Morning and Evening

William is a male nurse whose military training gives him an air of assurance and command. He’s not arrogant or demanding at all but one is always aware of his confidence and capability. He’s also straight-laced enough that when he tells stories on himself, they’re hilarious.

William responded to one of the C.N.A.’s this morning who said that she was flabbergasted when a patient asked that she tuck her breasts inside her panties. “Flash” (That’s what I call her because she’s speed limit challenged) was telling us about it without revealing the patient’s name and the team was rolling with laughter. William, who tells these things with his glasses on the tip of his nose, one-upped Flash by saying that soon after he started with hospice he was assessing a woman and couldn’t find a bowel sound with his stethoscope.

William said, demonstrating with an imaginary stethoscope, “I placed the stethoscope here and didn’t hear anything. I moved it over here, and still didn’t hear anything. I moved it over here and glanced up at her, and she was smiling (William demonstrating a sly grin) --still no sound. All at once, it came to me, it wasn’t her stomach I was listening to; it was her breast.”
William paused with the timing of a professional comedian while we died with laughter and then said, “I was so embarrassed. I mean what do you say, ‘Please lift it up so I can get under it?’”

I had to tell that because that’s how the day began today. It ended with a man dying while I held his hand. His wife was on the other side of the bed and she and the social worker worked at trying to get some medication ready for him. All at once his breathing changed, his eyes rolled up into the extreme right side of the sockets; he made a face and died. His wife called his name desperately, threw herself back on the bed, then, still sobbing, laid her head on his chest while me and the social worker comforted her.

It never seems to get easy. It was up close and personal and we were both exhausted after it was over. I am amazed at how intimate this work is because people throw themselves into our arms as if we were family. They expose their most intimate feelings with us with almost complete abandon and we are found to be trustworthy 99.99% of the time.

If I had known how this day would end, I would’ve turned my car into a local park and hidden out in the abandoned camping sites while the rain and wind whispered me to sleep. I would have waked long enough from time to time to pray and prepared for the death; cleansing myself for the sacred transition. I would have watched the clock with dread and finally eased out of hiding to travel a sort of “Green Mile” to the dying man.

But, it didn’t happen that way. A routine visit writhed and twisted into a different creature and my partner and I had to shape shift as well. Fortunately, the shape of our compassion is just under the surface and the shift into it is usually readily done. We are authentic people who live out our ideals.

Foggy Daze

It’s a rainy evening here in Tobaccoville and that stirs mental whirlpools that draw me into myself but my little study is a little too well insulated to hear the music of the rain outside during times of cool weather. I could open the door but then I’d over work the heater and – well, I just get quieter in my solitude and hear the drops tap woodenly on the deck and ping the metal of the air conditioner once in a while. I’m satisfied with that.

I snarled at my 16 year-old tonight. It’s a long story but after he went up the road with his buddy (walking, not driving tonight) I realized that my grumpy disposition came from a day that I just didn’t know was hard.

I’m working with a woman and her paraplegic daughter whom I’ve known for years and who ended up on my patient census accidentally. I could have transferred them to another chaplain but didn’t. After all, I’m practically a doctor and, what the hell, I know myself well enough to know if there are conflicts (?) Today, I realized that I was utterly confused about what I saw in the family dynamics and felt anxious about my diagnosis and spiritual assessment of the patient and her caregiver. I asked the social worker on the team if I was doing any damage and she said no, not that she could tell. My clinical supervisor would undoubtedly remind me that all dual relationships are fraught with danger but I got caught up, not so much in my pride, but in my deep wish to help these folks through their crisis.

I haven’t seen them in years and my friendship with them came out of one I had with their father/husband - a fellow officer when I worked in law enforcement. He was able to give me opportunities that have an effect on my life even today, 15 years later and shared with me liberally. He died shortly after I left the department and I grieved his death with anger and depression in those days. I have the chance to give back something special by helping his family through another terrible loss.

Human relationships are very powerful things and those of us who tinker with them are subject to all manner of problems if the work is not done with squeaky-clean differentiation and crystal clear goals. My lenses are foggy right now. My work over the next few days will be to get defrosted so my friends will have the best possible care.

First things first, though; I just called my son out to the study to apologize for growling at him and make it clear as to what I expect so that he can get the car.

I think I’m feeling a little better.

Message of the Week

The "Message of the Week appears in the Winston-Salem Journal each Friday. Our Hospice is scheduled to supply the column twice a year. I was asked to write this Fall's column. Here it is.

This is such a beautiful time of the year. It’s a time when our side of the earth tilts away from the sun and we take our turn in the darkness of longer nights. The land uses the darkness to heal and let go of the busyness of summer. Some insects die off, some sleep and the trees release the leaves from tethers that nourished them in the heat of summer days and preserved them through summer storms. It’s a time of gathering and taking stock in the terms of traditional family farming.

Dying is also a time of letting go and taking stock for those who are making that transition and for those who are caring for them. Over the last century, dying has become an artificial struggle of life against death and the sterile coldness of medical science has made the natural processes of death a sort of enemy. The Hospice Movement restores the richness of the warm and artful practice of medicine in which death is a part of living when it comes in God’s time. It saddens me as a minister to hear that people believe that Hospice is about death when those of us who love our patients and our work see it as life-giving and full of positive human experience even when things get harder than we like.

If we are among those who only see the autumn as an annoying season of obnoxious leaf blowers and leaf collection trucks at the curb, it may be difficult to fully appreciate God’s gift to us in the season. If we only see dying as a time of failure and hope only in clicking, beeping robots plugged into human bodies to keep them alive for a few more days, then we miss God’s gift of a peaceful, humane death.

The book of Ecclesiastes is often quoted as evidence that God’s timing is perfect. It says that there is a time to be born and a time to die. Just as we can be certain that the earth will continue it’s rotation and our friends in the Southern hemisphere will experience fall about six months from now, we will pass through our time of darkness and emerge into rebirth and spring. The ministry of Hospice is to midwife us through the difficult transitions in the last season of life. Hospice tries to make every moment of that time as comfortable and sacred as possible using the very best of the science and art of medicine, the very deepest of human compassion, and the finest expression of God’s love.

Chaplain Ken Bradstock
Hospice and Palliative CareCenter

whaddjusay?

This business is not all grim. John is 97 years old and is married to his second wife, Jean. She’s just a young thing and his children don’t approve of the marriage. These wild mid-life crisis can be hard on families and the children are having a tough time getting used to their stepmother, she is, after all, only 76. Most of the kids are in their 70’s and mom is the right age to be their sister (for God’s sake) it’s a scandal that they’ve had to deal with for the last 25 years. The family isn’t sure this little fling will last and this hussy will probably break dad’s heart sooner or later. What’s worse is that dad is a preacher and marrying a woman that young will probably ruin his ministry some day. (It’s just not the decent thing for a man of God to do).

John is indeed a preacher and learned his craft under the great Billy Sunday. And he can certainly preach. One of the delights of my visits is to get him fired up enough to preach. He has a thousand-mile stare that comes over him as he sinks into the rhythm of a real Southern evangelist tent preacher with a rich, booming voice to match. John has enough Bible memorized to write his own version and he quotes freely with only a little hesitation to give the words time to maneuver the calcification of his timeworn mind. The connections he makes across passages tend to be a little mixed up at his age but for the most part he could probably still hypnotize a congregation – given enough Geritol.

This couple is a delight to visit because they are very much in love. I went into see them just last week and asked John what he’s been up to. He got a little smile on his face and she laughed and said “Yeah, Honey, (She says “honey” with a real North Carolina mountain accent that sounds much sweeter than it looks in print) why don’t you tell the chaplain what you’ve been up too. John laced his fingers and laid his hands on his tummy and said in mock dignity, “You see Chaplain, what my wife is referring to is my attempt to clean my hearing aids in the most efficient manner.”

Jean, who could not contain herself, was already laughing, “Yeah, Chaplain. It was efficient. He soaked his hearing aids along with his teeth.”

“John! Is that true? You soaked your hearing aids?”

“Yes, Chaplain, it’s true but my question is, why would that woman ask me to tell the story and then go on and tell it herself?”

By this time Jean and I were laughing through tears and John was grinning through his clean white dental plate. “And,” Jean choked out, “he claims to hear better now than before he soaked them.”

I love it.