Health Care

Many of you are familiar with Dr. Randy Pauch’s Last Lecture: Achieving Your Childhood Dreams. For those of you who have not seen this amazing lecture, informed by his journey with terminal pancreatic cancer, here is the YouTube video of the lecture:

In his book, he ends it with a request for information from those of us whose own parents died when we were young. My mother suggested I write to him; the letter follows. I do not expect him to read it, for I am sure he is deluged with mail of all kinds these days. I did, however, think the letter was a good summation of my own thinking about how to help children who face the death of a parent.

Dear Dr. Pausch,

I am writing to you because I understand you seek first-hand reflections from those of us who lost our father at a young age.  I was six when Daddy died from a MI following a year of being in the hospital off and on due to viral myocarditis.  I can remember my mother coming and taking me on Fridays to see him at lunchtime.  We would stand outside of the ICU in the grass, and the nurse would open the window so I could see Daddy and talk to him.  Thankfully, the ICU was on the first floor!  In 1977, children were not allowed into the ICU proper, but my mother wanted me to see Daddy with my own eyes.  She is a nurse, which I think helped inform her understanding differently than the prevailing wisdom of the time.  Now, unless there was an issue of infection, we would never keep a child out of the ICU.

You may wonder how it is that I know this fact.  I grew up to become an ordained minister in the United Church of Christ and have worked as both a hospital and hospice chaplain.  I did my Residency in Clinical Pastoral Education at RUMC in conjunction with the JMSHCC.  My clinical rotation was as the first chaplain for their stand alone Trauma Unit.  Prior to that, I worked at the UNCH and with CDS, where I helped families facing the brain death of a loved one.  In January, I left Hospice and became the Support Services Director for the CCA.  I offer to you my credentials for two reasons: 1) I want you to know I understand grief and bereavement issues as both a mourner and as professional; and 2) I want to spark your imagination about the potential to use the deep shit of one’s life for good–even if that shit happens as a young child.

Daddy’s death taught me some very fragile, yet important lessons, at six.  Freud would call it my “primary narcissistic trauma.”  I call it the moment my DNA changed.  Whoever I might have been without his death at that moment, ceased to exist.  The only potential future before me included the loss of my father.  I would travel without his presence.  Period.  Every moment of the time of being told about his death is real to me still, but so is Daddy.  In today’s grief lingo we speak of “continuing bonds.”  Even death does not end our relationships with those most dear to us.  One need not believe in an afterlife  in order for these bonds to exist. (I dream of one, but I do not know one exists.) The way I put it to the families I care for is this: The love in our hearts keeps them alive within us.  Nothing can separate us from that love.  It never dies as long as we remember.

Remembering is the greatest gift.  I know your children are young, but I remember more of being 0-6 than any of my peers.  Why?  My mother was keen to ask me to continually retell my Daddy stories.  Even as it broke her heart, she listened and cajoled.  I am 37 now, but I still remember being on a National Airlines flight at 3 months of age.  I cannot, however, remember what I did last Friday night!  Why?  My theory is that my young memories became reinforced by the storytelling so much they became marked within my mind and saved as permanent not temporary.  When I was six, it was not a big deal to think back two years and remember playing with Daddy at the park.  Now, I would be hard pressed.  So, my first thought is your wife needs to be committed–even when she cannot breathe or hardly get out of bed–to ask your children to tell her stories about you.  The whole extended family would also need to be encouraged in this regard.

Secondly, leave for your children as many personalized letters and videos, etc. as you can and make them age appropriate through college and young adulthood.  I know this will be the most devastating thing, but I suspect you have already begun this process.  My father did not do this at all.  In fact, I have a rock in my living room with his penciled “Jack” on it as my only reminder of his handwriting.  (He sent the rock to my Grandmother as a joke because our dog kept bringing her rocks as tokens of love when she visited.)  I often ask Mother if he would be proud of me…what he would think of my work…if he loved me?  Although in my heart I believe these things to be true, how much the better to have them before me.  You come across to me as a man of good humor and realism–don’t forget that in these remembrances.  Your children will look to them to decipher who you are, and who they are that is you.  They will be both mirror and guide, so set reasonable expectations for their life coupled with a humor-filled dose of “Daddy was a human being, after all.”  Losing a parent at a young age immortalizes the parent–Daddy died and climbed onto a pedestal in short order.  Some of this is inevitable, but I also think you can show your tender underbelly.

So many parents I have worked with as they are dying want to protect their children from the inevitability of the pain of their loss.  They want to delay it as much as they can.  This is not helpful, because then the death appears as a trauma.  When someone is sick and dies–as in your case and in my own story–warning shots can go across the bow so as to make the death (loss) expected and not a surprise.  Children over the age of four can usually handle some form of warning shots, especially reinforcing that you are indeed sick.  Depending on emotional maturity, the ages of four to six may be able to handle the possibility of death.  Over six, in my opinion they need to know death is not only a possibility, but also a likelihood.  I often use the analogy of giving your child Motrin for fever: You never give the whole bottle, but a dose at a time helps them to heal.  In the same way, I suggest dosing out these warning shots.

Lastly, I urge you to write letters to your children for when they are 25.  In these letters you need to say one very important thing: Goodbye.  I wish I had been able to say that to Daddy.  My father was healing at the time of his death, and as a result, we went on a little vacation before he was to go back to work July 5th.  He died on that trip the morning of June 28, and so I went from seeing him leave with Mother for a few private days one morning (I stayed at my Grandmother’s.), to having Mother tell me of his death the next.  Most of the 400 deaths plus I have attended afforded some opportunity for the family to say goodbye, which our death rituals do as well.  But the opportunity for the one dying to say it rarely is taken, if even there is the time and space for it.  “Goodbye” is powerful and healing.

You know, there really is no “right” way to do things here.  This totally sucks!  At the same time, there are things I learned as a child that helped me become a tender and intelligent woman and chaplain.  Truth and kindness go a long way–for yourself and for others.  I do not know what will happen when you die, for you or for them.  What I do know is that healing, which is coming to that place where a loss is integrated into our lives, and a rich and full life is possible with great and terrible loss.  Your death will change their future, their DNA.  The loss is that profound.  And with that change great potential will open for them to use that loss to make their lives more, not less.  This will be their choice, just as it was mine.  May the teaching and loving you do now and the legacy you leave them help inform this choice.

In kindness and solidarity,
Jacqueline Hope Derby

This little piece is what I presented to my congregation March 30, 2008 for Colorectal Cancer Awareness Month. Please check out the American Cancer Society and the Colon Cancer Alliance’s websites for additional information on this “Preventable. Treatable. Beatable.” disease.

Good morning.

The purpose of my coming before you today is threefold:
1. To help engage your imaginations about the ministry I am a part of on your behalf working with those who suspect they have or who do have Colorectal Cancer. I began in January after leaving my work as a hospice chaplain.
2. To talk to you about the importance of routine screenings for colorectal cancer, given March has been Colorectal Cancer Awareness Month.
3. And thirdly, to keep my promise to Pastor Laurie to not talk about the poop too much! Of course numbers one and two are all about the poop!

You know, talking about the poop is what makes being in this church—and in our denomination—unique and special. We try to face our fears when it comes to the tough stuff. I grew up in churches where women were told to deny the call of God on their hears just because of their gender. Yet Congregationalist woman Antoinette Brown was ordained by her congregation in 1853. I stand before you today talking to you as a woman minister because of the witness of this congregation in my life these last 13 years of my membership. I am here because of our willingness to come and reason together about what the faithful life entails for our whole person, and because of our covenant together to support one another when the poop hits the fan!

And at some point, it always does.

My work puts me in contact with people from all over the country dealing with the messiness of life.  Some may call me with simple questions about screening, while others face terribly hard dilemmas about the efficacy of continuing treatment when the colorectal cancer is devouring their liver, their lungs, their body. I counsel people about where God is in their suffering. I hold their story as sacred, even as they struggle to understand how Cancer came to their door. I guide. I educate. I listen. And every single day I stand at the threshold of our failed medical system, and often out of compassion school people without insurance or means on ways to work the system to get screening or treatment. Even as I stand here today, I fear my message will strike a chord in someone who needs to be screened but cannot afford it. “Here, at Coral Gables Congregational Church?” you might ask. For at least six years of my membership here I was one of the millions of Americans living without health insurance. Did you know me then? “So, yes. Even here.”

When we are willing to talk about the poop, we are willing to acknowledge that it is not a problem someone else has “over there” that we might sweep in on our white horses and save them from, but instead we acknowledge that it is right here in our midst. Or as the bestselling children’s book by Taro Gomi points out, “Everyone poops.” And because of that, each one of us here is at risk of developing this terrible disease. That is the bad news, but the good news is that with routine screening—starting at the age of 45 if you are African American or age 50 for everyone else of normal risk—colon cancer can be found before it is—well, cancer. Getting your routine colonoscopy every ten years does not just tell you if you have cancer, but can actually be both preventative and curative if you have polyps or one of the early stages of this disease. Even though colorectal cancer grows slowly, getting it out early helps to ensure that it does not have any time to pierce the wall of the colon and spread, which is most often fatal.

Colorectal cancer is the second leading cause of cancer related deaths among men and women combined—only lung cancer beats it. Yet the only way we see a decrease in deaths is due to screenings. Why don’t people want to get screened? Fear. Dave Barry summarized this fear in a recent essay as, “You don’t want a doctor to stick a tube 17,000 feet up your butt.” And for him, it was only when his younger brother—who did not put off getting screened at 50 like he did—announced that he had colon cancer that Dave finally went to be screened. As Dave pointed out: What if his brother had put it off like he did?  Sadly, he most likely would have had a terminal version of the disease.

The beauty of our faith and our faith community is that we come together to grow to be whole people of God. Whole people. God is still speaking to us, my brothers and sisters, in our day and age with our advances in being able to help prevent this disease. The number one commandment in the Bible—said over 60 times in both the Hebrew and Christian Scriptures—is, “Do not fear.” So I tell you today the same thing, “Do not fear the poop! God will be with you!”

And I will be in Fellowship Hall after the service with brochures and to answer any questions you might have.

Thank you.

Working as a hospital and hospice chaplain over the last eight years, I can trace certain themes I repeatedly hear from my patients and their families. These themes include: questioning of why bad things happen to “good” people; the meaning in suffering; the timeliness or “out-of-time” sense when someone dies; trust issues with the medical community; causality; God’s intervention (or lack there of) in our lives; and the meaning of hope/feelings of despair. You know…the light stuff! The most common spiritual intervention I provide directed at a single place of spiritual suffering centers on the popular myth: “God never gives us more than we can handle.”

I write the word “myth” intentionally because indeed this is just that–a myth. We human beings created this idea out of our own hope that it might be true, but not based on any ancient sacred text we might hold to within either the Jewish or Christian traditions. There is a text in the Christian Scriptures that does have somewhat similar language, so the popular consensus is that it has been misquoted just enough to get the other idea into our popular lexicon. The text comes from I Corinthians 10:13 where the Apostle Paul writes, “No temptation has seized you except what is common to man. And God is faithful; he will not let you be tempted beyond what you can bear. But when you are tempted, he will also provide a way out so that you can stand up under it.” The part that is interesting four our discussion is where he writes, “[God] will not let you be tempted beyond what you can bear.” I guess we could call this “Biblical Telephone!” One person after another tweaks it just enough that over time we ended up “God never gives us more than we can handle.”

The problem comes from when we go around spouting off this myth as Biblical truth and live our lives by it!  Worse yet, we often tell this to people truly hurting as a way to try and assuage their pain.  Would you feel better to know that when the most horrible pain of your life is upon you–and you feel like you are going insane from not being able to bear it, yet having to anyways–to know that God had allocated this pain for you knowing you could handle it?

Just recently I spoke to a woman on the Helpline I answer who struggled with this notion. She had just been diagnosed as Stage IV, and she was shattered. She endured more grief and loss in the last twelve years than most, and now with hardly any emotional, physical, spiritual, or financial resources must wage war on this horrific disease–after being Stage Zero a couple of years ago and given the “all clear.” In our conversation, the issue of why would God be “giving” her the cancer came up. Why? Because she had been taught (most likely at church!), “God never gives us more than we can handle.” The implication is that God is giving the cancer for some higher purpose. She told me she believes in a loving God, which led me to ask, “Is a loving God then the creator of your heartache?” I reminded my caller–who is a Christian–of Jesus’ own words on the cross, in which he quoted the Psalmist saying, “My God! My God! Why have you forsaken me?” I believe those words are the cries of someone who intimately knows what it means to endure much much more than they can handle.

If the ancient Hebrew and/or Christian Scriptures are important to you, let me direct you a gem from Proverbs 18:14: “A man’s spirit sustains him in sickness, but a crushed spirit who can bear?” I do believe that feeling supported, loved and cared for while we battle the diseases within (and the dis-ease without) help us to heal in body, mind and spirit. This is why it is so important to surround ourselves during our healing journeys with those who can listen and hold the most fragile of moments–those times of despair, anger, hurt and loss–and celebrate with us the moments of life, hope, love and laughter we will experience even with disease. No one can bear our pain or illness for us–in that we are totally alone–but they can carry us while we bear it by carrying our spirit close to their own. Without that, our spirits will be literally crushed, and that is too much to bear.

My encouragement to you today my dear friends is this: God is not the author of our heartache or our broken bodies. We are fragile and live in a fragile world where brokenness is par for the course. God (or Love, if that fits your spirit better) is, however, always wanting to be part of the circle of support cheering us on, believing in our power to create goodness and beauty in a place where there is pain, and encircling us with comfort in the living we are doing right now…even when it is truly more painful than we can bear.

My Dear Faithful Reader,

We have come to the first anniversary of my blog. First of all, thank you so very much for the affirmation of reading my blog (some of you more than my own Mama!) and sharing with me the places my writing touched you and your story. I must say I am rather surprised by all of this! What started as a way to post photos of my then six week-old puppy Emma–who was still living with her Birth Mother at the time–transformed into something I never expected. I grieved the loss of a meaningful relationship. I worked through much of what it meant for me to work as a hospice chaplain. I highlighted the hilarities of my dating life. And, most importantly, I educated you on men in tank tops!

Given Top Ten Lists are so passe I say, “Nine is Fine!” Here are my favourite nine posts from this last year:

9. I Heart Atheists! This post is dedicated to my patient “Hank,” of whom I wrote. I am glad he is no longer struggling to breathe or to find love.

8. Posting My Big Secret This post received the most private email because people were worried about me. In many ways it was the hardest to write. I reveled an important secret, and in so doing found a way to tell my closest and dearest just how much despair (my definition of anti-hope) I felt following the break-up. This post continues to have meaning for me due to my continuing love of Post Secret, and because I hope by exposing my pain–even as a minister–others fearing the only way through is out might feel comforted.

7. I’m Coming Out: Jesus Know About My Vibrator The year’s most embarrassing and second funniest post. I still cringe when people ask me for my website address thinking about them reading this particular post. Of course this is exactly why it is on this list–I am a glutton for embarrassing myself on this blog with the bitter truth. For the record–and thankfully–I have had sex since I wrote this post! (Once.)

6. The Whispering God Where is God when bad things happen to good people? In part, this post contains my answer to this question and my own thinking about God’s intervention–and lack there of–in our lives.

5. 40 Reasons I Make A Great Girlfriend (and her evil twin 40 Reason I Will Drive You Crazy & Am Not Perfect) This was so much fun, and I met my friend in Austria through putting up the “Great Girlfriend” list on craigslist.

4. A Rose Garden Relationship I continue to think about what I wrote in this post. If there is such a thing as your own writing being a gift to you, it would be this post. I feel it helped me clarify what relationship values continue to remain important to me and also what I ultimately have to offer all of my relationships, including the one I have with myself.

3. You Play, You Pay This post about my prayer for my Aunt Charlyne to come to terms with her cancer and still remains at the forefront of my thinking about her. She finished her second round of chemo, and she will find out next week the results of her latest PET scan. She told us at Christmas she feels the cancer is spreading.  All my work with patients has taught me our bodies tell us the truth–even long before the tests and doctors do–so I cannot help but wonder if hers is telling her a truth now. I do not know what will happen with her body, but I know she will be surrounded by love regardless of the outcome. This is what matters most.

2. Tank Top Wearing Man Candy? The single funniest thing I have ever written! I cannot see a man in a tank top without thinking: “Baby, if you only knew how I felt about THAT!” If you love it too, please go out to Urban Dictionary and suggest “The Tribble Factor” for a word/definition.

1. The Mango Tree My homage to my father and the continuing bonds of love death cannot separate us from and how these bonds continue to inform our present and propel us into our future.

Here is to a wonderful Year Two!

I quit my job.

Back in November, just after Teri’s husband was murdered I gained focus about the abusive nature of the hospice I work for. Needing some time off–even just one day–to breathe, regroup, grieve and find my spiritual center, I asked for some comp time. In the past, the company has given comp time when staff suffered through a major crises and led their team through it. My Social Worker and I definitely qualified, but after I approached the subject with our covering Team Manager we received a text message (no conversation, mind you) stating, “Be strong for the patients.” I could not help but wonder, “With what?”

I reached a breaking point following a week unlike any I experienced in all of my time as a chaplain. I have blessed the parts of a baby girl in an emesin basin, held the hand of a man hacked by an ax, comforted a father about to bury all three of his boys, led a procession with a dead armless/legless baby out of the NICU in a satin box, watched a man die shackled to his bed, had the stench of burning flesh in my nose so bad I had to put toothpaste above my lip to breathe, and been hunted down by reporters following a colossal medical mishap–and that was just at work! My personal life losses also possesses quite the body count as well, and more than once I wondered if my own body would be added to the count at the hand of John or myself. Never, however, had I entered into the gruesome world of murder and known the victim and their loved ones. Never had I loved the one so closely affected and devastated.

After I received the text message, I looked for a new job and found one. I start on Monday.

The first of June last year I wrote “The Cost of Being A Chaplain.” The piece focused more on the financial stresses involved, but originally contained a whole litany of just what two days of working in hospice looked like for me. I pulled out the emotional cost side and began a different post (never completed or posted) called “What It Takes.” That piece began…

Paparazzo said to me on Sunday, “I really do not know what it takes to do your job.” I think it is hard to explain to anyone who does not work with crisis situations, but even sometimes our co-workers just do not get it either. Being a chaplain is unlike most jobs. On the surface, we may seem to have it easy. I go to people’s homes and listen to their stories about their lives. Beneath the surface, I map these stories, looking for places where the support is not present to help them navigate in a healthy way the pain before them and offer comfort, guidance and ways to pick up their own coping skills to shore up those tender places. In so doing, I see the terrible weaknesses hid from most, and must gently place a healing balm there without disturbing the person’s sense of self or fracture their hope/imagination regarding God or love. In order to be a chaplain, you must embrace the painful places, ever be on the lookout for shitty theology trapping someone in a prison of despair, and bear witness to the fragility of humanity. What others flee from, you must draw close to and absorb. We also do a lot of apologizing for the so-called “religious” and teach about what it means to be a spiritual person. And we do this without equanimity with those we care for, without much support of any kind, with a smile and sense of humor, and while being as less threatening as possible–unless we must kick some ass to help our care receivers. Trust me! I have kicked some ass when needed!

Pastoral Care is a wonderful profession, but as caregivers we need certain supports to continue to give of the sweet milk of our own lives to those we care for. My employer did not understand this, nor did they want to. I wrote a “Manifesto” for my exit interview. Here are the basic bullet points:

• Implied and explicit Corporate expectations change and do not always reconcile with one another.
• Unreasonable expectations regarding time allocation (leading to requiring a minimum of a 50-hour work week, on-calls added), especially on a Home Team with high turnover.
• Paperwork in triplicate but no computerization.
• Unequal compensation for company employees in the same job, based on age of program not cost-of-living. (For example, the counties above and below my own have chaplains being paid $5-10k more than in my county for the same work and the same cost of living. Chaplains in the GA program make more, but they have no on-call responsibilities unless a chaplain is specifically requested because unlike us, they do not have the legal right to declare someone dead.)
• Inadequate compensation creates stress and grift. (The starting Chaplain salary is almost $17k less than what the average Associate Minister in my county makes. Both Chaplains and Social Workers are shortchanging on their visits to “make-up” for the disparity…at least emotionally. I have a real problem with this from an integrity standpoint, not to mention it is illegal.)
• Company policy changes that decrease company loyalty and shortchange pay. (They decided to put out 9 of the Social Service staff on holiday–with pay if you still had PTO, without if you did not–two days before Thanksgiving because they “did not have enough money.” The company is publicly traded, so the information about their cash flow is readily available. The truth? Their net revenue was up 32.8% for the Third Quarter from where it was in 2006. The profit was to the tune of $13.8 million! Not enough money my ass!)
• Death attendance visits counting against productivity requirements. (It is a FUCKING HOSPICE!!! How can going to a death be counted against the Psycho-Social Staff? They consider the day a “loss” given the person died–although they did get paid for the day. Some weeks I would go to as many as three deaths on my team. Unproductive my ass!!! )
• The way in which on-calls are handled. (Too long to bore you with here, but needless to say…sometimes I felt it was a choice between my life or my job.)
• A corporate culture of fear and urgency.
• Patients and families come behind shareholder profits. (Hollowing out services to the dying to make a profit is immoral and will eventually bankrupt the company. I am going to send the CEO a copy of The Divine Right of Capital.)
• We are not prepared for RN staffed Continuous Care or Pediatric Continuous Care.
• Not enough emphasis or time for true staff support and emotional care.
• Questionable charting practices, which I believe to be illegal.

I am ready for a change and for renewal in my professional life. I want to work where I am valued, and where I can use my gifts. I want to help individuals, and I want to contribute to the way in which we think about how to care for those suffering at the macro level as well. I never want to be on-call again!!!! I want to write more for a living. I want work to be work and home to be home again. I want to be paid a living wage. I want my creativity to be blessed not questioned. I do not want to feel I need to dumb myself down because it is threatening to some of my colleagues.

The new chapter begins on Monday! YEAH!!!!

This is the Eulogy I wrote for my patient I called “My Love.” Maybe you will see a small part of yourself in times of great struggle when you read this:

As I began to think about what I wanted to say about my dear patient—whom I loved greatly and who I know loved me as well—I kept hearing the song from “The Sound of Music” in my head where the nuns sing: “How do you solve a problem like Maria? How do you hold a moonbeam in your hand?” “Maria” was definitely a firecracker and a moonbeam! In all honesty, I did not meet the same Maria her family describes because in many ways that version of her never existed in the same way after she after her hospice admission in April of 2005. Maria never could fully accept the myriad of her life changes or heal into the person who rose from those ashes. And yet, her spirit—that “moonbeam”—could not be stopped by COPD or hospice…even if Maria struggled to see that for herself at times.

I once asked her to describe her life before she took that long last final terminal turn. She told me how much she “enjoyed her children” and how they had “always been [her] heart’s desire.” Children and animals…Maria drew close to her the tiniest and the most tender. She described herself as being handy, artistic, creative, fun, funny, and “a pleasure to be around.” She also felt like the disease not only was choking the life out of her body, but also that the process had stolen all the life out of living in the here and now. This was the Maria—“My Love” as I usually called her —whom I met in September of 2006. I met a woman ravaged by a disease and full of dis-ease as a result.

It was love at first sight. You may find this so odd given I am standing here breaking the cardinal rule of Memorial Services and talking about the tough stuff! Knowing My Love as I did, I think she would be proud of me for being willing to be honest about just how “shitty” this was for her these last few years. And no, she would not mind one bit that the Minister said “shitty”—it was a favourite word of hers after all! (She also had a way with the f-word, something I appreciated, but let’s have a tiny bit of decorum here.) I also know she would be proud of me for seeing into her—into her deepest most beautiful and hurting heart—she liked to say to me, “Intimacy means “into-me-see.” And I did see her intimately—broken, anxious, hurting, longing, suffering, grieving, wanting, hoping, searching, funny, smart, creative, insightful, wise, kind, loving, honest—brutally honest. I heard her laugh, rubbed her back as she cried, kissed her cheek, had her frail arms embrace me, and her hand cup my face—not to mention I have been the recipient of her pointed right finger on more than one occasion! I am so sad that I will not see her again…and I am so happy for her that she finally has the peace she sought and needed so desperately.

Part of why I love her so much relates to the tenacity she showed to stay her course no matter what. We all suffer in prisons of our own making, but even in those places where we are literally marking the days on the wall, life is possible. I read about how Nelson Mandela kept a garden on Robbins Island, where he was a prisoner for 27 years. He said it was his lifesaver. Maria kept a garden of her own in many ways. From little rituals that defined her life, to meaningful friendships where the introduction was based on her decline, not her beauty, wit or brains. She tried to sort out the story of her life, to try and find meaning with the terribly unfair thing that had happened to her. She tried to grieve all she lost on the way to losing her life. She sought peace. Maria showed unparalleled strength and courage in the face of devastation. She held on—tightly, mind you—for so much longer than most of us could even imagine doing if we were in her place.

Like all of us, she would often ask me why this had happened to her. She blamed herself for ever smoking, but I am here today to promise you that none of us “deserves” to have our breath taken away from us by a terrible disease. I know it is such a normal human desire to try and make sense of things by figuring out the cause-and-effect. Let me tell you the universal truth of why we suffer: We suffer because we do…it is part of what it means to be human. Human beings break—mentally, physically, emotionally and spiritually. The Blame Game never leads to healing, and when we break, to have courage to try and heal in the face of that brokenness—well that is true bravery. Maria had a brave spirit because she tried, and she held on, and she continued to laugh for as long as she possibly could—even when it was through her panic and tears. Yes, even this last month of her life when she became too weary to talk most of the time, she would carefully spit out each and every word of a zinger and make her family laugh!

Maria was not a superhero; she was just a woman…a human being like all of us here. She never walked on the moon. She never received a miraculous healing and lived to tell about it on Oprah. She never won the adulation of the masses or had her words or artwork revered. But she was a ray of light—a moonbeam to those of us here—and that was something her disease never stole from her. As each of us carries some part of her humor, her love, her life, her mischief, her spirit, her story in our own hearts, she continues to live on and bless us. I don’t think she would want it any other way.

Closing Prayer for Maria’s Celebration of Life:

God, we possess great imagination about who you might be, and we cling to the ideas about you our brothers and sisters share. Our brother David said you know everything about us…that you examine our hearts. Do you know each moment we sit or stand? Do you really count the hairs on our heads? We need you to, for we suffer and need to know you are with us even in the darkest place or the deepest valley. Find us and comfort us with your tender embrace.

God, we wonder if you know our thoughts when we are far away from you? Come quickly and hear them now sweet Shepard. We are full of love, remembrance, humor, and longing for our dear beloved Maria. We are so grateful she can breathe deeply now because her lungs, spirit and mind are at peace, and we are so sad that we will only hear her laughter in our memories. Comfort each one here—especially her family—and may the promise be true that if we ride the wings of the morning or dwell by the farthest oceans, even there your hand will guide us and your strength will support us. And help us to hold tightly to all of our stories, memories and love of Marsha, so we might speak of her and keep her spirit alive within us for as long as we live. Amen.

Sometimes I fall in-love very easily and shamelessly with my patients. I do not mean to speak of romantic love, but instead of how a special spark will exist and you just love instantly as a result. I recognize how common threads from my life and theirs act as catalysts, but sometimes I am at a total loss for why I feel so compelled by them and their stories, loved ones, life, illness, etc. I had two different “Jacquelines” this year, so I think we can easily trace why they were special to me right from the start! My nurse Wendy and I fell in-love instantly with “Yoda” and for no other reason than the man was a complete gentleman. I also think the way he would speak of his wife and how he longed to see her again touched me deeply–both in my understanding of how death does not end love and in my own longings to have a man feel that way about me. And then there is my patient I always referred to as “My Love.”

Whenever I would come into her home I would say, “Hello My Love, tell me about you today.” If I said, “How are you?” she would always reply, “How the hell do you think I am?” I always met that with a snappy, “Shitty for sure, but better now that I am here!?” (smirk included free of charge) She would snarl and laugh all at the same time! My Love suffered with COPD and with the horrible box of living with a terminal disease. Dis-ease all around her, I felt from the very beginning of our time together in September 2006 that she suffered from Complicated Mourning. The DSM IV (the psychological diagnostic Bible) basically says one suffers from Complicated Mourning when after a year from the initial time of the loss one still experiences the loss in the same way as when the loss first occurred. In other words, one never moves beyond the initial grief reaction. Imagine if you learned of the death of your closest friend…hold that thought, feeling, body trauma for just a moment. Now imagine never letting that feeling morph and heal, but instead staying exactly the same always. Complicated Mourning occurs most commonly after sudden traumatic losses, including but not limited to: homicides, death of a child, multiple losses or concurrent losses, and/or suicide. In the case of My Love, the person she saw herself to be died when she entered hospice in April of 2005, and she never could fully grieve the myriad of her life changes or heal into the person who rose from those ashes.

I can remember feeling intimidated walking up to her large home for the first time…what turned out to be a very pretty prison of her own making. I greeted the most beautiful woman. In her mid-sixties, she could have passed for being in her forties but for her hands, which belonged to a woman thirty years her senior. Her hands told the story of her weakened lungs, weakened resolve, weakened resilience. I always notice people’s hands–even as a child I would compare my own to my Mother’s and Grandmother’s all through the church services. Her hands continued to tell her story in that they were most often clenched. She would sit in her recliner, leaning back to her left with her left hand tight and her right arm locked out straight to her seat. She would wag her right index finger at you to make a point, but the rest of her hand stayed firm. Her hands never lied about how desperately she was holding on, and they never lied about how desperately she was living.

I think of my “Patient Zero” as a mother from when I served as a Youth Minister in North Carolina. She and her husband–both lawyers–engaged in one of the bloodiest divorces I ever witnessed, and I only saw the aftermath. She also had Breast Cancer with mets to her liver. I visited her at Duke after a surgery to help with the spread of the cancer in her liver. Her goal simple: Live until her 10 year-old turned 18. God forbid her former husband raise her or interact with her more than the bare minimum the court ordered! She too held on tightly. She told me as I stood by her bedside following the surgery how she prayed God would help her to let go of holding on with such vigor and desperation. She did not pray for her whole hand to unfurl, but instead she asked God to come and loosen just the tiny tip of her pinkie finger so she might breathe a bit easier. With this image in mind, I often find myself praying the very same thing–for myself and for my patients.

When I left My Love’s home after our first visit, I leaned in close to her and said, “My prayer for you is that you will have just one minute of peace each day. I am not naive. I do not think a feeling of peace will just overtake you out of nowhere. But I do believe one extra minute per day is possible. This is my prayer.” She gripped my hand with her right hand and said, “You understand. Thank you. Yes; pray for that for me.”

See My Love was so terribly stuck. She was near death when she came onto hospice in 2005, but after a drug allergy diagnosis and correction she rallied. When the old version of herself died, so did all her dreams of  this being something she could and would beat. Imagine a plane circling the airport–which in this case represented death–day-after-day but never flying anywhere either. She was terrified of getting sick, and subsequently her precious grandchildren represented the kiss of death. She also missed them terribly and longed to hold them, play with them, and witness the intricacies of their growing up. This is just one example of the ways she held onto her life but never really lived. My Love was so terribly stuck.

My Love never could consciously release herself from her ritualistic hovering over death. A fall a few months ago, and a series of events began to unravel her desperate hold onto a life she hated and hated to have any change to. At the beginning of December her husband moved her to an inpatient facility when her death became more imminent. I visited her there often, and would look painfully upon her still clenched hands. After her death this past Thursday, I sat in the same Family Room where she lived in isolation for these last two and a half years…a room without her chair, hospital bed, commode, mirror, eye brow pencil, pashmina, blush, and oxygen. A room without her. Her family looked at me excitedly and her daughter related something they just had to tell me: “Her hands were at peace the last two days. We noticed it and thought we had to tell you because you would be so glad to know she stopped holding them so tightly. She died with her hands open and at peace.”

Why her? Why did I fall in-love with her? She was a bright, enthusiastic, funny, creative, sarcastic, honest, lonely, hurting, broken woman. I do not know what to say beyond that I loved her deeply because I did. She never “earned” my love…in fact she tried it more than once. I just know I loved her right exactly where she was–clenched hands and all. Her husband asked me to officiate at her funeral. He knows the day of her funeral is also my last day with hospice, so he called it “poetic justice” that my last responsibility for hospice is her funeral. I fully agree, but even if I had already left I still would have done it for her…anything for My Love.

I am applying to Vanderbilt’s Graduate Department of Religion, and today finalized my application. W00T! (Which, is now officially a word.) Here is my Statement of Purpose, a.k.a. why the heck I would want to subject myself to more education and debt:

In order to understand why I am applying to Vanderbilt’s Graduate Religion Department’s program in Religion, Psychology, and Culture, I must first paint for you the two important intersections of my life these last eighteen months. The first road began when I started dating an atheist. Yes, once upon a time an atheist and a minister met and fell for each other. Despite the curious rumblings of friends and family, he proved to be the one person (thus far) most similar to me when it came to the questioning the role of religion in society, the individuality of the faith story/existential quandary, and the core essence of spirituality, namely curiosity. We asked similar questions, and while we fell to either side of a dividing line due to differing conclusions, we could easily reach the other one over that line.

Our conversations awoke a deep need and desire in me to discuss the fragile and hurting world through the lenses of Pastoral Care, with its tenets of “being” and “healing,” and logic. I had already read Rabbi Lerner’s The Left Hand of God, but he pushed me to read Neo-Atheists such as Harris, Hitchens, and Dawkins, as well as the economist Naomi Klein and philosopher Jamie Whyte, among others. We began a blog reflecting the core issues we felt must be addressed for the future of humanity. He wanted his voice to be one of reason and science in the face of religiosity and mythology. I wanted mine to be the voice of a servant to the hearts and minds of hurting people with a strong commitment to logic. After we parted ways, I struggled to find ways to continue this conversation. I began my own blog and reworked the one we started. I kept reading. I volunteered and started a chapter of “Drinking Liberally” in order to meet other people to talk with about these things, but these actions are not enough. So, on one hand, I am applying because of a post break-up intellectual void. I need the conversation, discipline, exposure and mentoring only a graduate program can offer me at this point intellectually.

The other trajectory of my life unfolded for me by working as a hospice chaplain. I currently serve as a Home Team Chaplain in a middle to upper-middle class area. My typical patient is over sixty years of age, most likely Jewish or Roman Catholic, married, and retired. Repeatedly I heard the same story of faith narrated to me, and I began to call my patients and their families “The New Agnostics.” [1] I described them as such because regardless of what faith tradition they report historical and familial roots to, their descriptions matched one another. I see three distinct characteristics in this group: 1) A move away from the precepts of their historical religion, while still keeping some limited rituals from the tradition; 2) The centrality of a benign and altruistic God, who is best exemplified by the love of their family and/or friends; and 3) An co-opting of language, ritual, belief, and values specific to traditions other than their own seen as being coherent with their own spirituality. On the whole, they eschew attendance to services, with only some Catholics wanting a ritual visit from a priest—one they almost always have no connection with whatsoever. For example, I provided care to a woman who left Reformed Judaism for Kabbalah, only to not be connected at all but who reported that the two most important factors of her faith were “The Golden Rule and Karma.” Often to my surprise, they have read, seen or otherwise been influenced by the writings of the current Neo-Atheist movement. [2] They disagree, and still believe in “a higher power,” but they keep reading them and report to me the “good points” raised. Paradoxically, when they move away even from this kind of agnosticism and completely abandon their faith, or spirituality it is almost without fail due to the love of family or friends no longer being available to them. The larger systems of community or congregation based social interaction no longer provide “back-up” to their individualized spiritual belief.

By comparison, when I worked in Chicago as the Pastoral Care Resident for the Trauma Department, I saw young men of colour replace their family of origin with their family of choice—namely their gang affiliation. The search for meaning so great, that even in the face of the failure of society as a whole to address the needs of persons of colour—whether that be by the modalities of education, employment, access to services such as healthcare or training—another type of connection was found without regard for its inherent destructive nature. I saw a whole generation eschewing the spirituality of their mothers and grandmothers and a kind of unidentified atheism within them. This was in sharp contrast to the agrarian based spirituality I encountered in North Carolina regardless of economic or educational background. In other words, the types of spiritual crises I minister to has been largely dependent on geographies, economics and education. And within these larger structures of society, fractured, discarded, or amalgamated religious belief emerges.

I firmly believe humanity is at a crossroads where the potential for radical change—if not total abandonment—of our religious systems is imminent. The rise of fundamentalism across the globe speaks to a deep spiritual hunger, as well as an economic and educational famine the whole of humanity must contend with, but especially those of us in the One-Third World. I fully own that my own practice has thus far been limited to those living within the luxuries of the One-Third World, even as they are sometimes impoverished within it. What I see as opportunistic from a Pastoral Care standpoint is the types of interventions we offer as providers are more needed now—on both the individualistic and societal levels—than ever before. While at the same time, I also see a need to rethink these interventions outside of the systematic hermeneutics most seminaries ascribe. I want to be a part of this re-tooling and creation, and I want to be able to both research emerging spiritualities and teach how to provide essential spiritual care that creates an opportunity for genuine healing even in places where traditional religiosity has been abandoned. Let me be clear: I believe religion on the whole has failed, and I want to be a part of the phoenix of faith rising from her ashes.

The esoteric and existential questions posed to me now by my patients and their caregivers require me to “sit Shiva” with the failures of the religions of my patients. As a result, I provide care to people whose spiritual needs are much more difficult to map than ever before. I know my Spiritual Assessment skills are excellent. I even surprised one of my supervisors in Chicago—the inimitable George Fitchett—with the depth of information I garnered from my patients during my Residency! I can see all of the intersections, but my studies have not always prepared me for these emerging spiritualities, and what to do when they are in-fact in crisis. What interventions can be offered when the replacement spirituality no longer works? The emphasis on “being” with those we care for is important, but spiritual care providers are asked profound questions related to meaning. Although I do not believe we ought to answer these outright for those we serve, I do think our active listening, teaching, preaching and other interactions must reflect an understanding of what is at stake for those we care for.

My theological education provided some helps, especially Mary McClintock Fulkerson’s approach to Theology from a perspective of practice and story. Also, I took two spirituality classes with Father Phillip Leach, which I still find invaluable in my own practice but more from the standpoint of self-care than application. Admittedly, I did not study Pastoral Care while in seminary. Finding myself to be a “duck to water” (per Nape Baker, my first Supervisor) during my CPE Internship was a surprise, and my own interests centered more on Medical Ethics at the time than the philosophy of Pastoral Care or Psychology. In fact, as I researched PhD programs while in my CPE Residency at Rush, I looked for programs where by I would be exposed to the theories behind the practices.[3] I am an avid reader, so I have sought out books on my own and read psychological theories on-line, but I see the places where I lack the theory behind the practice. In large part, I believe this program will fill in those gaps and accelerate my own thinking and practice.

I also see the ways these emerging expressions of spiritual thought influence me. For example, so greatly has my own understanding of the need to speak of God without imperatives become that I no longer speak of my own beliefs as being normative, but instead temper with “God is for me…” in all of my interactions and writing. I see the issue of faith and its efficacy impacting my colleagues…oftentimes, ministers—even those from the more progressive traditions—in theological crisis. We are wholly affected by the ponderings of those we care for, but we are not wholly supported in trying to flesh out the implications of these questions on our own spirituality and pastoral care practice. I see ways of negotiating these waters, but often lack the time, training, or resources to work on these dilemmas to benefit my colleagues and myself. One recent success stemmed from teaching my fellow chaplains about how to incorporate Healing Touch modalities into their practices, and it was also taking a course in Healing Touch that led me to seek a PhD program now. I came away from the seminar knowing I needed an opportunity to take my practice to a new level and to be able to offer a wider array of interventions for those I care for. Lastly, I do not think we speak often enough of the manipulative nature of the “helping professions,” which is why I think these issues are not just paramount to those we tend to but also to ourselves. How do we arrive at our own theological clarity (not to be confused with certainty)? For without this we are more susceptible to compassion fatigue, manipulation and the eroding of our own healthy boundaries.

When I am asked why I am applying to Vanderbilt’s PhD program I answer this way: I want to study emerging spiritualities, specifically Neo-Agnostics and Neo-Atheism and the Pastoral Care emergency they generate not only in the types and efficacy of interventions offered, but also the spiritual crisis that can result for the provider when the failures of systematic doctrines are exposed through logic and science. Quite honestly, most people shake their heads and roll their eyes a bit. However, there are the few—especially some of my pastoral care colleagues—who pump their fists up and down and say, “Yes! Yes! We need that!” One such colleague, Paul Veliyathil, who is from India, an avid student of Eastern philosophy and spirituality, and of the Disciples of Christ tradition commented to me when I first began my application process, “You are on the cusp of it all. This is what it is all about, but no one teaches these things or talks so much about them. As long as the conversation continues to only mention emerging spiritualities or give passing reference to the Ancient Eastern Philosophical mindset, we will not be able to provide the type of care needed desperately for our patients and for the world as a whole.” I will admit that his words have been a comfort to me these last three months because it is one thing to be fully convinced that you are on the right track for yourself—it is another to inspire others to support you in that pursuit.

Another person who added an unexpected blessing to my thinking and process is Naomi Klein. She recently spoke at my congregation about her book The Shock Doctrine: The Rise of Disaster Capitalism. I found myself fascinated by her use of narrative language in framing the societal hunger for meaning following a disaster. One of Duke’s many gifts to me has been the theological emphasis of the Divinity School on Narrative Theology. I asked her how she would suppose to offer wide-scale healing when in my own work as a chaplain dealing with individuals in crisis demonstrates just how difficult intentionality towards healing often is. She commented that my question was “brilliant” but that she is more focused on identifying the issues and not on offering the solutions.

I, for one, want to be a part of creatively thinking about healing paradigms and how they might be offered to individuals and communities. As my Spiritual Director in North Carolina once commented to me: “You are called by God once and for all and called by name, but what God will call you to, Jacqueline, will change over time.” I know that I want to first have the opportunity to learn and add more theory to my practice, but I also want to be a part of a wider conversation about how we prepare seminarians for ministry in this ever-evolving world where access to information has created unparalleled spiritual diversity. I hope that at some juncture I will be able to serve in a hospital again, where I would like to do research and work on the application of emergent spiritual models in crisis situations. I also know that my future is unwritten and yet to be explored. I recognize some hurdles in-front of me, including mastery of French, which was not needed on the side of the tracks I grew up on! But I also see an amazing opportunity for me if accepted to Vanderbilt, and an opportunity for Vanderbilt to benefit from my experiences, gifts and enthusiasm.

Respectfully submitted by Rev. Jacqueline Hope Derby

1. I am now familiar with Winifred Gallagher’s book by the same name, but I was not when these thoughts began for me.

2. I realize calling it a “movement” might be seen as a leap, but I really do see an emerging “evangelical” atheist movement. The blog de-conversion.com with its accompanying forum is a good example of the by-products of this movement.

3. I seriously investigated two other similar programs, but in talking to colleagues who attended these institutions and those who attended Vanderbilt, I came away feeling that your program and faculty would be the best fit for me.

I wrote the following piece for my company’s bi-annual Memorial Gathering to honor those who have died with our hospice. The theme for this season’s services is “The Light of Love.” The first section focuses on “The Light of Remembrance,” which inspires the piece.

In the summer of 1977 my father died. I remember the day as being rainy and very cold, but in reality it was a hot and humid Florida summer day. I guess my little girl mind was so overcome with grief that the only way to describe a day when you lose someone you desperately love is to think of it as being cold and dreary with dark clouds crying. That is the funny thing about remembering the past—we are always looking back at it through a particular lens. I saw that day through the lens of pain and loss for so long that the day itself became transformed to match the feelings.

I also look back and remember holding Daddy’s hand, as he and Mother would lift me up over the curb, swinging me back and forth. I remember seeing his arms outstretched to me, as I would scoot down the high slide at the park by his office. I remember the look on his face when he opened my door to find Kelly Grey and I sitting on the red carpet with the pink ceramic pig smashed into a million pieces.

Kelly lived just six houses from mine, and we were born exactly three weeks apart. We would walk the grass of our neighbour’s front lawns to get to one another’s homes safely. Our parents had taught us to do this, so we were full of four-year old confidence. Somehow we decided this particular day that she would come to my house, but we neglected to ask my napping Mother—out of kindness, of course. As we sat in my room, she asked me how much money was in the pig. We decided to count the money, but alas the pig did not have an opening on the bottom, and the small slot on top did not send the money back to us when we shook it. I offered to go and fetch my tiny hammer from the garage. Daddy bought it for me, so I could “help” him with his household “Honey-Do-Lists.” I marched out to the garage where he was working at his tool bench, took down the hammer, and replied to his inquiry about needing any help with a simple “no thanks.”

Daddy had not had a four-year old in the house in over sixteen years, so it took an extra moment for him to comprehend that there was no need for me to have the hammer that would be qualified as “good”—which also proved to be just enough time for Kelly and I to smash the pig to smithereens. So there we sat on the floor of my bedroom with one dead ceramic pig, one hammer, countless change, and one Daddy staring down at us saying, “What in the world!? Kelly, where did you come from? Does your Mother know she is here?” He had that look I knew as meaning I was in T.R.O.U.B.L.E. He also had the mischievous smirk around his eyes of appreciating my ingenuity. He would know…I got my ingenious and mischievous nature from him!

You may wonder how it is that I remember all these little details of my ever too brief six years with Daddy. The answer comes from my Mother, who never shied away from talking about him and from keeping the light of remembrance stoked within me. She would ask me, “Do you remember when we met Daddy for lunch?” or “Do you remember going on the boat and catching your first fish at the marina?” She kept the memories alive—she kept Daddy alive—even when it must have cut her heart to a million pieces to have to do so. I know she wanted to go to bed and never get up because her heart was so full of agony and loss. My Grandmother had to take her in hand and tell her to get up because I needed her. Being a widow herself, she also promised my mother that she would stop crying all the time—“eventually.”

I am sure Mother wanted to forget sometimes—to forget all the love, laughter, happiness, touch and connection she had with him—because the forgetting might make the pain less. Instead, she held onto my Grandmother’s promise that “eventually” the pain would lessen, “eventually” she would not be crying all the time, and “eventually” she would invest in her own life again. In holding onto that promise, she kept Daddy’s love alive for me by reinforcing all of my memories of him.

Now when we talk of Daddy, we light up with the remembering. He is ever close, ever dear, ever loved. When I drive her nuts by announcing just exactly how we will be going about accomplishing a particular task—step-by-painful-step where she is merely an extra pair of hands—she shakes her head and says, “Just like your father…you are just like your father.” When I tease her or say something terribly funny she says, “Just like your father.” In fact, it has become quite the joke between us. Mother will compliment me on something and I will with deadpan delivery tell her, “Well you know, I get that from Daddy.“ She just shakes her head and laughs! When we are with other people and they comment on how bright I am, we look at each other, giggle and chime together, “She gets that from her father!” We both know how much her love and care for me has shaped me, but in those little moments we bring forward into our lives right now the love, humor and intelligence of a man who has been dead over thirty years. We keep him alive within us, which makes him a real person to even those who never had the honor of meeting him.

Remembering the one you love who has died is a precious flame within you, but you may at times be afraid that it will burn you. I want to encourage you today that the light of remembrance can only illuminate your life and warm your soul. I know because eventually that is what the light of remembering my own lost loves has become.

Today is a horrible day. Today my dear sweet Patient Care Secretary lost her husband. Paul died tragically when the prisoner he was transporting overpowered him, struggled with him, shot him, and threw him out of the transport van. (Here is the link to the CNN story.) There are no words that make sense of this horror. I literally am shaken and grieved to my core. For my dear friend, for her family and his, for the future they planned that never will come to fruition, for my grieving team, for myself.

I have been with so many people as they were told of the death of their loved one, and I never had adrenaline overtake my body. However, as she was told my right leg quivered uncontrollably. I am so heartbroken that this did not go differently, but here we are and Paul is dead. I met him and thought he was a lovely and kind man. He came to my Open House just after my birthday in early March. I also knew him through her and all of the tender love stories she would tell. Theirs was a second love, yet it was a gift of unmeasurable joy for both of them.

The news is reporting that the young man who killed Paul had written over his heart “Break This Bitch.” Was that a warning? Did he think his heart could not be broken? Had it been broken so badly that he started down the road of drugs, robbery, and armed robbery that led him to commit a murder? No matter what pain he had been through in his life, it does not dismiss the pain he has caused because of the choices he has made. But yet again I am reminded that if we do not face our pain–not just face it but actually heal it– we set off a series of events that can not only lead to our own destruction, but to that of others as well.

I cannot help but wonder if his heart is broken now?

Last week I wrote two nominations for our Employee Appreciation Awards. One for my nurse Wendy, and one for my Secretary. Here is the one for her so that you might know her a tiny bit and think of her with prayers for comfort as she negotiates the terrible cyclone of sudden traumatic grief and loss:

Three Sets of Footprints

All of us have read the poem “Footprints” about the person who notices only one set of footprints in the sand during all of the most trying times in their life. Inquiring of God why this is, they learn that those were the very times when God carried them. How true for us all! Life cannot be done as an individual effort. Each day we rely on unseen hands to carry us through and make our lives possible. From farmers to the checkout person at the grocery store, cannery workers to those at the recycling center, and loggers to soft toilet paper manufacturers, from the President of our company to our Patient Care Secretaries, our lives are interdependent.

Here at our hospice we think in terms of our Teams, and for our team—Team 151—there is one person we literally cannot survive without…our Secretary TBR. Even our Team Manager agrees that we do fine when she is gone, but those days when T* is out of the office are painful. Our team holds our collective breath until she returns, for she truly carries us through and helps us to thrive out in the field. She is so faithful in the little things, and if she misses a tiny beat she will go off to make sure we have whatever we need, even when we could do if for ourselves. She delights in the giving! T* knows that love is in the details, and although it might seem strange to speak of love at work, it is the only word to describe the dedication and attention to detail she offers. T* always speaks with kindness and concern, offering up love freely to us and to the patients and families she serves with us.

She also will go above and beyond to help her co-workers. She does not want to see anyone fail, for she knows what it means to work hard to keep your head above water. She patiently teaches the new PCS’s coming through, while lending a hand to other teams whenever needed…and not just our sister team! If ever there was a team player—encompassing the whole of our office—it would be T*.

She also takes the time to care about the stories of the individual families we serve. You should of seen her delight and gracious embrace of one family as they celebrated their 70th Anniversary last Christmas. T* was able to be at their home for our little celebration, and she was so tender with this lovely and fragile couple. Seeing the joy in her own face at finally being able to meet them was priceless. She holds the needs of our patients and families close and ensures they have what they need, sight unseen almost 100% of the time. It is no wonder she often is mentioned in our “Thank You Notes” from our families.

Team 151 is a terribly busy home team. In October alone we had around twenty-five deaths, yet our census stays stable. Twenty-five new patients filling our roster just as the other twenty-five came off of it. Talk about paperwork! Yet T* not only keeps us straight (no wonder she usually arrives before seven each morning!), but she will take on the slack when another PCS is out or falling behind. How does she have the time? How does she have the stamina? And to think she does this with kindness, professionalism and intelligence! No wonder our Team Manager knows her place in regards to T*! No wonder we admire, cherish, and love her as we do!

T* embodies the love of God by carrying us physically as a team, but also by the love she extends to us as team members and to our patients and families. When we look back at our lives and our time here we will see three sets of footprints in the sand, and when we see those times with only two sets we will know it was T* who helped to carry us. Please help us in acknowledging her unquestioning fidelity to our corporate values by honoring her as she so justly deserves.

I wrote the following about one of the nurses on my team,
as my team nominated her for Nurse Caregiver of the Year at our company.

The road not take is often a lonely road. Fellow travelers are few and far in-between. One goes on passion and commitment even when the body, spirit and mind seem completely spent. Often, only the tender angels of mercy, compassion, gentleness, and love serve as companions for the at times solitary work of our hospice nurses. Where would we be without their unquestioned faithfulness to our patients and families?

Our team—Team 151– wants to raise up the faithfulness of one particular nurse, Wendy T. This year’s theme for our Employee Recognition Awards is the perfect fit for what Wendy exemplifies, in that she always takes the higher road of doing right by her patients and their families. Wendy’s story at our hospice is one of consistency. She is not trying to go and do one extraordinary act for one extra-ordinary situation. She seeks no fame, and in fact is sure to be a bit embarrassed by our accolades. Day-in-and-day-out, Wendy gives the same tender and intelligent care to ALL of the patients and families she serves. The only complaints from her patients come when she has the audacity to be on vacation, and they miss her terribly! She makes that much of a difference in their lives.

The impact Wendy has begins with the trust she establishes. Being a hospice nurse with us for over 15 years gives her a depth of experience families and patients lean into. They know she has been in this space before and is not learning on the fly how to care for their beloved. That being said, Wendy’s openness to learn new ways to medically intercede for our patients, her flexibility to try new things, and her willingness to embrace the whole of the Inter-disciplinary Team’s expertise exemplify why she can be trusted implicitly. She uses the depth and breath of her practice as a nurse to give roots to her work, just as she reaches above and beyond her comfort zone to capture any intervention that might soothe a troubled patient. And she is also faithful to always call the family of her patients following their death to reassure a troubled heart, offer her support to them, and listen to them as they process both the death and the care we extended.

In the Christian Scriptures there is a passage written to the church in Thessalonica by the Apostle Paul where he speaks of being “gentle…like a nurse” when he visited them. Here is that passage re-written to speak of the way Wendy works on our behalf:

As God as our witness, she never comes with words of flattery or with a pretext of any kind, nor does she seek praise from anyone. Although she could make demands given her seniority and expertise, she does not. Instead, she is gentle amongst all, like a nurse tenderly caring for her own children. So deeply does she care that she is determined to share with all those she touches not only the healing balm of palliative care, but also her own self, because each and every patient and family has become so very dear to her.

By mixing in the good milk of her own life with the vulnerable hunger of those we tend to, Wendy gives of her very self to all. She creates bridges between herself and her patients by opening up and showing her own tender places of loss so they know a fellow sojourner is with them on the last important days of their life journey. If all roads lead to hospice, then the dedication, passion, skill, expertise and compassion of our employees must be honored, for our company does not exist without our faithful workers. We raise up our colleague and friend, Wendy T., because she is faithful to walk this journey in our name for the patients and families, even when it requires her to be on the solitary road not taken. Please join us in honoring her fidelity to all we say we hold dear and seek to embody, for she is already accomplishing these values daily.

I often think of the themes in my life as acting like boomerangs. Something may happen to me–a great pain or loss–that sends out the very best of me scatted against the wind, but eventually they all return to their rightful home within me. This last year has been full of this kind of scattering, and if you have ever read my blog, you know what I am talking about. A year of more challenges and stress than my body, mind or spirit could handle, and a heart so broken I thought it was beyond repair for most of this year.

Now there is just something about a list that I dearly love. Lists organize my life! I have running lists for the things I need, the things I want to accomplish (like having more sex in the coming year–twice in 12 months is just not enough!!!), lists of places I want to experience, lists of problems I am facing, and, well, the list goes on and on and on… This blog has been full of some great lists:

• A list of my experiences right up to my blindsided break-up: Post-Mortem: My November
• A list of the reasons why I am a good girlfriend: 40 Reasons I Make a Good Girlfriend
• A list of all diseases, losses and freak-outs of the last year: The Stress Mess
• A list of why I don’t trust men in tank tops (and my personal favourite post): Tank Top Wearing Man Candy?
• Not to mention the list of all the men I loved before (go on and hum it, you know you want to): The Dating Game

So in honor of my little list making fetish, I offer up on my one-year anniversary since this unbelievable year began with my emergency root canal the following list of all my gratitude for what this last year gave me–in no particular order:

1. My Ordination. This day was full of more love than I could have ever imagined, and I have drawn deeply from those waters this year.
2. Surviving This Year! If you read “Posting My Big Secret” and “Shift Change” you know that this is an ACCOMPLISHMENT all by itself! Not only do I feel I survived, but I feel stronger, happier and more at peace with who I am than at any other point in my life.
3. EMMA! Gotta love Miss Puppy Girl. She is my joy. We have really fallen in love these last few months, especially after her mean cousin Morgan left! Morgan, my niece, is part of the Puppy Gestapo. Her departure turned on the “My Mommie is not a meanine.” light over Emma’s head. Plus, she is FINALLY growing up…a little bit. She still has to wear a leash in the house–all the better to catch her and take my stolen bra out of her mouth with!!

   

4. Paparazzo. I have said it before, and I will say it again: I do not know how I would have made it through without him. I tease him that he is always “pulling my pigtails,” i.e. driving me nuts just because he can. Yesterday morning while doing crunches on the living room floor, Emma bit my ponytail and pulled hard. The more I would go to stop her the more she would pull. I ended up in a pool of tears and laughter! No wonder the two of them love each other so much–they are cut from the same cloth!
5. Casa Derby. I lived for 2.5 years without my own belongings, so coming home in February filled my heart in ways I cannot even describe. I missed my Red Turkey Rug! I missed my books, music, bed, sofa and enough dishes to host a party for an army. How sweet it is to be home again. Moving home also brought new friends and neighbours. They met me mid Apocalypse and adopted me straight away. I needed the affirmation of new friends, and so I am grateful the latest incarnation of Casa Derby came with some.
6. My Mama and My Sista. These two continue to show me love, love, love, even when I am only full of fear and despair.
7. My Work and Team. I get unbelievable joy knowing I am doing the kind of work that crosses the religious divide and finds people right where they are and ministers to their hurting hearts in that place. My patients and their families are my teachers, and I value their lessons. Ministering to my atheist patient this year, and the work in general, has given me my inspiration as I apply to Vanderbilt’s PhD program. I also have a wonderful team to work with, but especially my manager, my social worker, my secretary, and my nurses Wendy and Lisa. They all make each day a worthy sacrifice. (Trust me! At what I make, the word “sacrifice” is perfect.)
8. My Bereavement Group. If I ever have a friend go through a crushing break-up, I will immediately buy them Alan Wolfelt’s book Understanding Your Grief: Ten Essential Touchstones for Finding Hope and Healing Your Heart . Working through this book with my group, and the group’s grieving processes in general, helped me to identify that what happened to me was just the normal grief one experiences when someone you love dies. I suddenly no longer felt so isolated in my grieving, and listening to them give voice to their mourning, gave me an opportunity to accept my own. Once I got that the person I knew and loved did in fact die–metaphorically and literally, in as much as that person was no longer real or real in my life–I could finally find the courage to accept the