My Condolences

Some time ago I wrote this condolence poem. I offer it here for the comfort it may provide for you or for someone yo know who is grieving:

These days,

May the Angel of Solace be beside you

Every time you wake,

And the loving touch of friends and family

Sustain you before each nightfall.

May the bittersweet release of

Fear, hurt, sadness and gratitude

Reassemble the scattered shards of your soul.

 

Lessons My Older Self Taught Me

Today I took my time machine back about fifteen years and 60 days ago so I could make my younger me a better chaplain right away. Why let her waste her time, and not benefit her clients at the same high (ahem!) level that I am employing right now? And I tacked on the extra days so we could luxuriate in some better weather; if one has a time machine, one should use it to best advantage. A transcript of our conversation follows:

Karen the Elder: “Karen, I’m here to do us a favor: I’m going to make your life easier, which means making my life easier. I figured by the benefit of my experience accumulated all these years, I’d clue you in.”

Karen the Younger: “That’s mighty nice of you. I’m all for diminishing the amount and degree of tough times ahead, as I’ve already had my share before now. And it’s good to see I will still look relatively pretty in my sixties. I’m burning with curiosity to hear what you’ve learned. You know me, curiosity is what drives me on in this job. And are you still highly curious?”

Karen the Elder: “Are you kidding? I even wrote a gentle science fiction book called Curiosity Seekers. I was gonna say, ‘check it out’ but it won’t be written until 2017.”

Karen the Younger: “What a tease! Now I’ll have to wait all those years.”

Karen the Elder: “And not only that. You will be getting a book published four years before that about hospice called Encountering the–”

Karen the Younger: “No way!”

Karen The Elder: “Well, that’s another story so to speak. I can’t stay long, because being in another time is a strain on the body. So I must go to my suggestions for how to be a better chaplain with the bonus of less stress at the same time:

First off don’t worry so much about drawing information out of a patient, as if you had a fishing line and had to reel in a heavy fish with all your might. You know about spirituality. You know about the mystics talking about receiving. And of course you know about mostly listening and being silent. So put those all together: You quietly sit with the patient, let the conversation meander in a natural way after you make a couple of open-ended remarks, and see what the patient releases for you to receive. As one of my mentors long ago said, “Each patient you see is the face of pastoral care.” So everything you are receiving is a gift arising of their comfort with you and their needs to share it and how special that is that you are there to receive it.

And so I think of receiving what the patient says as a spiritual act. In some cases the patient will sense it too and not only feel that you are honoring what they choose to say, but feel a summoning of God’s presence. I know there are requirements for the medical record, but I think whatever information arises out of the client’s need to impart it will ultimately result in what is truly spiritual care. It will be more to the point for what a chaplain should say in the clinical note as opposed to a social worker.

Karen, of course you already know about chaplains listening and being silent as much as possible. But the trick is not to feel anxious about it when both the client and you are silent, as if there was some contest as to who will break the silence first. Rather, be lost in thought as the patient may be, sojourn with their quiet and just listen for something that might burst through the surface for either of you. If not, close the visit by saying it was nice to spend a few quiet moments together.

Another thing: I used to think when a patient or family member expresses strong emotions I should be calm and soothing. That only goes so far. It’s better to broaden the tent of whatever emotion they are expressing to extend over you. If they are angry, join in being angry at whatever they are angry at; if joyful, then join in the celebration. Guilt though is another matter. You do not of course want to heighten this form of what I call ‘anger at the self.’ Acknowledge it as something they feel, but suggest in the future this may ease as they get a different perspective with the passage of time.”

Karen the Younger: “And what about—”

Karen the Elder: “I wish I could spend more time, but I am getting fatigued and must return to my present. But let me just add one more thing; Don’t be so intent on what you want to give a client. Find out what they want to give to you. They might want to reveal their pain, their sorrow, their regrets, their love, their beliefs, their hopes. Don’t forget what I said: maybe it will make the book Encountering The Edge a better book. Bye now! Oh, and you’ll be starting a blog called OffbeatCompassion… Bye!”

Karen the Younger: (teardrops fall)

The Temperature Of Water

My curiosity can get me into trouble, so I was very careful not to ask about a pattern I have noticed regarding some of my African American patients. I was afraid that if I asked one of their family members about it, they might think I was being prejudiced. Same thing about asking about it online. I might give the wrong impression to readers. But finally I found the right context and right person to ask. And now that I have gotten your curiosity up, I will reveal the pattern: it struck me how important it is for many of my African American patients to get water that is iced or at least very very cold and fresh. They also emphasize that the remaining water in their cup will absolutely not do. White patients in general have not made much of a point about this.

A patient’s wife who I will call Catherine explained it to me thus: “When our ancestors were slaves, working in the fields, they had to drink lukewarm water that they had taken with them. It was hot out in the fields, so their water was not refreshing and tasted stale.” Catherine thought some more about this and talked about later times: “And this memory passed down through the generations. In the old days, Whites had iceboxes and refrigerators, but Blacks did not, and besides the money being too much for us to have those things, Whites thought luxuries did not matter to us. So we went on having lukewarm unappetizing water for some time more. I think that’s why you hear this from your patients about drinking nice cool water.”

If you are an African American, I would like to know what you think of Catherine’s theory. And besides taking requests for fresh ice cold water very seriously, I would like to know if there are other matters I should be sensitive to when I serve as a chaplain to African Americans. Of course generalizations for any race or ethnic group are hard to come by, but if there is some particular example in your own experience we can all continue learning together.

 

You can also discuss this with me through Twitter:  https://twitter.com/chaplainkkaplan

Less Is More, Chaplain Style

Got your timer out? One of my hospice visits last week clocked under five minutes. Jonathan, from a culture vastly divergent from mine, let me know when the visit was over. It wasn’t that he had had more than enough of me; it was because our task was done. He wanted prayer, and as usual, I first ask patients what they want to pray about before I begin. He said “about my family.” He went from a seated position in his bed to a lying down one as he prepared to listen. I thought about the fact that he was only in his fifties, with his children keeping to themselves in a back room during the visit, and his wife out on some chore or at work. I took out a very handy booklet with modern freshly created prayers, Jewish-based but as about universal as you can get. I turned to the prayer called “For Family and Friends.”(From Gates of Healing, CCAR Press). Part of it says, “Let them feel free to bring me their own joys and sorrows that I may continue to participate in their lives even as they share mine.” I recited it to him slowly, so he could savor the words and also so he could leisurely convert the foreign language of English to Amharic. He then sat up and softly said, “that prayer went straight to my heart.”

Getting ready to lie down again, he remained quiet and confirmed when I asked, “Is that enough for today?” I consumed more time putting on all my winter wraps and making sure I had everything in my bag than making the visit itself. I called to his daughter to let her know I was leaving, and she sweetly thanked me and opened the door as I stepped back out into the clunking and clanking of the ongoing construction outdoors.

 


For writing shorter than that visit, see me at https://twitter.com/chaplainkkaplan

Making It To The Top Of The List

Since I have seen untold thousands of patients and their families in my eleven years as a hospice chaplain, I think it is a fair question people put to me at my talks when they ask, “What do the families you serve have most in common?” But for many years, I would say, and believe, that there were no real patterns. “Every case is unique,” I told them, wondering to myself why this was such a pressing question. I sensed that they did not like this answer. Was it the uncertainty it implied that bothered them? Did they want to know more about what to expect when the time to put a loved one on hospice arrives? Read on, and you will see that I will no longer leave you in the lurch.

I know that articles labeled “Top Ten” reasons, most popular diets, cities to live in, and so on can really grab a reader’s attention. Now it’s my turn to have such a list, even if not quite so long. That is because at long last I can discern the most common themes that families bring to my attention wittingly or unwittingly.

I’d say guilt gets top billing for what family members talk to me about when they are in spiritual distress over their loved one’s impending demise (and after). They feel they could have done something differently or did not do enough. This reminds me of a joke about what two different families did for their loved one. The Cohen family took their elderly mother to Florida so that she would not have to deal with the cold and could more fully enjoy her remaining years. She died soon after. The Levertov family kept their elderly mother in New Jersey so that she could enjoy her friends and community. She died too. The Cohens lamented, “If only we had not had Mom make that arduous trip and be torn from her familiar surroundings, she would have lived longer.” And what did the Levertovs say? “If only we had taken her from the harsh winters and had her make new friends to enjoy the balmy weather with she would have lived longer.” It is not easy to talk someone out of guilt, even with jokes like that. I try to provide relief by telling families that so many other families, who have done all they reasonably could, also feel guilty. Normalizing it like that gives them perspective and hints at the logic that if everyone feels guilty, then maybe no one is really all that guilty. Or at least,like misery, guilty people love finding out about company.

Nor does this guilt stuff stop here. Besides fretting about cheating the patient of how much time they should have left, they worry that if they are not present when the patient dies, they will feel guilty about not having been on hand for the final sendoff. Family members have to do other things, anything from leaving the room to taking a shower to boarding a plane in order to get back to jobs and childcare. And of course there’s plenty of guilt to go around for feeling the “forbidden” sentiments like relief or even delight when the person dies, because they were nasty stinkers. Or they feel that way because now a family can go ahead with making various plans and can see an end in sight for the financial drain. Hell, yes, money talks loudly at such times!

Second place for top spiritual concerns is uncertainty. How this torments families! So many ask me or the nurse how long their loved one is going to live. Unfortunately, this can be hard to predict. Sometimes I think a patient is going to die any moment and they live for several days more, or the opposite. I agree when people say the uncertainty hanging over them is worse than the death itself. There is also the uncertainty for the family concerning how they will cope after the death and what unexpected feelings may surface. The way I address this is to first of all acknowledge how nerve-racking and stressful and all round crappy uncertainty is. I then say that after the death, our hospice team will be available to guide them through the grief journey for an entire year. All hospices offer bereavement groups and one on one contact as well as literature about grieving. (My favorite grief book is How to Go on Living When Someone You Love Dies, by Dr. Therese Rando. It is so clear and almost entertaining in its style.)

On the positive side of spiritual concerns, top place goes to gratitude, excepting abuse cases of course. Even though the families are sad and usually angry about a good thing coming to an end, they are grateful for having had all the years they did have with their loved one. Their loved one enriched their lives through nourishing, encouraging, enjoying, and sharing love with them. Sometimes the gratitude is for whatever time is remaining, and sometimes as death occurs, for an end of suffering.

Rounding off my list of top four spiritual concerns is humility. Families realize how little control we ultimately have, and that we go through our lives at the mercy of innumerable factors. Some find comfort in believing that whatever happens throughout our lives including the timing of our death is all God’s Plan. More to the point, as the grand mystery of death itself extends its reach, rolling out its carpet of eternity, we stand humbly at its fringes.

______________________

For Karen’s microblog see her at https://twitter.com/chaplainkkaplan

A Dementia Returnee

What would it be like if a person with dementia could be cured and then be able to describe her journey to and back from this disease? I let this play out in my imagination in my gentle science fiction book, Curiosity Seekers. And if you are curious about such a premise, you can read two excerpts below. The first excerpt is from the beginning of Chapter Two, “A Dementia Returnee.” It refers to the main characters and their financial planner Virginia, who gets the disease and is one of the first cured. The second excerpt is where Virginia starts to recover, and with the help of a researcher, starts a diary of her experiences “returning” from dementia. Later in the chapter, she continues recovering and keeps her diary, but some new challenges arise. You want to know what they are? You’ll have to read the book!

Here are the two excerpts:

“Even a recluse knows that around the year 2056 patients with dementia had become as obsolete as doorknobs. But only a precious few individuals are aware of how the initial returnees from this malady reassembled their minds. Even less known is what the experience felt like to them on their way back, which by my sights is the most fascinating of all. As it so happens, Muriel and Gomer Ackerman witnessed this remarkable part of medical history starting in the year 2053 because of their association with their financial planner and friend Virginia Boyden. Upon her retirement in 2047 she became very good friends with Muriel. When Muriel had made that card to cheer Virginia up after fifteen years of service, neither realized then that the planner was exhibiting the first signs of dementia.”

“Dear Sweet Diary: I feel like I am catching up with the pace of what is occurring, like a rocket catching up to some fleeing asteroid and now able to see what is on it. A researcher here named Dereck explained that I am taking a drug that might make me healthy again. I’m not sure what kind of health he is talking about, but it seems that I can grasp an ever-expanding environment around me. I feel like reality is resuming its lodging in some previously vacated spaces in my brain. Yes there’s this nursing home, for that is where I am obviously. Did I have amnesia after all? Dereck has explained, but I still can’t make out what happened. The nursing facility is in a town not terribly far from where I used to live, and visitors come in from the outside, and I can remember more and more about what they have to do with me and me with them. I can talk in a code they can understand more easily, and they have stopped looking dismayed like before when I had randomly tossed out words hoping some of them would land in the zone of appropriate responses. I am still missing some words, but my visitors, especially my family, can now help me put together a fairly close estimate of what I really want to say.”

Write or imagine your own ending to this story, or find the book at https://www.amazon.com/Curiosity-Seekers-Karen-B-Kaplan/dp/1541326946

For my microblog, go to https://twitter.com/chaplainkkaplan

 

Autumn Contemplation

This guest post by author Leaf Seligman is a lyrical reflection about this season, our core selves, the teachings of trees, and the resurgence of old griefs. Reading this is like beholding a photograph that has faded but fills us with tenderness all the same.:

“Bathed in the beauty of such radiant fall foliage,these days, I cannot help but turn to the trees for inspiration. It’s not lost on me that deciduous trees appear most exquisite in peak color right before they lose their leaves.

Autumn reminds us of the impending winter—not just the annual season but the metaphorical season of our lives. A time I am in now at sixty, the decade my mother assures me will be my best. In the autumn of our lives, hopefully we know ourselves and have made peace with the conditions and circumstances that shaped us. By autumn, we have found our authentic expression, our passions and we take note of our gifts, synthesizing them and offering them to the world in meaningful ways, with a bit more kindness and clarity than we did in summer or spring.

By the time winter appears, we recognize the shortness of our days. Like animals preparing to hibernate, we prioritize, conserving finite energy for what matters most. The frivolous and unnecessary: be it banter, decorum or social obligations, fall away, leaving a core self sometimes diminished, sometimes intact, that preserves the essence of who we are. And while the trees with their bare branches focus inward, quietly reinventing spring, we like the fallen leaves, contemplate our moment of final release.

The trees suffer with us, and long before us, in the arc of their four hundred million years on planet earth. Trees know everything there is to know about loss and resilience, devastation and renewal, bravery and death. Trees, connected underground by fungal networks that extend over hundreds of acres, experience loss as we do. Each loss we experience touches all the other losses, as if linked by underground pools, so that grief rises and falls like a water table. Some days we feel saturated, and other days, dry.

When grief rises, it can be a subtle sensation, a slow dampening of energy, or it can crest like a mighty swell, toppling us. Either way, it rises to gain our attention, insisting we notice the loss, honoring what or who has been and is no longer, summoning a presence of an absence we might otherwise overlook in the busyness of our days.

Think of trees hollowed out in the center or with a scoop of side canopy removed to accommodate utility lines. The trees do nothing to mask what’s missing. This we can learn from them: to honor the losses, the diminishments, and not shrink from acknowledging them. Many of us know the experience of inhabiting a loss as others tiptoe around the perimeter, afraid to say anything when what we desire most is the opportunity to speak of the person who has died or is ill; instead of pretending the source of grief isn’t there, we welcome the chance to recognize it. Any of us might worry, feel uncomfortable bringing someone up for fear we will upset the grieving person; yet like the trees, we don’t magically forget that we had another child or spouse or dear friend who suddenly isn’t there. We wake each day knowing and being able to acknowledge it lessens the burden.

Trees bear their scars. Unlike us they do not cover them. They simply incorporate them into the bark and branch of existence, into the wholeness of being.

A great value to glimpsing a tree with a scar from a decades-old lightning strike or pestilence is the reminder that old griefs re-emerge and they, too, need acknowledgment. There are so few places and spaces in our lives to honor old losses by name: to take a moment or longer to acknowledge that sometimes, the missing returns, even increases, with the passing of decades. I miss my brother who died almost fifty years ago, more now than I missed him in my thirties or forties. I invite you to consider the long lost losses that resurface. Imagine being able to invoke them, to honor them, to make a space the way trees retain the shape of lost branches while still growing new leaves.

In the last year, when my own grief surfaced with a force that often dropped me to my knees, I reached deep into the stores of faith and friendship that have sustained me over the years. Like the trees that need wind resistance to develop deep roots, we draw on the winds that might otherwise destabilize us if we don’t reach out, if we don’t dig deep into the sources of sustenance. And having the opportunity to stand our ground can deepen the conviction that roots us to core principles, to the values that shape us.

.We all can do this. Trees have been around for four hundred million years. They can teach us the virtues of community and sacrifice, compassion and ingenuity: just consider photosynthesis—resilience, endurance and legacy with an economy of prose and abundance of example.

Whatever the season surrounding us, and whatever season of life we inhabit in this precious moment, we are never alone. We dwell among the great teachers who tower over us and occasionally grow underfoot, springing up in yards and meadows, reclaiming land once farmed or grazed. The trees exemplify life’s longing for itself and summon us to do the same.

On this radiant day, a shower of blessing in the form of autumnal leaves, yielding, may we pause in the presence of our arboreal elders, welcoming wisdom, taking heart. May we stand in our truths as resolutely as trees, hallowed by what hollows us, strengthened by winds that sink our roots deep so that our branches grow sturdy and wide”

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Leaf Seligman began writing during her Tennessee childhood. She has taught writing in colleges, jails, prisons, and community settings since 1985, and worked as a minister, jail chaplain, a youth services caseworker and a restorative justice practitioner. Her books include A Pocket Book of Prompts, Opening the Window: Sabbath Meditations, and From the Midway: Unfolding Stories of Redemption and Belonging.

https://www.kirkusreviews.com/book-reviews/leaf-seligman/from-the-midway-unfolding-stories-of-redemption-an/http://www.bauhanpublishing.com/shop/from-the-midway/