The Taser's Edge

Weekly Reflection for 6/8/2009

Longtime readers remember that during my initial CPE unit last fall, I began posting my weekly reflections, sometimes with slight edits for a blog format. That is, I want my blog to be personal, but not ridiculously confessional, like some blogs are.  So ,without further ado:

This week when our group discussed the format for Pastoral Work Reports, I was struck by the new-to-me question regarding what Spiritual Assessment we would like to chart.  I quickly began thinking through how much my spiritual assessment says about me.  The list of things I almost always ask about: Family, Place, Religion, Non-family support.

Family: I am very close to my immediate family and to much of my extended.  I talk to family often on the phone (at least twice a month for my parents and siblings).  But I am far away, and I just noticed how much I am probably feeling it all the time.  The closest immediate family member is my sister, who lives in NYC, at least 8 hours away.  And in weighing whether or not to pursue this residency the single most important consideration was what it would do to the rare times (summer and Christmas) when my family is able to gather together.  I am also aware at this distance that, with Holly, I am creating my own family here in Durham.  This is my home.

This is not to say that asking about family is all about my own needs.  I think people are parts of systems, and family has a tremendous impact, even (and especially?) if someone has decided to remove themselves from their family, as some people I visit have.

Place: Upon reflection, I think I must ask about this because I am so aware of my place.  Again, 8 hours from the closest relative.  What’s more, as a child, place was very important because we moved around a lot.  “The Farm” referred to my mom’s family’s non-farmed land, and to the people who live there.  “Going home” meant leaving our home and traveling to see extended family.  For Holly and I, we “go home” to Illinois, and then “go home” to Durham from there.  When I ask patients about their homes, whether far or near, I am making the assumption that place is important to humankind as a species, whether we love to put down deep roots in one place, or whether we need frequent changes of place in order to feel whole.  I try not to assume much more than that, and I sometimes wonder if the question has a strong tendency to turn the conversation into a fact expedition rather than getting to emotional issues that patients and their families are experiencing.

Questions of religion, of course, are natural to chaplaincy.  Of all the important questions I ask, however, the question of what religion people belong to sometimes falls to the bottom of the list in importance.  Yes, it is important for charting a Spiritual Assessment, but to know whether a patient at Duke is Baptist (which all of them are) or Catholic (which a few of them are) or Jewish (which next to none of them are) tells me very little in the way of their actual spiritual wellbeing, or in terms of what their spirituality means to them, or in terms of the way that their time at the hospital is bringing change to their lives, spiritual and otherwise.  At some level, there is even great possible harm to this question.  If someone tells me they believe in the power of the cross or of healing prayer or of fellowship with other people, I have to choose not to over-identify with them.  I must consciously reject the natural tendency to project my own faith upon someone whose faith shares some similarity with mine.  It is easier said than done.

Finally, there are the questions of non-family support, including friends, co-workers, neighbors, people from religious communities, etc.  People live within all kinds of systems, and a patient’s quality of life is directly affected by how healthy or unhealthy, life-giving or destructive, those systems are.  Loneliness is rampant in the hospital, to the point that one almost hesitates to ask about support systems, for fear of exacerbating a patient’s loneliness.  But asking is important.  So I always do.

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