Journal of Sacred Work

Out of Loneliness

Who, if I cried out, would hear me among the angels' hierarchies?
   -Opening to the Duino Elegies - Rainer Marie Rilke - (1875-1926) 

What do you seek here? Is it comfort? If so, I offer you all the comfort I can from the cool illumination of this page along with this news: you are loved.

If you seek comfort, I invite you to listen to your breathing, to be present to the air that warms as your body draws it in, holds it, exhales. Breathe in rest. Breathe in comfort

If you seek beauty here, I invite you to look around - to use your sacred eyes and ears...

True Charity

"Nonprofit Status Scrutiny:
Is your hospital prepared?" - HealthLeaders Magazine

   The above headline appears as both a warning and an invitation in HealthLeaders Magazine. The warning is clear. Non-profit organizations - especially hospitals - are under fire from Congress and the IRS. The invitation is equally clear. The magazine is sponsoring a webscast December 14 to offer help in dealing with the impending threat to that nonprofits may lose their tax exemption.
   Some of us, including many veteran hospital leaders, might say that it's about time that non-profit hospitals faced-up to their responsibility to be true charities. Excessive preoccupation by many charity leaders with bottom-line performance, branding strategies, and retail style "customer service" programs has continued to blur the line between for profit and non-profit hospitals...

The Placebo CAUSE - The Impact of the Invisible in Care Giving

   

The physician should speak of that which is invisible...he becomes a physician only when he knows that which is unnamed, invisible, and immaterial, yet has its effect.  - Paracelsus (1493-1541)

   Born the year after Columbus discovered America, Paracelsus may have discovered something far more important than a country. He may have been the first to fully appreciate the role of the unchartered land of the invisible in the treatment of human illness. Unfortunately, much of contemporary medicine is delivered with little or no appreciation for Paracelsus' wise insight. 
   Sometimes, a physician must become a patient to discover something with which he or she may have lost touch. Illness lays bare so many invisible pains not touched by typical medicines. When doctors become patients, they discover that words like "placebo" which they may have disdained are actually quite powerful.
   It is this phenomenon which causes me to wonder that since there is a Placebo Effect, what about something we might call The Placebo Causes - invisible or seemingly benign events which may provoke illness...

After Thanksgiving

When you see injustice, give love. 
-Erie Chapman

   So often the world makes no sense. After a period of thanksgiving, rest, and freedom from want, we return to discover a world where injustice is far too common.
   Too many people suffer needlessly. Patients that should live, die. Those who should have enough money have too little. Patients in desperate need of organ transplants are too often denied insurance coverage and some of the critical health care they require. A child's emergency may be a nurse's everyday work. And there are other kinds of injustice.
   When inequity falls on the shoulders of anyone, it hurts everyone who cares.
      In the corner of an Emergency Department waiting room, a forty-year-old African-American mother of four waits for the care she needs. Her breaths are labored. She emits groans. She weighs nearly three hundred pounds. Like the woman in the image (below,) she wears the universal face of suffering. The admitting clerk glances at her and turns away in disgust...

Love's True Voice

36 Jesus answered, "My kingdom is not from this world...37...Everyone who belongs to the truth listens to my voice.
John 18:36,37

   Hard as it is to live truth, it may be even harder to live love. Is there a difference between living truth and living love? The answer can seem confusing.
   Imagine you are an Auschwitz prisoner in 1944 - something perhaps impossible to contemplate but powerful as an illustration of the most dire circumstances. You watch as a starving fellow prisoner steals a piece of bread while a guard's back is turned. The guard whirls, aims a gun at the prisoner and shouts at you, "did you see #10489 steal some bread?" The truth is that you did. Should you tell the truth when you know the guard will beat your fellow prisoner? Or should you tell a truth that comes from God, a truth which tells you that love calls for compassion...   

Secret Thanks

Secret Thanks

We never speak our deepest gratitude because it cannot be spoken.

Instead, as you sit around the table amid the chatter & the candles & the sweet potatoes that exhale their aroma the way fog rises from a slumbering pond, there will be a time of thanksgiving when you will write, on the hidden walls of your heart, in the space between the scars, secret letters.

And no one will know that you are giving thanks:

to the teacher that winked at you in the third grade signaling from her powerful throne that you were magic;...

Caring Relationships

    Teams where members care for each other and look after each other are more productive than teams where each person is an island.  - Erie Chapman

   The well-known painting (left) by Norman Rockwell of a family gathering at Thanksgiving is called, "Freedom from Want." It was painted in 1944 as part of an effort to communicate to Americans some of what we were fighting for in World War II. The message suggests that we want more from life than food. We want the fellowship and warmth symbolized by sharing in companionship with others.
   A recent news item reports results of a study suggesting that children living in homes where the family does not sit down to have dinner are twice as likely to smoke and get involved with alcohol and drugs as families who gather around the dinner table on most evenings. How could the old family ritual of eating together have an impact on the drug use habits of children? Could it be that children missing the companionship of family seek to fill the hole in their hearts with substances that will help them feel better for a few moments? Could it be they are seeking the attention they missed at the dinner table?...

Love's Outcomes

   You can give medicine without compassion and still help someone feel better. But you can't give medicine compassionately without feeling better yourself. - Erie Chapman

   In the business and science-based world of modern health care, the person who raises the subject of love may be looked at with skeptical eyes. What does love have to do with profits? What does love have to do with curing disease?
   The odd thing about these questions is that if you ask business and science people to name anything more important than love they can't do it. If love is so important, why do we view discussions of it as awkward in settings where care giving is essential?...

Sunday Reflection: Faith-based Leadership

Then Jesus began to say to them, "Beware that no one leads you astray." - Mark 13:5

   The leader of a faith-based hospital rises to address the annual meeting of the hospital medical staff. He begins with some well-designed joking then turns to the more serious part of his report. The hospital has experienced a strong quarter financially, he says. He offers Power Point slides as proof. This is good news. He goes on to compare how well the system is doing compared to a competitor who is a for profit organization. Okay, but when will he talk about the mission that distinguishes a faith-based charity from a publicly-traded company? Next, the CEO talks about marketing and branding after which he concludes his report to polite applause.
   Where were the words about caring? What about clinical performance? What about staff morale? What about the heart of an organization that wears a large cross on the outside of he building?...

The Art of the Apology

A stiff apology is a second insult.... The injured party does not want to be compensated because he has been wronged; he wants to be healed because he has been hurt.   -G.K. Chesterton

   A patient with an especially acute migraine headache lies writhing in pain in her hospital bed. She pushed the call button half an hour ago and the nurse has still not arrived with her scheduled pain medication. Finally, the nurse charges through the door. "I'm sorry I'm late," she says with irritation, "but you have to understand that we're short-staffed tonight."
   The "I'm sorry, but..." apology is no apology at all. As Chesterton says, most people injured by a mistake feel hurt and want to be healed. They seek healing from the disrespect implied by the hurt. Excuses compound the hurt.
   So what could the nurse have said that would be more caring and healing?... 

A Good Loneliness

The awareness of loneliness might be a gift we must protect...because our loneliness reveals to us an inner emptiness that can be destructive when misunderstood, but filled with promise for him [or her] who can tolerate its sweet pain.  - from The Wounded Healer by Henri Nouwen

   It was autumn, 1997. Fortune had smiled on me. Although I was out of a job because of the sale of the health care company I had helped run, we had plenty of money. There was only one problem. I wasn't going to work any more.
   Our wonderful children were grown and on their own. My terrific wife was happy in her work writing a weekly column for a major newspaper. I wasn't needed any longer - either as a bread winner or as a father.
   Day after day, I stared out the window trying to enjoy this unfamiliar freedom. Without the stimulation of work, I found myself in the midst of a profound loneliness. Soon, this loneliness got a name...

The Astonishing Energy of Flow

   We can access incredible energy, as occurs with the Flow phenomenon, if we work hard, stay focused, stay committed, and have the wisdom to know when to let go and let Love takeover.
-Erie Chapman

   Sometimes, seemingly from nowhere, an astonishing kind of energy will arrive in our lives. Things we thought would always require hard struggle suddenly (and all to briefly) become easy for us. The phenomenon, dubbed "Flow" by a famous psychologist with a complex name Mihaly Csikszentmihalyi, typically occurs after we've been struggling for a long time to master something important to us.
   Athletes call the experience "being in the zone." But I have heard caregivers use similar terminology in their work. A gifted surgeon may say the he or she entered the zone in the middle of a complex surgery. Suddenly, a challenging surgery becomes easy and the doctor discovers all of his or her skills and gifts coming together in perfect harmony.  Another caregiver may notice the same thing in the course of looking after a difficult patient. As they find themselves fighting to control the problem before them, they suddenly experience a serenity that enables them to make all the right moves with complete grace...

Presence to Magic

It's not whether magic happens or not. It's whether we notice its occurrence. To be fully present is to be fully alive to ourselves and to others. It is in this presence that the magic of love appears.       - Erie Chapman

   My colleague, Cathy Self, told me recently that she happened to notice an autumn leaf at the exact moment it separated from the tree that bore it. "I'm not sure I've ever really seen that moment before." Karen York shared that she noticed for the first time this autumn the way leaves stain cement like "ghosts of themselves who have left their imprint." She even had the sensitivity to photograph what she saw (click on her photo to enlarge) and to email it to me. She is a person open to the magic around her - to seeing in new ways life becomes visible by her willingness to be present.
   The question is not whether magic occurs, but whether we, as caregivers, notice its daily occurence in our world and appreciate it into our lives...

Sunday Meditation - Why Love is What Matters

¹Unless the Lord builds the house, those who build it labor in vain. Unless the Lord guards the city, the guard keeps watch in vain. - Psalm 127

     A female enters the Matthew Walker Clinic seeking care. Diagnosis? She is pregnant. But the medical diagnosis does not begin to touch the human tragedy. The pregnant female is twelve years old.* As if this fact isn't sad enough, it turns out that the father of her baby is her father.
   Fortunately, the girl is placed in the care of a loving caregiver - Dr. Michele Williams. Dr. Williams offers more than medical treatment for she knows that this girl hurts in many ways beyond the physical. Unless Love is engaged in the care of this patient, those who treat her will, like the Psalmist says, labor in vain. Unless this girl is surrounded with love, there will be no healing...

How Healer's Heal - Letting Go of Ego

If only we would let ourselves be conquered,
as things are overcome by a great storm,
we would expand in space and need no names.
-Rilke
   A Radiology transporter reaches out to touch the arm of a patient in pain. "Is there anything I can do for you?" she asks. But the patient has already received something apparently remarkable. "The moment the transporter touched me I began to feel better," the patient said later.  A housekeeper hears a delirious old man calling out for his daughter. She puts down her mop, walks into the room, and holds his hand. Almost immediately, he calms down and falls off to sleep. A nurse strokes the back of a tiny baby and energy moves through her to him. In none of these cases were any drugs administered. What happened?...

The Quilt of Change

    Organizational change and personal change require the recognition that we are all sewn together as if we were quilts. Culture determines change. - Erie Chapman

   A year ago something strange happened in my life. After four decades of marriage, my wife couldn't take it anymore. The "it" she couldn't take was (fortunately) not me, but my closet. We're fortunate enough to have separate ones, but the mess in mine had gotten too much for her. She hired a woman to reorganize the space from stem to stern.
   When I arrived home, she stood back and awaited what she assumed would be my shout of joy to see my closet so beautifully organized. It was, I must admit, an amazing sight. Two drawers contained those plastic dividers that look like French windows without the glass. Inside each diamond-shaped space, a pair of socks was folded neatly.  Shirts were soldiers lined up for review. Pants hung respectful distances from each other. I could go on, but you can see the picture. The place looked to me more like a store than my closet. The room had been transformed. But had I changed?...

Love's Arc

Loving leaders are called to weave together the dreams of many into a tapestry so marvelous it brightens the arc of love's rainbow.  - Erie Chapman

   We carry within each of us many bright and wonderful dreams. Too often, these dreams lie dormant because we are afraid.  The role of loving leaders is to be weavers. The leader need not dream alone. He or she has the opportunity to unify many different dreams.
   Martin Luther King, Jr. did not think up the idea of integrating the south. He listened to the dreams of others and crafted  a strategy and a message of such eloquence that millions could say: "Yes, he is speaking for me and I want to join with this cause!"   
    This is what every great leader does. And it may be what you are called to do at this moment in the history of caregiving. As Nobel Prize Winner Nelson Mandela (left) said so well, "Your playing small does not serve the world...We were born to make manifest the glory of God that is within us. It is not just some of us. It is everyone."...

The Music of Grace

   When staff feels called to meet the unusual needs of patients they are living out radical loving care.
-Erie Chapman

 The story is told at America's premier Healing Hospital, Parrish Medical Center in Titusville, Florida. A patient was dying. His last request was that someone come sing to him one of the world's favorite hymns - Amazing Grace. But who would sing to him? Word of the dying man's request sped around the hospital until it landed in the ears of a member of the environmental services team. Within minutes, the housekeeper appeared to sing at the dying man's side and the words to the immortal tune filled the room.
   The patient did not pass away that day. So each morning, for five mornings, the housekeeper reappeared to spread his rich-voiced rendering of the song across the departing spirit of this patient. On the fifth morning, as the housekeeper reached the final verse, the patient passed away.
   Did the housekeeper offer the music of grace because he was paid? Of course not. Did he sing because this was part of his job description? Again, the answer is no. In a Healing Hospital like Parrish, stories like this are common...

To Whom Do You Report?

²⁹Jesus answered, “The first is, ‘Hear, O Israel: the Lord our God, the Lord is one; ³⁰you shall love the Lord your God with all your heart, and with all your soul, and with all your mind, and with all your strength.’ ³¹The second is this, ‘You shall love your neighbor as yourself.’ There is no other commandment greater than these.” Mark 12:30-31 (emphasis added)

  Caregivers typically work in highly structured settings. Hospitals and many large charities have clearly defined hierarchies. When caregivers are asked, "Whom do you report to?" they often respond with words like, "My manager, my supervisor, my director, a vice president."
   Is there a better response? I got some guidance on this from a very unlikely source...

The Atomic Power of Team Energy

Teams and organizations are powerful fields of energy.   
- Erie Chapman

   Your team has an impact on you that is positive or negative but rarely neutral. Similarly, your team can have a powerful impact on the people they care for if they develop a group focus that engages Love's energy. Entire health care organizations create energy fields that are healing or not, depending upon the nature of the energy circling within them.
    We know about the enormous, even atomic power of groups through stories. What I mean by atomic power is the ability of a group of people to generate forces so powerful that they can save lives simply by the attitude a the circle of people takes towards someone in need. Their energy becomes atomic because it is exponentially so much greater than the power of any one member and so much stronger than a group that has no vision. Consider the atomic power of Mother Theresa's small circle of nuns on caring for the poorest of the poor in India. Reflect on the ability of the relatively small Southern Christian Leadership Conference (SCLC) to implement wholesale changes in desegregating the South in the 1950s and '60s.
   Consider the case of a former prostitute and drug addict named Katrina and how she was saved by an organization in Nashville named after St. Mary Magdalene (see painting, above, left, by Titian - 1531) ...