I lost it... I mean misplaced...

What a day!! I had an appointment at 8am downtown, so I had to get up early. I was about to leave and I could not find my hearing aid!! We looked everywhere!! I had it last night. I remember I had it in my hand while talking to sweetie.. and then I don't know. We were doing so many things trying to get things in order for our trip but I don't know where it is. So I went to the appointment, came home and hunted again. Did not find it. Went to work late. And it was a wierd day from there. Came home and looked in every room again. My colleagues are convinced it is in the washing machine... it is not. We never went near the laundry room yesterday. We have looked everywhere... it is not in pockets as I was not wearing any pcokets at the time. It is not on the floor, under dressers, couches, beds, etc.. Not in the kitchen, not in the garbage... have NO idea where it is and we are going to my mother's for a week. I suppose I can function without it. I am not deaf, but it is inconvenient. I'm sure it will show up when we pack. In the meantime, I feel like a part of me is missing... (like when you don't where your glasses, watch or ring...)

Irony or coincidence

Today I am at work. Saturday is quiet compared with the normal weekday. Since the moment I arrived, I have been paged off my feet. I have been thinking about the irony of some situations I have encountered. Of course, when I am paged, it is usually about death, or pending death. Today, I met a woman waiting at her husband's bedside. He may need to have his legs amputated.
How is it that people tend to lose the "one thing" that they love? Last year, a man who was a well known writer and theologian died of a brain hemorrage, or the story of Iris Murdoch, a writer who had dementia. Ironic, isn't that, that we lose what we use the most and sometimes take for granted.

I had an Aborginal patient tell me that a lot of physical ailments related to our spiritual/emotional ailments. There is a connection in the body that is astounding.

Back to the irony of living -- what do we do when we lose that ability or gift we were so dependant on? How do we go on? I guess this is the test of time and faith.

The Star Thrower Story by Joel Barker
There's a story I would like to share with you. It was inspired by the writing of Loren Eiseley. Eiseley was a very special person because he combined the best of two cultures. He was a scientist and a poet. And from those two perspectives he wrote insightfully and beautifully about the world and our role in it.
Once upon a time, there was a wise man, much like Eiseley himself, who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work. One day he was walking along the shore. As he looked down the beach, he saw a human figure moving like a dancer. He smiled to himself to think of someone who would dance to the day. So he began to walk faster to catch up. As he got closer, he saw that it was a young man and the young man wasn't dancing, but instead he was reaching down to the shore, picking up something and very gently throwing it into the ocean.
As he got closer, he called out, "Good morning! What are you doing?" The young man paused, looked up and replied "Throwing starfish into the ocean."
"I guess I should have asked, Why are you throwing starfish into the ocean?"
"The sun is up and the tide is going out. And if I don't throw them in they'll die."
"But young man, don't you realize that there are miles and miles of beach and starfish all along it. You can't possibly make a difference!"
The young man listened politely. Then bent down, picked up another starfish and threw it into the sea, past the breaking waves. "It made a difference for that one!"

This story has appeared in various places on the net, and in books that I have read, such as the current one. Spiritual Caregiving: Healthcare as a Ministry. This is one of the books that I picked up at the conference I attended last Friday. The keynote speaker was Harold Koenig who is a medical doctor talking about the need to include spiritual health as a part of the healthcare/hospital experience. He encourages medical personnel to consider a return to their roots... (hospitals were founded by religious groups, mostly Christian) and reintroduce the concept of spiritual care into their caregiving and also their personal lives.

Blustery Day and the results of Nature

It is interesting what things remind you of. Today, I am reminded of Winnie the Pooh and the Blustery Day.

Today has been very windy and rainy. Umbrellas broken and people almost blown over... and when I got home, well.. there was a tree blocking the road and sidewalk. It had fallen onto the road and covered a truck and a car. A few hours later the road crews came to clear it. The area was sectioned off with the yellow "Caution" tape but people drove through it and onto the curb anyways. The branches were thicker than my wrists and people still drove through it. I was in the middle of the road/tree, taking pictures when a car came right at me. I waved him to stop and he finally did about 2 feet from me. Then he gave this "what the..." look while he was on his cellphone.. and then DROVE over the tree branches and curb and went on his speeding way... people in BC are crazy.

Game time!!

When I was younger, my family had a tradition on the weekends. We would haul out a game on either Friday or Saturday night. There would be popcorn or something, and we would spend an evening playing Clue, or Parcheesi, Sorry and a host of others. I remember these times with a smile. As this is a tradition that I intend to continue.

My latest acquistions, as of last night, are Cranium and Trivial Pursuit of the 80's version.

Some games are timeless. I look forward to a group of friends getting together for game night.

The important thing to note about playing a game.. is to play for fun. True, it feels great to win. But I think the important point is to play. I can't remember what the score was for the last game of Dutch Blitz but I do know that I had fun. And I could play all day and not care about winning or losing a game as long as it is fun. There is just something about games that brings out the child (hopefully not childishness) in people.

Medicine's soul is suffering, activists say

This story was published in the November 13th, edition of the Vancouver Sun. I went to this conference on Friday.

Medicine's soul is suffering, activists say
Modern health care is technologically rich but spiritually poor, conference is told

In its drive for scientific purity, modern medicine has forgotten its roots and become a wasteland in which humanity does not thrive, says a keynote speaker for an international conference on spirituality and health care. In a sense, he says, health care has lost its soul.
Stephen Graham Wright, a nurse, minister and professor who has devoted much of his career to restoring spirituality to health care in England, was in Vancouver for a weekend conference sponsored by University of B.C. Interprofessional Continuing Education and attended by 300 people from around the world.
Referring to the Arthurian legend in which a king rapes one of seven virgins guarding seven wells and then hoards the water for himself -- an act that gradually turns the countryside into a wasteland -- Wright says the modern health-care system has similarly wasted away, starved for the human touch.
Back when health care was provided by the churches, it was based on the idea of compassionate care for others, he says. There was little technology and the workers devoted much of their time to providing comfort to the patients.
But as medicine aligned itself with science, it developed many cures and treatments for patients. That was good. But the focus of health-care professionals changed to treating diseases rather than people.
"The assumption is that people can be cared for, satisfied and nurtured purely through the scientific realm," Wright says.
But it creates a profound disconnect among health-care workers in which patients are seen as "the appendix in bed three" or "the liver in bed nine," he says in an interview. He adds that it hasn't been good for the workers either, who suffer increasingly from burnout.
Wright argues that the loss of the soul is the single biggest omission of modern health care, increasing dropout rates among both patients and staff and pushing costs to the limit.
"There is a growing sense around the western world that something is missing in modern health care," he says. "It is technologically rich but spiritually poor. People don't just get better by having the machines working efficiently or the right drugs put in. There is more to it than that.
"The question is how can you restore this sense of connection so that health-care workers can really be there for people."
That is where Christina Puchalski comes in. As director of the Institute of Spirituality and Health at George Washington University, she works with the Association of American Medical Colleges to develop learning objectives and ethical guidelines for including spirituality in medical school training.
"It's not religion," she emphasizes, noting that the medical colleges would never accept proselytizing. "Spirituality is expressed in how someone finds meaning and purpose in life.
"It might be religion, but it might be family, nature, arts, humanities. Bike riding could be your source of transcendence. It's whatever puts you in touch with what awes and inspires you."
Puchalski became aware through studies and her own patients that spiritual beliefs or attitudes can have an impact on how people cope with things.

"If you are pessimistic about something or believe your illness is a curse, you are not likely to do as well as if you can find some hope and meaning," she says.
She started teaching a course at George Washington University in 1992 on spirituality and eventually founded the institute. At that point, not counting the religious medical schools, only two other medical schools included any curricula on spirituality. Now 102 of the 141 medical schools in the U.S. include spirituality in the training and 70 per cent of the schools make it compulsory.
Puchalski says she is very pleased with the trend because she wants medicine to return to its earlier focus on providing compassionate service to others.
"We take an oath to put our patients' needs above our own, but the health-care system makes that hard to do. We are trying to bring back that service."
After conducting a survey of Canadian medical schools and learning that spirituality is not taught here, Puchalski is working with the Association of Faculties of Medicine in Canada to develop similar programs.
She recommends that physicians conduct a spiritual history just as they do a medical history, lifestyle history and emotional history, when they meet a patient.
For example, she will ask patients if they consider themselves spiritual or religious. If they say no, she will ask what gives their lives meaning. Then she will determine how important those beliefs are in times of stress and if they have specific beliefs that might influence their health-care decisions -- beliefs such as those of a Jehovah Witness, who might refuse blood transfusions.
"If you are truly interested in a person and who they are as a human being, that will signal to them that you care," she says.
She says spirituality programs in medical schools also help set ethical limits on the risks of over-stepping personal boundaries.
"We teach that proselytizing is unethical. Don't do it," she says. "We say the physician has an obligation to respect the patient and must understand that there is often a power differential. In that case, it is beyond unethical, it's abusive because the patient may coerced."
But she says if a patient wants to talk about God, the doctor should listen even if the doctor doesn't agree with the beliefs. "You would talk about it just as you would talk about sports," Puchalski says. She doesn't have any interest in sports herself, but she will still discuss them if the patient wants.
"By understanding people's spiritual beliefs, we can make better diagnoses and treatment plans." kgram@png.canwest.com
- This story can be heard online after 10:30 a.m. today at www.vancouversun.com/readaloud.
© The Vancouver Sun 2006

Case of the Vanishing Remote ...

So Sweetie and I cleaned up the house the other day. We gave a grand tour to a guest and after they left, sat down to watch a show. We have 4 remotes and the one that is for the VCR is gone!! We have hunted through the whole room. Sweetie said that he used it to turn on the TV and then picked up a different one for the DVD player. Well, we hunted. In the couch, under the couch, behind the couch, in boxes, near the computer, in the bathroom, in the kitchen ... it ... is GONE!!
And the annoying thing is that I need it to tape my shows... and without it, I can't get a tape into or out of the VCR!! UGH! Wierd!! We both agree it is wierd. It has been 2 days now sans remote.. wierd. I'm wondering where it walked off to and where we will laugh at finding it.

Being sick is not fun!! My sweetie has been sick for the past few days and felt well enough to go to work today. I have not been as bad as he, (nausea and vomitting) but have been queasy for the week. Today, I said enough is enough. I kept waking up last night. So I decided to bite the bullet and just not go to work today. I am supposed to go to a conference tomorrow, just for the day though. I hope to be able to make it. It looks really good. I can't remember what I registered for though..

Some times ministry happens when you aren't looking...

Some days you encounter people who touch your heart as they reach out for help... and you wonder what happened to them? How did their "soap opera/drama" play out? Today, I had one such answer. It is ironic because I had mentioned to my colleague yesterday about the people that show up in our office requesting help and you honestly don't know what to think. Well today, R showed up in my office again to thank me for my assistance in the previous incident. He told me how well things are progressing and that he is safe, happy and healthy. The situation he had come for help with was resolving nicely and unexpectedly.


After R, I went to my floor and saw a lady who attends my church. This is where the ministry happened. But not mine, hers. Here is a woman who has immense pain and yet is a strong witness for God. She spoke about how she uses her gift of "talking" in our congregation. She ministers to people who come to our church by greeting strangers and welcoming them. She told about how she has been approached by others to help them learn of the God that she loves when there are "plenty of other qualified teachers, why do they pick me"?

I sat there with tears in my eyes and I did not hide it. Not something that we want the Chaplain to do when they visit. "What is troubling you my child?" "Oh you have given me a gift, don't you know? You have reminded me that there are people who use the little they have at every chance they can. This is not something I get to hear from patients in immense pain as your condition dispenses." She continued to tell me stories of her life and how she got through her illnesses in the past, all due to her faith in God. This was a far cry from the story I heard in the next room. Another Christian lady who has been stricken with a rare and debilitating disorder. She told me she does not feel she has anything left to contribute. Oh! If only I could get these two women together... Very different perspectives on a similar circumstance.

Some times ministry happens when you aren't looking for it.. Sometimes we minister, other times we are ministered to.

How does your area rank?

It seems that Healthcare is a major issue here in Canada. Of course, it is in my work as well. Here is a current report as from CBC.ca.

Hospital waits shortest in Ont., longest in N.B.: report
Tue Oct 24, 1:50 PM

Canada-wide waiting times for surgical and other therapeutic treatments increased slightly in 2006, a new survey suggests. The right-wing think tank the Fraser Institute released its 16th annual rating of wait times for 12 specialties on Tuesday.
The average total waiting time for Canadian patients between referral from a general practitioner and treatment averaged 17.8 weeks this year, up slightly from 17.7 weeks in 2005. Seven provinces saw increases while wait times decreased in Alberta, Ontario, and Newfoundland and Labrador.
Ontario's average wait was 14.9 weeks, compared to 16.3 weeks for second-place Alberta and a high of 31.9 weeks for last-place New Brunswick.
Too many cases that should be handled by family doctors are being passed on to specialists who are being overwhelmed, said New Brunswick's former health minister, Dennis Furlong. Specialists also need better tools and more time in operating room to do their jobs, said Furlong, who runs a family practice in northern N.B.
But Furlong disagreed with the underlying thrust of the Fraser report, saying with all its problems, Canada's publicly-funded system is still one of the top three or four health-care systems in the world.
The next-longest waits were found in Saskatchewan at 28.5 weeks and Prince Edward Island at 25.8 weeks.

Two stages of waiting

Co-author Nadeem Esmail says it's the second-longest average wait time the institute has measured, and Canadians shouldn't expect to see any dramatic improvements as a result of the latest federal-provincial agreements.

The waiting time between seeing a specialist and treatment - the second stage of waiting- fell to 9.0 weeks from 9.4 weeks in 2005. Increases in waiting times in B.C., Saskatchewan, Manitoba, Nova Scotia and Prince Edward Island were offset by decreases in the five other provinces.
Patients waited longest between a GP referral and:

- Orthopedic surgery (40.3 weeks).
- Plastic surgery (35.4 weeks).
- Neurosurgery (31.7 weeks).
The shortest total waits between referral by a general practitioner and treatment occurred in:
- Medical oncology (4.9 weeks).
- Radiation oncology (5.0 weeks).
- Elective cardiovascular surgery (8.0 weeks).
The wait for neurosurgery increased significantly (by 12.9 weeks) over 2005 levels while wait times for otolaryngology (ear, nose and throat procedures) increased by 2.9 weeks, internal medicine by 0.6 weeks, and orthopedic surgery by 0.3 weeks. Wait times improved for patients seeking treatment in:

- Urology (decreased 1.2 weeks).
- Plastic surgery (decreased 0.8 weeks).
- Radiation oncology (decreased 0.7 weeks).
- Medical oncology (decreased 0.6 weeks).
- Gynecology (decreased 0.5 weeks).
- General surgery (decreased 0.3 weeks).
- Elective cardiovascular surgery (decreased 0.3 weeks).
- Ophthalmology (decreased 0.2 weeks).
The median wait for an MRI across Canada was 10.3 weeks. Patients in Ontario and Nova Scotia experienced the shortest wait for an MRI (8.0 weeks), while Newfoundland and Labrador residents waited longest (28.0 weeks).

What a day!! I can't remember when I've had a worse day!!
It started with me driving to work because I had a meeting near our house at the end of the day. When I got there, I discovered that I had forgotten my ID and my keys. So I had to use the spare key to get into the office. Then I realized that I had left my cell phone at home. How or when I realized that I had forgotten the phone was when my colleague and I went to get my car when I parked in my other co-worker's spot... and we got there... and there was no car. So I'm looking oh.. now where did I park? It was an apartment building space that the co-worker leases. Oh, maybe it is behind that one... no.. it's... not... here.. Ok, I calmly said. The car is not here. My car is gone. You've got to be kidding me. They towed my car. My colleague was like "what? where's the car?" "the car is gone." I said. "they towed it." When talking to someone else, they said how do you know they towed it, why didn't you think it was stolen? I told them we have a club and an immobilizer... unless someone hotwires the immobilizer, it is going nowhere. So I call my other co-worker to tell her that I will be late. Please tell the others at the meeting. We will just wait for our boss, whose car was in the next lot and ask him for the ride.

"Well, you are now an official Vancouverite. You've had your car towed!!" Ugh. whatever.

So I go to the meeting which is on the other end of town... the furtherest from my work. Normally, they tow cars to a spot close to work, near the Burrard Bridge. But this was not Busters. This was "In-Tow" who took my car to a lot in East Van. So my supervisor drives me to the lot, because she was towed at one of our other meetings, so she remembers it well. It took a bit to find, as it is out of the way... and I haven't even gotten out of her car and a woman is looking at me from a ticket window and says are you here for the red neon? Did you bring cash? our machines are down. No I didn't have cash!! Luckily, my "driver" had not yet left. We go to a gas station where I find an ABM and go back. Then I drove home... tired, exhausted.. went in the house and put my head against the door. "this has ... got to be... one of the worse days of my life" only to turn around to my husband handing me roses... "Okay, not the worse day, but a good way to end a bad day!!" Well it is only Monday, hopefully I've gotten the worst of it out of the way....

Music as prayer...

I had a key chain that I have since lost.. that said "Music speaks where words fail". Sometimes this is the mood or notes, and other times it is like poetry... saying that which one cannot often put into words. This is now my third year in my church choir. It has been a blessing to me in more ways than I can count. I often find myself singing practiced songs throughout the week. This is the song from this morning... it is one that I know by heart. It helped me through rough times last year and continues to do in different ways...

Do Not I Love Thee O My Lord?
Do not I love thee, O my Lord?
Behold my heart and see,
And turn each cursed idol out that dares to rival you.
Do not I love thee from my soul? Then let me nothing love.
Dead be my heart to every joy, when Jesus cannot move.

Within the darkness of this heart,
other gods would vie for my affections,
but thou art exalted, thou art exalted far above all gods.
Let nothing keep me from thy love.

Thou knowst I love thee, dearest Lord.
But, O, I long to soar far from the sphere of mortals joys,

And learn to love thee more.

CAPPE AGM

Yesterday was the AGM (Annual General Meeting) for CAPPE BC. There were more people at this meeting than at our April (Spring) meeting, which is good. It is important to meet for colleageality's sake and for support which is not often gained in our place of employ. I'm just glad it's overwith. I was so nervous about overlooking something necessary ... anyways, with my having to leave the room to look after things in the kitchen, caterer, etc. I didn't really get to hear all of the key speaker who went a "little" overtime...

It was tiring. Hopefully now I can focus on some other things, like work and my hubby. More later.

Faithful One

How long O Lord?

Have you forgotten me?

How long must I lie in bed

feel uncomfortable

Wonder why?

Why do you seem so far away?

How long must I grope in the shadows?

Light a lamp to guide me

Shine on me

Give me hope ...

I trust in you

Faithful One

You set my heart singing

Singing of your salvation

Celebrating your unfailing love

This was written by Nicholas Wilson, based on Psalm 13. This is a bookmark that was given out at his funeral. Nicholas was the chaplain for Children and Women's Hospital in Vancouver BC. I don't know for how long. He was from England and made the journey back, and that is where he died. He had liver cancer and had been waiting for a transplant. He didn't get one and ailed while visiting family for the last time.

This poem speaks of the despair and isolation that so many people feel in their lives. Sometimes we are suffering from a physical ailment, while other sufferings involve the mind, psyche or the soul. I think that despite the ailment, the poem, like the Psalms, speaks to all aspects of the human journey of life. It is hard to rely on God and not blame Him for our sufferings and pain. I have a lady in own of my wards is also in pain. She has been depressed for the past week, but today she said she woke up with a positive attitude. Despite the constant pain in her body, she still relies on God for her strength. It is probably a number of reasons that she "feels" better, but I would like to think it is because she remembered her faith in her Faithful One. Just like Nicholas.

Finally...

Guess what came in the mail yesterday? The marriage certificate. It was mailed direct to us, versus the postal redirect so not sure what happened there. Now I can finally get the legals in order!!

(Patience is a virtue but I wish things would hurry!!)

And STILL.. nothing

You know what... I still don't have my marriage certificate. It has been 8 weeks and NO marriage certificate. So I got fed up and called the Vital stats in town to ask if I wasn't supposed to have one for free. Oh yes, it was mailed 2 weeks later. Well where is it? Hmm?
So they are sending a new one to the proper address. Finally!! I will be able to get stuff done. Luckily, work has changed my name and gotten me business cards without the certificate, but most other places, like the bank, credit card companies, etc, need to see a copy of it in order to change my name. I figure if I'm doing that then we would wait to add sweetie as POA or joint account holder. Too much red tape some times. Now we have to get a will, and change the bank accounts, credit cards, passports, etc. This should be fun (sarcasm) and yes, I do want to get rid of the old name. Although the new one is longer to spell and I forget a lot and sign my old name from time to time.

Definition of grace

I have been very shocked at what is going on in the world lately.. shootings, wars, idiocy from various sources. I have been interested in the Amish shooting incident. My heart goes out to them. It is still seemingly senseless that this event even occurred, but when I read a recent article (posted below in case the link disappears) I truly believe that this community understands the meaning of grace.

Amidst mourning, Amish turn to forgiveness
'The hurt is very great, but they don't balance the hurt with hate'

Thursday, October 05, 2006

NICKEL MINES, Pa. - In just about any other community, a deadly school shooting would have brought demands from civic leaders for tighter gun laws and better security and the victims' loved ones would have lashed out at the gunman's family or threatened to sue.
But that's not the Amish way.
As they struggle with the slayings of five of their children in a one-room schoolhouse, the Amish in the Lancaster County village Nickel Mines are turning the other cheek, urging forgiveness of the killer and quietly accepting what comes their way as God's will.
"They know their children are going to heaven. They know their children are innocent...and they know that they will join them in death," said Gertrude Huntington, a Michigan researcher and expert on children in Amish society.
"The hurt is very great," Huntington said. "But they don't balance the hurt with hate."
In the aftermath of Monday's violence, the Amish are looking inward, relying on themselves and their faith, just as they have for centuries. They hold themselves apart from the modern world and have as little to do with civil authorities as possible.
Amish mourners have been going from home to home for two days to attend viewings for the five victims, all little girls laid out in white dresses made by their families. Such viewings occur almost immediately after the bodies arrive at the parents' homes.
Typically, they are so crowded, "if you start crying, you've got to figure out whose shoulder to cry on," said Rita Rhoads, a Mennonite midwife who delivered two of the five girls slain in the attack.
At some Amish viewings, upwards of 1,000 to 1,500 people might visit a family's home to pay respects, said Jack Meyer, 60, a buggy operator in Bird in Hand, Pa. Such visits are important, given the lack of e-mail and phone communication, Meyer said.
The Amish have also been reaching out to the family of the gunman, Charles Carl Roberts, 32, who committed suicide during the attack. Dwight Lefever, a Roberts family spokesman, said an Amish neighbour comforted the Roberts family hours after the shooting and extended forgiveness to them.
"I hope they stay around here and they'll have a lot of friends and a lot of support," Daniel Esh, a 57-year-old Amish artist and woodworker whose three grandnephews were inside the school during the attack, said of the Roberts family.
Huntington, the authority on the Amish, predicted they will be very supportive of the killer and his wife, "because judgment is in God's hands: 'Judge not, that ye be not judged.' "
Roberts stormed the school and shot 10 girls before turning the gun on himself. Investigators said Roberts may have been planning to sexually assault the Amish girls.
He revealed to his family in notes he left behind and in a phone call from inside the West Nickel Mines Amish School that he was tormented by memories of molesting two young relatives 20 years ago.
But police said Wednesday there was no evidence of any such sexual abuse. Investigators spoke with the two women Roberts named, who would have been four or five at the time and neither recalls being sexually assaulted by Roberts.
"They were absolutely sure they had no contact with Roberts," state police Trooper Linette Quinn said.
A deputy county coroner described a gruesome scene at the school Wednesday, with blood on every desk, every window broken and the body of a girl slumped beneath the chalkboard, below a sign that read: Visitors Brighten People's Days. Roberts's body was face-down next to the teacher's desk.
"It was horrible. I don't know how else to explain it," said Amanda Shelley, a deputy coroner in Lancaster County.
Funerals for four of the victims -- Naomi Rose Ebersole, seven; Marian Fisher, 13; Mary Liz Miller, eight and her sister Lena Miller, seven -- are scheduled for Thursday at three homes. The funeral for the fifth girl, Anna Mae Stoltzfus, 12, is Friday.
About 300 to 500 people are expected at each funeral, said Philip Furman, an undertaker. The church-led services typically last about two hours before mourners travel in horse-drawn buggies to a cemetery for a short graveside service.
Five other girls remained in hospital -- three in critical condition and two in serious condition. They ranged in age from six to 13.
Enos Miller, the grandfather of the two Miller sisters, was with both of the girls when they died. He was out walking near the schoolhouse before dawn Wednesday -- he said he couldn't sleep -- when he was asked by a reporter for WGAL-TV whether he had forgiven the gunman.
"In my heart, yes," he said, explaining it was "through God's help."

© The Edmonton Journal 2006

And the world goes crazy....

What is going on with the world? The latest thing to hit the news is the shooting of girls in an Amish school by a "32 year old man with a 20 year old grudge". Oh my goodness!! http://www.cbc.ca/world/story/2006/10/03/angry-shooter.html

There are all sorts of theories about this event. Copycat theory based on recent shootings, didn't have anything again Amish (supposedly), and I'm not sure what this 20 year old grudge is... the innocents are the ones that suffer. And the world weeps with them.

Odd week ... hope the next one is better

Well work has been a little wierd lately. Stressful at times due to "reconfiguring" of some staff positions, makes you wonder what/who is next.

So today, I did an inservice for 10 nursing students about what pastoral care is. I mentioned things like the morgue, spiritual assessment, misconceptions that people have about our work. Just last week, a patient asked me if I sent to see him beecause he is dying. Oh no. I had to tell him. I'm part of the team. You've been here a while and I haven't been able to meet you. That seemed to calm him down. But then he wanted to know what I was... what tradition. What box did he put me in? Was I there to preach at him, I suppose is what he wondered....

This weekend was hubby's bday. We had 15 people come to the house. It was good to have all the people come. Of course there were some that didn't make it, but that is to be expected considering the large number. I didn't cry over the ones that didn't come. More cake for us.

On Friday past, I went to a patient's wake. It wasn't a funeral and it wasn't really a memorial either. It was at the family's home. The man was in his 40's and had been in hospital on and off for a number of months/years. Even spending one or two of his bdays there. It was like a big party. Just what he would have wanted. He was always waiting for the next party/family gathering. It was good to go. The family really seemed to appreciate that I came. There were a few other staff from the hospital and residence where he lived as well. But it was a hard week overall and some stress. So far this week is going better.

Wheels of Life

... and they didn't tell me!!

On Friday, I was trying to log on to the network at work.. and couldn't. Oddly enough, I could do so at noon but not at 2 pm. The IT person was telling me that I had been typing in my password wrong and so it locked me out... or that I had "forgotten" my password. I don't think so.. a person doesn't forget something like that .. well not me. Well, the reason was explained this morning when I came to work. There was a note on my desk.. FYI from the departmental secretary. Email sent from IT telling me that they changed my user name to my married name so I may have some problems accessing email if I didn't know... NO!! I didn't know. HOW am I supposed to know my user name is changed when they send it to the "new" one? and don't tell me? The thing is that I was told I have to have my marriage certificate to change all this stuff so they had sent back my form requesting this and then do it ANYways... argh!!
So that ... was cool. My new name is official. Then I went to send an email. Someone asked for a file.. so I go to attach it and ... no files!! They transferred my email and FORGOT about my files that were on a separate drive. So interestingly enough, someone from IT showed up about 30 minutes after I report the problem and fixed it within an hour of my request. I guess the "oops, I did something" reports aren't too much of a priority but the "um, where's my files? that YOU lost" speaks louder on the priority list. Wierd how life works eh?

Hearing Things that People Didn't Say

Okay, so I sometimes hear people say things that they didn't. I don't mean body language or reading between the lines.. I mean that I hear them say this ... when they really said that! For those you who don't know, I have a hearing problem. I do not hear high pitches; last eight notes of the piano, nails on a chalkboard, birds, cell phones, pagers, certain female voices drive me crazy .. Mariah Carey, for example. So I heard my colleague say something that she did not.

I heard her say... "So I hear "Jane" (co-worker whose name is changed) has a new interest. His name is Alan." really. I said. Oh yeah. Oh yes, she went on. "For at least 6- 8 months." Really? I go. Is this person staff? My colleague gives me this wierd look and says "Who's Alan?" She goes.
"Her name is Anne." Oh really ... I say. For 6 months you say, hmm. That's interesting. (To myself, I'm thinking. she's dating a WOMAN?! Oh my, that's different. Oh well, everyone has a right to their own preferences." ) "Who's Alan?" She repeats. I looked at her and realize I have no idea what has been saying for the whole conversation. I'm sorry," I said. "Could you start over?" My colleague then said " She has a new intern. Her name is Jan". I was so embarassed. Then I told her what I thought she had said. We had a good laugh.

CBC News In Depth: School Shootings

CBC News In Depth: School Shootings The world is going crazy it seems. A few days ago, all the news would talk about was the trauma of 9/11 (01) and now we are hit with another trauma in the Canadian news. How do you make sense of these people that do massive.. well massacres? Columbine comes to mind... Montreal massacre, the shooting of the women... Crazy world we live in. Makes my job necessary.

We're pastoral care... we don't do those kind of things.

Yesterday, my colleagues and I were having lunch and one of them said "We're pastoral care. We don't do those things". I forget the context but I remember one of them laughed and said that should be our new motto. What those things might be we aren't sure, but we liked the irony, because we seem to do so much.

Later that day, I had 2 of my staff ask me 20 minutes apart, if I had lived with my husband before we got married. I replied, "in the words of one of my colleagues, 'we're pastoral care. We don't do those things." Good for a laugh, so every once in a while you may hear us say.. "we don't those things! We're pastoral care!"

Hope for a better life

Today, I was sitting by the elevator waiting to go for lunch, when one of my former patients got off the elevator and told me that she was getting a transplant. They told her while she was on dialysis and so she wasn't prepared. Just showed up at the hospital with what she had and checked in. At first I wasn't sure what she said. I thought she was just there for short stay. That is common, I didn't think that she would be there for a transplant. I haven't seen her for a few months as she has dialysis at a different location now. So I walked her up the hall and we were escorted to a room right then. So when I left a few hours later, she was about to go to surgery for her transplant. I wonder what people go through with that. I mean, they spend months or years waiting for a transplant and when it happens.. are they really prepared?
So we talked about what she would go through. Was she nervous? Had a prayer and then I left. Her surgery was to take about 4-6 hours. So that'swhere she is now and I will see her in the morning. Usually, I don't know the people before the transplant. I meet them when they are admitted to the hospital for treatment or when they come as outpatients for dialysis. So this was a bit different for me even. Despite the transplant, there is not always a guarentee that the kidney will be okay, not be rejected.
There are two ways that kidney transplants occur; through living donors, or cadaveric. Because we can't plan on the cadaveric showing up when you need it, most transplants are through living donors -- family members or friends. There can be issues with both. We hope that the transplant takes, but when it doesn't I can imagine the guilt that some people feel. Having a person give up a kidney that was working for them. and now it doesn't work for any one. I can't imagine how hard it would be to face the other person.

Gifts in our lives...

I have a somewhat motley collection of friends. I met most of them at church, which is also where I met my husband (I'm still amazed at that!), and we have done many outings together. Formal outings organized as part of the church group that I am in, and informal ones too, such as hanging out at PNE or playing blitz. (The girls and I haven't done this for a while. I will have to organize a get-together or at least brunch to visit since the move ...)
I first came to Vancouver in November 2002 and joined in activities at my church pretty much right away. That is just how I am. I was a member of an organizer/leadership team for the social group that we have for our age group, but dropped out earlier this summer. With the wedding, becoming the secretary for the executive board of CAPPE BC, and starting my next level of certification, I decided that this year I really would scale down my extra activities. I have said that I would but this time I dropped from the leadership team. Partially because I was frustrated by the politics of the team as well. As you may know from social theory on groups, that the more people and characters you add to a group, the harder it may be to communicate effectively.

character roles : joker, rule-keeper, sloppy, defiant, worrier, peacemaker, self-pityer, apathetic, clever, devious, hypocritical, sports player, uncertain, outgoing, impatient, generous

When you have too many of the different characters, it can get messy.

The thing is that my husband is still in the leadership group and it is hard not to jump in with my traditional organizational skills and my desire to be invovled. The question is .. what is the point of a group? or activity? Some people are good at planning for the long-term (I am not one of these people) a go with the flow type person. This can be like at work. In the hospital, we spend our time focused on the one goal: helping our patients to be healthy, have good quality of life and all that. We do this from our perspectives/or bubbles. Hence, everyone has a different idea of what the end result should look like.

Physio, dieticians, nurses, medical teams, pharmacists, and spiritual care all have their own way of looking at the situation and even though we use the same terminology about care, we may have very different meanings about how the "work" should be done. This is the frustration as there are many voices to listen to and depending on who yells the loudest, that is what the team will follow and some people are left feeling that they are shut out or given very little opportunity to demonstrate what they can offer to the patient.

Let me get back to what I was saying about my friends. I met most of them at church. Some I am closer to than others, some come and go, but in the end, they have given me a wonderful gift. I am "Kathryn" to them, not "Reverend", not "Chaplain", but just Kathryn. I am allowed to be myself when I am there... I am thought of or introduced as "This is Kathryn. Oh yeah, she works at the hospital as a chaplain." The fact that I am ordained as clergy, to which they all witnessed in October past is not really a big deal to them. I was not ordained when they met me, and I am not their chaplain. Not expected to have an official role with them. This is something that came about because of who they are, but also because I worked at it. I was training at a different school and when certain people in the area found out "where I was from", I was classiifed as "one of those". I did not want that here in this new city/province. And it has worked out well. While my church has ordained me, they set me "aside" to the work of chaplaincy. I am not required to "do work" in the church for them, but I will offer what I can. They free me to attend and give as I am able and to be fed by the Spirit, and fed socially. There are those in my church who give me special treatment because of my role, but not as many as if I had been living where I grew up. This is very freeing. It is a part of the psalmist statement "Be still and know that I am God" A lesson that I have struggled to learn. To be instead of to do. It is very hard in this society at times, due to expectations, but also due to personal expectations as well. A gift that many are not able to embrace.

Enlightened Religion?

Bruised ego

Yesterday as I was on my home, and fell on the subway escalator near the bottom. I was so embarassed. I was wearing strappy shoes and one came off my foot, and the other was partially off. I fell flat on my butt and had scrapes and bruises up my right leg and right arm. People asked if I was okay, I said yes, I'm jsut wearing the wrong shoes for this. Just silly shoes.

Some times God puts you in the place where you are needed, even if you didn't want to be there...

Today was an odd day. It was one of those days where there was never a minute to rest. Crazy things happening. Today I was coming out of one of our offices and encountered staff from another department trying to help a man find a "pastor". He wanted pastoral care, was I pastoral care? Yes. Am I minister? Yes. Well he was told to talk to my other colleague, a male, who was away. Did he want to talk to a man? or would I do? Well... then he poured out this story about the past few days. He said he remarried because he was lonely, only to discover that his wife is not the woman he thought she was. Then he told me details of how she abuses him, verbally and physically. He has called hotlines for domestic abuse. There are shelters for battered women, but not ONE for men. He has been staying in a hostel for the past week. He began by saying that he had not been a man of faith but had recently returned to the faith. He just wanted someone to talk to and pray with him. He told me that he would return and tell me how it ended.

Yes I know that men get abused too. I think it is one of those other hidden occurences, like miscarriages, that people do not want to share with others. Pride, or just too painful to admit, I don't know.

Then I went back to eat my lunch that I had started an hour and half earlier. My boss shows up and looks at his watch. "How long have you been sitting here?" meaning that sometimes we linger a bit longer than normal and it WAS 2 p.m. "Well if you must know, I have been here for 15 minutes. It is just one of those days and I will probably only be here for 10 more while I finish my conversation with my colleague. Is that alright?" Yes I'm just kidding. He said.

I left that area to go check in a patient. Instead I spy another outpatient that I have not seen since February. She tells me that she is going to court tomorrow regarding the assault case against an ex-boyfriend. We catch up on the story, she tells me about the details of his arrest, how she has an alias because she does not want him to find her. Hurt her. And that she is going to court tomorrow because she wants to proove to him and herself that she is strong enough to face him.

This was my day. Sometimes God does lead you to places or people that you really would rather not deal with. But I know that if I don't do His leading, that I will miss out on awesome experiences with people and I won't be like Jonah. No whale for me.

Yesterday I went to a Jewish "unveiling" service for one of my patients. I took my husband and we met the family of the deceased, sister, brother, nephews, and those who were close to her. There was about 20 people there. I was the only one from the hospital. We gathered in the parking lot, visiting and introducing ourselves and how we knew P. After this, we began a long walk up the cemetary to the grave site. There was a brown cloth draped over the stone. The Rabbi began by the call to gather, and the Cantor also did his piece. While I did not know what he was saying, in Hebrew, it was familiar and beautiful. The Rabbi invited the sister/brothers to remove the cloth together and then they said the Mourner's prayer together.

Mourners: Yit-ga-dal ve-yit-ka-dash she-mey ra-ba
Be-al-ma div-ra chir-u-tey
Ve-yam-lich mal-chu-tey
Be-cha-yey-chon uv-yo-me-chon uv-cha-yey de-chol beyt yis-ra-el
Ba-a-ga-la u-viz-man ka-riv ve-im-ru a-men.

Mourners: Let God's name be made great and holy in the world that was created as God willed. May God complete the holy realm in your own lifetime, in your days, and in the days of all the house of Israel, quickly and soon. And say: Amen.

Congregation: Ye-hey she-mey ra-ba me-va-rach
le-a-lam ul-al-mey al-ma-ya.

Congregation: May God's great name be blessed, forever and as long as worlds endure.

Mourners: Yit-ba-rach ve-yish-ta-bach ve-yit-pa-ar ve-yit-ro-mam
ve-yit-na-sey
Ve-yit-ha-dar ve-yit-a-leh ve-yit-ha-lal she-mey de-kud-sha
Be-rich hu
Le-ela le-ela mi-kol bir-cha-ta
ve-shi-ra-ta tush-be-cha-ta
ve-ne-che-ma-ta da-a-mi-ran
be-al-ma
ve-im-ru a-men.

Mourners: May it be blessed, and praised, and glorified, and held in honor, viewed with awe, embellished, and revered; and may the blessed name of holiness be hailed, though it be higher by far than all the blessings, songs, praises, and consolations that we utter in this world. And say: Amen.

Ye-hey she-la-ma ra-ba min
she-ma-ya
Ve-cha-yim a-ley-nu ve-al kol
yis-ra-el ve-im-ru a-men.

O-seh sha-lom bim-ro-mav
hu ya-a-seh sha-lom a-ley-nu
ve-al kol yis-ra-el
ve-al kol yosh-vey tevel ve-im-ru amen.

May Heaven grant a universal peace, and life for us, and for all Israel. And say: Amen.

May the one who creates harmony above, make peace for us and for all Israel, and for all who dwell on earth. And say: Amen

My husband later said that while the service was different, it was good because it gave a nice summing of the person.. a nice way to say good-bye. In our North American traditions, our Christian traditions, we will have the funeral/memorial service about a week after the death, but there is usually nothing more. Where I grew up, it is more common to see a memorial, with picture, in the paper about a year or many years after the death of the loved one. My mother told me she did not want that done for her. It can be somewhat tacky. But in a sense, there is nothing for those of us left. The funeral service happens... and that is it. There is no real mention or understanding of grief. People are expected to just "move on" or get over it. We see this in soap operas. A character dies and there is no mention of them again, or it is dragged out, boring the audience. Grief is not something that people wish to think about, but it is a part of life. I liked the unveiling. It was helpful for me as I was not able to attend the service at the time of her death, and I think it was helpful for that family. To remember the life of P. and her passion for living even up to the end.

My relationship with P. was short compared with her long life, but she inspired me to learn more about the Jewish tradition. I had previously liked to read books by Anita Diamant, which are novels and informative books about Jewish life. And this has inspired me to read about other traditions as well. Sikh, Hindu, Buddhist and Aboriginal spirituality.

I have recently learned the joys of commuting to work. On the subway, I have time to read so I have read one of the free papers. The latest issue for debate is as followed:
Visitors find Vancouverites cold
By MATT KIELTYKA, 24 HOURS
Vancouver's unique culture may go a long way in explaining why so many visitors see Vancouverites as uncaring.
International student co-ordinator at UBC's International House, Regina Lyakhovetska, says many students get the cold shoulder from locals.
"Students say people are very polite, but that does not mean there are a lot of people willing to help," said Lyakhovetska. "They say Vancouverites are more closed to themselves and it is hard to get to know them."
The feeling is amplified when you're new to the country and trying to adapt to life in Vancouver, she said.
Joe Fardell, president of Tourism Calgary, said Vancouver has a reputation for not being the friendliest city in the country.
"It's friendly, but at the same time it's not as friendly as other cities when it comes to tourism," he said. "Compared to smaller cities like Halifax, Vancouver and Toronto just aren't as friendly."
Fardell said people in Vancouver are so used to having tourists wandering around the city they don't go out of their way to help.
"It's just a different culture, they expect tourists to do their own thing," he said.
Not surprisingly, Fardell rates Calgary as the friendliest city in Canada, but he says it's an honest answer.
"I haven't been here that long and I've lived all over the country, but Calgary is No. 1," he said. "As for Vancouver, maybe top five."

When I first got here to Vancouver, I said to one of my girlfriends from back home, that the people were friendly but something was missing... the warmth. I don't know if I think that Vancouverites aren't friendly, but I thought that the "lack of warmth" was due to the "big city" living/mentality. One letter to the editor suggested that we keep to ourselves because we are tired of being harassed by panhandlers. I wonder if that is really it...

Poverty of Spirit

I have been reading this novel, Among the Children, by David Adams Richards.I picked it up at a book store for cheap. It is set in New Brunswick, which is cool, because I am from the Atlantic region, and tells the story of a family through the eyes of the oldest son. I haven't finished it yet, but so far the content is intriguing. The son talks about when he realized what poverty was. There is poverty of physical wealth, and then there is poverty of spirit. Something deeper. It does not mean that the person is not functional, or gives up, but it seems to me that when one knows poverty and lives poverty, it permeates one's being.
In the story, there seems to be a sense of Self identified in the characters in that some believe they are better than certain others. The narrator shows that poverty on outer appearance is not necessarily reflective of the individual within. The father was targeted often by his community and blamed for the sins of others and yet he chose not to defend himself or to retaliate.

My colleague and I had a conversation yesterday about the misconceptions of poverty. We both live in Canada, but she had lived in Chicago as well. I commented that the book shows the gap between the upper class and the poor. Her comment was that there are some countries that like this, that have no middle class. She also pointed out that it is the working middle class that made this country (Canada) what it is. I think that poverty, inyourface poverty is not seen as much in Canada as in other countries. This is when we had a discussion about the working poor. The people who work for a living but have nothing to show for it.. Immigrants who come to this country to give a better life, or get a better life and end up working at McDonald's for minimum wage. Digging deeper into debt.
It is also easy to compare oneself to others. Often it is in the vein of "they have.. and I have not, I want that thing"... but I think it is harder to compare oneself the other way. To say that we are content with what we have, that it could be worse. People often want what they do not have and then wish they had something further when they do achieve the first thing....

Poverty of Spirit ... I haven't finished reading the book yet, but I will think more on this. I think it can a meaning on the physical plain as in "have not" and "give up", but maybe it means more... as in "blessed are the poor in Spirit"... an attitude towards the world and our place in it, not just from the physical plane, but the Spiritual world as well.

Things people say ...

Today I was talking to a patient who is dealing with the death of a family member. There are cultural differences as the family is East Indian. So I was asking about the different traditions and what is normally done, or expected, and what they are doing that is different from their cultural norms due to the circumstances related to the death. In listening to the person talking about all the family dynamics that go along with this and the expectations that go with this situtation, I was reminded of some questions people ask me when I give talks/seminars about my work in healthcare. My areas of specialty have been dementia, grief related to chronic loss and grief related to death. So inevitably I get asked what to say to grieving people. How can we be pastoral to those in grief? I remember starting with "well, here's what not to say" before I could come up with what to say.
Often people mean well, but say things that aren't appropriate, or aren't helpful to the grieving person(s). I have always hated when people say "S/he is in a better place. .. is not suffering." and the clincher "It was God's Will." I shudder at that one. I will admit. I used to be an offender and use these exact phrases ... but since I took a course in my training where we used a book call "The Will of God" I have learned what that really means. The Will of God.
For centuries, the human mind has sought to understand the meaning and purpose of existence. How did the world/universe come to be? Why? What are we to do here? What is the meaning of life? of suffering?Throughout the years, humanity has answered these questions with various theories.. Let's look at the question of meaning and purpose of life, and the place that suffering/death have in it. This could go anywhere, I know. But I will look at it from a theological perspective as pertains to the concept of Will of God put forth in Weatherhead's writings.
He basically says that God did not intend for these "things" to happen. That this is not the world that He created and thus this is not how we were meant to live. Is God in control now? Yes. Why doesn't He just fix it then? Wave the magic wand and make it all different...? Because that would go against the laws set forth in Creation.
In the words of another writer

Dr. Weatherhead separated God's will into three parts: 1) Intentional; 2) Circumstantial, and 3) Ultimate (ICU).

1. God's INTENTIONAL WILL is for our good. This is Adam and Eve in the Garden. When God created Adam and Eve, it was His intention that they live forever and be happy. But they sinned and were expelled from Paradise.

2. His CIRCUMSTANTIAL WILL is because of the circumstances in our lives. It is within this will that we find God's permissive will. This is Jesus in the Garden of Gethsemane. This is Job 42:2: "I know (faith) that you can do all things; no plan of yours can be thwarted."; It is the all of Romans 8:28, that glorious rod and staff of the grieving: "We know that God causes all things to work together for good to those who love God, to those who are called according to His purpose." I know (wisdom) I can (possibility) do (accomplishment) all things whatsoever He asks!

3. His ULTIMATE WILL is for His glory and our good. This is Christ's resurrection and our resurrection. It is us all in the New Earth.

The wonderful revelation as I read this book is that God's intentional will finally becomes His ultimate will, even as we go through the circumstances of our life. Dr. Weatherhead gives the example of the young man in London whose intention was to be an architect but, because the war changed his circumstances, he joined the Army. At the time this was the honorable course. The young man could not control the evil circumstances of Hitler and his desire to conquer the world, but he could control his reaction to them.

As I read the book I was comforted in the fact that nothing falls outside the circle of Divine Providence:

1) the knowledge of God embraces it;
2) His power is sovereign over it;
3) His mercy holds it creatively.

The key here is God's goodness. The parent does not will evil for his or her child; neither would a perfect God will evil for His children. At the time Dr. Weatherhead gave his talks, the people in England needed desperately to know that there was a living and loving God in spite of the horror going on. We need to understand God's will and its components before we tell the person prostrate with grief that "It's God's will." As I read this incredible treatise, I viewed us as being in God's ICU unit and God taking care of us as only He can do, no matter what our circumstances.

From reading this book by Weatherhead, it changed my thinking about "will of God." I was taught as a child that God is in control. I was also told about fairies, magic, and superheroes. I thought God was like a superhero, trying to save His doomed Creation from messing up even more of their precious existence. Irony is that God is in control but not the way we think He is... I will write more on this... (when my wedding is over!!)

Change and waiting in the "Space in Between"

There is a saying that is something to the effect "there are only 2 sure things in life; death and taxes." Or something like that... But I think there is another one that says " the only sure thing about life is change". Change is inevitable. It is a part of life. Without change, we grow bored, and unchallenged. Change is good. That's why we move the furniture, or go to another room/place. But too much change, especially all at once is not good

This involves some degree of stress. Stress is healthy, and stress is unhealthy. Depends on what kind you get, the type of personality you have and how you cope with stress. Me... I don't cope will with extreme amounts of stress. (In case you haven't noticed.) I tend to get sick. When I first got this job, I moved across the country to a new city, a new job, a new community, ... a new life. I was only here in Vancouver for 3 weeks, and I got sick. So sick that I had to stay home for the third week of my job. And every so often, when life /work got heavy.. I would get sick. A cold, the flu, strep... With all of this change and stress, I wonder if it isn't a 'grief reaction'. In the case of what I just described,I had lost my home, community, support group, security of the job that I knew, .. so that is a lot of losses.. cumulative. I have a patient who is not doing so great. He was described as being a "bit down". Well let's figure out why. He's had numerous medical issues, heart issues, stroke, fractures, and now he is told that his functioning has declined so much so that he is not allowed/able to return home to the place where he was living. I am sure that when a psychiatrist goes in and does the scale to measure depression, they will say that "yes he is depressed". Often what is missed is that is a normal part of a grief reaction, and not just that the patient needs what we call " a happy pill". Sometimes people need to be depressed. It is hard to face changes and it is harder when you don't have time to adjust to old ones before new ones are added.

Change is inevitable... and it is how you approach/handle change that counts. Well. Once again, there seems to be extreme amount of change/stress in my life. I will get married in 9 days. I will then move the rest of my stuff (futon, TV, VCR, computer, clothes and dishes) from my apartment of 3 years to a townhouse. I will learn the joys and annoyances of living with my new spouse. He will learn the joys and annoyances of living with me. I will go away on a honeymoon trip and return to a house crammed with wedding presents and freshly renovated rooms. I will return to work after 3 weeks of being away and scramble to make sense of what has gone on while I was away -- with my patients, staff and colleagues.

So I take a breath.. and I think about all the change that has occured in my short time here in Vancouver. Just this past year has been monumental with some major changes -- losses and transitions. And I remember that there is always a constant regardless of the situation. God says I AM the same, yesterday, today and tomorrow. I will never leave you nor forsake you..

I was regretting the past
And fearing the future.
Suddenly my LORD was speaking,
“My name is I AM”.

He paused.
I waited. He continued.

“When you live in the past
with its mistakes and regrets, it is hard. I am not there.
My name is not I WAS.

When you live in the future,
With its problems and fears,
it is hard. I am not there.
My name is not I WILL BE.

When you live in this moment,
it is not hard. I am here.
My name is I AM.

Helen Mallancott.

Irony is that we spend our lives waiting. Waiting for that event, this job, this illness to pass, graduation, moving to new place, .. we are always waiting for the next good thing. In the meantime, we exist in the "space in between" the good thing we had and the good thing that we want. That is what life is .. waiting for the fulfillment of God's Kingdom in our lives. Waiting til we see God at the throne on Judgement day, waiting till we begin the eternal journey of living... in the meantime, we anticipate the change that till come, obsess about the changes that did occur and that changes that are happening now. I have been waiting for this day.. my wedding day for 7 months since the engagement.. but I have anticipated it for my whole life. I hope that I have as much excitement and hope about other events to come as I continute to wait and exist in this "space in between",

Sick as a dog...

I don't deal with stress very well in case you don't realize. I am at home from work again because once again I sound like a dying frog. Add to that, the fact that it ts like 30 something degrees out. It is not easy to sleep, or pack, or clean or do anything except be sick. Sit on the couch like a bump and be sick. On a Friday. When it is bright and sunny outside. Sick at home with too many things to o and not enough energy to do them....

This is an article published in today's edition of the Vancouver Sun. It relates to my renal unit and the work that I do. It tells a bit about what the donors go through with the process of donating a kidney. There are more live donor transplants then cadaveric (deceased) donors. Relatives or friends get tired of seeing their loved one suffering through the process and pain of dialysis that they agree to be tested and give a kidney. There are often guilt issues that result with this process. It is not always a guarantee that the transplant will be successful, as you read below, and I wonder about how the persons involved feel about this. How the recipient feels, putting their hope on this transplant only to have it not work and now there are 2 people that don't have working kidneys...(the donor has given up a working kidney and now only has one), and the guilt they feel. The disappointment the recipient has, or the anger the donor might feel. Often the persons donating are family or known to each other, but it is rare that there may be an anonymous donor.

The article is talking about social justice. The fact that the government will focus on giving free drugs to addicts, but won't assist with live giving operations... Irony indeed.

Kidney donor puts job on hold to help chum
Woman could benefit from new plan that helps with costs of donating
Glenn Bohn, Vancouver Sun
Published: Thursday, July 20, 2006

Brenda Cote of Burnaby found a friend who is willing to donate the kidney that Cote desperately needs to stay alive-Jo Wright, a self-described "tough chick" who lives in the West Kootenay town of Nelson, is willing to sacrifice one of her two kidneys, but she doesn't think it's right that she should also have to foot the cost for lost wages, travel expenses and other bills. A new $300,000-a-year program announced Wednesday by the Kidney Foundation of Canada and the BC Transplant Society is aimed at helping Wright and other live donors of kidneys or livers.The three-year B.C. pilot program will compensate donors for reasonable out-of-pocket travel and accommodation costs, as well as lost wages. The two non-profit groups say the initiative makes B.C. the first jurisdiction in Canada and North America to reimburse living donors for expenses related to organ donations. A living donor faces big expenses in a pricey place like Vancouver, where all organ transplants in B.C. are performed. And the sacrifice doesn't end after the operation. Living kidney donors may have to stop working for six to eight weeks; the recovery time for liver donors is longer, usually eight to 12 weeks.Wright, who will be eligible for compensation under the new program, has already put out money for her altruistic offer, even though she hasn't gone into an operation room and doesn't yet know when that might happen."I'm putting my job on hold and raising two teenagers on my own, but I'm determined not to worry about the money and just focus on the fact that I may be able to help," Wright said during a telephone interview from Nelson. Last week, Wright went to Vancouver for the final round of tests needed to determine whether she would be a suitable donor for her friend. Wright drove to Vancouver instead of flying to save money, but estimates she's out about $500 because of costs and lost wages for the three days of work she missed. She left Nelson in the evening and drove at night, to keep the number of missed work days to a minimum."There's been a little bit of wear and tear but I'm a tough chick or I wouldn't take this on," Wright said.Then she made a pointed reference to a Vancouver medical study that offers free heroin to selected addicts: "The thing that really burned my britches is that I can go to Vancouver and get a free shot of heroin, but I can't get help to take someone off a medical dependency list."Cote, 43, had a kidney transplant in 1987 and subsequently gave birth to her daughter Erin, now 13.But she's been back on a life-saving kidney dialysis machine for several years and she needs another kidney transplant.Cote said Wright was willing to donate a kidney last November but she had just started a new job and didn't have the money at that time to go to Vancouver and take time off after the operation. "She would have come in a heartbeat, if she was able," said Cote, who has been on an official list for a transplant for two years.The Living Donor Expense Reimbursement Program was outlined Wednesday at a Vancouver news conference. Half of the $300,000 annual budget for the three-year pilot program comes from the B.C. government, through the Provincial Health Services Authority, which is matching contributions from pharmaceutical companies. The province says it expects to recoup its $150,000 contribution within five years because additional live kidney transplants should reduce dialysis costs.

gbohn@png.canwest.com- -

-The gift of life

Some facts about kidney transplants in B.C.-

The first living donor kidney transplant in B.C. occurred in 1976.- Since then, there have been 862 living donor transplants.

- Each year, there are twice as many living donor transplants as transplants from deceased donors.- Almost 300 B.C. residents are now waiting for a kidney transplant.

- Depending on blood type, the wait for a transplant from a deceased donor could be as long as eight to 10 years.

- On average, about five or six per cent of the people in need of a transplant die while they are on the waiting list.

Sources: BC Transplant Society (www.transplant.bc.ca) and Kidney Foundation of Canada (www.kidney.ca)

Things we don't like to think about until we have to .. but then it is usually too late.

I will be the first to admit guilt..that while this comes up from time to time, I do not like to think about this either. I hope that after sweetie and I are settled into married life, that when we look at the important papers, this will be one of them. Advanced Health directives or DNR orders or living wills, as people call them, are important for everyone. But no one wants to write one. It's that "what if" that no one really wants to think about... like "what if ... I had an amputation, what if I lost my job, what if my spouse left me, what if I was told I had a fatal diagnosis and there was no cure...." No one really wants to face this, until we do. It is things like a funeral, or some other story in the news that sparks our thoughts on "that which we do not wish to think about ..." . Sometimes it is easy to turn off the TV and think about something else, and at other times we can't. The Terry Schiavo case sparked great debate on a national and international level. Where I work in the hospital I see/hear horror stories of 70 or 90 year old patients brought in yet again, and because there is no health directive, they are given CPR (a procedure that can be long and actually breaks ribs..) and are intubated. "Is this what Grandma/mom wants?" To be kept alive on a respirator, and when/if she wakes up will have to go through pain and struggle through rehab. Would she want this? Maybe she does.
In the end, I think it comes down to one question. At what point, do I think that my quality of life will suffer? How much pain is too much? At what point do I stop enjoying my life?
There are different levels of intervention. i.e comfort care only, intermediate care, or full treatment. There's even different ones if you are in the community versus a facility.

So if someone does not have an advance directive, and let's say they have a bad stroke or a car accident and it doesn't look very good for the outcome, the family is often asked what to do. In ICU, this often is the case. We (medical team) aren't asking you (family) to "pull the plug". In the end, it is the medical team that determines the prognosis and the course of treatment. But if it looks good for recovery but the patient will have severe to moderate side effects/trauma, it may be that the individual would not want to live this way. Although there is nothing on paper, someone might know that this is what s/he wants. Or it may be that family are in too much shock to process what is going on. The written directive is a guide to medical team, is a way for a person to speak when they verbally aren't able to.

True, there is always a chance that things change. That the person thought one thing but when a trauma hits they change their minds. Like my lady who died in February. She was a very strong personality, but when it came down to it. She said "you know, despite what I seem to say.. I have decided that this pain is too great for me. That living this life of dialysis every other days, not sleeping in a bed because I'm in pain... I've decided enough is enough. This is no life for me." Or when you decide you would rather not be resuscitated, you may have the "near-death" experience and decide that you aren't ready to meet your Maker. It is possible, but then, isn't it still better to think about these things before you really have to.. and then it is too late?

Words we say ..

The "How are you?" question has been a challenge for my ministry. It is a question that rolls off my tongue as I am a Maritimer (Eastern Canada). We ask "Hi. how are you?" as a greeting. Sometimes, it is in passing, sometimes in concern. I was reading another blog. It brought to mind one of the first clients/residents I had in my Clinical chaplaincy training. One of my residents said to me..."do you really want to know?" I remember telling her, "of course I do, I wouldn't ask if I didn't mean it". That was a learning moment for me. To learn the value of the words we say.

Themes that surface...

Have you ever been going through your daily life and you're struck by this realization? There are themes that repeat. Subtle at first and then they yell at you in the face. I wonder about these things... is it that your journey of life, that is just what happens to surface.. what you are focused on? or is it because God says you need to learn this lesson? Have you ever had to learn a "lesson" more than once? .. because you didn't "get it" the first time. That used to happen a lot when I was younger, and I would look up at the sky and say "Sorry God. Did it again didn't I? I'll try to do better."

Well the theme that seems to come up in my work right now is family dynamics. Yesterday I listened to a woman tell me that her family doesn't care about her. They are too busy with their lives and family isn't important to them. It is hard to know what to say as there is obviously conflicting ideas of living. She is "Old World" and cooked for her family and looked after them. Doesn't understand why they don't have the same ethic. I wonder how much is that she is lonely as her husband has died and her identity was likely looking after her family, and how much is that she isn't able to let go and let her children live their lives. That is a hard thing about being a parent.. family. Letting go and letting the children live their lives and make their own mistakes.

Today, I heard another longtime client was talking about her children. One of them blames her for everything that is wrong and the other has drug problems showing up only when it is convenient or when they can get money. It is hard to throw a child out of the house, but sometimes necessary. There are also cultural issues that I wonder about as well. In every generation, we are considered a product of the generation past. You have likely heard or said "I hope I never become my parent" and then later we hear something come out of our mouth or see ourselves do something and shriek in horror.

The thing about hearing the "story" or concerns of one's family is I am only hearing one side. I don't know what the "family" experience is. I asked the second person about possible responsibility that she may have in the actions/inactions of her family. She is willing to concede some of her part of this story. The irony is that is so easy to critique when one is not involved.. but when it is YOUR family or situation, that is harder. When I heard the story yesterday, I felt guilt that I do not write to my grandparents enough, and wondered at how my family sees my function/role in the family.

It is a life-long struggle. We seek to belong and when we are secure, we seek to find our own identity away from our structured environment. That is what we do as children. We develop attachment to our parents and we are affected by the type of attachment we have. Love is an essential need for any child. A child needs to feel loved and cared for to feel secure. If they do not form attachments or felt secure, they are affected in their development This is according to Erik Erikson's theory of development. He posited that every stage is affected by the previous one. Once we have gained that security, we attempt to break from that to determine/find our own way. This is typically adolescence, early 20's. The problem is, that as parents, it is hard to watch our children make mistakes and suffer failure. We want to protect them. But sometimes we over do and the child isn't able to develop a sense of autonomy or has unhealthy dependence on the parent. It is a complex web.. and hard to balance. When to pull and when to let go. So many times, I want to tell my patients what I think they should do.. my opinion. But I can't do this due to the type of counseling we offer. We can't say as chaplains or pastoral care professionals that we think they are being idiots and we wish that they would smarten up. But we can love them and help as we are able. Sometimes we have to let them fail before they succeed. And sometimes it is easier to say what we think, then to do.