Odd bits and pieces

I have not written in some time, largely because things at work have been busy and I have been tired, and so a lot of bits and pieces of stories are stuck in the bits and pieces of my mind. I've lost a bunch of weight due to modifying my diet for blood pressure reasons, and I like that! My foot is just about totally better--I can walk my big dogs in regular shoes with just a little soreness and no pain, and I really like that!!!

We have had rough times at work with very, very sick patients accompanied by very, very stressed families. Some time ago we had a run of patients with liver failure, often involving alcohol consumption. We've also had some patients with cancers that kind of putter along for awhile and then flare up like wildfires overnight. Patients of both types can seem to be doing pretty well for some time and then crash, and families often are just so shocked they can't keep up. "She was fine two weeks ago," they will say, looking at us in disbelief as we begin the process of what is charted as "teaching re: dying process." Sometimes family members become angry and accusative because they cannot, really cannot believe their relative's position is going so very far south so very rapidly. They insist that the staff is overmedicating or underfeeding or any number of other things. They believe that there HAS to be a way to make their relative comfortable but still awake, alert, oriented, and able to relate. The bad stuff is just too bad and coming too fast for them to cope. Thank heavens for our wonderful physicians who are excellent at talking to families and explaining what is going on. Sometimes the families don't believe anyone except the doctor. Sometimes they don't believe the doctor either...

One thing that anyone doing hospice work learns fast is that old communication patterns, old relational patterns do not change just because someone in a family is dying. It's not like TV, where suddenly every member of a family is called to be their very best, and to behave in ways they have never behaved before, so that Complete Healing happens. Rather, people and families can be profoundly stressed by a terminal illness and impending death, and react in the ways that are most familiar to them. If a family has never "done" direct communication, that's in most cases not going to start now. If a family has been a welter of conflict since its inception, through multiple generations, that's in most cases going to continue. If a family has reacted to stress by manufacturing chaos, then an impending death is likely going to result in chaos. And, if a family system's preferred reaction is to create chaos, then that system will fairly predictably blow up when supporting institutions are least prepared to respond--that is, nights and weekends. Thus, the job of on-call chaplain for nights and weekends can be very interesting indeed.

To be sure, some families make some astounding changes when a member is dying. I have been tremendously moved--for instance, by a son long in conflict with his ill father who said, matter-of-factly, that they had decided they didn't have time anymore for quarreling and it was time to lay everything out on the table and get it over with. And so they did. And I've been similarly moved by other family members who have been inspired to take responsibility for their own participation in estrangements, seek to make amends, and offer words of love and appreciation. That's grace in motion, but to expect it of all families leads only to frustration and judgment. We only get a snapshot of dynamics, and we don't see the future. It is not true that everything has to be tied up with a bow before death--it's not true that that is "the last chance." What is, is. Even if it makes my hair stand on end.

So, our favorite mortuary driver showed up last Sunday when it was snowing outside. (The weather forecast, by the way, had mentioned "a chance of rain.") He was in his usual dark suit and long dark overcoat. He was smiling as he said, "It's snowing." I responded, "Yes, but it's not sticking to the roads yet." "Ah," he answered, "But it will be later on. And there will be NO traffic by then, and THE ROADS WILL BE MINE." He had a very sinister gleam in his eye, so I imagine some Very Quiet Passengers got the rides of their lives, or perhaps I should say the rides they never had in their lives.

We have a favorite mortuary too, now. The owners bring us donuts. LOTS of donuts. The owners are thin. This seems a little unfair. They are trying to build relationships in the community--hence the donuts--and I like them because they respect hospice work and are (we hear) very nice to families who select their mortuary. We cannot explicitly recommend or disparage any mortuary, especially one that feeds us donuts, but I do like these folks. Especially because one of them told me they could get me all manner of horrible marketing collateral for funeral products, which is another whole post in itself. I may take them up on the offer...