Unitarian Universalist Church of Palo Alto

Another Country

I am a Unitarian Universalist minister whose ministry is hospital chaplaincy. This often takes me into spiritual territory that is not my home.

I remember my first unit of Clinical Pastoral Education. This is, for many seminarians, the trial by fire known as “CPE.” Most seminaries require their students who are preparing for parish ministry to spend three months working and being educated as a chaplain, most often in a hospital, though there are other options, such as ministry to homeless people or people in prison. I did my required unit of CPE at St. Mary’s Medical Center in San Francisco in the summer of 1991, following my first year of seminary. One of my greatest fears, perhaps even greater than the fear of being paged for a death in the middle of the night while on call, was being asked to pray. And sure enough, just as I am the one whose lap is chosen by big, furry, allergy-inducing cats whose homes I visit, the requests for my prayer-evoking services came rolling in. Sometimes I could use the Lord’s Prayer or the 23rd Psalm or the rosary, something that I could read or recite. But at 9:30 one night I was called to pray with a man — I’ll call him Tom — who was alone and afraid because he was having heart surgery the next morning. And I knew Tom needed a deeply personal and heartfelt prayer. I don’t remember what I said, but I do remember that my words seemed clumsy and halting, and I left fearing that I had done more harm than good.

I have since learned a great deal about the art of spontaneity, about assessing a patient’s or family’s spiritual needs within minutes, if not seconds, and tailoring my ministry to their beliefs and hopes and fears. Sometimes this includes prayer and, just as I opened this sermon with a prayer that I hope was meaningful to you, my prayer will be very different depending upon the person for whom I am providing spiritual care. For instance, I would be highly unlikely to evoke Jesus’ name in prayer within this community, but when I pray with a Baptist patient, I understand that the prayer will probably not be considered a true prayer if it is not closed in Jesus’ name. I try to meet patients and families where they are rather than where I would like them to be, within my comfort zone. I try to address their spiritual needs in a manner that speaks to their spirit, whether they are Jewish, Muslim, fundamentalist Christian or atheist. So I have developed some pastoral skills within the past 15 years. And yet, what I did for Tom back when I was beginning to learn how to be a chaplain is essentially what I would do for him now: share his fear, speak words of hope, be with him — one powerless human being with another, evoking power through connection, as any of us would try to do for one another.

Skills you can learn; to find compassion you must dive deep within yourself and find who you are in the darkness, then bring that awareness to your interactions with others as they encounter their own deep, dark places. In CPE, learning to provide spiritual care to patients and their families is only part of the package — and it’s actually the easy part. The other piece of it — the piece that evokes such dread from many students — is the self-disclosure and self-discovery that is required to fully benefit from the program. In addition to visiting patients, CPE students spend a good deal of time in peer group and with their supervisors as well as in solitude, writing reflection papers and self-evaluations and verbatims. The verbatim is an intense analysis of a patient visit in which the student writes out as closely to word-for-word as memory allows (hence, the term “verbatim”) a conversation she or he has had with a patient or family member. Then the student assesses the person’s spiritual needs, how well the student addressed those needs, and what the encounter evoked in the student. Students present verbatims to a group of their peers and supervisors, often bringing to light issues that have been deeply hidden from others and themselves: prejudice, fear, trauma, grief, rage. It requires a lot of courage to see yourself as others see you. The other intense group process is the Interpersonal Relations Group or Covenant Group, for which there is no agenda but honest engagement with one another and which also requires a tremendous amount of risk-taking and vulnerability if one is to grow into a better minister and a more whole person.

When I finished my three-month CPE stint back in 1991, I never expected to go through that again. I had fulfilled my requirement; I was headed back to seminary and looking forward to becoming a parish minister. I had it all planned out. And aren’t we fortunate that we can give ourselves the sense of security that comes with calendars and budgets and meticulous preparation, allowing us to keep at bay the dim knowledge that there may be a monster under the bed or just around that dark corner up ahead. Monsters that come in all sizes. I tripped over several little ones when I walked out of the doors of Starr King School for the Ministry following graduation and found no church waiting for me with open arms. So I got a job as an office manager for an acoustical consulting firm and did various part-time ministries.

But then I walked right into the arms of one whopper of a monster. I got up one morning to get ready for work and immediately felt as if I had a plastic bag over my head. I was breathing in and out, but nothing was registering. Then I felt terribly nauseated and thought I was going to pass out. So I laid on the floor for awhile until I was able to get back into bed. I thought I had some awful flu bug and called in sick from work. Well, after gasping for air and blacking out several times over the next 24 hours, I finally decided I’d better call someone. So a couple of friends came over and by the time I had crawled to the door and managed to reach up and unlock it, I heard the ambulance siren outside the house. When I got to the emergency room, I thought they must be having a really slow day because there were doctors and nurses all over me. I had pulmonary emboli, bunches of blood clots in both lungs. They did all kinds of tests and scans and a clot-busting procedure known as TPA, which they also use with people who have had strokes. That procedure is probably responsible for the quality of life I enjoy today, but it had a more immediate downside. As a result of being so anticoagulated, the blood pressure cuff they used in the ICU caused my left arm — from several inches below the shoulder to the tips of my fingers — to swell up and turn black. There was talk of amputation, but I dodged that bullet. But I could not avoid the months of deep physical pain as my arm healed, nor could I avoid the deep emotional and spiritual pain of having come so close to death. I wanted to live my life more fully, celebrate my gift of rebirth, but I could not. I was consumed by fear. I clung to my unfulfilling office job and as the months and then the years passed, I felt my spirit dying. Finally, I found the bottom and pushed back up toward the surface. My focus as a minister was no longer in the church, it was clearly in the hospital, where I had experienced such fear and pain and vulnerability and such hope and relief and gratitude for my life.

Aren’t we fortunate that our carefully-laid plans sometimes get out of our way in spite of ourselves and allow us to find life right where we weren’t looking for it? And isn’t it exciting when we discover that we can befriend our monsters and see them for what they are: vital parts of ourselves. I went back to CPE and entered a year-long chaplaincy residency at California Pacific Medical Center in San Francisco, making plans (plans again) to become a hospital chaplain. Yet I found the personal and professional challenges of CPE to be so transformative that I decided to become a CPE supervisor, teaching students and ministers to be chaplains and encouraging them to connect more deeply with themselves through their engagement with others.

And now I’m doing both, because in addition to being a CPE supervisor-in-training at the Palo Alto VA Hospital, I am also a chaplain on the hospice unit, where I provide spiritual care to people who are in the process of dying. I’m often asked, “How can you do such depressing work?” Actually, the hospice unit is one of the most life-filled places I’ve ever been. Our purpose is to help people live the rest of their lives fully, not just to take care of them while they wait to die. People who are dying are still living; they have hopes and dreams and goals. Those hopes and dreams and goals are different than they were when these people were well, but there’s that monster around the corner again. Our goals change because our lives change. We don’t have power over many of the changes in our lives, but we can tap the power of the spirit within each of us, even when our bodies and minds are weakening and fading away.

Most of us die as we have lived, for better or for worse. And sometimes, in the process of dying, people take the opportunity to fully embrace their lives, to make changes and open their spirits to hope and love. These people are often able to experience what we call a “good death.” One of the first patients I met on the VA hospice unit was a World War II vet I’ll call Dave. He had been divorced twice and had children from both marriages. During his dying process he reconciled with his older son from whom he had become estranged. He grieved the loss of watching his youngest son grow into a man. Three days before he died, his ex-wife sat at his bedside, just the two of them, and they expressed their love for each other and talked about their life together and apart. Later she told me that he did something in that time together that he had never been able to do before. He told her that he was no longer afraid of death, that he genuinely believed that something very good was awaiting him. Dave changed his life; he accomplished the goals he set for himself at the end of his life, to reconcile himself with his family and with his death. He gave himself, his family and the staff of the hospice unit, myself included, the gift of his enormous spirit. Dave had a good death.

In beginning this sermon, I said that as a chaplain I often enter spiritual territory that is not my home. Maybe it would be more accurate to say that my spiritual home is growing larger as I share in the lives of so many people with such a diversity of experiences and thoughts and feelings and beliefs. I enter the land of the dying and the dead. I share in the lives of students who come with various faith practices and spiritual beliefs and who leave often with new insights that reshape and reform their beliefs. I talk and pray with homeless veterans who come into my office, often seeking the free meal tickets given out by Chaplain Services.

I am a Unitarian Universalist minister whose ministry is hospital chaplaincy at the Veterans’ Administration, and this is not only new territory, this is another country altogether. We live in the United States of America, and yet their country is so different from mine. Naive boys who went off to Vietnam with their lives ahead of them are now aging men who have to beg for free food from the government they were called to serve, from people like me who have never been in a foxhole or seen a bomb explode or killed another human being or held a dying brother soaked in blood.

In January I attended a weeklong seminar on post-traumatic stress disorder (PTSD), a mental and emotional condition which many veterans of war suffer. At the VA hospital in Menlo Park, there are comprehensive PTSD programs for both men and women. Many of the women are survivors of rape by military officers. And the men have been in battle of another sort. I had the privilege of sitting in on some support groups these men participate in. One evening, I sat next to a young man I would guess to be in his early 20’s, fresh from Iraq. And I thought, “You’re safe now. You’re going to be okay.” It was not until later that I realized that he was still on active duty, that they would fix him up and ship him back. I was horrified and saddened. Then it occurred to me that he might actually want to go back. One thing I have learned about many of the men who have fought in war is that they are willing to die, not for the concept of freedom, not for their government or for their country or for you or for me, but for their brothers and sisters, their comrades in arms. They’ve got each others’ backs.

We all serve our country in our own way. It is our privilege to live in this beautiful part of the world where, in spite of the failings and problems of the United States, we truly do enjoy great freedom. We express our gratitude for that freedom by using it to make not only the country in which we live, but the world in which we live, a better place for all of us. Some of us do this by enlisting in the military; some of us do it by protesting our country’s military presence in Iraq. What we all have in common is the moral imperative that we serve our country as our consciences inform us.

When I lead a worship service at the VA, there is an expectation that I pray, and that I include in my prayer all those who have “made the ultimate sacrifice.” Now, my politics may be vastly different from the politics of others attending that service, and then again, they may not, but there is one point on which we all agree. Regardless of our convictions about war, those who have given up their freedom, their very lives, in war deserve our respect. And if they’ve made it home alive and need some help, it is their right to receive it. To “sacrifice” means to “render sacred.” It’s not war that is sacred, it is life, the quality of life. And it is my prayer that we render life sacred, that we have each others’ backs, not just among the citizens of the United States of America, but in our relationships with the citizens of Iraq and Afghanistan and Vietnam and Korea and Germany and Japan and throughout the world.

I am a community minister. With the spiritual support of this congregation, each day I enter another country. Each day I represent UUCPA and the Unitarian Universalist Association in the spirit of peace and hope. Sometimes I think it would be far easier to work in a hospital where I don’t encounter around every corner a reminder of my own opposition to war. As a person with strong liberal politics and spirituality working for the government in an institution that holds a strongly conservative view of patriotism, I often come up against my own aversion to being offended. On my part, this requires openness to diversity of a sort that I often overlook. As Unitarian Universalists, we have become accustomed to looking at our limitations and shortcomings regarding ethnicity, culture, sexual orientation, disability, ecology. But when it comes to our passionately held beliefs, how do we hold ourselves in community with those whose passionately held beliefs are in opposition to our own? It would be far easier for me to judge the immorality of war at a safe distance rather than face-to-face with real flesh-and-blood people with whom I create relationships each day. But I am a chaplain at the VA, and I choose to live with the questions and the discomfort because they connect me with these veterans who have such profound questions and discomforts of their own. And I hope it’s all right with you if I bring you all with me in spirit when I enter this territory, this other country, and work to help our spiritual home grow larger and more whole.