I have recently been attending a different local congregation.   It is Centenary UMC on US Route 220 North in Cumberland.  The congregation and I have been in a process of getting to know each other.  One of the steps in that process was my delivering the sermon today.  I received a lot of favorable comments about the content of my message.  More affirming than those comments was the universal invitation that everyone made to me to continue attending the congregation’s worship services.

The picture of the building reminds me of one of the churches I served in my first full-time appointment.  The people also remind me of the members of that congregation because of their friendliness and outgoing nature.  Centenary has been diligent in maintaining their building which speaks both to these sense of dedication to stewardship of what they have received from past generations, and their desire to attract new members.  Both of these are healthy signs for any congregation!

I had a bonus today because my colleague and Pastoral Care Department Director attended the service as an expression of support.  That is something else I want to comment about for a moment.  Colleagues supporting colleagues in any setting is important.  We enjoy a lot of that at Western Maryland Health System, which is a very positive part of the organization’s DNA!

Thursday, October 23, 2014 was a sad day for south Cumberland as a house fire that started in the early morning hours claimed the lives of two young girls: Halaina Smith age 3, and Emily Edwards age 7.  No parent wants to lose any child they love to fire, but to lose two in the same fire at such young ages is a painful experience that I don’t have words to describe.

Tonight, Saturday, October 25, 2014 our community came together at 7 PM at the scene of the fire for a Candlelight Vigil.  The picture you see is the house where the fire took place as it was decorated with battery operated candles and tokens of remembrance for the two young girls.  You are able to see some of the participants holding candles.  This picture does not do justice to size of the assembled crowd.  Without counting I would say at least 100 people gathered.  The mother of the two girls was there and we were able to talk for a few moments following and exchange hugs.  She thanked me for all of the staff at the hospital who care for her and her family as they were being treated following their removal from the burning home.

The vigil tonight reminded me of this Bible verse:

The light keeps shining in the dark, and darkness has never put it out. John 1.5

Each of the girls Halaina and Emily had the light of God in them throughout their lives.  Now that they are no longer on earth, the light of God is in them now more powerfully than it was when they were on earth.  The scene of those gathered on the sidewalk and in the street with the candlelight reflecting in their faces was a sign of the goodness in our world that is represented in light.  My prayer is that the light of both Halaina and Emily shines brightly in the Heavenly realm until we are all able to see it.  I will continue to pray for the family survivors who are still trying to pick up the pieces of their lives and move forward.

One of my frustrations in life is when someone explains to me how they feel, then when I respond, they interrupt and tell me I am wrong even before I have finish my first sentence.  Occasionally I encounter people who are upset with something related to our health system.  I always ask them to tell me about it and listen intently to their description of the event or situation.  What frustrates me is after I have given them the respect of listening, they don’t even let me get five words out of my mouth before interrupting and telling me I am wrong or are just quoting the “party line” to defend the health system.  I am sure I am not the only person to ever be in this situation.

I do want to offer advice to anyone who wants to voice a complaint to someone.  After you describe the situation, be courteous enough to let them finish their response before you respond.  You will be taken more seriously by the person you are talking to if you treat them with the same respect they showed you.  It may also work out that there is another side to the situation than you are seeing.  For resolution of an issue to take place, both people in the conversation have to keep an open mind and show each other respect.  Try it next time and see if this approach is more satisfactory.  I think you will find it works well.

The picture above represents the outlook of our hospice program.  Each week the team meets to discuss our patients and their current needs and how we can best provide them.  We also build connections between members of the team.  This week for Pastoral Care Week the team had a Pastor Appreciation party for me as the pastor or chaplain to the program.  In addition to a lovely card that everyone signed I was given an olive wood box with the image of the Last Supper carved in it.  Inside the box was a gift card to one of my favorite restaurants and a book of humor.  The humor book was really appropriate because I am a frequent contributor of humor items for our daily employee newsletter.  We honor every clinical discipline during their designated week.  This week was my turn to be the celebrated recipient.  One of the best things about being on this team is that everyone cares for and respects all the other members of the team.  Knowing you have the support of your colleagues is very empowering as we work with situations where people are nearing death and suffering from serious illness.

This week is Pastoral Care Week.  The theme this year is Spiritual Well Being.  We have several activities taking place this week to mark the event.  So far my favorite event has been the Pastoral Care Banquet we hosted on October 20^th for our volunteer Chaplain Associates.  We had a full meal catered by the Dietary Department and then adjourned to the Hospital Chapel for a Service of Blessing the Hands.  I was thrilled to see the smiles on the faces of those who attended as volunteers and those who came as their invited guests.  It was obvious our volunteers were touched felt appreciated for the efforts they provide on a year-round basis.  I was glad to be part of an event where a heart-felt “thank you” was delivered and appreciated.  I hope that all the other pastoral care departments that are celebrating this week also have equally meaningful events in their institutions.

Today in worship my pastor preached on the instance where the Pharisees asked Jesus if it was allowed in the law to pay taxes to Caesar.  Jesus asked them to produce a coin to pay the taxes and asked what image was on the coin.  The answer of course is: Caesar!  The picture above is the front and back side of the type of coin Jesus was referencing.  The moral of the story is that the Pharisees were asking the question in hopes of giving them grounds to ridicule or arrest Jesus.  They really did not want an answer about proper tax payments.

As I reflected on how this applies to my ministry as a chaplain I started to remember questions I have heard people ask in that setting.  Many times the questions really don’t have an answer.  That is okay if there is not an answer.  In those cases the person asking the question is processing their emotions and just asking the question, without receiving an answer is helpful to them.

I realize the previous paragraph may seem confusing so I want to use an example to illustrate my point.  In this example the spouse has just learned the patient died.  The spouse had wanted to be there for the moment of death and only missed being there by less than 5 minutes.  The question the spouse asked was, “Why couldn’t _________ (fill in the name) have waited until I arrived?”  We don’t know for certain why the death was not delayed for 5 more minutes.  Some theorize the person wanted to die alone and waited for a moment when no one else was in the room.  Others theorize that it was kinder on the spouse for them not to have watch and listen to the “last breath” being taken.  I am sure there are other answers people propose for this question.

When I am with a family and listen to their questions, I listen for the emotions that are contained within the questions.  In the example I have used many times the spouse states they did not want their mate to die wondering how much she/he was loved by the survivor.  The surviving spouse suddenly feels a reason to feel guilty because they were not there at the last moment of life.  There is always something I know about how the spouse attended to patient prior to the moment of death and I try to use what I know to remind the survivor that they were attentive to the patient.  One example is this, “I know you wanted to be here at the moment of death, but last night when the patient had a fever and you put cold compresses on the forehead to bring comfort, you were there in a way that I am sure the patient knew and valued even though the patient was too weak to speak”.  The survivor usually smiles and says something to the effect, “Yes I was there for that and you know I was needed then”!

I encourage you next time you hear a question think for a moment and decide is the person asking the question as a method of gaining information? Or is the person asking the question as a method of sorting out what has happened to them?  Many times affirmation of what we know is a lot more comforting than speculating on a reply that can’t be proven!

After having my dog, Cooper, at the kennel for 8 consecutive days as I traveled it was a joy to be reunited with him again.  Part of the joy is watching him discover that the things he loves about our home are still here waiting for him when he returns.  We have a normal path we walk most of the time.  He has learned that path and now makes the proper turns even if he is several feet ahead of me on the leash.  I like the fact that I can expect in most cases that he will make the proper turn.  He has two places on our route where he stops and sniffs intently for several minutes.  I am assuming he is finding the scent of another animal in those locations but then not being a dog, I really can’t say for sure.

When we were in the back yard I attached him to a “tie out” so I could move the car into the garage.  Afterward I went to connect back onto the leash and in the process he was not connected to either the leash or the “tie out”.  Being the smart pup that he is, as soon as he realized he was unanchored he began to run.  I knew outrunning him was a futile attempt on my part so I called to him “STOP”.  He did the right thing and waited, even lying down on his side, until I got to him and could attach the leash.  I was thrilled that I was able to avoid a chase scene and that he was safely tethered to the leash.  Had he been home for days in a row I doubt he would have laid down and waited for me the way he did.  But since he missed me, he did lie down and we had a happy reunion on the driveway and also the rest of the evening when we were in the house.  I am so thankful that Cooper did not get away from me when I brought him home!  I think Cooper is also glad we are reunited!

The circle is one of the universal symbols we use for completeness because it has no beginning and no end.  In chaplaincy I often refer to the shape of a circle when we form a prayer circle of family holding hands around the patient while the patient is in the hospital bed.  These prayers are always powerful for me and families respond positively to them.

Today I want to talk about another way that the image of circle sometimes describes my family encounters as a chaplain.  I am the type of person who likes to have closure.  So when I meet a patient and/or their family during their hospital stay and then realize they have been discharged before I have seen them again I wonder how things went for them after I saw them.  Sometimes I am given the gift of being able to see patient and family before they are discharged and learn how things are going and details about the prognosis.  Today I was paged to the death of a patient.  This particular patient had suffered a code blue several weeks earlier.  I was just around the corner when the code was paged and moved to the area and was able to offer immediate comfort to the spouse who was there.  The patient was moved to ICU where I was able to continue to have encounters with the spouse and other family members.  As the family and I said our good-byes to the patient, I was able to feel the emotional bond that we had developed over many visits.  As I left the encounter I was sad for the family because of the journey of grief they were beginning.  I also had a better sense of closure than I often get because I had been able to follow the family through nearly the entire hospital stay.

Relationships are important.  They always have a beginning.  Sometimes their ending is defined and other times the two parties just don’t get the chance to see each other again.  I am even more thankful now for relationships I have with patients and families where closure is part of the outcome.

Today I gathered with medical professionals including chaplains from all over the state of Maryland.  We met at Johns Hopkins Hospital in Baltimore MD.  The event focused on community health partnerships.  In community health partnerships health care delivery is structured to overcome the barriers that prevent people who need health care from receiving it.  The most intriguing concept presented is that more health care is provided in private homes and apartments than any other setting, including hospitals and clinics.  If the care provided is our homes and apartments are done well, the need for office visits and hospital admissions DECREASES!  As the Baby Boomer generation enters the Medicare phase of their lives the old health care provision model will produce costs that are unsustainable.  Moving to an increased focus on health care being provided outside the hospitals and clinics is the key to containing health care costs.  For this to happen each community will have to develop plans that are designed for their locality that include partnerships with medical, governmental, and faith-based organizations who will all work together for the common good of their community and its citizens.

If you are reading this and are thinking, “This won’t be easy”, you are correct!  We have learned in life that other important changes that were necessary are not easy, and this important change is no different in that regard.  I encourage you as you learn of discussions of new programs in your area arise to get involved in the discussion.  This is a grass roots effort and there is a role for everyone in making it work!

The image above is “The Cross” it is in Effingham, Illinois along Interstate Highways 57 & 70.  I am using it as today’s image as we look at advance directives and the whole issue of “quality and quantity of life”.  I recently dealt with a family that was in agreement on what care plan they wanted for their patient.  The problem was that the advance directive, which was completed for the purpose of aiding the family actually created problems due to the wording in some of the sections.  As medical professionals in good faith read the document some came to opposite conclusions on what should be done to honor the wishes of the patient.  After some discussions the interpretation of the health care agent was honored.  A few days later the patient died.  It was a peaceful death, in just the setting the family knew the patient wanted and that they wanted.  Sadness was in plentiful supply.  But faith was present in event greater supply!  The family was Christian and they were able to claim for the patient the promises that God makes through the sacred writings of the Christian faith.  The family did not want the patient to linger in the weakened condition that existed.  While I would have loved to pray for a total healing in this earthly life, it was clear the total healing was going to come in the heavenly realm.  The family gained comfort from my presence and prayers not just at the moment of death but along the way in the decision making process.  I am still struck by how well the family coped with the reality of death and being in unison of opinion as they decided how to provide end of life care that honored the patient’s wishes.  I also offer this as an encouragement to all readers to have an advance directive and discuss it with your family.  If it has been more than 5 years since you drafted it, it is time to review to see if what you wrote in the past still represents your desires for the present and the future.  A well-crafted advance directive can be a blessing to family members as death approaches.