Ineffective Individual Coping/ Ranting

It would seem that this week I have experienced a bit of ineffective individual coping, I don't know how else to explain it... I spent all day Monday at Overlake Hospital trying to jump through all the necessary hoops to get my students in to start their clinicals today. Apparently the instructors are supposed to orient their own students to the hospital and to the floor they will be working on. This is a little difficult to do if you've never worked at said hospital on said floor.
So Monday was my crash course in hospital and medical oncology orientation, agonizing to say the least.
After spending all day working out the clinical situation, I went work at the good old UW. My patient was especially unstable and the family was very needy. The entire night I kept hearing things like "He's starting to look better," and "I just know he'll come around." Of course I knew that these statements were not true, but how do you say that to hopeful family? I did my best not to feed their false hope and prayed hard under my breath.
Somehow I finished the night and made it home. By the time I was getting ready for work on Tuesday night, it didn't seem like I had slept at all. I took back my assignment from the night previous, my unstable patient with the needy family. It seems as though that night they were beginning to understand that he wasn't going to get any better. When I went into the room, his three teenage kids were at the bedside and very tearful. I tried to stay out of the room as much as I could that night to allow the family some private moments to say goodbye, but I tried to stay close enough so that they knew I was there if needed. It's a hard balance to find.
The kids finally left for the night to go to the hotel to try and get some sleep while the wife stayed.
As I was outside the room charting I noticed his heart rate start to drop, 110 to 90 to 80... I knew we must be getting close so I headed into the room. As soon as I entered, his wife (who was a nurse) asked me what was going on. I told her that his heart rate was dropping and that she should call the kids. I just stood there with her helplessly as we watched him slip away. A few minutes later she said, "He's gone isn't he." I tried one lost time to feel for a pulse and listen with my stethoscope; nothing but the rhythmic sound of the ventilator which was still giving him breaths. I recorded time of death at 0122 and waited until the rest of the family arrived and then left them in the room with him to say goodbye.
Of course the "death packet" must filled out as soon as possible. There I sat pushing papers and calling the medical examiner, the attending physician, and the organ donation agency. I turns out he was eligible for cornea donation which his wife graciously consented to. Now it was time to give his family the bereavement packet and start post mortem care preparing the eyes for "harvest."
More family drama, more co-worker drama, the medical examiner changing his mind about autopsy after I had extubated and delined the patient... Seven thirty finally came. I got home just in time for a nap before teaching my lab. It was the first time my students were doing injections on real people, each other... Shaky hands with needles can be a very entertaining thing. During office hours I helped some students learn how to administer an enema to a plastic doll. I have such a weird job sometimes.
Then it was off to plan a Bible study and the students orientation. By the time I got to church and found my Bible study being video taped, I just wanted to cry. Ineffective individual coping? Yes!!! I guess maybe I just can't change gears that fast. I've just to remember to pray.

Herding Elephants

Following last weeks incident I went back to school on Tuesday expecting to find an elephant in my classroom, instead I found a whole herd of them!
It started out by seeing the head clinical instructor in the hallway. She had emailed me over the weekend saying she knew I was late for clinicals and was asking what had happened. So there I was leaning on the front desk as I attempted to explain the whole thing once again. Thank God I work for a Christian university... Unfortunately/fortunately, I didn't just stop at the events of the day but I went on to continue to talk about what I had learned from the whole thing; that inviting someone to pray with you is a privilege that just may encourage them as much as it does you. Allowing others to witness what God is doing in your life is a powerful thing...
That same professor and I co-teach a lab. Later that afternoon when it was time for skills practice, I was surprised to see her start abruptly crying. Of all of the faculty she is one that is usually very controlled and has the most defined boundaries. Class was just beginning and the students where starting to come into the lab so I kicked them all out into the classroom and gave them a quiz.
By the time they finished the quiz she had regained composure and the class went on as usual. I didn't see her at all after class as she seemed to have left the campus hastily.
Later on that afternoon as I was asking our office administrator about my groups clinical paperwork, I found out that she had been recently diagnosed with cancer. My immediate thought was, "Oh no, what did I just say to her?" Perhaps it was the best thing I could have said. Of course I didn't know at the time that she had cancer, those comments came my own brush with vulnerability and I'm willing to bet that God planned it that way.

Uber Blessed!

Thank you Angela, for reminding me to look on the bright side; indeed they do care!
It seems that I too had my worst teacher day ever this last Friday. It all started out on Thursday evening when I got home from teaching clinical in Everett. Sometime during the course of the evening I realized that I just wasn't feeling right. I tried to push through and return a few phone calls but by the time 9 pm rolled around I decided to call it a night, or at least try to. So I went to bed only to find out that I couldn't sleep.
The last time I saw the clock was at about 2am. I must have fallen asleep because somehow I woke up at 6:25. I know that doesn't sound like a problem but when you think about the fact that my class starts 6am in Everett, it's a big problem. I rolled out of the bed the minute I found out what time it was just to make sure I could. I grabbed my phone only to find that it had been on silent and there were 4 missed calls, all of them from the students.
As I called them back, the first thing I heard was "Professor M, is everything ok?" When I arrived at the clinical site I found them writing SOAP notes. They had already done devotions and prayed. They once again asked if everything was alright and of course I assured them it was. When I told them I was sorry for being late one of them spoke up and said, "Therefore there is now no condemnation..."
We then decided that just because the day had started badly, that didn't mean it had to end badly. Unfortunately only a few minutes later I found myself sitting on a desk in a cold sweat with no blood perfusion to my body while trying to go over a patients medications with a student.
I felt somebody take my wrist looking for a radial pulse which they apparently couldn't find. It took some very eloquent speaking to convince 4 nurses and 8 nursing students that the arrhythmia would eventually go away and I didn't need to go to the ER. I somehow made it to the next room into one of the recliners where I was "attended" by 4 of my students. Honestly all I wanted was for everyone to leave to me alone, but I must admit that their concern was genuine and their intentions sweet.
It wasn't too much later when the dean arrived. He had brought snacks and offered to take me home and round on my students for the rest of the day. After more eloquent speeches and some in depth explanation of the cardiac conduction system complete with diagrams, I managed to convince him to head back to the school and his "deanly" duties.
I was still feeling fairly awful but the students somehow helped me make it to the end of the day. Later that evening when I listened to my voicemail: "Miss M, how is my beloved teacher. I'm just wanting to make sure you're doing ok..."

Reflections on Yom Kippur

Last Thursday marked another Yom Kippur. As I look back to very first post on this blog I am absolutely astounded by God's amazing works and how He has shown me just a little of what that "more" is.
I think back to Yom Kippur 2005, the infamous "Avocado Incident." It was a year of transitions for me; my first year in my own home, my first year working as a nurse... I was fasting for Yom Kippur, or at least trying to, when I started praying. I think I must have been a little frustrated and perhaps angry at God. As I was praying I saw an avocado on my kitchen counter. "God, if you really are God and you really do love me, how much would matter if I ate that avocado. I know we are free from the law... But what attitude am I about to do this in?"
Yom Kippur 2006 marked a parting of ways with a close friend. She chose to deny her Saviour while I prayed desperately for the strength to hold on to Him. Though we are still friends, it's never been the same.
It wasn't long after Yom Kippur 2007 that I learned about reconciliation; God's desire for us to be reconciled to Him, and what it means to be "given the ministry of reconciliation.
Now it is Yom Kippur once again and I have had the wonderful privilege of sharing it with the the Body. Last Sunday I had the opportunity to participate in the ancient tradition of Taschlich with some friends from dare I say it... CHURCH! We all went down to Greenlake for a little scripture reading and some therapeutic rock throwing as an illustration of Micah 7:19 which says: " You will again have compassion on us;you will tread our sins underfoot and hurl all our iniquities into the depths of the sea."
Thursday marked the closing of Yom Kippur. After clinical was over three of my students and I went on a bit of a "field trip" to attend services at Beit Tikvah. How wonderful it is to be reconciled to the Body of Believers and share these meaningful times with them! God is faithful to His promises, Amen.

Sitting By the Pool

Last weekend I had the opportunity to attend Special Meetings (aka church retreat) on Whidbey Island. The setting was amazing the and we couldn't have asked for better weather. I will admit however, that I was a little apprehensive about attending something called "Special Meetings." ;)
The first night I managed to skip out on singing Kubaya by the campfire under the guise of "helping" Angela and Justin get people checked in. On Saturday I was on both the breakfast and the dinner crew so that helped me conveniently skip out on a few other gatherings.
On our way out to the Island Angela had asked me what I hoped to get out of the weekend. I believe my answer went something along the lines of "I don't know." The only thing I knew was that God told me I had go. One night before we went to bed I think I even said that I didn't really expect anything incredibly "spiritual" to happen to me that weekend. "Special Meetings just have so many people and so much that is distracting that I just don't expect an 'epiphany'. Maybe I'm just here to support others and that's just fine."
Sunday morning rolled around and once again it was time for church. When the speaker began to talk about the crippled man sitting by the Pool of Bethesda I was stunned. Angela looked straight at me at the point and I knew she was thinking exactly what I was thinking. Just read a few entries back to the "Pink Kool Aid" entry! He went on to talk about waiting upon the Lord and reading ones self for healing the wholeness that comes from knowing Jesus and seeking Him.
Here I was sitting by pool once again getting a Son burn! It felt pretty good actually.
Malachi 4:2
But for you who revere my name, the sun of righteousness will rise with healing in its wings. And you will go out and leap like calves released from the stall.

Joy is the Flag

A couple of weeks ago during Sunday School worship time we found ourselves singing "Joy is the Flag." I haven't sung that song is eons and for some reason it really stuck around in my thoughts.

"Joy is the flag that is flown from the castle of my heart for the King is in residence there.
Let it fly in the sky let the whole world know that the King is in residence there."

I must say that maintaining joy is sometimes a battle. Just a few days ago I was at friend's house. Semi jokingly I asked her if she had experienced any "Holy Spirit Induced Euphoria" lately. She whipped out her guitar and started singing worship songs. She took a short interlude to go downstairs to check on the laundry so I took that brief moment of solitude to belt out "Joy is the Flag." Then something happened, something a little crazy, a little "endorphinating;" joy became the flag because the King is residence.
The King James Version of Psalm 22:3 says, "But thou art holy, O thou that inhabitest the praises of Israel." Now there has been some argument about the interpretation of that verse but whether or not God inhabits our praises, I know His Holy Spirit inhabits the hearts of those who follow Him and praising Him is what we where meant to do from now to eternity. While I agree the Christian walk isn't about a feeling, I do believe that we are called to reflect the joy of the Lord which is our strength. A heart that is properly focused on God can't help but fly the flag of joy.
Also, in my medical opinion I do think that worshipping the Lord really does release endorphins. Maybe I'll do my dissertation based off of that hypothesis!

Why I do what I do...

I was talking with some of my teacher friends the other day about the upcoming school year. Somehow the issue of salary came up (I think I was having to explain why I am still going to work so much at the hospital during the school year). It's true, teachers aren't paid nearly enough and it doesn't get better the higher the education you happen to teach! I really had to sit and think for a moment why I'm about to sign this contract or why anybody does for that matter. It's obviously not for the money. Maybe that that's what makes teachers so incredible, they do what they do because they love it (or at least some of the time) and/or God told them to do it.
Somebody once told me that teachers are really some of the only people who get the opportunity to make an impact everyone in the entire the world. I suppose indirectly there is some truth to that.
This morning I had a breakfast with one of my former students. We talked about her first job, her first death, her future hopes of grad. school and becoming an educator... Now I remember, this is why I worked so hard to become a real teacher. So, thank you to all of my teacher friends who prayed for me and encouraged me throughout grad school. I'm excited to join the ranks!
You gotta love 'em!

Pink Kool Aid (Part 2)

No, I didn't want to run away. I wanted to stay, to sit a corner and to work/pray through anything and everything that came up. I wanted to let myself be angry at the "joy robbers" or to a least feel something and do so in a safe place. Why didn't that happen then? Why couldn't I have just stayed, prayed and sought the Lord?
Granted I had a prior commitment I needed to honor, but did I miss the point of why God had brought me there by keeping it? I don't get it, I thought I was ready for something and now I find myself waiting again. I know this can't just be a mean trick but sometimes it feels like it.
In some ways I feel like the lame man who waits each day by the Pool of Bethesda but never makes it to the water in time be healed. The man waited 38 years for what seems in some ways to be a rather anticlimactic moment. Jesus walks up to him and says "Take up thy bed and walk." So what does he do but get up and proceed to walk off carrying his mat. I've got to be missing something here...
Is the Pink Kool Aid perhaps fear and doubt? Could I myself be accused to drinking the Pink Kool Aid?

Pink Kool Aid

It was Saturday night and there was no sleep to be had. My body was calm but my mind was restless. Could God really be telling me to drive to Portland?!? Indeed He was... When I could stand it no longer, I got up, got dressed (in a green skirt no less) and left the house at 0530.
After so some amount of dawdling, I arrived at the dreaded camp meeting at 0915. Afraid to just randomly saunter right onto the campus, I called Angela and asked her to walk outside. I'll bet she didn't expect to see me standing there! As we walked into the office I was immediately "greeted" by Angela's mom who was practically in tears. I must admit that I was too but for vastly different reasons. Apparently word travels fast with the AF crowd because it wasn't long before I was seeing other folks I knew coming out of the woodwork. It would seem that there is quite the text messaging chain...
Later on that morning as Angela and I walked about the campground on "official business" I couldn't help but think that the place reminded me of some type of internment camp. The 1 room cabins which had no windows and were about 2 feet from eachother, the fenced compound, the codes on the gates... All these things add to the story but they weren't the real reason for the fear and trembling.
Poor Lindsey was the one who had to sit next to me during church service. As long as she wasn't looking at me, I was "fine." Actually, the whole experience was more difficult than anticipated but oddly enough I didn't want to run away...

Earning a Living

I'm sitting here at work lulled into a sort of semi-conscious state by the rhythmic sound of my patients ventilator feeling slightly burned out streaming Spanish worship music on youtube to combat the post Mexicali blues. I can't help but think about how much it stinks sometimes trying to "earn a living." It's funny what we put ourselves through all in the name of earning a living, the time we lose, the gray hairs we get, the elevated blood pressures, the ulcers, and the list goes on... Don't get me wrong, I'm not saying that we shouldn't have jobs and pay our bills but to think that we can somehow "earn a living?" No, I'm not really talking about the whole salvation by works thing; I'm talking about the innate tendency to we have to feel like we need to constantly be doing things to legitimize our very existence.
I often think about this in regards to my patients. I wonder how they must feel about thier own lives when thier minds and bodies couldn't possibly be capable of "earning a living." The truth is that we can't earn the right to live or the right to exist and we cerntainly can't earn LIFE. All these things are a gift; if we could only live them as such.
While "youtubing" some Spanish worship music I came across this song "Razones Pa'Vivir" (Reasons to Live) which I have heard many times before but never truly listened hard enough to figure out the words. Translated it says something like this (I think):

You have given me so much
I cannot express my gratitude
I cannot tell of all you have done for me
You give me love, you give me peace
You took from your plentitude
In order to fill me with your light
My heart is blessed to live this way
Your blessing has touched my existance

I have reasons to live
I have songs to write
I have a voice and I have a heart
I have a Way to follow
I have love to share
I have a voice and a heart

You have inundated me with your love
With understanding and compassion
With your care and with your warmth
Every morning I can see
When I breathe I can see the sun
You are always faithful
My heart is blessed to live this way
Your blessing has touched my existance

Divine Cardiology (Part 2) Don't Lose Heart

About a year ago I had a phone conversation with an old high school friend who happens to be a physician. She had told me about a book she was reading called "Waking the Dead" by John Eldridge. She highly recommended that I read. I finally picked up a copy at the book store a few weeks later, but not being much of a reader I never made it past the 40th page.

The night before we left Kigali Naomi and I were chatting in room when somehow that book made it into our conversation. Ironically I had packed the book in my carry on while in Seattle but I hadn't cracked it the entire trip. Now I had to read that book! I am glad that I did...

It must say that I found it quite thought provoking. There were a few things that "made me go hmm," but overall what I got from it was worth the "hmm."

In the first chapter of the book the author makes this quote by St. Irenaeous; "God's glory is man's heart fully alive." He goes on to make the point that once we have made a confession to follow Christ, we have a "circumcised" heart. The evil is stripped away and we have a new heart, a good heart. God in fact loves our heart so much that He died for it. He wants our hearts to be "alive" and healthy. God's desire is for us to live in wholeness a victorious life. Wow, God loves my heart because He made it good? God thinks my heart is worth fighting for? That's quite a powerful concept if it is indeed true.

The author then discusses the idea of spiritual warfare. If our hearts have been made "good" (I think this the idea of sanctification for all you AF folks out there) then of course the Devil is going to target you. We need to be able to prepared and equipped to fight for our own hearts and our relationship with our Lord. Because He has made me in His image and has redeemed my heart I do not need to go life ashamed and bound to the thought that no matter what I do I'm going to mess it up. After all, in my weakness He is made strong.

Don't lose heart because you'll miss it when it's gone! You're heart really is something worth fighting for.

Divine Cardiology (Part 1)

I was in nursing school sitting in an unidentified class with a particularly long winded professor when I suddenly broke into a cold sweat and grew very pale. My table partner, being very perceptive, noticed my plight right away and told me to leave class that she would share her notes. Similar episodes, sometimes accompanied by chest pain, continued to happen from time to time for several years.
As a nurse in cardiothoracic intensive care this happened several times while at work. It wasn't until two years ago however, that one of the charge nurses was on to me. She would see me rolling around my patients room in my computer chair looking like "death on cracker." It wasn't until she threatened not to let me come to work that I finally saw a cardiologist.
I wore an EKG monitor constantly for an entire month and even had to print my own strips. Of course as a cardiology nurse I also analyzed them but I found myself stumped right along with the cardiologist. The rhythm abnormalities didn't appear to follow any sort of usual pattern. The options were an invasive heart procedure which could possibly end in a pacemaker or a trial of a host of cardiac medications. The drugs helped a little at first but unfortunately also caused a very slow heart rate. For over a year we tried but couldn't find the answer. Fortunately, though symptomatic, the arrhythmias are self limiting. But I continued with my crazy schedules and stressful lifestyle and thus continued to mistreat my heart. I don't think I was entirely convinced that it was worth taking care of. Eventually, the cardiologist and I decided that because we couldn't find anything that "worked" and because the rhythms were not life threatening, we would discontinue care and ride it out for as long as possible.
Unfortunately the episodes were disruptive enough cause some hesitation in what activities I chose to participate in. I finally quit working on my beloved ambulance because I was afraid that one day "the thing" would happen at just the "wrong time." Worse yet, somebody might find out about my "broken heart."
Everyday I go to work, I see broken hearted people. I fill them full of drugs, shock them, manually pump their blood, pace them, etc... None of those things are really able to cure them, they are just meant to hold them over. In reality my patients are cardiac cripples. What most of them really need is a new heart, a good heart.
To be continued...

Hiding

I’m hiding in my classroom, it’s hard to explain… I came to Africa to teach. Yes, I have been teaching and yes, they have been learning. However, unfortunately they are not doing. This morning I was supposed to teach a class but there was some sort of “miscommunication” and now it’s not happening. We’ve lost so much time over miscommunications like this.
Since Naomi and I now have our morning free, we decided to work in various wards of the hospital. Naomi went to maternity and I rounded on our bus accident boy who was now in the ICU. He is doing a little better than expected but still not out of the woods yet. After ICU rounds I went up to the emergency room. I found a very emaciated man lying in a bed with a severe oxygen deficit. The oxygen machine was there but it was not on him. I turned on the machine and placed the mask over his face. I took his vital signs and listened to his chest with my stethoscope. He needs IV fluids and some laboratory studies.
The nurse finally came so I asked him what was wrong with the man but he didn’t understand. He gave the man some oral medication and some water which of course he promptly vomited back up. He showed severe wasting which was probably due to end stage HIV. I tried again to explain that the man needed fluids but both the doctor and nurse closed themselves into another room with a patient less sick.

I would have started doing all the tasks myself if I thought I could find the supplies. But in reality what is it going to do? Is it worse for me who knows what to do to be in inactive, to not do those things out of fear and/or frustration and not wanting to make trouble for my hosts? Should I be trying harder to communicate? Do I need to be more aggressive.
Here, I am a consultant. But I am one who likes and needs to consult and debrief with others. It’s not very easy to do here. Sometimes I wonder if it’s even OK to do this. Should I be ashamed for thinking these thoughts? Am I displaying “ineffective individual coping” for needing to discuss this? Am I worth less as a teacher, a nurse, or a “missionary” if I can’t make taking action a part of my teaching? So… I hide in my empty classroom feeling like an imposture.
Don’t worry I know that this is all part of growing and learning how God use us even when we .feel our efforts are futile. ;)

Out of Sodom

Today in Sunday School we were discussing the demise of Sodom and Gomorrah and the story of Lot, his wife, and his daughters. Wow... That story spoke to me in so many ways. Praise the Lord for His love and mercy in leading me by the hand out of Sodom and into the safety of His mountain.
The long awaited testimony:
I was a child born into "The Church of Sodom." I lived in a world that professed to be righteous and wise knowing the Way. In reality we were a community riddled with terrible grievous adulterous sin. "The outcry of Sodom and Gomorrah is so great and their sin so grievous..."
Indeed the outcry was great, so great in fact that it was heard not only by God but the rest of the surrounding world. A child was drown by her mother, several parishoners committed suicide, and the place was so full of deceit and even sexual sins which they tried to legitimize as "a new move of God."
Indeed God sent them warnings of His judgement to come, but most of the people wouldn't listen and they were blinded by their own sinful ways and desires. To leave "The Church of Sodom" was to leave "comfort", life, everything... But to stay was in Sodom was to invoke the wrath of God.
I must admit that we lingered in "The Church of Sodom" and hesitated much like Lot. God in His mercy took us by the hand and led us into the hill country narrowly escaping a fiery demise. There are some who looked back and didn't make it. But once again praise the Lord that for some reason He saw fit to grab me by the hand and drag me out of Sodom.
Of course there was the living in exile in the cave part to deal with for a while but I believe that part too has it's place.
Praise the Lord His mercy and grace.

Variations on a Theme

April 7th 2008: The 14 year anniversary of the Rwandan Genocide
In Rwanda the entire week strictly observed with special prayers and ceremonies lasting for hours on end. Parties, applause, and most music is forbidden
April 19th: The first day of Passover
May 2nd: Yom HaShoah "Holocaust Remembrance Day"
This is somber holiday which is observed by most Jewish communities and many non Jewish communities with prayer, fasting, and special memorial services.
September 11, 2001: A day that "We will never Forget"
On these days we allow ourselves to time to remember the fallen, reflect on the pain, and thank God that He delivered us.
A few days ago I found myself walking down a familiar path in the woods. What was I doing there again? Remembering... The good, the bad, the angry, the sad, the helplessness, the deceit, the loneliness, and the bitterness. It's perfectly safe and even healthy to do this, once in a while.
The Theme: Because we are all human with a sinful nature and a free will, we perpetually find ourselves in the most dire perdicaments. We do unthinkable things to one another, sometimes the unthinkable happens to us. But God is bigger than all of this and He faithfully persues us.
A few days ago I was informaly asked if I would share my testimony in church. I don't think I'm quite ready for that yet. But the interesting and wonderful thing is this: We as believers might have different stories, but they are all really just variations on a theme. We were bad, God is good. God called, we answered. We were hopeless, we found hope in Him. What a victorious symphony!