Tuesday, September 8, 2009

Training exercise

This week should be pretty exciting for me and for my co-workers and for some kids who come from some hurtful backgrounds. I recently accepted a job working for New Horizons, a company which works with families and children who are either at risk for all sorts of legal, physical, and emotional problems or have already experienced them. Specifically, I'll be working as part of the direct care staff at the Audrey Grace House, a residential treatment center for troubled adolescents.

As part of our training, the staff of AGH spent some time at the Ranch, in Goldthwaite, TX, another of New Horizon's facilities. Early in our training, the instructor, Randy Fry, led us in an exercise that was designed to give us some perspective into the lives of the kids we'd be serving. He asked us each to take a sheet of paper and tear it into three smaller pieces. On each slip of paper, we were instructed to jot down a person, place or thing that was important to us, personally. Nobody shared what they wrote down, but we were further instructed to stack them in order of importance. Silently, we each weighed our connection to the person/place/thing on each slip of paper and sorted them accordingly. Then Randy said, "Now that you have listed and sorted the three things that are most important to you, take the third most important thing, crumple it up and throw it away. Imagine that it was ripped from you." We each did as we were instructed, crushing the slip of paper into a wad and tossing it into the middle of the circle of chairs. "Now, you've lost that important thing, but what if your next most valuable thing was also taken away from you? Throw away your next paper." Slowly, we processed the implication of what Randy was saying. Several of us hung on to our papers, the weight of what they represented in our lives holding us back. "Go on, throw them away, " said Randy quietly. When we'd all tossed our crumpled treasures in the middle, he instructed us to do it one final time. "Now, take that thing that is most important to you and throw away too." As each of us considered the person/place/thing we'd written on the slip of paper, the paper became more than a paper, it was a real thing. It represented, for most of us, a spouse, a parent, a child, or a relative. We sat in silence for a few moments. Then Randy said, "This little exercise that we've just done is what happens in reality for most of the kids that come to us. They have had their homes, their families, their treasures all ripped away from them. It is understandable that they are scared, angry, fearful, resentful. Most people have a hard time seeing the kid underneath their acting out behavior."

We spent a while processing what we were feeling during the exercise. For me, I'd had a bit of a dilemma trying to select what three things were most important. I have three children and a wife... those are four things and I only got three slips of paper. On one of the slips of paper, I'd written the name of my son, Ethan. I had decided to let him represent all three of my kids because he has been the child who has, until recently, demanded so much of my attention because of his diabetes. When it came time to crumple up and throw away that slip of paper, I couldn't do it. Intellectually, I knew that it was just a piece of paper and this was just a training exercise. Emotionally, I was experiencing a shadow of the pain and hurt that losing him, losing any of my children, would bring. The thought occurred to me then, in the middle of the exercise, that because of his medical condition, the possibility of losing him was more of a reality than I'd like to admit. All it would take is a lapse in our vigilance with his diabetes and he could be in a coma within a day.

The point of the exercise was to help this group of staff, who will be working directly with hurting kids, develop empathy, an ability to see past their anger and acting out and to love them. It was a good exercise.

Keep the Audrey Grace House in your prayers as we begin a journey with this new facility.

God, be with the staff as you bring these kids into our circle of influence. Give us eyes to see them as you see them. Use us as your arms to comfort them, your hands to guide them and your voice to encourage them to grow and prosper despite their trauma. Be with the kids and help them to be responsive to the love that we have to offer them. So many of them have developed a hardness, a shell meant to protect them from being hurt or disappointed yet again. Bless the work of the treatment center as we help the kids to learn about themselves and learn to function at home, at school. Heal the hurts and let your grace and mercy abound, in their lives and in ours. Shape us into the instruments of your love and mercy, as we have received them from your Son.

Thursday, September 3, 2009

As I lay dying

DISCLAIMER: This post may be disturbing to some. Reader discretion is advised

So, many of you know that I work as a hospital chaplain a few nights a week. In that role, I have been present, in the room even, with families as their loved ones have passed on. Sometimes, it happens quietly, as those assembled share stories and memories. The machines that monitor the patient’s vital signs display numbers that continue to fall until the only sounds are gentle sobs and hands rubbing on backs, offering comfort in grief.

I often get comments from people about how tough my job must be. “Man, I couldn’t do your job…” or, “How do you deal with being around death so much?” I usually reply something about how it can be difficult, but it has its own rewards. This is true, but each situation is unique. Some deaths really bother me. I hate the “failure to thrive” deaths on the maternity wards. Those are the worst for me. Next up are trauma deaths that involve an innocent party (mostly drunk driving ones). A lot of deaths that I get called for, I am able to focus my attention on the living. They are the ones that I am usually called to comfort. It is rare that the patient actually needs me. Most of the time, when I am called by the nursing staff because of an imminent death, the patient is so far gone that there is no interaction. I am called to comfort the family. That is a lot easier for me, interacting with the living. It is usually pretty emotionally charged and sometimes there are deep-seated family issues that pervade the room and stifle the grief, but those times are rare. All in all, I think I manage to walk a fine line between being emotionally involved myself and remaining calm and stable for the family. I usually manage to pull it off. I don’t lose sleep, but am able to climb back into my bed after being called out in the middle of the night with a peaceful heart, knowing that God used me to be his arms of comfort to a family in a crisis situation.

But last night, whew. I had a full fledged panic attack. It wasn’t even linked to any one experience, but I just couldn’t hold it back. First of all, I was really tired. It had already been a long day and I was getting ready to go to bed at about 2am (a typical bedtime for me, being a night owl). As usual, I went to check on MH and Ethan, to make sure that their blood glucose was in range overnight. As it turned out, MH was 70 (too low) and Ethan’s registered HIGH on the glucometer, meaning that it was over 600 (WAAYY too high). I woke MH up and gave her some juice and crackers to get her BG back up and woke Ethan up to have him check his ketones and drink some water. Then I had to stay up for another hour so I could check their numbers again. Anyhow, by the time I stumbled up to my bedroom, it was 4am. My mouth was really dry and as I lay in bed, I did that little trick to try and create some saliva in my mouth so I could get my palate to be comfortable. It didn’t work. It felt kind of the way it does when you have a cold or sinus infection and you swallow over and over trying to make things go where they should go, but you can’t get your mouth and throat to feel right. Am I making any sense? Anyhow, suddenly, I imagined that I was laying in a hospital bed, dying. Awake and aware, but unable to communicate that my mouth was dry. All my memories of seeing people in the ICU with tubes in their noses, BiPAP machines taped to their faces, mouths held open and gasping for breath as they struggled to get air into their bodies… they rushed into my head and I couldn’t stop myself from feeling terrified. My rational brain asserted itself and said, “Jeff, you’re not in a hospital. You can get up and get a drink of water.” But for some reason, I just kept lying there, waves of panic gripping me because I imagined myself with my hands in restraints in a hospital bed. Some patients get their hands tied down because they unconsciously pull at their IVs and tubing.

Again, I imagined myself as a person dying, tube in my throat, preventing me from talking or being able to close my mouth, the dryness in my mouth unbearably annoying and I, unable to slack the thirst, panicking. I couldn’t stop my brain from taking me into a scene where I was surrounded by people crying over me, but not really seeing or hearing me as I silently pleaded with them to get me some ice chips or water or something.

This lasted for about 5 minutes last night. I even sat up in bed and tried to get a grip on my overactive imagination. Finally, I was able to generate enough saliva to swallow and get my mouth feeling back to normal and the panic-y feeling went away. But for five minutes, it was terrifying.

Does this weird stuff happen to other people or is it a by-product of the hospital work? What do you think?