"The Heart of the Matter"

This morning I found a copy of The Courier. This is a free paper that is found in the downtown area of Vancouver. I usually read The Georgia Straight as it has more availability, but I prefer the articles in the Courier. This edition of the Courier had an article about a patient that benefited from the Heart Program at St. Paul's. While it is not my program (I cover renal and geriatrics), I still found it to be a heartwarming story. The subheadline above the doctor's photo says "A day later the only surgeon in BC trained in life-saving technique would have been in England". I wasn't going to read this article but that grabbed my attention. The article is a bit long, but I was fascinated!

The heart of the matter
by Fiona Hughes-staff writer
At 22, Andrea Marrie is the picture of health. The athletic Campbell River native is five-foot-eight inches and an enviable 126 pounds. (She knows because she weighs herself every day, but not for body image-related reasons). Clear-skinned and with bright green eyes, Marrie has been hitting the slopes of Vancouver Island's Mt. Washington all winter where she coordinates ski lessons. She graduated with a biology degree last year at UBC and hopes to return to the university in the fall to start a master's program in occupational therapy.
To look at her, you wouldn't know about the life-threatening ordeal she experienced less than a year ago-except for half-inch wide scar that peeks out from the opening in her blouse. Stretching to below the rib cage, it's the kind of scar often associated with open heart surgery.
Her near-death experience began not long after she celebrated her 22nd birthday, when she, like many of her friends and fellow students, came down with what she thought was a simple bout of the flu.
Her bizarre story and even more startling recovery began last March. Marrie was working at one of her two part-time jobs while studying at UBC. It was a Friday night and she was at the East Side home of a wheelchair-bound man with a brain injury. Marrie was his homecare support worker for the evening. As the evening progressed, her hands and arms began tingling and she felt dizzy. She had been feeling unwell for a few days, but decided to go to work.
She could handle a cold, but what was happening to her then was more than run-of-the-mill aches and sniffles.
It frightened her enough that she called her boyfriend, Kenny Prichard, who was just coming out of a night class, to tell him she was beginning to feel very sick. As they were talking, her condition deteriorated and she decided she'd better call 911. After hanging up, her boyfriend and one of Marrie's roommates raced to meet her.
"I called 911 because it didn't feel normal," Marrie recalled. "I was kind of freaking out at this point."
As she was on the phone with a 911 operator, she broke into a cold sweat, fainted and dropped the phone, unable to tell the operator her location. Prichard and her roommate Kelsey Ragan arrived and found Marrie lying on the floor with the 911 operator still on the line.
"She was very pale and totally weak," Prichard recalls. "She could barely open her eyes. She was sweating but her palms were very, very cold. At this point, I realized this was more serious than we thought."
The ambulance arrived quickly and raced Marrie to Vancouver General Hospital, where she waited two hours to be seen. The ER staff diagnosed her with dehydration and the flu, but they kept her for observation overnight. Prichard left at 3 a.m.
Fairly certain it was a simple case of the flu, doctors released her the next morning with fluids to rehydrate. Prichard picked her up at 8 a.m. and took her home. It wasn't long before she started vomiting and feeling lightheaded.
Ragan insisted she go back to the ER, but this time at UBC Hospital nearer where they lived. Marrie felt too embarrassed to return to VGH.
"I didn't want to go back to the ER for just the flu," Marrie says. "I thought I'd tough it out. When we got there, I sat down and told Kelsey my roommate to go home and finish her term paper and that I'd be fine. I don't remember anything after that until waking up a week and a half later at St. Paul's Hospital."
After examining Marrie, UBC Hospital emergency staff raced her back to VGH. Prichard and Ragan, who sensed her roommate's illness was more than a flu and had not gone home to finish her term paper, followed by car. When they arrived at VGH and saw an unconscious Marrie hooked up to a breathing machine, multiple tubes and IV lines, and with half a dozen doctors hovering around her in the coronary care unit, Prichard's heart sank.
"I knew it was really bad then and I was freaking out at that point," he says. "I never thought she had something that could kill her. We asked the doctors how bad it was so one of them took us aside and sat down with us and told us it was very serious. They were brutally honest and bluntly told us, 'There is a possibility she could die tonight.'"
Marrie's parents had been called on Vancouver Island, but couldn't make it to Vancouver until the next morning. Prichard and Ragan were told to say their goodbyes.
That night, Dr. Anson Cheung was preparing for a trip to London, England the next day when his cellphone rang. It was VGH. He was told about a young woman who had gone into "cardiogenic shock" or heart failure, and to come to the hospital immediately.
Marrie's heart had failed so badly it could barely pump blood. Her body was going into shock and her other organs were shutting down. Marrie was dying.
Cheung, the surgical director of heart transplantation at St. Paul's Hospital, quickly hooked her up to an ECMO-a heart-lung machine that performs the functions her heart could no longer do-and transferred her to St. Paul's, the province's heart centre.
"The [ECMO] is quite bulky and it was a bit difficult to transfer her but we did it," says Cheung, who kept Marrie on the ECMO for another day.
Despite not knowing exactly what caused Marrie's heart to fail (the main theory, although even now no one is certain about the cause, is a virus due to the rapid onset of illness), Cheung and the transplant team at St. Paul's, including clinical nurse specialist Annemarie Kaan, concluded that she was a candidate for a heart transplant. But since no heart was available, Cheung inserted a mechanical heart pump, or ventricular assist device (VAD) into her abdomen. He is the only surgeon in the province trained to insert VADs. If Marrie had fallen ill one day later, she may not be alive today. Although Cheung would have flown straight back from England, he may not have arrived in time.
Cheung cracked open Marrie's rib cage to insert the one-and-half pound VAD into her abdomen and attach two tubes to the left side of her heart. The device was then connected to a battery-operated portable driver, or air compressor, which looks like a piece of carry-on luggage that can be wheeled around.
The VAD took over the pumping function of Marrie's heart. Ventricular assist devices are only used on critically ill patients who need a transplant and risk dying if a donor heart is not found soon. Patients with a VAD can return home and resume a more normal and relatively active life. By living at home rather than in hospital, patients increase their strength, which increases the chances of a successful transplant operation. Last year, 13 British Columbians received a VAD. Marrie was one of two patients requiring two of the devices. One in four patients who get a VAD, however, will die waiting for a transplant.
In most cases, a VAD is connected to the left and most important side of the heart, which pumps oxygen-rich blood to muscles, skin and organs. The right side of the heart receives the blood that has come back from body tissue and pumps it into the lungs, where it receives a fresh supply of oxygen.
The procedure, which Cheung had done numerous times at St. Paul's since introducing the VAD program at the hospital in 2001, took four hours. The surgery was a success, but Marrie wasn't in the clear. Her heart was getting worse.
A day after receiving her first VAD, Marrie was back in surgery to get a second fist-sized pump inserted into her right side.
"Usually, with bad heart failure if we fix up the left side of the heart the right side of the heart starts to get stronger as well," explains Kaan, an Australian nurse who was recruited to work at St. Paul's VAD program. "If not, we insert a second pump, which is very rare. It only happens in five per cent of [heart transplant] candidates. Andrea obviously needed a second VAD."
About a week after receiving the second pump, Marrie finally woke up. She remembers the moment with vivid clarity.
"I was delirious, confused and paranoid," the 22-year-old recalls. "I wasn't aware I was on the VAD when I woke or what had been done to me and I couldn't talk properly yet. But I could tell my mom was so happy and relieved to see me open my eyes."
Less than 36 hours after surgery, Cheung made Marrie stand and walk.
"I was scared trying to feel if my heart was beating. I was constantly putting my hand over my heart to see if I could feel it beating," she says.
Marrie then found out that she was on the wait list for a heart transplant if her heart couldn't recover on its own. Statistics weren't in her favour. No one in Canada and only a handful of patients around the world had ever survived without a transplant after receiving two VADs.
"It's a very rare occurrence for a patient to recover when two devices have been inserted," says Cheung, who trained at the University of Manitoba, Western, Stanford and was recruited to come back to Canada to work at St. Paul's. Cheung had previously been working and training in Pittsburgh, where he specialized in inserting VADs. In 2001, St. Paul's became the first hospital in Western Canada to insert VADs. There are now 10 centres across Canada inserting the devices, which have been extensively used in the U.S., Australia and Europe for two decades.
Canada was slow to introduce VADs because of a lack of trained surgeons and their prohibitive cost. Marrie's two titanium pumps cost $50,000 US each. The portable driver costs $75,000 US but can be reused for different patients. The pumps are a one-time use only device because blood flows through them, making them a biological hazard.
News of a transplant came as a shock to Marrie. Two weeks earlier, she'd been out on her regular five-kilometre run and had been snowboarding at Whistler and Mt. Seymour and playing intramural Ultimate at UBC. She was young and healthy. Heart transplant candidates are typically male, 50 or older and with a heart damaged from a heart attack.
With support from friends and family and a hospital psychologist, Marrie adjusted to the devastating news and her new life attached to a mechanical heart. She even developed a sense of humour about it all.
"My friends and I started calling the pumps Vaddie," she says smiling over peppermint tea at a Kits caf‚ recently.
Prichard admits that Marrie had her share of ups and down, but stayed positive and motivated.
"She was remarkably strong and tough during her recovery," says Prichard, who remains good friends with Marrie, from his home in Toronto. "Andrea has always been a motivated person in terms of school, work and friends and family. She had periods of frustration, but she mostly stayed positive and upbeat."
Five weeks after her two surgeries, Cheung discharged Marrie from St. Paul's. But she couldn't leave Vancouver just yet. She needed to stay close to the hospital for physiotherapy and regular monitoring of her heart and VADs. Her parents each took a leave of absence from their jobs and rented a basement suite in the city to be with their daughter. Marrie led as normal a life as possible, spending time with Prichard and her friends, going to the beach, which Cheung didn't like because of worries sand could get into the driver. Not all VADs require a portable driver. Some patients, larger men for example, are inserted with heavier pumps powered by a battery pack worn around the waist like a belt.
The average time on a VAD is six months, but one B.C. patient has stayed on a pump for 17 months. Cheung, who's earned the nickname "cardio cowboy" for his pioneering work in the area, said a patient can live for years on a VAD.
He also predicts that in five to 10 years, VADs will eliminate the need for heart transplants altogether.
"With the advance of these devices, their durability, their decrease in size and livability, [VADs] will become as common as pacemakers-we will be able to implant them permanently," says Cheung, who performs 90 per cent of heart transplants in B.C. "A person will be able to live on these pumps until they die at a normal age. With transplants, a heart only lasts 12 years on average and a patient has to be on anti-rejection drugs."
These devices, however, are not suitable for children.
"This is not a long-term solution for them. They are still growing, they're too small for the devices, they can't look after them properly."
Three and a half months after her ordeal started, Cheung and Kaan sat down with Marrie to inform her they wanted to remove the pumps. Marrie was happily surprised-and scared. The "Vaddie" twins had become a security blanket. Marrie knew her heart had gotten stronger, but she was still nervous about not having the pumps as backup.
Cheung and Kaan reassured Marrie her heart was robust and ready to work entirely on its own-and it did. Marrie's heart made Canadian medical history.
"Andrea is the only patient in Canada who had two VADs removed and had full recovery of her heart," Cheung says. "That only happens in about two per cent of cases worldwide."
Although still recovering, Marrie eventually moved back in with her roommates and her parents returned to their jobs on the Island. To keep busy, she took two courses at UBC and finally learned to cook. She's on two types of medication that she takes multiples times a day. Eventually, she'll be down to one medication, but she'll be on it for the rest of her life to ensure her heart beats in a slow steady rhythm.
"Andrea's heart rate was quite high when she was sick and if it [beats] too fast for too long, it can stress the heart," Kaan says.
Marrie is vigilant about her salt and fluid intake. She's allowed a maximum of 1.2 litres of liquid a day while in recovery. (Less fluid lightens the workload for the heart.) It's the reason she weighs herself every day at 9 a.m. Marrie weighed 135 pounds before falling ill and dropped to what she describes as an anorexic-looking 108 pounds while in hospital.
"If I gain three pounds a day it could be a sign of heart failure," Marrie explains, noting the weight gain would be fluid buildup. "I also check my blood pressure every other day."
Although she's been told she's completely in the clear, Marrie has had her share of panic. During her first night staying over at Mt. Washington, Marrie worried about her distance to the nearest hospital. Another time when she was snowboarding and hiking up a hill, she ran out of breath.
"'Hey, are you guys out of breath?' I asked the friends with me. They all said yes so I knew I was OK."
Marrie wants to travel and to visit Prichard in Thailand where he's just left for a UN internship to work with refugees. Maybe one day she'll have a family. But she wonders if all those things are possible.
Of course, says Cheung.
"Andrea's prognosis is excellent," he says. "She can train for a marathon if she wants and I would encourage her to travel. She can do whatever you or I do."
published on 01/26/2007

Close to the Bone

I have been home sick for most of the week. Now that I finally get my appetite and most of my strength back, I have to write/prepare for a funeral service tomorrow. It is my first Funeral service in Vancouver. I have done numerous memorial services as part of my work, but this is the first one where I am the sole officiant. I did a "joint" service at a local nursing home for one of my renal patients which received good comments from attendees. Some of my staff came as well.

It is harder to do a service for someone that you did not know very well.

Since I have been home, I have begun rereading some of my books that I normally don't have time for .. or the brain for. You have to be in a certain mood for some books. Especially when you do the type of work that I do. It's not that I deal with death and dying all the time, but the issue of illness and suffering does comprise a lot of my work. After a while, you want to read ANY thing BUT.. something related to your field of work. Yet it is ironic that when I look at my library, there is a spiritual and psychological component to even my novels.

Close to the Bone is one of the books that I picked up a few years ago. Probably because it was cheap and likely related to my work. It is talking about the way that suffering affects us, our response to suffering.. either our own, or someone else's. The author relates a Babylonian myth as part of the beginning pages in describing the experience that most patients experience as part of their hospital experience.

Inanna is a queen who descends the depths of the underworld, to see her sister who is suffering.

The descent of the soul into the underworld which illness can precipitate, does not always have the impact of a shocking, sudden and unexpected abduction or the immediate devastation of being at the center of a major earthquake. Persephone's myth applies when this is so, but there is a second myt that parallells the experience of people whole illness and decent occurs in stages through an incremental loss of footing in the ordinary world of good health: either they have an illness with a gradually worsening pattern, or they maintain the illusion of being in control and minimize the emotional impact of having a serious medical problem. The myth that resembles the journey they take goes back at least five thousand years to the Sumerian goddess of Inanna.
Inanna was the Queen of Heaven and Earth. Heeding the news that her sister goddess Ereshkigal, Queen of the Underworld, was suffering and in pain, she decided to pay her a visit. Inanna mistakenly assumed that she could descend with ease. She would find however, that the power and authority she had int he upperworld had no bearing on how she would be treated in the underworld.
Inanna knocked imperiously on the gate to the underworlds demanding that the doors be opened. The gatekeeper asked who she was, and then told her that in order to pass through, there was a price. She would find that there was not just one gate, but seven. At each one, the gatekeeper told her that she must take off something she was wearing to pass through. Each time, Inanna responded indignantly, shocked that this should be so, with the words: "What IS this?" Each time, she was told: "Quiet, Inanna, the ways of the underworld are perfect. They may not be questioned."
Her magnificent headdress, the crown that designated her authority, was removed at the first gate. The lapis necklace ... double strand of rich beads.. breastplate .. gold bracelets .. royal robe. Naked and bowed low, She entered the underworld. Over and over, at each gate, symbols of power and prestige, wealth, and office were taken from her. ... Over and over, she would say "what is this?" and be told, "Quiet Inanna. the rules of the underworld are perfect. They may not be questioned."
Whenever a person becomes a patient and enters a hospital, the experience is not unlike Inanna's. Metaphorically, there are a series of gates to go through, and at each one, something is taken away. At the door of the hospital, s/he unwittingly crosses the first gate. In increments, thereafter, a patient is stripped of dignity, choice and authority. However important the patient is in the world, however significant s/he is to someone else does not matter here.
The second gate is the admissions desk... the third gate is usually the hospital room. Here each patient takes off street clothes which are reflections of individuality and status and puts on standard hospital gown that often is ill-fitting, too short and opens up the back. ...
Metaphorically and actually, illness and hospitalizations strip us of what covered and protected us in many ways. Indignities happen, and a "what is this?" protest may be met by words and attitudes from hospital staff that resemble those that Inanna heard: "Quiet, Patient. The orders of the doctor are perfect. They may not be questioned." Even when our physician are healers whom we trust, and they as well as the others communicate what an why whatever is being done is required, and even if we are fully involved in the decision-making, the journey is still similar to Inanna's. There are still gates we go through, which strip up of persona and defense: we become exposed and bare-souled.
The writer goes on to say that when we have been stripped so much, we reach our bare core and find things that were buried, or that we were not aware of. We are faced with the raw product of Self. Suffering brings us in contact with things we would otherwise prefer to forget, according to Henri Nouwen, a theologian. It is what we do with this time of suffering or death that defines our character, and provides a model for others. Some aspects of suffering give us NO CHOICE, but we do have a choice as the author of this book continues in the chapter. We can face it with dignity, or we give up.

This experience of being stripped to the bareness of it all... this is what I see everyday. My staff see it sometimes more intensely than I do. When one sees and experiences suffering on a daily basis, there is something inside that cries out for someone to do something. The mind rationalizes that even though I cannot change the situation, I can often comfort in the care given. That or the brain reacts with one of many defense mechanisms so that the intensity and raw pain are not felt so deep by the caregiver, so that the vicariousness of it all isn't touching too deep. There is a necessity of balance. The caregiver needs to separate themselves from the suffering and pain they witness, but there needs to be some acknowledgement that this cannot go on.
Hard lessons in life.

I spoke too soon

I am feeling somewhat better. My husband on the other hand.. experienced the joys of my weekend, however, unlike him, I woke up whenever he did. Which was frequently.

I think that the symptoms are mainly gone and now it is a matter of recovering. This morning I got a call from the Occupational Health and Safety Nurse, telling me that they did declare on outbreak and closed a ward in my charge yesterday. And then proceeded to tell me about the latest news written in the paper about said topic. So I can't go to work til Thursday. Fine with me. Now I have to clean up the house and disinfect what I was too sick to do before.

This morning, I was called by the family member of the "funeral" I am to do on the weekend. The patient passed this am, and the staff were paging me not realizing I was not there for the day. But they did call my secretary's office and got things straightened out. Luckily, I had done some work for this yesterday in helping with arrangements as they wish me to do the service and also to have it at my church. We'll see what goes on. Considering it will be on my "day" to work, it might be an issue. We'll see about this too.

Being sick, especially on one's day off, is not fun. I was at work on Saturday doing the usual flow of the day. Spent a lot of time on one floor where a patient was dying. The family had asked that I do the service and assumed that it would not be long seeing the way the patient was failing. I told the family member that I would be back on Tuesday and she could contact me then about future arrangements. When I went home, I felt slightly nauseous, later with acute onset of nausea, vomiting and diarrhea. It lasted a little over a day. I have not had symptoms since returning from the doctor's. (Of course, one does not have symptoms... just like when you take the car to the mechanic...) But nonetheless, I have Norovirus Just as I suspected. I had been told by nursing staff that they had a few cases. This is fairly common occurrence in my workplace, happens 1-2 times a year. So as a result, I am not allowed to return to work until 72 hours after the last symptom. Which from what I can tell was earlier this morning. Of course, I haven't really eaten anything either.
So I was "resting" when I remembered that I had not yet called the church re: the memorial service. So I called to find out if I am allowed to have services for non-members, and the time, etc. Called the family member, gave more info, and my home number as I will not be at work tomorrow as previously stated... The patient is still with us.

You know, it is interesting. The dying process. There are certain generalizations and certain elements that are unique to each person. But inevitably, I will hear a question... why is this happening? What happens when it is all over (morgue and funeral protocol) when will this end? How long does this take? It is interesting really. It is different for every person. Some continue to fight/hang on.. while others declare themselves. One of my ladies decided to stop dialysis treatment, shocking many. The pain was too great for her, the quality of life not good, so she decided that enough was enough. I was visiting her on her last days. She asked me to deliver some items to some staff members "when I die tomorrow". Die tomorrow? don't talk like that.. No, she was firm. Tomorrow. And she was right. It is different with everyone. Every case has different issues, but in the end, the results are the same. Whether they were younger (50-60's) or at the end of the life span (80-90s). Life and death are interesting. And in the end, a soul is lost from us to join those who have gone on before.

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This morning, my husband and I went to the notary to begin the process of writing our will. We do not yet have children and there aren't too many assets to deal with, but it is better to write it sooner than later. One of the questions is whether a living will is be included. A will is a legal document, a living will is not, and hence a guideline for others to follow in the event that you cannot speak for yourself. My husband said if there is no brain function, than pull the plug, otherwise I want to live. For me, it is not that simple. I work in a hospital and see the various options. I understand the concept of quality of life (QL), and it means different things to different people. One man told me that QL for him was being to do his job... having his mind, another man's idea of QL was being able to go in the outdoors and go hunting.. his possible amputations would not be good QL. Irony is that despite this knowledge I haven't really defined what QL would be for me, nor have I written an advanced Health directive (aka living will), nor have I had a will. But then I'm young...

Shelters

I was at my local church for business with the staff that run the shelter. I was told about this article http://www.cbc.ca/canada/british-columbia/story/2007/01/11/bc-shelters.html?ref=rss I have been a supporter of shelter considering that their work and ours tend to collide from time to time. I was told that the writer initially came to write a story about homelessness, but after talking to some of the volunteers and staff changed their mind.

Reading the manual...

Yesterday's sermon began with the minister telling us a story of using a fireplace/type of log he was not used to. It was one of those supper hot , ultra burning ones.. they were getting concerned about burning the house down and got the fire extinguisher. One said to the other, "better make sure we know know how to use it". His next statement was that it is not a good idea to be learning the instructions/reading the operating manual when you are in the middle of a crisis/emergency. It is also not a good idea to be doing that in a moral crisis either. It is important to be prepared so that you know what to do when crisis hits.


One of my friends told me that this blog has helped her to understand the actual "work" I do in my job. That statement from the minister resonated with me. Essentially, the patients/people that I meet in my work are in the middle of a crisis that they are not prepared for. ( But then, life is full of unexpected events isn't it?) Often the people who are in the hospital and those affected, (for serious illness or prolonged, I'm talking about, and mostly at onset) are not sure how to deal with it. I have found that a lot of people do not have a "religious" or "faith" foundation and hence they are groping for any kind of help to decide what to do.

When one is in the midst of a crisis, they are often not thinking clearly. On autopilot. They may not see the big picture. This is part of my work, to help "read the manual" so that they don't have to. I don't mean that I am telling them what to do, but rather helping to make sense of what is coming out of their minds/thoughts.

Art and what it says...

Blessed Art Thou




Hmm.. Today's local paper had an article about this painting.. under the heading of Blessed Angelina.. (here is link to the blog by artist, Kate Kretz.)


Angelina Jolie has been turned into the Virgin Mary in a controversial new painting by artist Kate Kretz.
The actress and humanitarian is depicted as the mother of Jesus Christ, while her adopted kids Maddox and Zahara and biological baby Shiloh are featured as angels in the piece, titled Blessed Art Thou.
The painting, which will be unveiled at the Art Miami Fair today, addresses "the cycle of celebrity worship" and depicts Jolie in a flowing gown hovering in the clouds above a dimly lit shopping store, populated by shoppers.
Kretz, who spent five months creating the painting, says, "Our culture is deifying celebrities, but, in the Bible, it is the meek who are blessed, so the title presents a question for the viewer to ponder.
"Angelina Jolie was chosen as the subject because of her unavoidable presence in the media, the world-wide anticipation of her child, her unattainable beauty and the good that she is doing in the world through her example, which adds another layer to the already complicated questions surrounding her status."
Kretz, a former professor, reveals her virgin [Jolie] and Zahara figures are loosely based on a painting by Sir Anthony Von Dyck, while Maddox's pose is borrowed from a painting by Italian High Renaissance artist Raphael.
January 5, 2007
24 hours


So the explanation is that it is a "food for thought" regarding the deification of celebrities. Interesting .. considering an article in the Vancouver Sun a few days ago with headline that celebrities are not health experts and yet people look to them as models on everything from dieting to exercise advice.
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This reminds me of other artworks I have seen over the years.

An ad for the Catholic priesthood based on Matrix style pose, an effort to attract candidates to the dying vocation. I saw this picture in a newspaper with an article explaining the rationale. It said something to the effect of "the appeal of religious vocation is dying out and hence there was an attempt to make it look adventurous, daring, exciting.. etc."

'A tribute to women' ... The Last Supper advertisement for Marithé and François Girbaud

This is from an ad for clothing from a Parisian company... banned for defaming the Christian faith.

Milan bans Da Vinci parody February 4, 2005 (Excerpt)

Their decision follows a ruling by the city advertising watchdog last month. This Last Supper "inevitably recalls the very foundations of the Christian faith", said the Istituto di Autodisciplina Pubblicitaria. "This kind of image, with a high concentration of theological symbols, cannot be recreated and paro died for commercial ends without offending the religious sensitivities of at least part of the population."
"One of the women apostles is kissing the naked torso of a man, which just makes the imitation more offensive. As does the use of Christian symbols like the dove, the chalice and the position of the fingers of the female Christ."

Of course, there are other interesting interpretations of art in the "deification" or use of religious genre that have sparked interest, or controversy. Interesting that it is often controversy that sparks our vocalization in the interest of protecting the Christian faith, but rarely is there a unified voice otherwise. It is hard to define this issue as spirituality and faith are a personal issue. We are not to judge others for our difference of opinion, but are encouraged to attempt dialogue versus debate.

Interesting isn't it? As the point of art is usually to make a point about some aspect of society/cultural norms, and to spark thinking about the definition of norms and rationale behind current thinking/behavior.

Thoughts anyone?

Praise the Lord. I found that which was lost...

Praise God! for He is good! All the time! The theme/title of yesterday's sermon. Well, I realized in the rush and bustle of everything... I did not really pray to God to help me find my hearing aid. Today, inspiration hit. I would look under the bed in our guest room. Well it wasn't there. But there was a box on the bed.. maybe it was in there... I didn't even need to look in the box. There it was on the bedspread... with this crazy flower pattern so it was hiding in plain sight. Oh thank God I found it. Functioning for the past 2 weeks with out it has been hard.

The Lord is good. All the time.

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.