Te Agradecemos Santo Padre

The patient I had the honor of caring for was an elderly, gentle Mexican man. Prior to entering his room, I spent some time looking at his chart. He had had an ischemic brain event (like a stroke, but caused by occlusion of his carotid artery) a few days ago which had led to emergency surgery to open up his left carotid. The surgery was successful and allowed him full sensation and motor function of his right side. However, he was not yet able to speak. After thoroughly examining his chart and looking up the various medications he was on, I went down the sterile , septic smelling hallway to his hospital room.

As I turned a corner, I found myself on Holy Ground.

There in the room with him was his family - two elderly women dressed in long skirts, bright colors, scarves on their heads and an elderly gentleman in a straw cowboy hat. Also in the room was a younger Mexican man in scrubs who worked at the hospital - family friend. I walked in and was a little disoriented. With the traditional clothing, only Spanish being spoken, and the way that the family loved on each other, hugging and kissing on the cheeks - I felt as if I was no longer in America. Such beautiful loving people. I shook hands with each person in the room and introduced myself. The two men who spoke English explained what was going on. They were calling a friend in a neighboring town so that they could all pray together. I think they were letting me know so that I could leave the room, but I asked if I could pray with them. We stood in a circle, holding hands. They prayed like I do not see Americans pray, each person praying out loud and simultaneously. I couldn't understand all of the prayers as they were in Spanish, but I got the gist of them. They were thanking God for this beloved family member's life.

Te Agradecemos Padre, We Thank You Father

What an absolute honor to enter into prayer with such loving, humble, sweet people. Where I may have otherwise felt awkward or culturally out of place, thanking and praising God together brought me into close relationship with these strangers immediately. There were no longer walls of cultural or language barriers, but rather bridges of unity from a shared love of the same Father. I love the way that communal prayer and worship transcends all discord and transforms human dissonance to harmony. I love that anywhere I go in the world, I can pray with someone, even if they are of a different faith, and we are simply children sitting at God's feet. And there we are, people praying, more alike than we are different. I love that my chosen profession of nursing is holistic, incorporating all aspects of being human including spirituality. I am so glad that I can openly pray with the patients I get to take care of without any fear of reprimand from my instructors or hospital staff. I am grateful that the nursing model of health care, sees the whole person and stands firm on the knowledge that a person's God and a person's family and a person's story and a person's integrity and a person's beliefs are as important and even more important than a person's disease. People are made up of so much more than their bodies and I love being able to care for whole people, and not just their symptoms and illnesses.

I met a woman who had been married for 53 years. She told me this as I changed her diaper. She told me that she lives with her husband and smiled wide as she informed me that her husband is "swell". Later on, I saw them walking the hallway hand-in-hand, still in love after all those 53 years. She told me that their secrets to marital longevity are "having a sense of humor" and "understanding" and "not getting angry about little things". Pretty basic but very wise.

I cared for a woman tonight who had fuschia fingernails and a green owl ring on her hand. She was severely crippled and just so remarkably vulnerable as I changed her diaper and cleaned up the stool leakage on her bedding. She no longer has motor control and her body no longer stretches out and her legs are permanently folded into a tight fetal position, making it quite challenging to provide care for her. It is easy, especially in the early stages of nursing education, to get caught up in caring for bodies and performing difficult care tasks, and fail to look a person in the eyes, to smile; to listen to them and hear their story. This woman could barely express herself verbally but when I looked into her eyes, I could tell she knew exactly what was going on. As I began to speak to her and keep eye contact, we began to communicate without words. The infected pressure ulcer on her backside is deep enough that I can see her tailbone. It will likely never heal and will probably be the cause of her death. But I know she is a woman who wasn't always like this. She has children and a home and a story of life before Multiple Sclerosis. She has watched her independence, her footsteps, her voice, all of life as she knew it faded away. Yet still, the light in her eyes and her song remains. Te Agradecemos

Tantrums and Tables

So last night I had the truly unpleasant experience of watching a grown man throw a temper tantrum. And tonight I watched the film Girl, Interrupted while reading about borderline personality disorder. Let me tell ya, nursing school will turn you into a hypochondriac. As so often happens as I read about various diseases (psychiatric or otherwise), I began to compare myself to the symptomatology of borderline personality disorder.

True confession, I am not a guru, nor shining example, of mental health and well-being. I know, I know. I do appear to be pretty much perfect, but I am, in fact, not yet entirely restored to the fabulous creation God designed me to be. As I went through the list of borderline symptoms, I saw so many things that sounded much like either who I had been in my past or who I currently am. For example, impulsive, check. I prefer to reframe it and call it spontaneity, but whatever the name, I've got it. Inappropriate anger, check. Mood instability, check. Identity disturbance, check. Dissociation, check. Fear of abandonment, check. Feelings of emptiness, check.

The DSM-IV allows a therapist to diagnose borderline if 5 of 9 criterion are met. I just listed 6. This caused me to think three things: a) Borderline is a "junk drawer" diagnosis. Like your daily horoscope, many people would look at it and go "Aha, That's me!", and b) These symptoms are often exhibited in response to an unmet need in childhood...a crying out of the inner child, if you will, and c) These childhood needs are all the ones that God has worked on and loved on in me.

And this threw a whole new light on the words of Jesus in Matthew 18. Jesus tells the people that they must come to Him as a child. To me approaching God as a child means coming in innocence, gentleness, humility, fearlessness, honesty, freedom, and wonder. In terms of healing, God wants to do the work. He wants us to come to Him like little children and let Him meet our needs. He wants to fill up the empty places. He wants to be the One who will never abandon us or let us down or reject us. He wants to root us in Him and stabilize us and reveal our true identity. He teaches grace and peace where there was once hostility and bitterness. He teaches us that it's okay to be angry at the things that are unjust, cruel, and just plain ugly. But He shows us fierce love and teaches us to throw over the tables of injustice (Mark 11). And He does it as He does all things, with grace.

God, thanks for being absolutely crazy about we humans, no matter how crazy we are. Thank you for inviting us to come to you as children, and for loving us as Your children. Thank you for the way that You heal our brokenness as simply and sweetly as a mother kissing a boo-boo. Thank you for the way that Your love makes us whole and healthy and well.

And next time, when I experience one aforementioned grown-up throwing a temper tantrum, I will say a little prayer for the little hurting kid inside of him - that God would kiss his wounds and that he would get healed up, that God would turn his world upside down and love him to smithereens.

But, God, if you want me to throw over some tables and lay the smack down, just let me know.

Pacemakers

A physiology lesson: The heart contains these curious little nerve cells which spark the heart's intrinsic electrical conduction system. These cells set the basic heart rate, rhythm, and pace of our heartbeat and are aptly named, pacemaker cells. These pacemaker cells in the heart spontaneously fire, a unique cellular trait called automaticity. When pacemaker cells fire, they spurn an electrical charge to which the rest of our heart nerve cells respond. Cardiologists refer to this response by other heart nerve cells as capture. The nerve cells respond (capture) and electricity courses through the tissue, the heart muscle contracts, fills with blood, and the blood is pumped to the lungs to be oxygenated and to the rest of the body to give life. The blood that flows through us is the life force that carries the oxygen and food that nourish our body and allows us to live and move and breathe. If the pacemaker cells did not spontaneously generate a charge, the heart would not beat, the body would not live. However, because of the automaticity of heart cells, the heart will beat without input from the nervous system. This means that the heart will continue to beat, even outside the body, as long as its cells are alive. I love that, while it is generally understood that pacemaker cells slowly depolarize as ions pass through membrane channels, scientists still don't really understand how exactly pacemaker cells in our heart spontaneously generate an electrical charge. I like to give credit to God for starting the chain reaction that gives us life. I think that the impetus that causes our pacemaker cells to fire is the Godspark in us all...the breath of life.

So basically, the heart according to me:

• God breathes life into us
  
• then pacemaker cells spontaneously fire and send electricity through the heart
• electrical stimulation causes the heart muscle to contract
• heart muscle contraction fills the heart with blood
• blood gets oxygenated in the lungs
• oxygenated blood get ejected from the heart and feeds the body
• the fed and oxygenated body allows us to walk and talk and think and see and smile and create and....love

Sometimes things go awry with our hearts. Sometimes they fail to spontaneously fire. Sometimes they do spontaneously fire but the other nerve cells don't respond, they fail to capture the signal. They don't pick up what the pacemaker cells are putting down. This is called a heart block. When the pacemaker cells stop pacing or when they send out a signal too weak, or there is a heart block, a prosthetic electrical device can be implanted in order to artificially spark the heart. These electrical devices are called....well, pacemakers. They perform the function of the pacemaker cells when they fail to adequately do their job.

Lately I have been in a bit of a funk. I have somewhat isolated myself from my people and have spent a lot of time laying on my bed staring at the ceiling and listening to my own heart. And what does my heart say? Well, the normal "lub-dub, lub-dub, lub-dub" heart sounds speak to me a little differently these days - they say "look-up, look-up, look-up". Interestingly, this is the one thing that I am finding the hardest to do these days and yet, the most essential thing for my well-being. Whether or not I respond, even if I fail to capture His spark, God continues to breathe life into me, to speak to me, to beat my heart to His rhythm which says softly over and over again "Look-up, Look-up, Look-up".

When I look up, I look into God's eyes and see where my help comes from. I see the people specifically placed in my life who are my "pacemakers" when I have a heart block or I fail to capture God's electric lovespark. My world is filled with pacemakers, people who live their life in response to God's lovespark and generously pass it on to others. Thank you, wonderfully loving pacemakers. Thank you for the consistent phone calls. Thank you for not letting me isolate myself and stare at the ceiling too long. Thank you for taking me out for sushi and Thai food. Thank you for asking the tough questions. Thank you for walking slowly beside me as I hobble along. Thank you for not flinching or squirming when I get all weepy. Thank you for hanging in there with me as I wrestle with God and question the ways of this broken, lovely world. Thank you for sitting silently until I am ready to talk. Thank you for listening to me lament. Thank you for praying. Thank you for loving me wherever I am at. Thank you for all the many ways you all nourish my heart. Thank you, my pacemakers, for sparking. Thank you for generating new life.

I am most grateful.