Worry Lines
ministry

Worry Lines

Sitting in the noon light of the atrium, he locks his eyes on mine and says, “27? You look older.”

The chatter of thirty lunching employees quiets to an indistinct drone.

“You know that’s not a nice thing to say to a woman.”

“Hey,” he shrugs. “I tell people, I gave my arm to live forever. I’m a demi-god!” He bears his teeth in a grimace-smile.

I try not to glance at the half-sleeve that billows like a flag from one shoulder, empty.

“How’s that working out for you?” I spike at him.

“Great. Look at me!”

We face off over a lunch table full of groceries and receipts. Hadi (a Persian name he claims is pronounced “hottie”) runs errands for the hospital employees as part of an initiative to improve quality of life for busy medical professionals.

I look down at my lap full of dry-cleaning, worry the hangers into a neat stack.

“So you think I look old?”

“No, you look—I was kidding,” he shuffles his papers. “I mean, I’m trying to look older here. That’s what this is about,” he motions toward his spotty goatee. “How do you think it’s working?”

I stare at him. The volunteer pianist, who comes at lunchtime to entertain families and staff, tinkles “Blue Moon” in the corner.

“You look 65. Congratulations.”

He licks his lips, smirks. “So you have some outstanding charges from your shoe repair, and I only have your old credit card on file.”

I hand him my card and stare at out the window. His body leans over the iPad, as if willing his phantom arm to hold it in place. He pecks at the touchscreen with his index finger.

When he’s finished, I scuttle into the bathroom and lock the door. Under the harsh fluorescent lights, I notice a starburst of tiny fractures in my skin, expanding from the center of my brow. I lift my forehead in a surprised expression, try to stretch out the kinks.

Not wanting to visit my insecurities on the patients, I drag out my lunch break as long as possible. I google the ages of my favorite actors and try to discern the imperfections in their peachy, elastic skin. I slouch at my desk and send out a flurry of insecure text messages to my sisters and mom.

“What exactly did you mean,” I write to my sister, “when you gave me that moisturizer that claims to fight both acne and wrinkles at the same time?”

Finally I follow up with a patient I’ve seen twice over the past few weeks. He lies puddled in his bed, his body swollen shapeless with some yet unidentified disease. Under his chin sits an omnipresent vomit bowl the color of Pepto-Bismol.

“Mr. Callihan?” I say quietly.

His eyes are shut, lids cinched tight in discomfort.

“Yes?” He mumbles and squints up at me with great effort.

“I’m Caroline, the chaplain. I came to visit you last week.”

“Yes.”

“How are you feeling today?”

He flinches, as if responding to an invisible kick or punch. A blue vein pronounces itself on his forehead.

“Not so good.”

“Yeah?” I shift my weight. “You look like you’re in a lot of pain.”

“Yes. They gave me some nausea medicine, but it hasn’t kicked in yet.” Mr. Callihan sucks in a breath. “I’ve just been here for so long.”

“I know. Must be very discouraging.”

“Yes. If I could just relax.”

“What helps you relax? Would music help?”

He stares at the portable toilet in the corner of the room. For months he’s been using a bedpan; I wonder if the physical therapist left it as a visual goal.

“I used to like music, but now it hurts.”

“We have some lavender aromatherapy balls in the chapel.”

“It just makes me more nauseous.”

I search the dimly lit room for inspiration and give up.

“Sounds like the world’s just lost its color.”

For the first time this visit, he turns to me. His cloudy, prophet’s eyes search my face and then brim.

I reach for his hand, which is all bone and vein, despite the swell of his belly, and cold as marble.

When I pray for Mr. Callihan, he whimpers. I hear soft, moaning noises like a blind puppy lost under a house.

I pray harder. I squeeze his hand and grasp for the best words I can find. I want them to hang in the room after I leave, my syntax and vocabulary a colorful bunting strewn around his dark room.

But the prayer comes out stammered, unsure of its next step. “Give him strength and comfort. And take away the pain and the nausea and . . . any discomfort he may feel. Help him to know that you’re here, even when it doesn’t necessarily feel like it. And surround him with your love.”

It’s quiet hours in the ICU when I leave. I pad down the hall, past the sharp smell of fecal matter and a housekeeper sweeping a mop across the tile in slow, weepy arcs. I notice my face is clenched tight. I rub my eyebrows as I walk, try to release the tension.

That night I tell my fiancé about the visit. “The disciples walked around healing people all the time.” I feel concern score my forehead in parallel rows. My chin wobbles. “I don’t understand why I can’t.”

“You can’t fix everyone,” he says, touching my cheek, “you can’t.”

We follow a scarred and battered king. What made me think I’d finish this ministry fresh-faced and dewy as a babe? When did I decide that how I look is more important than what I do?

Maybe the cost of discipleship is tendered in premature grays and wrinkles. Maybe my body won’t stay an empty canvas. Maybe it will be a crinkled, frayed map of love the people I have loved—and the people I’ve failed to. I think of Hadi, how I didn’t listen to his own story. I was too busy defending my vanity against a one-armed man.

I try to remember this as I watch myself age. My face is one of my best and only tools for communicating compassion. When I see a new gray hair, I try to trace it back to the time I woke at three a.m. to the death of an eighteen-year-old on a joy ride. When I see a parenthetical fine line framing the corner of my mouth, I remember a man suffocating from COPD who wanted to be saved. When I see a growing crevice between my eyebrows, I remember Mr. Callihan. I couldn’t fix his body, but I cared for him, and he knew.

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A Bright Sadness
ministry

A Bright Sadness

When I’m not on call at the big hospital, I work at the Cancer Center, which is an outpatient facility where patients receive chemotherapy and radiation. When I first arrived, my boss told me to make rounds in the infusion room and the lobby.

I walk into the infusion room, a large open area with chest-high walls dividing each patient’s cubicle. Each person waits in a chair while the medicine drips through IVs with the slow, pained rhythm of a leaky faucet. The nurses use double gloves when hooking up their bags of chemo. The medicines are so poisonous that there is a whole protocol—several layers of nesting plastic buckets—for the event that the chemicals leak.

Some of the patients fiddle with crosswords or knitting. Others bring a friend or relative and huddle around their little TVs. Others just watch the room, their eyes always one step behind the nurses who flit from patient to patient.

I survey the room for the most approachable patient and introduce myself to a middle-aged woman in a cardigan. I ask her how things are going.

“Doing fine,” she says, lifting her eyebrows and holding a tense smile.

“I just wanted to see if there’s any way I can support you while you’re here.” I realize I am wringing my hands and try to force them down to my sides.

The nurse gently asks me to step aside while she sanitizes the nook of her elbow and searches for a vein.

I can feel the patient willing herself to look at me and not her smartphone, still held out in her hand. “Nope, got lots of help,” she says.

Next I speak to an old man with two hearing aids and a raspy, strained voice. I lean in to hear him and then straighten up to project my voice so he can hear me.

“I said, IS THERE ANYTHING I CAN DO FOR YOU?” The patient and his wife in the next cubicle turn and stare.

I briefly consider sitting down in the tiny “guest seat” in his cubicle, something like a motorcycle sidecar, but consider it too forward. After a few minutes of yogi-like contortions, a nurse pushes a stool beside me.

“Sit down,” she says. “You’re making my back hurt.”

I tell myself that this job would be better for an extrovert, for an older person, for someone who looks more maternal, for anyone who’s not me.

My boss, seeing me struggle, encourages me to start a group or class for the patients. The cancer center already offers Tai Chi, a healing arts table, yoga, photography, myriad support groups, and free massages.

“I’m sure you have something you could teach, one of your interests.”

I page through the empty rolodex that is my list of skills and talents.

“I guess I could do a book group?”

We settle on Barbara Brown Taylor’s Learning to Walk in the Dark. During the first group, I read long chunks of text aloud to stave off awkward silences. I try to articulate for the patients exactly what Taylor is saying. They are polite but quiet.

That night I call my fiancé and tell him I can’t do it. “What gave me the audacity to think I could teach these people how to live their lives? I am 30 years younger than they are and I’ve never had cancer.”

He tells me that good teachers ask the right questions. They help the student discover the answers for themselves.

When I read Eva’s terrific article on Teaching as Hospitality, it hits a nerve. Something about the way we’re expected to help the student (or cancer patient) transform, but end up in a kind of nervous, self-sabotaging performance that is much more about us than the people we are trying to help.

At the next book group I try to think about approaching each patient as the bearer of a great gift, as someone who can teach me. I give the participants space to open up. I learn to let my questions hang in the air, instead of answering them myself out of fear.

Most of them don’t even speak about their cancer as their major source of darkness. They talk about the people who abandoned them during their treatment, friends and family they expected to reach out, but who disappeared. They talk about the help that came from unexpected places. One man says that a 16-year-old kid in his neighborhood, whom he’d never met, dragged his trashcan back to his house after garbage pick-up every week. One person says knowing he will die is a gift. Everyone dies eventually, he says, but most people aren’t given a heads-up a year or two in advance. Because he knows, he can savor the last months of his life and nurse a “bright sadness.”

Now when I walk into the infusion room, I try to remember someone that I care about and miss. I pretend that I am going into the infusion room to meet that person—the giggly girlfriends from college, the muddle-breed dog I grew up with, my own granddad who died of cancer years ago—and I kindle that longing and affection into cider-colored warmth that carries me into this sterile room.

Each patient must be somebody’s loved one, I think. I try to approach them like they’re my loved one, like they’re bringing me a gift, like we’ve been apart for a long time and I can’t wait to hear what they’ll say.

Last week I approached a patient who’s blown me off every time I try to talk to her.

Before I can re-introduce myself she says, “I’ve seen you around a lot.” She considers me. “I’m almost to the end of my treatment, and I’ve been thinking a lot about what I’ve learned.”

“Yeah?” I lean against the counter, feel my shoulders relax. “What have you learned?”

Stand There: Ministry of Presence in a Medical World
ministry

Stand There: Ministry of Presence in a Medical World

I am a tall, young, female chaplain with a penchant for costume jewelry and leopard print accessories. When there’s a death or a trauma, I introduce myself to the family. “I’m Caroline, the chaplain. I’m here for your support,” I say, furrowing my brow and mustering all the earnest concern I can. They look up with red-rimmed eyes, say, “You’re a funny-looking chaplain.”

During my 24-hour on-call shifts, I sleep in a converted old hospital room with the same millimeters-thin blanket and industrial sheets as my patients. Someone has added a dresser, a rocking chair, and a lamp. No one has bothered to remove the “code blue” panic button—pushed when a patient’s heart stops —from the concrete brick wall. They are remodeling this wing of the hospital, and so some nights there is a constant hammering interspersed with the angry buzz of a chain saw from the empty rooms next door.

When I get a page, I rouse and scan the details. “50-year-old man, gunshot wound, level two trauma, 30 mins. out,” for example. I groan and roll over. There’s a misconception that chaplains never curse; I can tell you from working overnights, it is not true. I set my alarm for 20 minutes and savor the last few minutes of sleep before donning my blazer and badge.

Chaplains are out of place in the medical profession. In the hospital directory, my department—the Department of Spiritual Care and Wholeness—sits like an embroidered, life-affirming pillow among the medical pillars of pulmonology and oncology and gastroenterology. Everyday I ask the nurses on my unit if anyone could use emotional or spiritual support. They look at me like I have antlers.

Normally I must fight the current of nurses and techs spilling in and out of the trauma bay if I want to get information for a family. I get pushed aside, ignored.
But. If a child dies or a CPR is failing, or a leg needs amputating, I walk in the unit and the medical staff splits like a red sea.

I don’t have some secret the medical staff lacks. The role of the chaplain is just to embrace the emotion that others try to avoid. Sometimes the patient or family asks me for a cup of coffee, a Kleenex, an update from the doctors in the operating room. I’m asked to contact another family member. I do these things, but I try not to be reduced to my practical contributions.

Allowing others to feel what they feel is a form of hospitality. In The Wounded Healer, Nouwen writes that when we deal with our own issues of hurt and grief and insecurity, we are then able to be with others in their doubt and hardship. We are not so saturated with our own feelings that we cannot enter in. Of course, I can never fully resolve my own struggles; I will always be half-healed.

The Bible is full of unlikely characters, people that had no particular qualifications other than the fact that God called them. I feel the same way as I roam the hospital halls in the middle of the night. I can’t do chest compressions or insert feeding tubes or shock the heart into beating again. My pastoral authority grants me access to most secure areas of the hospital—the emergency room, the ICU, pediatrics—but all I have to offer is presence. I feel like dusty, sandal-clad Moses entering Pharaoh’s temple. I feel like Mary cowering before the angel Gabriel.

One night I entered the cath lab to get an update for the father of a patient who’d come in to the hospital with a heart attack in progress. Gathering all my courage and self-possession, I opened the surgery door and presented myself among the robed, masked surgeons. Before I could say a word, a doctor looked up at me and said, “There’s a scared girl here,” and quietly went back to his work of saving the man’s life.

My supervisor has a saying. Don’t just do something; stand there. We as chaplains testify to the ministry of presence, however homespun and inconsequential it sounds. We affirm the presence of a living, loving God in the darkest places of the hospital—the operating table, the dreaded family consultation room. Maybe it’s appropriate that the bearers of this presence arrive in strange packages. Who better to testify to the wildly improbable claim that God is present in the ER than a lanky, terrified white woman in leopard print flats?

On my way down from the on-call room, I sometimes pray, “Please don’t ask this of me.” I rub my eyes as they try to adjust to the fluorescent lights, pat my hair into some semblance of professionalism. I feel my own heart galvanize, speed up to hummingbird frequency as I walk toward the room, see the relieved nurses start to scatter, to let me do my work of sitting and waiting. I realize that tonight, yes, God is asking this of me. I tuck in my shirt; I look down at my ill-conceived choice in footwear; I inhale. I remember that wherever God sends me, I never go alone.