The Taser's Edge


Book Review: Working the Angles by Eugene Peterson
November 11, 2008, 9:34 pm
Filed under: Uncategorized


I turned to this book with a lot of trepidation.  I first became familiar with Peterson through The Message, the Bible paraphrase which I have (perhaps unfairly) hated since I first heard it.  Of course, I’ve never actually read much of it.  Then my first semester at Duke, I had to read Eat This Book, about the centrality of the Bible in ministry and the image of eating the Word of God.  It’s a nice Biblical image, but then Peterson just repeats himself over and over, never really moving beyond the basic meaning of the title.  I also saw him speak at Duke, and it was a similar experience—nothing all that new, inspired, or inspiring.  (It is, of course, possible that I didn’t give him a fair chance.  But it’s hard to forgive someone who murders the poetry of the Psalms for the sake of straightforwardness of meaning.  Again—probably an unfair statement.)

 

But Working the Angles is one of the required readings for the Anglican Missional Pastor, the pastor training program in which I am enrolled through the Anglican Mission in America.  During the next two years, I will have to read all five of Peterson’s books on pastoral ministry.  The other four are Under the Unpredictable Plant, A Long Obedience in the Same Direction, The Contemplative Pastor, and Five Smooth Stones for Pastoral Work.  I am not sure of the order, but they apparently don’t need to be read in order either.

 

I began with Working the Angles because I randomly was given a copy this summer, among 300-400 other books from a pastor’s and a church’s libraries.  But if I had not been assigned to read it, I do not know that I would have.  I’m incredibly glad that I did, however.

 

The title comes from an image that Peterson creates in the opening section of the book: “I see [the] three essential acts of ministry as the angles of a triangle.  Most of what we see in a triangle is lines.  The lines come in various proportions to each other but what determines the proportions and the shape of the whole are the angles.  The visible lines of pastoral work are preaching, teaching, and administration.  The small angles of this ministry are prayer, Scripture, and spiritual direction…Working the angles is what gives shape and integrity to the daily work of pastors and priests.  If we get the angles right it is a simple matter to draw in the lines.”

 

As in Eat This Book, Peterson draws the whole book around a central visual metaphor.  Here, however, it is not annoyingly repeated on every page, but is fleshed out.  In my understanding of pastoral ministry, there is a way in which the parts he names are arbitrary.  What I like about the book, however, is not that I think he nailed the three essentials, but that he speaks about them as very important parts of the pastor’s life, and that he has insights to offer about each one.  I look forward to reading the next one in the series, and I just-a-hair-less-than-loved this book, but I would say that it (like Eat This Book) struggles to offer anything particularly original or insightful when Peterson writes about Scripture and its use in pastoral ministry.  You may disagree.



Outside to In, Inside to Out
November 1, 2008, 5:21 pm
Filed under: Uncategorized

Over a month ago, I wrote a reflection on my difficulties with entering patients’ rooms. Much of what I wrote about may have had something to do with my personality. I am not one to initiate conversations with strangers in normal, daily life. This week I began feeling overwhelmed again, this time by even the thought of those hospital doors.

One Tuesday, I did one visit, and then spent 45 minutes transcribing the conversation into a notebook and then a Word file. It is factually accurate to say that I need to write several more verbatims by the end of the semester and that the most accurate verbatims come from writing down the conversation immediately. However, to say that I chose those long moments in order to make sure I recorded the patient’s words as accurately as possible is really not true. The reality was that one visit into the day, I needed a break.

It’s not that I feel guilty about it. I was sitting in the break room on the floor. Nurses knew where I was if they needed me. After a couple conversations with my CPE supervisor I knew that this “counted” as clinical hours, because I was still making myself visible and available to the floor on which I serve. What’s more, Duke has no visit quotas for its chaplains. And at any rate, guilt is not what this is about. It’s really about noticing for the first time how my outside experiences affect my ministry as a chaplain (hence this reflection’s loopy title).

Stress Outside: The problem is that I may be transitioning from the United Methodist Church into the Anglican Mission in America.

Stress Inside: I have been going through a period of several days of intense anxiety about choosing next semester’s classes, because of how my denominational decision will affect my class requirements.

Stress Outside: This stress is what was being “acted out” (and I use this in the psychological sense of my conscious actions and emotional state being determined by unconscious emotional sources within me) in my sense of being overwhelmed on my unit.

Stress Inside: I internalized this inability to enter rooms as a failure to be doing what I needed to be doing, a failure of faithfulness, not just to the CPE program, but to God’s call on my life.

Just like it sounds, that’s a lot of stress to bear. Although I recognized long ago that my experiences affect my chaplaincy in a macro- sense (hopefully a no-brainer), this week showed me the same truth in a micro- sense. Not only do all of my life’s experiences determine the shape of how I listen and care for patients in general, but the stuff that’s going on in my life today determines the shape of the visits I make today. It’s something I’m glad to be aware of. It’s also kind of scary.



Being Helpful in the Pediatric ICU
November 1, 2008, 5:15 pm
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Last week, my on-call followed two nights of six or fewer hours of sleep.  The day before mine was terribly busy, and the person whom I relieved had only been able to lie down to sleep at 4:30 in the morning.  This was good news for me, as long as the general pattern held—busy night followed by slow day.  But my night was well-punctuated—one call every two to three hours.  The final page came in at 6:10 a.m.

            It was for a family in the Pediatric ICU, whose child had been flown in from South Boston the night before after some type of critical incident.  I never knew what had caused her condition (but I overheard something about sickle cell from some nurses who also referred to her as “the girl who’s dying in xxxx”), and I never looked at her chart.  When I arrived, the mother was with two other family members in the conference room.  I introduced myself to her, and all she could say was, “So, do you want to come see her?”  We walked into the child’s room, took both parents’ hands in mine (the father was already in the room) and we began to pray for their child just as she coded.

            Instantly the room was filled with the medical team.  To my surprise, although they pushed us out of the way, they didn’t ask us to leave.  The parents stood there, the mother crying out to God over and over.  And in the commotion, I was shoved across the room, where I prayed and concentrated on radiating my pastoral presence throughout the room.  (I don’t really think it works like that, but this is not the only time I have found myself trying.)

            Thankfully, the nurse who was charting all the procedures done as the team revived the little girl gave me an opportunity to be helpful: “What’s today’s date?”

            “I think it’s the 24th,” I said.  As far as I can tell, that’s the best ministry I did in that room.  And when I make that comment, I'm not trying to say I was useless in the situation.  I'm saying that that is the way in which chaplains are sometimes helpful.  That is the way that pastoral care sometimes looks.



Some History, and then Some More History, and then Some Future
October 23, 2008, 6:13 pm
Filed under: Uncategorized

For my class Slavery and Obedience I had to read William Tyndale's The Obedience of a Christian Man.  He has some great (or otherwise thought-provoking) things to say:

To plenty of American Christians today:
"Prosperity is a right curse and a thing that God giveth unto his enemies.  Woe be to you rich saith Christ (Luke 6[:24])."

While riffing on Galatians 3:28:
"In Christ there is neither French nor English: but the Frenchman is the Englishman's own self, and the English the Frenchman's own self."

On grace (and his syntax can be dense [so I helped out]):
"It is [one] thing to believe that the king is rich and [another to believe] that he is rich unto me, and that my part is therein: and that he will not spare a penny of his riches at my need."

But, since he's writing as a Protestant in 1528, it predictably sometimes has a harsh and anti-Catholic outer layer which needs stripped away to find something beautiful:
"We are called, not to dispute as the Pope's disciples do, but to die with Christ that we may live with him, and to suffer with him that we might reign with him."

Not to entirely let him off the hook, but everybody was anti-everybody else, religiously speaking, for a while there (coming up on 500 years and counting).  If I had owned a first edition of the book at the time, I could have literally been burned at the stake for it under English law.  In fact, Tyndale (who you might know better as the translator from whom the great majority of the King James Bible was 'borrowed') was himself burned at the stake, but only after having his fingerprints filed off.  This was a formal way of saying that he was being stripped of his priesthood and thus could no longer perform the Mass.  If they had only read his book, they would have known that he didn't really want to perform the Mass anymore.  That's a heck of a quote (whether real or legendary) coming from his mouth in the picture that heads this entry.  ("Lord ope[n] the King of England's eyes," if you can't quite make it out.)

One problem with Tyndale and a lot of those early Protestants, however, is that sometimes they dumped important things along with the corruption that had occurred in Christianity, out of overzealousness.  For instance, Tyndale does a lot of work arguing against the sacrament of confession.  That loss is something we should mourn.  Although I think he was only exaggerating and not entirely fabricating the extortion which could be practiced with confessed information, confession is part of the Church that we need.  And to show how it could and apparently once did look…

Behold, an excerpt from Sozomenus' Historia Ecclesiastica (early 5th century):
"It requires divine, rather than human, nature never to commit a fault, and yet God has commanded that the repentant be forgiven…priests considered it, from the first, improper that guilt should be proclaimed openly, as if in a theatre with the whole congregation standing round.  Consequently, they appointed a priest conspicuous for the purity of his life, his wisdom, and his ability to preserve a confidence…In Western congregations it is carefully observed, especially in the Roman church.  There, the place for penitents is in public view; they stand there, sorrowful and (as it were) in mourning.  When the ceremony of the Mass is finished those who are excluded from the communion [note: by their own consciences]…throw themselves flat on the ground with groans and wailing.  Then the bishop, in tears, comes toward them and falls to the ground himself; and the whole church cries out together, bursting into tears."

That last sentence is what gets me.  After this part of the ceremony in the ancient church, the bishop would stand first and then lift each penitent to his or her feet.  I guess I kind of wonder if maybe that's what Judgment Day will look like.  Christ comes toward us in tears that match our tears, we all cry out together, and then he lifts us up to our feet and leads us home.
 



When Pop-Buddhism and Real Christianity Agree
September 30, 2008, 12:01 pm
Filed under: Uncategorized

I often find myself talking without addressing definitions of terms (especially when others in the conversation are also using the term as if we are talking about the same thing, which we may or may not be doing).  In this case, I am talking about the language of being.  The last sentence of last week’s reflection is a good example of how I use the term: “Showing up—and here I mean truly showing up and being in that room—is success.”

            When I say being in that sense, another way to speak the same thing would be to say, “being fully present.”  This concept comes to me through Jon Kabat-Zinn’s Wherever You Go, There You Are.  As part of my one-on-one therapy for anxiety and depression through Duke’s CAPS program last year, my counselor urged me to read it, and to try Kabat-Zinn’s exercises—meditation with slow breathing or following one’s heartbeat.

            At first, the pseudo-spirituality threw me off.  A conservative Christian in upbringing (albeit plenty more complicated today) I questioned using what was in my understanding coming from a Buddhist technique.  It certainly sounds nice, but it also sounds a bit too Oprah-spirituality.  The point of being present, from a therapeutic point-of-view, was to not label my emotions as positive or negative, to be non-judging inasmuch as that was possible.  By stopping the labeling, I could simply experience the emotion rather than try to push it away or run from it.

            This was difficult, because I was certainly holding the book at arm’s length.  My assumption and hope was that there was something in the Christian tradition which would offer me something of the same.  Surely, I thought, there must be a monk somewhere who has said basically the same thing.  Although Kabat-Zinn rang true for me, I wanted to know that it was safe.  I am not sure what I was afraid of.  Perhaps my question was this: How does following a Buddhist practice (if that is indeed what this is) work with my practice of Christianity?

            This was not the first time that Buddhist practice has interacted with my Christian spirituality.  At first in high school, and in various phases later, I have read texts of and about Buddhism.  This history is to say that I have been working for a while to come up with a theology for my understanding of what “rings true” in other spiritualities, and that it comes to bear on my ministry as a chaplain.

            I finally came up with an understanding that made me welcome Kabat-Zinn, and that was a particular emphasis on God.  In Exodus, God reveals the Divine Name: “I Am.”  Because I am created in the image of God, I am also to share in that.  Christ is healing the “I Am” image in me.

It comes down to very practical questions: What do chaplains do?  When I go into a patient’s room, why am I there?  Chaplains come and are.  At least ideally they do.  And in coming and being, they are trying to be God incarnated for a moment.  This begins to explain how exhausting being can be.



The Battle for Showing Up
September 19, 2008, 1:17 pm
Filed under: Uncategorized

 


 
 

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When I arrive at the office, I log-in to Lotus Notes, check my office emails, roll my calls to my pager, check for patient referrals, check office emails, make sure my pager is on, then check patient referrals.  (Yes, the list does seem to repeat itself.)  Then I get out my pocket notebook to see who I saw on my last day, and write them out in a list, often arranging them in numerical order—4104, 4109, 4202, 4211, etc.  It is exceptionally easy for me to drag my feet on the way from Baker House to Duke North.  Sometimes I find myself hoping that I forgot to do something back in Baker House.

 

Did I really remember to check for patient referrals?  Yes.  Twice.

 

Did I check my mailbox and write my hours on the whiteboard in the office?  Keep walking.  You can come back later.

 

Earlier this week, as I was slowly following the walkway to Duke North, I had a thought that was funny to me even at the time—This must be what death row inmates feel: ‘Dead man walking.’  It was this humorous thought that prompted me to write about this subject this week.

 

As I have already mentioned in my one-on-one time, I feel like I have absolutely no problems once I am in the room.  Last week, when a patient’s wife, mourning and raging after her husband’s heart stopped—yes, he was revived—just days after what should have been an unremarkable hip replacement, turned to me and drilled me with her eyes as she waved me out of the room, I was able to at least ask if I could get her some water, and I told her that I could come back if she changed her mind.  External pressure I can apparently take.  Internal pressure?  That’s a different story, and I suppose it always has been for me.

 

After completing the walk to Duke North, I’ll take the stairs, not for the exercise, but because I can take them slowly.  On the way up, I debate going up to the sixth floor chapel so I can ‘center myself for my ministry of presence.’  Sometimes I actually do feel like I need the prayer, but most of the time I am being entrapped in more psychological warfare.

 

It is the series of barriers that take my energy, not usually the patient interaction.  The barriers: referrals, walking distances, nurses to talk to, precautions to take for the patient’s health, perusing the chart for longer than I need to, and then finally knocking on that door.  The funny thing is, even when they don’t ultimately want to see a chaplain, I still end up in the room.  It’s inevitable.  And then the next room and the next room, each with new barriers to be crossed.  The 2 minutes and 38 seconds I wasted on the way to the first door was the major battle.  Each time I make my way to the next knock is a further skirmish.  With each knock, I have shown up.  Showing up—and here I mean truly showing up and being in that room—is success.

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The Shape and Shapers of Ministry
September 14, 2008, 9:36 pm
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From the beginning of my time in the program, one of my constant questions was, “How long is too long for a visit?”  I talked with others about my feeling that my tendency would always be to stay longer than was necessary or helpful.  I have come to think that this concern was shaped by an experience I had in the field education church that I served for a year.

            Mr. T was a man whom I had visited regularly in his nursing home throughout the summer.  He was one of those people whom I had picked to continue growing in relationship with, both for his sake and for the sake of my connection to the church.  After two months of visits, he became ill and was hospitalized at Duke.  On the 8th floor, I sat with him and his two middle-aged daughters one Friday afternoon for hours and hours.  The semester was in full swing, I was busy all the time, and yet when I walked out of that room that evening, I felt that it was the best use of my time all semester, despite the fact that I had not really done anything other than be present to him and to his daughters.  I came away amazed at how grateful those women were at having this stranger in their midst.

            Because this was the main experience that I had had of pastoral care in a hospital setting, I have found that it has been the archetypical experience against which I have weighed much of my CPE experiences thus far.  It has also determined my idea of the ‘right way’ to do pastoral care.  The ‘right way’ in Mr. T’s case was long hours spent talking about anything, talking about nothing, perhaps praying, but certainly getting to know the family’s story.  Dissonance arose when I juxtaposed this ‘right way’ in my head with my assumptions of what CPE expected of my clinical hours.  And it was just that—my assumptions of what CPE wanted, rather than CPE’s actual expectations.  At the beginning, all I had were those ill-founded assumptions.

            At the beginning of my CPE unit, although I had it in the back of my mind that I knew the ‘right way’ to do ministry, I also held in the front of my mind the idea that there was no right way to minister.  My conception was that the differentiation of styles of ministry was mostly formed out of the individuality of ministers (i.e., I am a unique type of minister because I am a unique human being).  Now, I still believe that everyone’s style of ministry comes out of their personalities, and that this does make everyone’s style unique, but the shape of ministry in a given interaction is not solely determined by my personal style.  (Praise God!)

            I am slowly coming to realize that the pastoral encounter, if it is effective, is perhaps most shaped by the particular encounter rather than the particular minister.  At some level, this seems like the way that it should be.  My personality is certainly something that I should bring into the room with me each time I make a visit.  But if that is the only thing I bring into the room, then the focus of the visit will be me.  And I am certainly the wrong focus when I am supposedly present for the patient.



The Problem of Pastoral Perspective
September 6, 2008, 12:16 pm
Filed under: Uncategorized

Each week of the CPE program, I have to do a reflection.  Couldn't hurt to post them here, right?  Maybe I can even find a picture to match the theme each week:

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This past week, the charge nurse on 4100 directed me toward a room which had not requested pastoral care, but which he thought could use some.  I spent 45 minutes with the patient and his wife, learned some about their lives, and left thinking that while the patient’s wife was very talkative, the couple was overall very nice.  Since then, however, I have had several conversations with staff about this room, and have heard of much more tension.  They tell me that the patient’s wife is incredibly demanding, and that while she does not raise her voice at the staff, she has at least once asked that her husband’s nursing staff be changed.

            Over the summer, I had an experience which was similar.  At C.A. Dillon Youth Development Center in Butner, I worked with teenagers, some of whom had committed terrible crimes.  And I found that when I would discuss a particular student with the staff members who were serving students in their units all the time, the staff and I had entirely different perspectives.

            The difference in perspective has to do with my privileged relationship to whomever I am serving in my role as “pastor.”  At C.A. Dillon, students had plenty of problems with authority (problems that landed them there), may have had no formal religious background in their home lives, but they were very willing to open up and talk to me as “Chaplain Jordan.”  At Duke Hospital, most of the patients I have seen thus far have had vaguely Christian backgrounds, but they lack formal connections to churches back home.  Despite the fact that neither the patients at Duke, nor the students at Butner had someone to call “pastor” at home, they welcomed the opportunity to call and relate to me as pastor.

            In the last paragraph I referred to my relationship with students as “privileged” and this is because it is a privilege to be asked to be pastor to people who, in their more private lives, do not want anyone to be their pastor.  Along with being a privilege, this is a tremendous responsibility.  It is also confusing.

            In my ministry at Duke Hospital, I find myself trying to weigh various perspectives each day.  I will speak to an RN who will tell me that a patient is struggling with a particular family issue, enter the room, feel that I have had a very real, intimate conversation with him, but then leave realizing that he mentioned nothing of what he has spoken to the nurses about.

            It is as if the patients want me to be in their rooms because of my position, but also want to present a particular version of themselves in order to satisfy the role that they assume I want them to fill.  Patients present themselves in one way, staff represent them in another light, I have my own initial impressions, and then I try to smash all these perspectives together and realize that they do not at all fit.  I suppose that this is when experience and discernment begin to play a role in pastoral care.  I am moving forward into this discernment with the assumption that it will be more art than science.  That, to me, is a very good thing.



Once Again Boarding Everyone's Favorite Ship
August 19, 2008, 9:38 pm
Filed under: Uncategorized

That’s right–The Internship!

This week is Orientation Week and it is surprisingly exhausting.  This fall I will be doing a CPE internship at Duke Hospital as part of my ordination requirements for my conference of the United Methodist Church.  CPE stands for Clinical Pastoral Education, and is—according to the less-than-swanky website of the Association for Clinical Pastoral Education, Inc.—“a multicultural, multifaith organization devoted to providing education and improving the quality of ministry and pastoral care offered by spiritual caregivers of all faiths through the clinical educational methods of Clinical Pastoral Education.”

Circular definition, ain’t it?

As they were saying, Clinical Pastoral Education brings all the tools of Clinical Pastoral Education to the ministry table.

 One last thing—today we picked our clinical units.  And after some deliberation, I am assigned to Neurology 4100 and 4200.  I will split the latter floor with another intern.  Below are descriptions of both units taken from Duke’s CPE Student Handbook.

 4100—“This is the neurology service with patients who have been diagnosed with brain tumor, seizures, and neurological disorders.  It is also a step-down unit for 4200.”

 4200—“The neuroscience intensive care is where patients with head injury or trauma, severe stroke, brain surgery and brain death patients are located.”

 No, I hadn’t noticed the phrase “brain death patients” until I was reading all this to Holly this evening.  It probably says something about the way that Duke has transformed me that all this sounds daunting but not altogether terrifying.  Thank you, Jesus.  And I really mean that.  Amen.



In Which Prudence Joined the Crips
June 1, 2008, 6:37 pm
Filed under: Uncategorized

     Last Sunday, Holly, along with a friend from work, and another friend’s wife took an assortment of dogs hiking on a trail in north Durham.  The stately Prudence was the tallest, towering over a pair of tiny Yorkshire terriers, but just plain taller than the mutt named Lucy.

            I was saved from going because I had to go to work.  Prudence, however, was breathing hard and laying around being extra lazy for days.  Also, she had ticks.  I might not have thought to look, but as it turned out that the Yorkshires had dozens of ticks apiece after their walk, we thought it best to check over Prudence as well.  She is built for tick removal—white with short hair—and it seemed that most ticks were intelligent enough to note her features and stay away.  At least most ticks stayed away.  As for the handful that remained, we didn’t know what to do, so we turned to the Internet.

            As a child, when I attracted a tick or two, removal was an intricate process.  Mom and Dad were for some reason very concerned that the tick’s head not be left behind in the skin.  As I recall, they would light a match, heat a needle, and then use it to discomfit the tick so it would reverse and be plucked safely, easily, and whole from the skin.  I might be confusing this process with the similar process of removing a deep splinter.  In that case, the needle would be heated for sanitation purposes, and then would be used to dig.  It was not pleasant.  I seem to recall one time, in the case of a tick, that Dad decided a soldering gun might be a more direct process.  The intense heat killed the creature before it knew what hit it, but the child escaped unscathed, save for the tick’s head left in his or her back.  I cannot remember which of us it was, but he or she did not die.

            Last Sunday, when we discovered the ticks, this childhood memory was running through my mind, competing with thoughts of Holly coming down with Lyme disease or Rocky Mountain Spotted Fever.  I made a mental note to remember this tick incident for some future doctor’s visit about a mystery disease that Holly would surely contract.  In the meantime, we consulted somebody’s website and they told us just to tweeze the ticks off.  It quickly became my job, and it was an easy victory.

            One week later (today) Holly is still fine.  Her readiness to be done with her first hour students has nothing to do, in fact, with ticks.  Prudence, however, remains the greatest victim.  While the ticks I removed last week were tiny, the one I noticed on her leg today was not.  It was well-bloated, and when I removed it Prudence yelped and bled, in that order.  Bled, as they say, like a stuck pig.  We had to improvise a dog tourniquet, because I was once again walking out the door for work.  (Fortunately that only happens three times a week.)

            But this story is not about me, and it’s not about Holly, and it’s not even about Prudence.  It’s about that tick.  You’ve no doubt seen a “Hang in There” poster, with a cat desperately clutching a tree branch.  In Prudence’s case, we had a tick holding on for dear life by burying its skull in dog meat.  The difference is subtle, so you might have missed it.  When the cat is rescued, it will go on with its life.  Even if it falls, it will likely land on its feet and keep on walking.

            For the tick, however, life at its most essential is just “hanging in there.”  There is no life after “hanging in there.”  It was born to attach itself to a sweet woodland creature such as Prudence, and then to gorge itself until its innards exceeded its outards in a bloody explosion.  From thence it would have proceeded, if the ancients are to be believed, to a paradise populated by owner-less Yorkshire terriers (a paradise also known as Yorkshire Terrier Hell).  This tick, however, must have had low self-esteem or been on drugs or perhaps she was a Freethinker.  I just pray she made her peace with herself or the tick gods as the tweezers clamped down.