My supervisor, a Unitarian, maintained that “all” Unitarians lived in their heads too much -- were too intellectual and proud of it. So he assigned me to the neurology ward where people had damaged brains, in order to teach me something that remained obscure. I think he was reacting to the knowledge that I had been an animal control officer, which he translated to “dog-catcher.” Actually, that had meant going door-to-door to see what was going on in terms of cruelty, neglect, maladjusted households, and --often -- severely troubled people. Along the way, of course, one bailed loose dogs into the truck and dead cats into a garbage can in the truck. Occasionally, one responded to a real emergency where there was danger even to oneself. The task was to take charge and restore order.
The other supervisors usually started their chaplains out as orderlies, carrying bedpans, giving baths, running errands -- whatever -- on grounds that it gave them a chance to get used to sick people and hospital protocol. They grew used to bodies. But my supervisor maintained that a chaplain was a professional, a person of elevated status and should not be troubled with such lowly tasks.
The supervisor also maintained that we should press people to scour their dark sides, to face the demons that haunt hospital patients, to go for what was deep. The first room visit I made was to a big hearty farm family gathered at the bedside of the matriarch, who was scheduled for surgery. “Would you like a prayer?” I asked. (I was being very un-Unitarian since the more militant humanists among the UU’s refuse to pray and I was feeling proud of my tolerance.)
“Yah, sure,” they said, bowing their heads and folding their hands. I prayed a powerful speech to God about walking with this woman through the Valley of Darkness and keeping an arm around her in this time of danger and need, and so on. At the end the father said, “Geez. This is more serious than I thought!” Everyone looked scared.
It suddenly occurred to me that I didn’t know what kind of surgery the woman was facing. I asked. “Hemorrhoids.” Oh.
Several neurology patients were young men who insisted upon riding motorcycles with the wind in their hair. When their heads hit the pavement, the results were catastrophic in terms of brains IF they lived. One such man’s young wife asked that the chaplain read from the Bible daily and supplied a list of the parts she wanted read. That was fine and I was happy to do it. The young man groped in all directions all the time, trying to get his bearings. He was not in control of his bowels and wore a diaper which he occasionally pulled at, becoming contaminated. If he focused on me enough to realize someone was beside him, he would grab my arm or, taking me by surprise, the lapels of the pastoral jacket I was supposed to wear. It wasn’t much different than dealing with a sick puppy. But I never could quite get the smell out of my jacket until it went through the washing machine. I tried to visit him late in the shift, because otherwise people around me were always lifting their noses up to see what that whiff was coming their way.
I had thought there would be a lot of talk about God in a chaplaincy, but mostly what everyone, especially older folks, wanted to talk about was the resumption of peristalsis so that their bowels would move. It was like being in a Victorian nursery. I acquired a store of jokes and reassuring stories. I also began to worry uneasily about my own bowels.
There was a dignified old black man, slowly dying of a brain tumor and evidently not coherent, whom the nurses wanted me to comfort. I sat by him but he seemed to be comatose or at least asleep. So I sang, responding to my own stereotypes. In a low voice, I sang and I felt better for it.
One day I dropped my notebook to the floor and bent over to get it. “Did it get wet?” the man asked in a clear voice.
I was wary. “Where are we?” I asked.
“Why, on the boat, of course.” After that, I would ask about the boat and fishing. After he got used to me, he asked, “Where’d you get this thing you got about singing?”
I had no answer.
But there was one patient whose brain tumor carried him into religious fervor. He was alert, eager to debate, wanting to tell everyone about the bright white light that came in the night and that was curing him. His brain surgeon was a former Jesuit with a terrible temper. I was told that on one occasion someone offended him so much that he threw a patient’s chart on the floor, across the hall, so that the binding broke open and paper scattered everywhere. Then all the people who were so terrified of this surgeon found out who the real boss was: the head nurse. She stood over him until he picked everything up and reassembled it properly.
The surgeon forbade me to EVER talk to this psychotic man. I was a Unitarian, I would mock him, I didn’t understand the works of God, I would interfere with everything the doctors could do. I was so angry I wept. “I thought I was here to learn. How can I learn anything if you just shut me out? Why can’t you teach me?”
“I have no TIME to teach you! I’m saving people!” This confrontation happened in the lunch room, in front of everyone. I was terrified that he’d fire his cafeteria tray full of food at me.
I did stay away from his patient. People told me many stories about this brain surgeon, how good he was, so skilled and dedicated, how he’d saved people, how he was married and had a dozen kids. But I stayed out of his way. For one thing, my supervisor was terrified of him. I yearned for that Jesuit surgeon to relate to me, I longed for an expert, someone competent and intelligent. But I also wondered what REALLY went on in a man like him.
I was the only one of my class who regularly got up to attend the physician’s reviews and classes at 6AM. I was fascinated by their reasoning, their ways of searching out clues, their renewed theories in the face of threats, their triumphs when they got it right, their deep sorrow when they lost. Sometimes I’d follow up with reading in the medical library on my own time. I read the patient’s charts carefully.
One woman had a cancer that was very painful. She demanded more and more painkiller. She’d go home, then get desperate for more painkiller and check herself back into the hospital. She was taking very strong stuff and though the cancer would be fatal, the doctors didn’t like her getting those drugs. The truth was that they didn’t like her very much at all (neither did her family). Finally they decided to cut her spinal cord. That means no more pain is technically possible.
She still hurt. And she had the worst case of flu ever. The doctor was exasperated. I sat down to read her file, which was inches thick. It would go along and then there’d be a break when she went home. Then it would start anew, go for a while, and when she went home, they bundled it all up, stored it, and started a new file when she came back. Maybe that’s why they missed it. The woman had been thrown into cold turkey withdrawal from a profound addiction. I pointed out the latter to someone. They were not grateful.
I thought that every doctor and every patient, ideally, should have a guardian who could use common sense to review what was happening. Many CPE people think that a chaplain has no justification for doing this, but I’m not so sure. I’ve had friends and parishoners who were diagnosed with something serious and who immediately looked for someone in their lives -- not a spouse or child -- who could act as a translator and ombudsman in a hospital or doctors’ office. I don’t hear the doctor very well when it comes to my own issues so I have to carry a letter into the office with me to make sure I ask what I want to.
Ideally, a chaplain would be an ethical and emotional authority figure equal to the huge power of doctors. The chaplains’ religious concerns would be justice, protection, and the sustenance of hope for both doctors and patients.
On the last day of my CPE, I passed the brain surgeon in the hall. He said, in a friendly voice, “Goodbye, Reverend Scriver. Good luck in your future ministry.” He’d been thinking about me, too. I grinned and waved.