Telling It Like It Was In Castro’s Cuba

In my last post I wrote that relating to others as a chaplain is like performing improvisational theater. I go into each encounter with a patient with no script in mind, and what they say shapes the give and take between us. But the flavor of interactions at hospice varies so much, I get to sample a number of careers, not just one. Sometimes I feel like a detective, following up hints my clients inadvertently drop which point to hidden deeper concerns that they feel too hesitant to express outright to a total stranger.  Other times I feel like a journalist, gathering stories of public interest. Besides “getting the story,” when I act like a reporter, I am giving the client in such cases the freedom to tell their story and fulfill their need to be heard and understood. Many of the anecdotes in Offbeatcompassion derive from this journalistic role.

Thinking back, there was a storyteller who was so anxious to have me listen in detail I think she wanted me to publicize her words so that more Americans would know what it was really like in the early years of Castro’s Cuba, in the early 60’s. I was genuinely surprised to hear such tales of woe and bravery. Like any reliable reporter, I “checked my sources” on the Internet and found that others have told similar stories.

I will call the narrator “Juana”, who spoke to me for over two hours while her loved one lay sleeping under a portrait of a friend who served in the Cuban Army prior to Castro. “My family was on the ‘losing side’, and they called the people on the losing side ‘worms,’” she explained.  As Juana spoke, these sorts of details reminded me of Nazi behavior. She went on, “The people did so-called volunteer work in the cane fields. Very hard labor they would ask people to do on their time off. But I did not do it.” Instead she went to study at a medical school, hoping to find a niche in Castro’s Cuba where she could do something productive and avoid some of the worst consequences of his regime.

But even there she felt society had become so warped that she could no longer find a viable place to fit in. She said, “the school had ‘cleansing meetings,’ where in front of all the students they would say which students they were going to expel. And then one time I heard a shot and later I found out a student had shot himself after learning that his girlfriend was expelled.” This gruesome story reminds me of the recent science fiction thriller movie The Thinning, whose equally gruesome premise is that those who fail a school aptitude test are executed in order to ensure population control.

One other significant anecdote she shared was about the U.S. Naval base in Guantanamo Bay. I have always thought of the part of Guantanamo Bay which serves as a prison, but Juana explained that Cubans would try to climb over the fence to be on U.S. soil and gain their freedom. Some Cubans eventually were allowed to go from there to the U.S. Juana told of one exploit where the escapees practiced going over a similar fence elsewhere before they went on a train that passed very close to the naval base fence. “The conductor had a plan in advance, these people went on the train on a particular day from all over Cuba; from many provinces. The conductor stopped the train real close to the fence. Not the usual stop. He opened the doors and the people all dashed out and rushed over to the fence. Many climbed up but the guards up on the towers shot at them and some were hit and killed. But a lot of the people made it. They made it to freedom.”

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Getting Into The Act

My childhood dream of becoming an actress has come true: relating to others as a chaplain is like performing improv theater, only the “audience” is participating at least as much, if not more, than I.

For instance one evening as I was walking towards one patient’s room, I heard someone just across the hall saying, “Look there goes the chaplain.” I took that as a cue to veer away from my original destination and detour towards that merry invitation. The beckoning voice was the patient Maxine’s brother, and as I walked in, Maxine looked me over with as much delight as if I had been made out of chocolate all ready to consume in bite-sized pieces. We three engaged in the sort of talk that paradoxically refers to nothing much in particular but warms people up to each other. Maxine suddenly stalled the banter with, “I want a hat. I want something around my ears.” It happened to be on the weekend when the receptionist was not on duty, and I was not sure where the donated clothes were stashed. As I stepped out to ask the aides and nurses, they did not know either. I even went over to one of the cooks, and as we were talking about the clothes, I noticed a white thin net the cook used while on her shift. Ah! There was the prop I needed. Better than returning empty handed I could improvise and bring one of those nets to Maxine. I asked the cook if there were more. Skeptical, she handed me one from a stack daintily lined up on a hook.

When I came back into the room I gambled on the patient having forgotten exactly what she had asked for since she had some dementia. Sure enough she enjoyed the attention of having me place it on her head, and her brother laughed along with me at how charming it looked.

That same day, I went to someone’s private home, expecting to see the patient Marge and her sister. Her sister had asked me to come over because the Marge did not have much longer to live. Instead, I saw an aide-turned-friend there who wanted to pour out his angst, not about being at the point of losing someone who he was so devoted to, but about the President of the United States. This was the first time I had listened to political fears as a form of spiritual distress, so like changing my direction from one “stage set” (i.e. room) to another, I had to swerve from the intimate atmosphere of a friend grieving imminent loss of another friend, to the public source of his feelings of vulnerability. This friend told me about how the President has bred in him his own fears and feelings of negativity which he has not confronted in himself before. He is worried about the resultant changes in himself and in our society. By the way, the “subscript” of this genuine alarm over politics may have been a way to hide from his sadness at the patient’s waning days. But as with improv on the stage, I went in the direction the other “actor” chose, not what I knew to be the deeper issue. Perhaps in the next “act” he will be ready to go there.

As I understand it, the way improvisational theater works is that one actor spontaneously starts some miming action or indicates some trait in him- or herself or in the other actors. This is called an “offer”. Then the other actors build on that, and so on, back and forth among the actors or among themselves and members of the audience. On my own “stage” a lot of times I wait and see what the patient will offer as a first cue for me to react to, and then I take it from there. Coming into these unscripted situations and having clients make the first offer is the appeal as well as the challenge of being a healthcare chaplain. It also cuts to the chase for spiritual healing.

Even The Patients Puzzle Over My Offbeat Career

It is one thing for a friend to ask how in the world I can deal with hospice work, but quite another matter when a patient asks me. The way Shirley put it was, “How can you do this job when you have to keep losing people you get to know?” I stumbled out an answer to the effect of Alfred, Lord Tennyson’s “ ‘Tis better to have loved and lost than never to have loved at all.” (No, that quote is NOT by Shakespeare.) To myself, and to my readers here at offbeatcompassion, I will comment on Shirley’s query more searchingly. First of all, it is always of note when a patient says something like that, because it makes me wonder what is behind it, and what it might  have to do with her own feelings about losing other patients she got to know very well and who had died before she did. Unusual for a hospice residence, for one stretch of time, several patients had been pretty alert and visited each other and smoked with each other out in the back before most became bedridden or died. Shirley’s comment possibly touched on her sorrow of anticipating that some day, she herself would lose everyone and everything when her time came.

Anyway, I will stall no longer about how her question applies to me and anyone else who works with hospice patients. Why was Tennyson right?  I think one thing Shirley was implying was, okay, I only get to know my patients for a relatively short time, and this keeps happening over and over, so is the pain of losing them worth the pleasure and experience and reward of having known them in the first place?  The answer for hospice caregivers, as well as for me, is yes, otherwise turnover in this field would be pretty frequent. I once heard at least for chaplains that the average number of years they spend in hospice work is about eight years. That to me sounds plenty long, so there must be a reason for it other than masochism. And it certainly cannot be the pay!

Sure I miss some of the patients I get to know well and find more in common with, like Shirley herself. But the mourning is brief, as the relationships are. When I lose members of my own family, just like everybody else, grieving is not a pretty picture. But I think because patients are strangers and not exactly friends no matter how much we like each other, the grieving is simply not intense or prolonged as with family. On top of that, I must maintain a professional distance in order to think carefully about what a patient needs to talk about and what kind of response will best help them. This leaves me mostly the “better” and easier part of grieving. Such grieving touches on the memories of the interesting things they said or showed me, such as advice about how to relax, pictures of them posing with famous people, or even an audio of a band they played in. At most I may feel wistful about a particularly endearing or admirable person. Writing about some of them in this blog or on Twitter is also an outlet for honoring their memory and my feelings about them.

If you do “this kind of work,” how do you handle the constant leave taking?

Her Reality Star

Pulled over here and pulled back way over there: This is the reality of grief. Newark poet Ms. Lillian Washington captures this sensation in her prose poem, “Her Reality Star.” Night is beguiling, but brings no release. Finally, the woman finds a hint to a way out from her despair from a source that is true to her life path.

Hope was no longer alive.

A spring eternal never sprung.

Her smile, like that in a child’s eyes, was gone.

The hum of the night’s forces as she walked the pavement

Began to fade into the distance.

No longer did she believe that the magic of that day’s night

Would bring her closer to freedom from the pain of her loss.

Daybreak would come soon and the pain of that day

As the pain of yesterday would haunt her again and again.

“Why?” she cried out as she stared into the midnight sky filled with streaking stars.

The deep dark blueness cradled the stillness of the other stars that

Stared back at her tear-filled eyes.

Soon silence came upon her. No longer crying, she stood up and a peaceful look now covering her face, she rose up and declared, “No.” No longer would she believe in magic. She began to realize she should believe in the power of prayer and she would find her way back to the happiness she once knew. With her new direction found, she did not have to believe in magic anymore.

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Author’s biography: In her teen years Lillian Washington performed with soul singer song writer Jackie Wilson at the Branford Theater in Newark, NJ with a female singing group called the Vandettes. Later as a member of the Theater of Universal Images she performed various plays at Symphony Hall and Essex County College in Newark. As a part of a comedy duo she did stand-up comedy at Catch a Rising Star in NYC.  Ms. Washington’s current goal is to become a published writer of poetry and children’s stories. She is a member of my writers’ group, The Angry Bean Writers.

Hobgoblins And Hospice

You would think hospice is scary enough without Halloween decorations in the residence dining room. Some depict skeletons with devilish grins portending what is to become of us all, and others are cartoons of tombstones with R.I.P written on them. The decorations are redundant in this setting are they not? Or at least ludicrous in drawing added attention to the bad situation the patients and families are facing—Come on, this is a hospice residence. Of course the people putting up the decorations were probably just thinking, “Let’s decorate for the holiday,” and had  no inkling about the irony of what they were doing, which is like a very bad pun.

This year for the first time I no longer find it fun to look at Halloween decorations in my neighborhood either. So many show old people with leering expressions and tattered clothing, and witches howling amidst flashing lights, ghosts gesturing to bloodied bodies, and vampires looming over their imminent victims. Maybe because I have worked for hospices for many years, it does not take all that much to skirt the boundary between taking the especially sad and overwhelming days on the chin, and descending into burnout. Or it could be now that I am older myself, decrepit versions of the elderly no longer amuse me. More than ever, I need as much comfort and beauty as I can lay my hands on, tune my ears to, lend my nose to, and focus my eyes on.

I realize that for society, such displays are a way to project our anxieties and dread over ageing and death and an attempt to push them away through caricature. In a way, working for hospice is dealing with Halloween all year long, except even worse, as I am facing loss not at the remove provided by dark humor but instead as the raw real deal.

So hey Thanksgiving themes, here I come!

Can I Take Your Spiritual/Emotional Temperature Please?

When you were in distress and went to a social worker, therapist, chaplain, your favorite clergy person, or friend and they said, “I hope I have helped you,” could you ever have uttered in the thumbs-down case, “Um not really”?  Unlike a nurse seeing vital signs returning to normal, chaplains and all the rest cannot be sure if the “spiritual/emotional” vital signs have improved by virtue of what we said  and how and when we said it, or through what we chose not to say at all. And was our visit too long, or not long enough? So in our frustration we are tempted to ask for an evaluation. We’d like feedback please. And maybe a pat on the back.

Think of it this way. If you were the client and someone asks if they have helped you, that expresses uncertainty on their part, as well as a desire to shut down the conversation. It is like saying, “I sure hope I helped, but if I haven’t, I am not sure how else I can go about healing you, and so I hope you don’t ask for more help.” A similar problem arises if the health professional or friend says, too early in the conversation, so-and-so might be of further help to you; here’s their number.” Both of these reactions are a way of saying, “I cannot listen to you as long as you would like, possibly because your topic makes me too anxious, or I feel too inadequate or incompetent to handle it.”

Okay. So we try our mighty best to repress such anxious noises. But this still leaves us with the puzzle of how well we did. (I’d like an “A” like anyone else.) When I am really lucky, the client will actually say how much better they feel, or look more relaxed, or ask me how soon I can visit again, or ask me to stay longer. In rare cases, they write me a letter of thanks afterward—super rare in hospice. And when I make mistakes, some clients quite readily make it clear that they want the visit to end, or would be more comfortable with someone else. Some have even become angry. I think to some extent or in some cases we will never really know if our visit benefited the client and will have to trust that if we intently and calmly listened, that alone did some good in the overwhelming majority of cases, because no matter what, everyone wants to feel cared about.

Full disclosure: While I was in the deepest throes of my own grief process, I had to go through several people before I could find those who would hear my story. The ones who did not make the cut said the things I noted above (They got a “C”) or made worse remarks than those (They got a “D” on a generous day). Maybe  being a chaplain myself intimidated some folks. I remember being nervous early in my career when I found out a client was a nun, pondering what I had to offer. Wasn’t I bringing ice cubes to the Arctic? In another case the client was a retired hospice nurse. Once again, the answer is simply to listen with full attention.This is what we all yearn for, no matter what our credentials are or those of the client. Just as the top three considerations for real estate are “location, location, location,” the top three for people in spiritual and emotional distress are, for the one asked to help: be quiet and “listen, listen, listen.”

Singled Out Versus Blending In

There’s an old joke in my religion that underscores our almost impish impulse to deviate no matter what: One pious Jew was stranded on a desert island and built two synagogues. When rescued, the crew members asked, “There was only you and your limited resources, so why two places to worship?” The Jew answered, “One was for me to pray in. The other one I wouldn’t be caught dead in.” Hmm, maybe the “other congregation” had a different way of handling the prayer for mourners (called the “Kaddish” in Hebrew and recited towards the end of each service). I have been reciting it for my father who died last December, and the tradition is to recite it for a deceased parent for about a year. In some synagogues only the mourners rise to recite it, while in others everyone stands and says it to support the mourners or to say it for those who passed but have no survivors to say it for them.

I have said this prayer in both kinds of congregations, and I have mixed feelings about each custom. On the one hand, if a few other people and I rise to say it, I feel acknowledged that yes, I am stepping through the peculiar passage of my first year without my father. Anyone present at that service who still does not know I had lost an immediate family member can later ask who I am mourning for and potentially become an additional source of support. On the other hand, I feel self-conscious drawing such attention to myself, as if a screaming scarlet “M” had sprouted on my forehead.

In the “other” synagogue, I feel more protected and less vulnerable as mourners and non-mourners alike participate in this ritual. But I feel that this dilutes and minimizes my feelings as they are “distributed” across the group. What do you non-mourners know about my feelings and those of the others grieving? The intention of course is fine, but it reduces the significance of the ritual for me. If everyone is carrying it out, then I am not doing anything special to mark my relationship with the deceased or to drive home yet again to myself the reality of the loss. I feel deprived of the power of this ritual.

If I and some other hapless survivors of another ship wreck had joined the Jew stranded on that desert isle, I would have instituted the following compromise: Everyone rises but only the mourners actually recite the prayer.

But wait, I hear an objection from the chair of the Board of Trustees: “That’s not the way to do it. Everyone recites but only the mourners rise.” Alas, we will need two synagogues after all.

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A prior version of this article was published September 6th, 2017 in the blog “Expired and Inspired”, in The Jewish Journal: http://jewishjournal.com/blogs/expiredandinspired/224040/two-jews-three-opinions-rabbi-karen-b-kaplan/ Permission was granted to place it here, with minor modifications.