Earlier today I completed my 9-month hospital chaplaincy (a three-unit CPE residency).  All ELCA seminarians are required to complete one unit of Clinical Pastoral Education, usually in a hospital setting as a chaplain, and usually over 12 weeks during the summer.  My experience was just like that standard summer experience – only longer and, because of the cumulative, snowballing nature of the learning on CPE, much more intense.  A few thoughts:

• My future ministry will be greatly impacted by this experience.  As a hospital chaplain, I was not called to be a Lutheran chaplain, or a Christian chaplain, or even a religious chaplain.  In our hospital the emphasis was to offer "emotional and spiritual support" to patients, families and staff.  My starting point for care was not religion or faith – it was most often the human experience of pain, suffering, and loss.  Empathy, listening, compassion, conversation, presence – these were my primary tools.  If religion was part of the other’s milieu, then that was part of my caregiving.  If religion was not part of the other’s milieu, then it never entered our discussion.  This radical emphasis on the other (rather than placing a priority on religion or my role as clergy-type vis-a-vis a layperson) will shape the way I engage in ministry as a Lutheran pastor.
• In one of my many struggles with pastoral identity over the past year, my supervisor encouraged me to imagine myself sitting with the patient at a bar, making authentic, natural, real conversation.  The problem was that I was over-thinking, working too hard at the task of pastoral conversation, preventing me from simply offering myself in these encounters.  I was trying to "be" a chaplain rather than simply be authentic.  As a result, I’m now looking to purchase two bar stools for my church office, to remind me of the real nature of pastoral work.  (I’m not sure that I’ll be installing a wet bar, however!)
• I’ve learned about the tyranny of the 9-5 schedule over these nine months.  For all the (justified) complaining we clergy-types do about our schedules – we work nights, weekends, and holidays, after all – I much prefer the flexibility of the clergy work schedule than I do the unforgiving inflexibility for a 9-5 job.  Miss a train by a minute and I was 40 minutes late to work.  Show up late to work, and I’ve screwed up the chaplain before me who has been waiting.  Ours was a strict schedule with shifts, daily report meetings and weekly schedules for clinical reports, didactics and group reflection.  There was little wiggle room in the schedule.  Together with a 90-minute commute in each direction, I was away from home 11+ hours/day – and saw very little of my children each day. 
• I’ve thought much more about my own health, death, and have often imagined the loss of my wife and girls.  I’ll be glad to get away from such direct and vivid reminders of my mortality, but I’m grateful, too, for the education.  I now know much more about death and grief, and can clearly state now from experience what kind of measures I want taken if I am ever in a critical or life-threatening condition.  (And I’ll write a post soon about what measures I want taken if I’m on a ventilator for a prolonged period of time – it killed me to see patients who were unable to communicate suffer through hours bad television shows.  Please, if I’m semi-conscious in a hosptial bed, do not put Maury Povitch on my TV!  Get me some ESPN or NPR, please!)
• I’ll miss the intimacy of entering into people’s lives during some of their most difficult times.  There’s something about a hospital gown and IV tubes that really prevents a patient from putting on airs about how they’re feeling.  Sunday mornings are a different kind of experience, filled with too many fake smiles and perfunctory "I’m fine, thank you" responses.  In recent weeks if a patient said, "I’m fine, thank you," to me, I was likely to gently call their bluff: "Yeah, except for the fact that you’re in a hospital rather than your home."  That often led into some conversation about their pain, their worry, and their hope for recovery and the future.
• My supervisors have encouraged me on a few occasions to explore becoming a Board Certified Chaplain.  This thought intrigues me, as I have come to greatly appreciate and even love the chaplaincy approach to pastoral ministry.  Some Board Certified Chaplains serve in congregations after or while they also serve in a clinical setting (hospital, nursing home, prison, etc.).  This is one of those discernment pieces that will stick with me for a while.

Many more thoughts later.  It is getting late.  G’night.

My nine months as a Resident Chaplain end on Thursday, May 31.  Over this time I have learned to pick up on cues, to be sensitive to signals spoken and unspoken, as I attempt to care for a patient or family member.  This evening, I noticed a cue of my own.

I am on my final overnight shift at the hospital (I arrived at 4:30pm on Saturday, and I’ll be here until 8AM on Sunday morning).  In doing rounds I met the grandmother of a man in his twenties who was severely injured following an auto accident.  He may permanently lose many bodily functions, if he survives this ordeal at all.  And so I sat with this woman and listened to her cries.

After a little bit my beeper went off – another trauma in the Emergency Department – and I left her.  As I entered the elevator on my way to the Emergency Department I found myself whistling the song from "Elmo’s World."  Immediately my girls, particularly Tali (our 3 year-old), came to mind.  I could see her giggling at Elmo’s antics and laughing with Mr. Noodle.  A big smile came across my face.

But then a tear entered the corner of my eye.  Too easily I was able to imagine myself in that woman’s position – in a hospital, grieving over the pain of my child.  What would I do if I were here, with my daughter in the Intensive Care Unit?  Holy God, what a wretched thought.  Please, take it away from me!  Perhaps that’s why I was whistling.  Rather than drag me into the emotional morass of pain and suffering, my subconscious moved toward silliness and laughter instead.

I feel twisted and torn.  Surely my transference-induced pain is nothing like the angst that woman is experiencing.  I merely put a toe in the water of parental pain.  She has plungled in it deep.

I’m looking forward to going home tomorrow morning and seeing my girls.  Perhaps we’ll watch some TV together.  Perhaps we’ll watch Elmo.

This has been one of those tough weeks that, nonetheless, yields a whole bunch of learning and insight.

On Monday I forgot that I was to present a Clinical Report (ie, a verbatim) of a pastoral encounter to my group.  Not good.  Luckily, one of my CPE peers was able to present a report she had written in advance of her next presentation, and we switched dates.  Later that same day I had individual supervision with my supervisors in which we talked about the ways in which forgetting to prepare a Clinical Report may be a product of my excitement about next year’s congregational internship and eagerness to move through the Candidacy Process toward my goal of ordination.  "OK Pastor Chris, where are you right now?  Here or in the parish?" my supervisor asked with a smile.  (I blogged about this earlier in the month: Always Looking Forward).

Today I presented the Clinical Report that was to have been presented on Monday.  It was about an encounter with a patient’s family in which I over-identified with the patient’s son and became emotionally enmeshed in the family system.  Upon hearing my presentation and analysis of the encounter, the group questioned my authenticity in the encounter.  Many of my peers felt I was distant or phony in the encounter, and that I was enmeshed only in my own transference issues, not in the family’s issues.  The encounter wasn’t a train wreck, but it was, well, imbalanced.  And though it was hard to hear and harder still to admit, they are probably right.  In this encounter I found myself falling into a role that allowed me to remain distant and react to issues that were more present in my past than in the patient’s room.

And then the real learning took place.  I began to reflect on how I relate to others in my personal life – my wife, my friends, my family – and to admit how emotional patterns formed in childhood continue to shape and influence my relationships today.  When I relate to my wife or my best friend, for example, there is part of me that is responding not only to these people, but also subconsciously to my mom, dad, and the complicated emotional realm that was my childhood existence.

And so, today was a reality check, a reminder that No Chris, you haven’t purged all the demons from your past yet (is a complete purging even possible?), and also a reminder that Chris, you don’t even have all those demons contained (again, is a complete containment even possible?).  My stuff comes out, and today I learned that though I likely will not ever contain it, I need to be aware of it. 

As I prepare to go out on internship, this is a good lesson to review.