Journal of Sacred Work

Open Forum on Loving Care

    Today, the Journal extends an invitation to readers to respond to the question: Who has provided the best example for you of how to give loving care and how did they demonstrate this?

   Click on "Comment," or scroll down to the space at the end of this note. All you have to enter besides your comment is a name and any email address. You do not need to have a Typepad account. Thank you for participating in this national dialogue on loving care...

Leaving The Comfort Zone

  In October of 1993, after leading the Chicago Bulls to three consecutive world championships in basketball, superstar Michael Jordan (left) made a strange decision. He quit. The reason? He thought it was time for him to try another sport. in the Spring of 1994 he was signed by the minor league Birmingham Barons and played with them for the rest of the season. It was strange to see this wizard on the basketball court look so uneasy on a baseball diamond.
   Career changes are tough. They take us out of our comfort zone and launch us into an unfamiliar world. Able to move easily in work to which we have become accustomed, we may suddenly find ourselves feeling awkward in a new role.
   The transition happens frequently in healthcare. First line nurses who are promoted to leadership roles may feel clumsy as they try out a role for which they may have received no training...

Lightning Raids on the Status Quo

   Sometimes I have this idea that all of us are sorted into two groups: Those that are here to protect the status quo and those that are here to raid it and change it. Most of the population, of course, is in the first category. Otherwise, there would be no such thing as the status quo. If you read the Journal regularly, you know I'm one of those in the small assembly known as change agents.
   We're often not a well-liked group. We make the majority uncomfortable. "Why rock the boat?" The majority moans. The reason for boat-rocking, of course, is that change agents think the boat is sailing the wrong way and, for that matter, that the wood on the boat is rotten.
   By definition, if you're pushing for change, you're always up against the resistance of the majority. But frankly, change agents can't help themselves. By nature, they are destined to seek out a better pathway...

Your Guardian Angel

   Lots of people believe in them. Some will laugh self-consciously when they admit that, yes, they think they've got one. When others scoff, they will defiantly recount specific occasions when their angel has saved them from disaster.
   Catholic churches have more pictures of angels than the Protestant ones I've attended. Across the centuries, these angels have been painted by such great artists as Pietro Da Cortona (1596-1669) who painted the image, above, in 1656. But angels, of course, appeared much earlier, in the Jewish tradition, showing up in the Old Testament. And belief in angles is crucial to the faith of Islam. Muslims believe that angels record each person's actions and take the soul upon death.
   Who are guardian angels? Some believers claim they have actually seen theirs. Others accept that angels are present to them as an energy that they feel.
   It's a nice idea to think of having a guardian angel. I know lots of nurses who wear angel pins on their uniforms. And I've seen plenty of caregivers who seem like guardian angels themselves...

A Pain-Free World?

"Tylenol. It's one more step toward a pain-free world."  - Tylenol commercial

   A pain-free world? It's an interesting goal. And one that America's drug companies have warmly embraced. There's lots of money to be made in selling stuff that relieves pain. After all, other than masochists, who wants to suffer?
   But there's something strange, perhaps even dangerous, about this goal. The notion that we can escape pain may live at the heart of some addictions. We all grow up with some level of desire to fill what some call the God-shaped hole. And the more empty some people feel, the more likely they are to pour alcohol, drugs, sex and gambling into the hole. The movie Mr. Brooks even portrays a serial killer who claims to be addicted to murder...

The Wittiest American

Clothes make the man. Naked people have little or no influence in society.   - Mark Twain

    He's my nominee for the wittiest person in American history. No, it's not Billy Crystal, Eddie Murphy, Lucille Ball or Will Ferrel - all very funny folks. I make my selection not only for his one liners but for the gold that threads through his entire body of work. Clearly, Mark Twain was a genius.
   It's unfortunate that we have no talking films of Twain in action. But we know from all eyewitness accounts that he was an extraordinary performer. He filled concert halls worldwide, making people laugh from Europe to the Orient. And he suffered from chronic depression...

Graveside Humor

   After promising you that I would write each day this week about jokes and joking, I found myself stuck today. It's difficult, especially for a non-comedian like me, to make up humor in a vacuum. Humor is the sort of thing that flows in relationship with others.
   On top of that, I've been feeling sorry for myself for two straight days now. The loving care movement feels like it's moving too slowly. And there are always plenty of other things to feel sad about: Iraq, about which 70% of this country is now both dismayed and angry as well as sad; Darfur, which is a continuous veil of tears and horror; the recent deaths of nine firefighters in a furniture store disaster. There are always tragedies in the world. It's when you're feeling sad yourself that the world's suffering seems even more heart-breaking and life can look hopeless.
   Then, late in the day, I remembered a funny thing that happened many years ago to a friend of mine at, of all things, a funeral...

What's Funny?

Laughter is what proves our humanity. - Garrison Keilor

    So two patients are sharing a hospital room. The first patient says to the second, "What are you in for?" The second patient says, "I'm getting a circumcision." The first patient says, "Darn! I had that done when I was born and I couldn't walk for a year."
   Whether you think this joke is funny depends on everything from culture to language to age to intelligence and even to whether you're male or female.
   There are certain words which some of us find funny, at least in English. One of my favorites is "kumquat." It's hard for me to say this word without laughing...

What Stories Tell Us

   There is a saying in most of the world's cultures that males are raised to tell stories. This doesn't mean that men are better story-tellers. It simply suggests that story telling - joke telling in particular - is, for many, part of being raised male. 
   I've wondered why this is true (if it is) and have concluded that part of the reason is competition. If I tell a joke to a mixed group, one of the males is sure to follow it with, "Well have you heard the one about..." And this is intended to set off a can-you-top-this pattern of exchanges.
   My dad was the story-teller in my family. My mother would read to us as children. But my dad would make up his own stories. The same was true with my mother's father. Why does this matter?...

Jokes & Joking

I would not want to belong to a club that would have someone like me as a member.  - Groucho Marx (left, with sidekick George Fenneman)

    Woody Allen liked Groucho's line so much that he used it as the opening to his classic film, Annie Hall. Jokes are one of our pathways to laughter. And laughter, according to all the experts, is great medicine. Norman Cousins was one of many to prove this when he literally laughed his way out of a terminal illness in the 1980s. He wrote a marvelous book about it, called Anatomy of an Illness, in which he chronicles how he watched funny movies every day and had people tell him jokes. In a matter of months, his incurable illness had left his body.
   Laughter eases the pressures of our lives. In the midst of laughter, the world is bright and our worries, at least for a moment, retreat... 

To See "Feelingly"

[Note: The following meditation is by Catherine Self, Senior Vice President of the Baptist Healing Trust]   

“And now here is my secret, a very simple secret: It is only with the heart that one can see rightly; what is essential is invisible to the eye.”                         -from The Little Prince, by Antoine de Saint-Exupéry

   Many of you have seen this intriguing and compelling quote in the Journal before. The idea of seeing with the heart is at the core of radical loving care. Yet a story is currently circulating around the world about eyes and hearts that were completely blind to the desperate medical needs of another (see http://www.msnbc.msn.com/id/19207050/from/ET/ ). That it happened at the hands of medical professionals in unconscionable. How could such blindness occur?...

Synchrony

The genius of our country is improvisation, and jazz reflects that. It our great contribution to the arts. 
- Ken Burns

    They are the magic moments in our lives. They are the times when every bit of our best energy seems aligned with the world's best energy. Light and heat flow through us. The words used to describe this feeling never do it justice: euphoria, flow, the zone, ecstasy. None of these touch the essence of this all too evanescent feeling.
   But there is one quasi word that at least signals the nature of this phenomenon. It is synchrony. We speak of feeling synchronized, or even "in sync."  And when we use this language we are invariably talking about alignment. Mechanical gears only work when they are synchronized. Teams only succeed in emergencies when they are in sync... 

Improvisation's "Random" Genius

When the sun is shining, as it is today, I'm in love.  - Paul McCartney

   An article in the June 4 New Yorker magazine seeks to chronicle the life of the 20th century's greatest pop musician. "Paul McCartney then and now" is the essay's subtitle. What emerges in the story is an account of a genius willing to trust his instincts. Among the many ironies in the life of this complex soul is that McCartney can neither read nor write music. Neither could his partner, John Lennon. Yet McCartney has nevertheless pursued a rigorous discipline that has enabled him to send his gift for improvising into our ears.
   The randomly awarded potentials of caregivers also need discipline in order to flower...

Spontaneous Living

Analysis kills spontaneity. The grain once ground into flour springs and germinates no more.
-Henri Frederic Amiel   
(Image, below, Age of Spontaneity, 2003, by Gregory Scott)

   A week devoted to improvisation and his sister, spontaneity, asks questions of courage.  Theoretically, planning reduces the chance for failure. But it has been my experience that slavish adherence to set plans can be the cause of enormous failure. Some would argue that is why America is having difficulty in Iraq. Stubborn adherence to an original plan for military success may have blocked our country from adapting more wisely to the cultural reality and deep civil strife we found after initial victories.
   Improvisation, as any performer knows, requires deep preparation as well as courage. Knowing how best to handle a medical or emotional emergency, requires that we prepare our minds and hearts...

Improvisation & Ego

   Strength lies in improvisation. All the decisive blows are struck left-handed.
     -Walter Benjamin

   We think that planning plays some part in our lives. But all plans are illusions. Every plan is subject to change at the last moment. No plan is so powerful as to survive, exactly in tact, the realities of life. Some of the great 20th century artists, like Wassily Kandinsky (1866-1944) attempted to create paintings devoid of any preparation (see Kandinsky's Improvisation #23 at left.) At first, they were ridiculed. But certain truths emerged from their work including the notion that great art could be a spontaneous creation.
   One kind of truth emerged when people attempted to interpret abstract art using traditional standards. "What the devil is that?" a conventional viewer would complain when confronted with what looked like random blobs of paint. And many may still wonder at the whole notion of art that is created purely in response to the moment's emotion. Abstract art may not be planned, but it requires preparation nevertheless. Improvisation turns out to be so important (and so under-appreciated) that is the subject of each of this week's essays...
   Isn't improvisation something all of us do all the time? Aren't caregivers called to improvise many times across any day?...      

The Benefit of the Doubt

[Note: Today's meditation was authored by Catherine Self, Sr. Vice President of the Baptist HealingTrust.]

Dr. Scott Diering is an emergency medicine physician currently living and working in Maryland. He is a husband and father and author of the book Love Your Patients! In his book, Dr. Diering describes how you know when you have “arrived” as a loving caregiver – “You are a truly loving caregiver…when you defend your patients from criticisms of other caregivers. You have arrived when you give your patients the benefit of the doubt.   
   Dr. Diering’s words cause me to reflect on how often I give others the benefit of the doubt, whether a patient, a physician, a co-worker, a family member or even a stranger.,,

Anniversary Time

   The Journal of Sacred Work was launched exactly one year ago today. Our goal at the time was to create meditations for caregivers and a forum for caregivers to communicate with each other.
   The numbers suggest some success. Since it began, this site has received well over 40,000 "hits."  Interestingly, 15% of those who visit the Journal are from outside the United States.
   This is the 320th article. A new essay appears before you almost every day.
   Importantly, there have been 1294 comments posted to this weblog. This means so much to us. To write often means sending your words into the air never knowing if anyone has seen them. Those of you who have been kind enough to comment have helped to keep the energy of this effort alive. Special thanks to regular posters Liz Wessel, Karen York, Diana Gallaher, Jan Keeling and Dr. Tom Knowles-Bagwell....

A Psalm of Joy

   The language of the Bible is often meant to comfort and praise as well as to instruct. When King David wrote the first group of Psalms, his wish, in many cases, was to sing praises to God. Some of the psalms may well have been sung to instrumental accompaniment. The point was to raise a joyful noise so that the highest power might hear and be pleased.
   In reading the Bible, some believe it is important to hold as close as possible to the most precise translation that can be found. Anyone who studies the Bible, as I did in Divinity School, learns quickly that there are many different versions interpreting the original language. Among them are translations of elegance...  .

Love & Memory "Away From Her"

Vitamins didn’t help. She would stand in doorways trying to figure out where she was going. She forgot to turn on the burner under the vegetables or put water in the coffeemaker.   
-from The Bear Came Over the Mountain, by Alice Munroe (photo at left)

   The story quoted above, and the astonishing gem of a film derived from it, "Away From Her" (now in theaters), are spiritual experiences for anyone with an open heart. The story of a woman descending into Alzheimer's is never limited to the individual, but always engages a kaleidescope of others. And that is the fascination that makes this film a masterpiece.
   The saddest thing about this brilliant movie is that so few people are likely to see it. And yet every caregiver needs to. If you check the popular movie website, Rotten Tomatoes, you will find that it has received a stunning 95% rating meaning that percent of the nation's reviewers have given it a top rating. Among the biggest papers, the total rating is 100% positive. Why do the critics love this film?...

A Time for Revolution?

"Many [healthcare executives] simply don't want to face up to the reality of the patient experience in their facilities." - Chuck Lauer, former publisher, Modern Healthcare

    During his many years as publisher of Modern Healthcare, Chuck Lauer (see photo) provided a positive voice in the hospital world. His voice is still strong through his weekly column in this influential magazine. In an editorial in the May 28 issue, however, you could feel his frustration with hospitals leaking through.   
   "Lately, the only comments I have heard from people treated in hospitals are negative," he wrote. "Providers tell me that the "patient is our customer," and then when I talk to people who have been patients in those hospitals they regale me with horror stories..."