was in the zone. It felt supernatural.

The next week everything was business as usual. Until I was driving home and I just started sobbing. Like, had to pull off the road, white-knuckled, clinched fist, bang the steering wheel sobbing. Not about anything in particular. I was just completely overcome and undone.

It felt so strange that this all came after the fact. The chaos was over, I had practiced my self-care, and I was in a good headspace.

I’m going to call this phenomenon the emotional rip current. The waves come in, toss us about, bang us into the rocks a few times and then there is this strange stillness. We have time to check our wounds, survey the damage, and catch our breath. It seems like it’s over. Suddenly the sand gives way and we find a disorienting pull toward the sea. There is no footing and it feels even scarier than the waves.

This is a fitting metaphor for pandemics. As surges come in, your healthcare teams brace themselves. They have learned how to hold the line. Their best practices have improved. They know more about what they are facing. So, when the wave hits they are prepared. They get to work and they fight like hell.

Then the wave declines.
There is a brief stillness.
Now for the rip current.

Pay attention to your friends. They want to celebrate with you, but they might hesitate. They might seem on edge. You might not understand it because everything seems better now. But, they don’t know if there is another wave coming. They aren’t really sure why the sand feels loose beneath their feet.

Hear me: This is a dangerous time for people who have experienced trauma. Risky behaviors. Heavy substance use. Suicides. Check in with your friends. They probably mean it when they say they are fine, but in an hour they might not be. Stay available. Love them well.

I’ve Got Their Six

On public safety day for Gilbert Leadership, class members have the opportunity to tour some of the police and fire facilities and learn more about the first responder resources in our community. Late last Spring I had the privilege of participating in this event. It was exciting to tour the SWAT Humvees, play with bomb robots, and spray a fire hose. I felt a sense of pride thinking about my extended family and friends who serve as firefighters, medics, and LEOs.

During the tour something caught my eye; as I was exploring one of the ambulances, I noticed a set of body armor and a helmet lying on the ground. Curious, I asked one of the Fire Chiefs standing nearby if that was for his team or the cops. My heart sank when he shared it was for the fire and rescue department. In an era of riots and social unrest, it appears that even “non-combatants” are a target. Something about a rescuer being in danger of taking a bullet or a bottle to the head while providing care just rubbed me the wrong way. It’s bad enough that police have to be equipped with military style defenses, but that unarmed medics do too says something about our society.

In the weeks and months that followed, I couldn’t shake the feeling that I had to do something to support our first responders. Growing up, my father was the Sheriff of our county and my mother a dispatch supervisor, so I am keenly aware of the toll a career in public safety can take. Though I am not trained to provide the services that these ones provide, I have extensive training and experience in caring for people just like them. I have dedicated my life to providing psychological, social, and spiritual support to others, especially the ones caring for and protecting our community. So, several months ago I connected with the Chief whom I met through leadership and offered my services, pro bono.

I am beyond honored to have the opportunity to serve as a volunteer Chaplain with Gilbert Fire and Rescue. In my role as a Chaplain with Dignity Health, I have encountered many of these men and women in our local emergency departments. I am excited to help support and encourage them as they protect the lives, property, and environment of the people who live, work, play, and travel in Gilbert Arizona. Where they go, I’ll go. I’ve got their six.

Glow in the Night

One of my favorite traditions during the holiday season is to place candles in the windows of my home. Historians record the origin of this tradition in various ways from signaling Irish priests that parishioners desire sacraments to informing weary colonial travelers of a place for rest. Whatever the origins, the common theme among all the tales is hospitality. And this is something we can all celebrate. Whether we are Christians walking through advent, Jews remembering God’s provision with Hanukkah, or Neopagans celebrating Yule, most of the world’s organized religions and spiritual practitioners see this season as sacred. It is a time for family, friends, and even strangers to come together.

In my own tradition, as we move toward the birth of Jesus, we retell the story of Mary and Joseph arriving in Bethlehem only to find the guest rooms full. Different storytellers have different tales, but essentially, Christ is then born into a humble space at the bottom of most social measurements. Oh, what a change we see by the end of the gospel though! We learn that in God’s economy there is plenty of room (John 14:2) and all are welcome (Luke 23:43). This is no surprise; after all, Jesus’ own tradition taught him that God is a God of hospitality. For example, Leviticus 19:34 teaches that the foreigner among us shall be as the citizen. Thus, from the beginning, God asks us to light a candle for the stranger.

I know we have been through a lot; our world aches with sorrows and pain aplenty. My prayer is that in this season we find the space to welcome weary travelers. I don’t know who your candle is for. Perhaps it’s for a widow who’s alone for the first time. Maybe it’s for the brother you haven’t spoken to in a while. It could be for someone who celebrates a different tradition than you during this season.

Or maybe you are the ragged, broken traveler. If that is you, may you find a candle in our windows. May you find our door unlocked and an open room. Blessing upon you this holiday season. Grace and peace to you and yours!

No Finer Meal

In an older part of town, down a well-worn residential street, tucked back behind a community park and a justice minded church, lies a modest house with a gravel driveway. In this house is a family and in this family is a humble woman of God who feels nervous making speeches and requires the assistance of a translator when hosting primarily English speakers.

Yesterday she hosted just such a group.

After feeding hungry bellies with carnitas and horchata, the woman asked to share some thoughts with her honored guests. “God wanted me to thank you,” she declared, “for caring for others in our community. I know you work long hours and work hard. At first I was going to send the food to you, but I wanted to host you here. I know it is not much, but it is my honor to share it with you.”

I glanced around at the healthcare team with whom I have had the privilege of serving during the last six months and thought how grateful I am as well. Gathered around mismatched chairs and tables covered with plastic super hero covers, I thought to myself “there is no finer meal in all the world.”

I have dined with powerful men and women and influential policy makers. I have attended world-class parties and eaten with the rich and famous. And grateful as I am for such opportunities, none has demonstrated such hospitality. Oh, that we could all be so authentic, so blessed as to give of ourselves in such a way! This is my most earnest prayer: that I may live as this one lives and love as she loves.

Worthy of Love

Today I met with a woman who epitomizes weariness. Recently I have encountered more and more of these patients. The burdens of life causing emotional, psychological, and spiritual angst that manifests in bodies and suspends a heaviness in the air like pregnant cloud pleading for reprieve.

“I am the caregiver,” she muttered.

“Who cares for you?”

“No one, I suppose.”

“What would it look like for you to receive care?” I asked.

“I don’t really know.”

We went on to talk more about the details and how the stress was impacting her physical health. We exchanged several clichés and Bible verses meant to encourage weary souls. All the while, I watched her eyes well up further as she buttressed the seemingly impenetrable walls. Well practiced, she remained at surface level for quite some time. In Chaplain vernacular this is “being up in your head.”

I recognize it easily; I am a caregiver too. I love to host, but have a tendency to avoid being a guest. It takes intentionality to be that vulnerable. I prefer to do favors, offer a hand, share insight, do something. Anything.

I asked the woman if she remembered the story from the Gospels when Mary pours nard on Jesus’ feet. When she confirmed that she did, I simply stated that even the Lord rested and allowed others to care for him.

This was the pressure relief valve. Her shoulders dropped, she exhaled, and gravity finally had its way with her tears. Though she never needed it, she finally had permission.

I share this story to share the permission. For you. For me.

Though there is considerable debate and conflation surrounding the story of Jesus’ anointing, one thing is for certain: no one is above the need for love and compassion.

This is especially true in the face of difficult trials. In several accountings of the story, Jesus connects the perfume to his death. And not that it will prevent his death, nor his suffering, but that it is a “beautiful thing” in spite of it.

Though suffering might remain and hard things will still be there in the morning, we don’t have to do it alone. There is no time like the present to lean in toward community. Come, let us accept the care of one another. We are worthy of such extravagant love.

Resilience and Deep Roots

fire

Did you know that the term Psychological Resilience was borrowed from other sciences including epidemiology? That’s right, the conversation about our ability to mentally and emotionally cope with crises came from the study of how to stop the spread of disease, including viruses. In microbiology, as well as ecology and other fields of study, resilience is the ability and rate of a system to recover from the disturbance and return to its pre-disturbed state. While I have seen some great conversations on whether or not we actually want to return to our previous state, resilience will at the very least get us through this crisis, where we can determine what is next.

Resilience is frequently partnered with other terms to describe various system’s responses to stimuli. For example, an Ecologist might discuss resilience vis-à-vis resistance. The latter being the ability of an ecosystem to remain unchanged when being subjected to a disturbance. In the Psychological world, resistance has some other connotations, but I’m going to stick with it for a minute because I like the analogy of a forest fire.

The fire is the virus- it is already burning, and without the aid of a vaccine, it is going to burn for a bit. But not all forest fires are created equal. Some forests, like the sand pine scrub forest in the OCALA National Park, have very low resistance because the ecosystem is dry and the tree’s bark is thin. However, what sand pine lack in resistance, they make up for in resilience. Fire actually causes their cones to open and their seeds thrive in the charred ground.

Much like old growth forests, what you have planted and how deep the roots go will help determine your resilience. Is your forest full of underbrush and weeds? Do you lack the self-care that prevents dangerously dry conditions? We’re all going to get a little singed, but putting in the work will help prevent everything for burning up completely.

The American Psychological Association’s 10 ways to build resilience:

  1. Maintain good relationships with close family members, friends and others
  2. Avoid seeing crises or stressful events as unbearable problems
  3. Accept circumstances that cannot be changed
  4. Develop realistic goals and move towards them
  5. Take decisive actions in adverse situations
  6. Look for opportunities of self-discovery
  7. Develop self-confidence
  8. Keep a long-term perspective and consider the stressful event in a broader context
  9. Maintain a hopeful outlook, expecting good things and visualizing what is wished
  10. Take care of you mind and body

 

 

 

The Cost of COVID is More Than Dollars

When I served as a Chaplain at the VA we spent a lot of time discussing moral injury and PTSD. Many of the veterans we worked with, especially those with combat experience, carried these titles with them. If you’re unfamiliar, moral injury first started appearing in literature following the Vietnam war to describe patients who loosely fit criteria for PTSD, but weren’t responding well to traditional treatments. It occurs when a person perpetrates, bears witness to, or fails to prevent an act that transgresses his or her deeply held moral belief. In other words, there is a split in our souls.

In the last several years many healthcare professionals have been reading about moral injury and realizing that there is a lot of overlap between their experiences and those of combat vets. This has led to some great articles arguing that clinician distress ought be reframed in these terms rather than “burnout.” I can go into that some other time.

Right now I want to address what we are currently facing. And this is not about masks or how we choose to proceed with our social response. We can go into that another time as well.

In my role I have the privilege of working with the frontline. Their job has always been hard. I have sat with nurses whose scrubs were stained with a mother’s tears and the blood of her deceased son. I have listened to doctors lament over treatments that stopped working. I have prayed with front liners of all faiths and traditions over what goes on in those buildings every day.

But something is different with this. I can hear it in the cracking, shaking voices of the most skilled, experienced, and stoic team members. I can see it in their eyes. It looks all too familiar. It reminds me of the soldiers I used to see at the VA.

I am concerned about the human cost; the most valuable resource we have. We cannot ask these teams to pull these shifts, take these risks, and injure their souls indefinitely. There is tremendous wear from long days full of moral and ethical dilemmas one after another and repeated exposure to high levels of stress. Let me be clear: The frontline is resilient as hell. And they are powerful beyond measure, but they are not immortal.

They need us. They need our prayers. They need our solutions. They need to know the community has their backs. The onus is on us to assure them that we are indeed for them.

Here are some basic ways we can help:

  1. Stop posting crap research and bunk science
  2. Receive their laments. Believe them when they share their stories
  3. Partner with your local facility or foundation to get them resources
  4. Lobby, vote, and hold officials accountable for a better, stronger approach to healthcare
  5. Don’t blame, shame, and try to sue everyone when there is an unfavorable outcome

Bonding Together

Several years ago, when I was assigned to the PICU at the children’s hospital, I noticed something unique about that particular team. At first, I experienced it as rejection. I told my supervisor, “those nurses are different than the other nurses; they are walled off and don’t want me up there.” He wisely encouraged me to give it some time. Weeks went by and still nothing. They were cold as ice. I began to think I’d never crack their shells.

And then a little girl came in. She had suffered a devastating aneurism that ultimately took her life. The week she held on included some of the hardest and most beautiful days I have ever experienced as a Chaplain. It rocked those nurses and shattered their steel-like shells into a million pieces. I held on tight. I wept with them, I prayed with them, and I stayed with them to the end. When it was all over, I was their Chaplain. They trusted me and let me in.

I have since gone through this process many times. Emergency, trauma, and intensive care nurses are some of the hardest, but eventually they allow me to join. What I have found is that these gritty, tough as nails individuals are some of the most empathetic, compassionate humans on Earth.

As a student of human behavior and psychology, I am forever wondering what makes people tick. This phenomenon of bonding through shared experience is especially fascinating to me. The good news is that there is a bunch of research out there on it. Turns out that the heightened empathy thing is not a fluke either. Trauma especially has a way of bonding us together.

I won’t go into all the details, but basically, part of the system that helps calm us down after stress gives us a hearty dose of oxytocin (the same hormone that bonds mother and child during breastfeeding). Oxytocin helps us feel empathy and togetherness. In short, teams that move through stressful scenarios together have a strong likelihood of forming bonds. A good example would be those old war buddies who remain connected for a lifetime.

As I reflect on opportunities that stem from our global shared experience, I hope this is part of the good that will rise from the ashes. I hope that we allow our minds to enter into this phase of shared experience. I hope that we find ourselves just a little more connected and having just a little bit more empathy.

Group-huddle

Let Go

Office_printer_KoOlyphoto

When I was first training as a resident Chaplain we would pull 24 hour solo shifts in a level one trauma center. For 8-12 hours during the day we would respond to consults and various emergencies. The 12 hours over night were spent in the on call room and we primarily responded to life threatening trauma and death.

My first Saturday shift I arrived fresh at 0800, eagerly grabbed the stack of consults from the printer, and began scampering about the eight story building. Up and down the stairs I went, room to room, visiting patients and listening to their stories.

By 1100 I had made it through the stack and returned to the office only to find a fresh stack lying in wait upon the printer. Determined, I snatched it up and went right back out. I worked right through lunch, proud of my diligence and work ethic. Sometime in the midafternoon I returned once again only to find another stack. This time, I sat down to pause and during my rest I heard the printer kick on. I walked over to the machine, lifted the warm page to read the assignment, and as I did, another emerged. and then another.

This was the first time that I truly understood that people are going to keep getting sick. People are going to keep dying. And there is not a damn thing any of us can do about it. I knew this in my head, of course. But this was the moment that it was internalized. I sat back down feeling so incredibly small and so utterly insignificant that I wasn’t sure what to do next.

I realized that at the end of my shift when I clocked out there would still be a stack. The stack would be full of consults for hurting people. People who were dying, people who might feel hopeless, people who needed love. And I was going to leave it there. I made a decision that afternoon. I decided to make peace with the world and with myself. I decided that I was going to release that which was never mine: control.

It is when the world feels out of control that we sometimes seek to control it the most. If we don’t let go, it will rip us apart. I’ve seen it with doctors and nurses, executives and administrators, police officers and firefighters, pastors and parents, soldiers and civilians. None of us can stop this world from turning.

Caregivers, I implore you: do not martyr yourself upon this alter. Let us not normalize exhaustion and celebrate poor boundaries. Let us not create cultures that dishonor our souls.

Clock out. Leave the stack there. Go for a run and then go home to love your family. Come back tomorrow.

Decision Makers: you have an ethical responsibility to the team you support. Do not ask them to sacrifice themselves, because they will. Staff them fairly. Train and equip them appropriately. Provide for them justly. The stakes are too high for anything less.

 

 

This Soup is Cold.

TUSCAN_SOUP

“This soup is cold.”

Since reading Eckhart Tolle’s “A New Earth,” I have often uttered this phrase in response to difficult circumstances. The line comes from a section in the book where Tolle presents the following scenario: he orders a bowl of soup in a restaurant and it is cold when it arrives. At this point he has several options, but really it boils down to two: accept the reality or fight against it. Choosing to accept it does not mean he cannot inform the waiter that he would like the soup heated up. It simply means that he does not take the scenario personally.

For Tolle it is about the ego. “The ego,” he says, “loves to complain and feel resentful not only about other people, but also about situations. What you can do to a person, you can also do to a situation: make it into an enemy. The implication is always: This should not be happening; I don’t want to be here; I don’t want to be doing this; I’m being treated unfairly. And the ego’s greatest enemy of all is, of course, the present moment, which is to say, life itself.”

When I say, “the soup is cold” I am practicing what we therapists sometimes refer to as “surrendering.” I prefer the term “radical acceptance.” It is the “accept the things I cannot change” part of the serenity prayer. The waiter did not do anything to me, just as life is not out to get you. We can blame, shame, and complain all day long and it will do nothing to improve the situation. A better path is to simply decide if we are going to eat cold soup or go heat it up.