The Red Shoes

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THE RED SHOES

This past February it happened and I was in complete disbelief that it happened. In one split second my life was altered. No, not a doctor telling me I needed further tests but in fact a sure thing, I had severely crushed several toes on my left foot.

MANY people begging me to tell the whole story and the ones I finally did wished that I had not, a bizarre accident. I will not be any more descriptive to you my readers either!

Fortunately within minutes I was being driven to a local hospital for x-rays as I texted an MD friend of mine for an orthopedic referral.

In all my years I hadn’t ever been to an ER for myself. I believed the injury to be serious enough to need surgery. Before I left for the ER apparently I gave explicit instructions to my sons wife as to how to take care of my elderly cat with her special needs. I have always found it interesting what a person will focus on amidst a crisis. I was just like everyone else. I was triaging the NECESSARY.

Indeed as I already knew 3 of my 5 toes were severely crushed. As a runner no less a person who works on her feet every day this was potentially a life-altering event. Trauma? Indeed!

The following day I consulted with the MD who told me he thought with time, I would heal without surgery. Time.. as we age that timeline stretches much farther than our patience does. The first week I was off my foot 100% with it elevated above my heart. The second week I was allowed to ambulate using crutches but again not allowed to put my foot onto the floor. The third week I was allowed to use the crutches and put pressure on my heel alone. The fourth week I was allowed to walk but only placing my foot flat, no flexing. The fifth week I was allowed to walk that same way without crutches. I was out of work for 5 weeks! If I had to have had surgery it would have been 6-8 or more so this was a true fortune in the recovery timeline.

As I was able I was allowed to rehab using gym equipment that didn’t compromise my foot. It was indeed it took a mental focus to drive a total of an hour to and from the gym to move for 20 minutes maximum.

Clearance? I was given clearance to go back to work when I could wear a particular brand of clog. The MD didn’t want me to be in any other shoe that would flex. This particular one has a thick and supportive foot bed.

I hobbled to the store determined to return to work as soon as possible. The clog style didn’t allow me to slip my foot into the shoe. I was disheartened.

But then, the clerk brought me just one more style. There they were! BRIGHT RED PATENT MARY JANE STYLE CLOGS!!

I could get my still swollen foot in them my loosening the strap. The red were the only color she had in my size. “Sold” I said!

I returned to work after many weeks away. Since then not one day passes that someone doesn’t remark about my shoes. Yes, I have continued to wear them all these months since. EVERY DAY I have worn the red shoes.

“There’s no place like home, right?”

“Do you click your heels?”

“Love the red shoes and your orange jacket!”

“Pop of color, love it!”

“Nice to see something cheerful”

The comments are varied and daily. Now, I feel an obligation to wear the red shoes much like other expectations. I begin my 6^th month wearing the red shoes. They came into my life as a necessary tool and now, they have morphed into a topic of conversation. Maybe someday I’ll wear my western boots!

Keeper of the Coat

 

Handed to me wrapped in sanitary plastic it came, the white coat. Uniform of the medical field that brings often anxiety but more so in my setting, authority, wisdom, and care; I awkwardly slipped it on. Immediately I scanned the area to see who might know me and be confused by my assumed role. Had I now become an employee of a neighboring facility? Medical, how could a Chaplain now be medical? The real question was for myself. How would I be viewed now in the white coat?

The MD who agreed to allow me to shadow her on medical rounds smiled. “How does the coat make you feel? Does it change anything for you?” she asked. I replied, “This is about how the patient will view and respond to me.” I replied. Yet, I valued her question to ponder.

I intuitively placed a pen and notepaper and my cell into the generous pockets. I liked that my hands were freed and I didn’t have to carry anything in my hand as usual.  The MD resident began to report on the first patient we were about to see.

We walked into the room and the MD introduced the 3 of us, noting my name and role as the Chaplain. She quickly discovered the man was more ill than the MD’s had expected. He was in what she assessed was unacceptable pain. She washed her hands and palpated his belly listening to his sharing of suffering. He needed to be examined exposing a part of his body that would be considered private under other circumstances. The MD’s moved to examine as I moved to not view that what wasn’t necessary. I later remarked to the MD’s although I am comfortable with all medical issues and views I was intuitively protecting the patients need-to-know privacy. I was moved by the care of the hands of examination, by the concern of the levels of pain, the incredible caring, concern and TIME needed to be sure the marshaled medical teams would come to care for this man. Phone calls, charting, more calls, follow-up later in the day. I was surprised by the amount of time this one patient utilized, appropriately so, of these MD’s time. There would be 7 patients seen before 12:30 this day.

My sense was the MD’s are troubled by a disease progressing that cannot be managed as well as they hope. I knew that but now I saw it first hand. I saw the concern during the exam, heard the discussions afterwards.

I had the sense of relentless disease and the angst to relieve the disease’s hold or at the least the suffering. The responsibility of the doctor to affect the process is a hands-on, intense and vulnerable.

We moved on. We moved on to 6 additional patients during the long morning before a late lunch. I was moved as I removed the white coat. I wondered if I held more value with the medical team wearing their uniform. I wondered if I was held at arms length because of the same uniform by the patients and families.

I reflected that the origin of Chaplain is said to be of the derivation of the term relate to the relic cloak (capa or capella) of St. Martin of Tours or from the Latin term Capellanus.

Keeper of the sacred? Wearing a cloak? Indeed, I will return to my non-white-coat visitation of patients. I am so grateful for this experience however as much as I appreciated watching the care of the physicians I also reaffirmed the patients need my care as well; Chaplain.

The Chaplain and the Cop

It’s probably no surprise to say that when an officer and a chaplain are working side by side it’s most likely not a happy event.

In my personal experience I have worked beside an amazing man who is the one who always showed up when something catastrophic transpired involving an officer or a child. He is the go-to debriefer. We have remarked that it’s not a good thing that we have to work together yet we are so very grateful we do.

That detective who became a colleague retired this past year. I’m so very happy for him. Now he is busier than ever but choosing his energy-spending vs. tragic loss and deeper issues choosing for him.

Over the years we have worked side by side I came to understand that much like so many experiences it takes “one” to know one. Some examples might be a breast cancer patient who tells their story to another; a leukemia patient who encourages a newly diagnosed one. There is also a bond between police offers that only an insider can truly sit beside another among tragedy and trauma.

My colleague and friend has given me many gifts of understanding over our tenure. Today I was hopefully able to pay that forward.

Today I was asked to see a retired police detective. He has cancer but that isn’t what’s on his mind. He is having serious issues with PTS reliving so many of the tragic losses he came upon before he retired. He also spoke of seeing every person no matter how “bad” as a person. He also told me about his own mentor when he was a newbie.

One of the radiation machines was being recalibrated this day. That unfortunately backed up the patient appointments.

Fortunately, an RN called me to meet this teary retired cop who after an hour gave me one of the highest compliments a chaplain could receive from a person in “blue”.

We shook hands firmly as he said, “I am so glad I talked with you today. Talking with you today was like talking to another cop.”

I am grateful to my colleague who I shall not name here to protect his identity however, to every officer whose heart sees the humanity in those who need a hand up and struggles with the consequences of extreme violence I am grateful.

Today I was blessed with the extreme and violent stories of a cop needing to tell. That may not make sense to you reading…… but it does to me.

It's A Dead Issue: Honoring Life

Went into that good-night
Passed
Passed away
Gone
End of the race
Bought the big one
Bit the dust
Gone home
Bumped off
Checked out
Croaked
Crossed over
Got their wings

These are only a few of the words and phrases used to talk about death without using the word dead.

No, this isn’t starting to seem like an uplifting blog. I hope indeed it doesn’t seem morbid!

Working in a hospital the terms we often use for conditions are specifically descriptive and clinical. The hospital staff use the term expired as in “The patient expired.” Much like with the phrases above there is truth. Somehow those phrases haven’t ever sat right with me.

Many of these terms make me think someone is trying to lighten the grief or make death all right when maybe that isn’t possible. Is it all right to lose your 90 year old beloved grandparent solely because of their age? Is it all right to lose a loved one from a chronic illness because their suffering is over? For me these words try to soften what truly cannot be softened.

Death

Death is stark, not light nor funny and ultimately one experience we will all share. My perspective is we cannot make death all right because the person is of long age, ill nor any other reason. Death takes a relationship and alters it forever. The person may seem present in many ways yet you are not able to even share a cup of tea.

I like to frame death like the following example:

He was an amazing man and will be missed in a way no one else can understand *and* yet I am grateful he is no longer suffering.

There is another side of death that many are not willing to mention. That is the relief you might experience because of the relationship you had was not one that brought goodness.

Someone said to me a few weeks ago that in her faith tradition a person is inspired and then when they die they expire. I’m still trying to reconcile the word expire used in a different context.

Theology and beliefs also come for consideration as well. But, I believe your physical body must die before what you believe about the afterlife can begin.

My feelings about this subject are my own and I do not expect anyone else to agree. I do think that to say a person has died marks with a word the stark transition that has occurred. In that I also think it gives us a beginning to honor a life.

The Safe Side of the Bed

New Chaplain Students

Last week’s blog was about how my patients in treatment and active follow up do not have a summer vacation.

Our hospital’s summer period offers training for chaplains, faith leaders, and lay people as well as future MD’s, RN’s etc. Many faith traditions require the C.P.E. [clinical pastoral education] program we offer. This past week was the beginning for our summer program. People come to this program for many reasons and often leave transformed differently than they initially expected. They are in for anything BUT a summer vacation!

Ten people come together for 10 weeks in this intensive immersion program. There are no restrictions of age or faith tradition to participate. The goal is to learn how to be present with those in crisis, illness, suffering and celebration as well as reflect on their own reactions and feelings. They respond to all who come through the doors as a fellow human; that’s the only assumption allowed!

As a mentor, not supervisor, I think I have the best of all positions during this time. I get to know each of the students and watch their interactions as the program begins and progresses. Many a thesis paper has been written on group dynamics. I love to watch the dynamic unfold every summer. Who is a leader? Is this person leading from a place of strength or fear? Who is quiet? Are they quiet because they absorb every detail and nuance or is he or she paralyzed with fear entering this program? There are too many emotions and dynamics to begin to reflect here, that’s for sure!

The CPE students are oriented by the permanent staff as well as the chaplain residents who are leaving after their own 10 month program. This process takes just three days. On the night of that third day the first summer student in the rotation takes the house pager and is alone overnight. In the morning we all gather to hear the report of every pager call after 5:00pm the previous day. We do this so each of the daytime assigned Chaplains can follow up.

At the end of the report this past Friday morning the group burst into clapping. Were they relieved for the first who had a relatively common call night? Were they clapping from nervousness thinking about how their own first night might unfold? Ahhhhh, that is for the student and supervisor to talk about.

I am always fascinated and aware of how amazing the people are who come to spend their summer vacation in our academic program. Often as clinical staff we are aware of our position being one of the “safe side” of the bed. That means we are not a patient vulnerable to the medical processes.

It was a very long time ago when I visited my first patient. I will never forget the care and wisdom my mentor Rev. Konrad Kaltenbach offered me. I attempt to pay back his gift every summer.

May each of our summer students have the courage to discover their weaknesses and acknowledge the strengths yet undiscovered. For the CPE students, as they begin, they surely do not feel there is a safe side of the bed!

It’s that time of year again. As I write it is the official start of summer. It’s been a rainy week and that is predicted to continue however the thunderstorms are indeed the hallmark of summer. Summer for so many here in the northeast is a time of joyful awakening. It’s been cold or dreary, then cloudy and wet, and then summer brings a time of renewal. Many cancer patients watch this from afar. Their time away is no summer vacation.

I met Mark many years ago in the bone marrow transplant unit. A nasty form of leukemia had flattened this vibrant and powerful man. He lay in a darkened room as his wife paced the hallway. She shared much about their lives and also about their adult children. She had done her own statistical research about survival rates and was terrified. I thought to myself as he navigated his treatments that he always seemed FLAT in his bed. After his treatment and discharge I saw him a few months later walking in the hallway of the hospital. He had grown his hair back into a ponytail and also had grown a beard. He remarked how he was only visiting a friend who was having a heart procedure. I reflected and thought of the flat affect I had remembered and now he was once again vibrant man before me.

Although I did my training in all areas of medicine, working in oncology for over 10 years I have come to my own non-scientific hypotheses, conclusions, or antidotal findings. One finding is that there is a rhythm that patients and families develop while coping over a long treatment period. Unlike a trauma or limited illness, the intensity during those times cannot be sustained.

A part of my new patient discussion can be a discussion about coping skills. Let me use the examples I use in my discussion:

If you have a injury, the flu, or time limiting event often people cope in this progression.

“Ugh oh.. I think I am coming down with the flu”, or “I fell and sprained my ankle”, or like scenario.

Regardless of the event, most often the progression of disability is a slow or sudden decline and then a linear progression to what I call the best recovery potential. An example in the case of an orthopedic injury the person may never be as strong as before that injury.

My experience with people in treatment for cancer is that their journey to wellness isn’t EVER linear. Symptoms from treatments, removal from their daily routine for months at a time, etc. all can cause a jagged up-down-up-down-up-down roller coaster of emotion even within a day. The coping skills that we normally develop cause emotional exhaustion. What I often see then is that the person become FLAT in the bed. Hopefully this doesn’t last over a long period of time as a new rhythm develops.

Several years ago I was watching the news when a story came on the TV about a school project for elementary students during the summer. They were to color a gingerbread man style cut out, put him into an envelope and send him on a summer vacation. If he were to visit the beach he could be photographed with a sand pail and write about how the sunscreen stung his eyes. He may have been sent to his grandmother’s house where he got to stay up late and eat ice cream for dinner. At the end of the summer he returned home with a journal of his travels. Stanley was flat yet his adventures allowed him to take on the vibrancy of a human child.

When I look at my patients who have come to the end of their normal push to cope and now lay flat in their bed I think of that flat character. My patients are indeed going on a journey and it is no summer vacation. They may be flat for now however I wait for the day when we all may celebrate they are once again going home.

Authors note: Patients name is not his real name

Distractions vs. Focus

Taking time to notice Cora’s light:

  It’s been several weeks since I blogged. I have missed the discipline of writing and have been told by my readers they have missed reading as well. Thank you to “you”! for saying so!

This can be such a frenetic time of year for many people. Weddings, Baptisms, graduations, moving, vacations etc. are on the rise as the summer months come more near.

Last weekend I participated in a multi-family yard sale for the first time. It was so awakening as to how many things I had kept over my years that had grown idle in my life. I sold a beloved table that even my son said he would miss but I am no longer hosting the overflowing family gatherings. I sold many children’s items as well. It was heartwarming to see items that had served many of us going on to continue in another home. The man who bought the table paced anxiously attempting to reach his wife. “I still am in the dog house for buying something before asking her. I can’t do it again.” He said.  He later took that chance and emptied his wallet 12.00 short of my FIRM price. That table was to be placed in his sunroom and serve making space for his family dinners. It made all of us smile as he loaded it into his truck.

I have been thinning out my belongings using a series of criteria:

1.     Have I used it in the 10 years I have been in my current space ?

2.     If I still like what it is, why is it in a storage container not being used?

3.     If I were to move to a smaller place, what would I be willing to leave behind.

4.     How many bread pans do I need if I am gluten free now? [laughing]

As I spoke to others about my yard sale adventure the reactions were all envy to have thinned out belongings or those who were overwhelmed by the idea of beginning a daunting task.

My own mother is moving. As she began to sort and pack I began to look at my own space and really LOOK using my sorting criteria above.

Indeed, everyone believes they are healthy until a doctor gives them news to the contrary and their innocence of health is forever lost. Weeks ago I made a comment to a friend that working in a trauma center and also seeing many oncology patients every day I am mindful that my life could be altered or taken in an instant. I said I wanted to lighten my life-load and not burden my family if accident or disease were to strike. That said I would also enjoy the minimalism vs. clutter.

Little did I know that my seemingly innocent comment almost became true.

Two weeks ago on a drizzling early evening I was driving to nearby town to go to a “big-box’ store for a particular item. It was after a long day at work and I was tired and thinking about all the TO-DO’s on my list for the yard sale, the wedding I am performing, the baptism and and and and.. etc. As I drove slowly up a hill and turned around the curve my thinking immediately changed. Coming at me was a jack-knifed tractor-trailer who had locked up his brakes as he was careening down the hill towards me. As many have said, these situations are remembered in slow motion. I was on a small country road without a shoulder, lucky there were neither telephone poles nor mailboxes as I first steered around the tractor part. Relief was for only seconds as I then saw the trailer swinging into my lane. Indeed, I stopped unscathed. The truck then hit a pole and spun around as if he were coming UP the hill not down. The truck driver was not hurt either. It took me a few days to shake off how unscathed I was and how close to being airlifted to a trauma center I had come.

In those days afterwards, and even now I have a renewed sense of the goodness and blessings in my life. As I lighten my load of “stuff” I am finding I have more awareness of the items that trigger memories, and usefulness of things I do keep.

I also have a renewed awareness to take time to notice the small stuff because in retrospect it may not be small after all.