Sacrament - Part three

I have been reflecting on the Last Supper, and what 'do this in memory of me' means to those within traditions of Christianity that have Sacramental tradition and those that do not. I am not seeking to drag up arguments about transubstantiation, although these views drive the way we practice our faith and how we 'do this in memory of me.' What I am seeking to do in these two blogs is simply to offer my heart's reflection during the past week. 
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In my third reflection on the Sacrament of the Lord’s Supper, I am considering a favorite theme of mine—that is, I should say, a long-standing desire to bring this into my life from the heart of my being: the sacrament to the present moment. To those unfamiliar with this contemplative path, the sacrament of the present moment was taught by Rev Jean Pierre de Caussade in the late 17^th century. To Rev de Caussade, it is only in the present moment that we have the precious ability to engage with the reality of eternity. Our past imagination and future concerns are a part of our mortal mind; eternity is, it does not have a past or future. Therefore, we are privileged to meet with the Eternal, engage with God and the heavenly hosts in our indivisible present. The ‘flipside’ of this understanding, is that instead of railing against the interruptions, tensions, and questions of our day, to truly engage with God, we must abandon ourselves to live in these present contentions of our world in our present moment: “the duties of each moment are the shadows beneath which hides the divine operation” (de Caussade).

 The following is a reflection from the Irish Jesuits who keep the site, Sacred Space (http://sacredspace.ie):

One conviction is central to Christian prayer: that God is active in it. We turn to meditation not so much as an exercise in self-improvement, as an opening ourselves to our heavenly father who is waiting for us. Three hundred years ago de Caussade wrote of the Sacrament of the Present Moment. It is only in the Now that we have access to God. Looking forward or back exercises the mind and imagination, but that distracts us from the true meeting of prayer, with the Lord who is present in my inmost soul. ‘Be still and know that I am God.’ (Psalm 46). There is a stage in prayer where we go beyond words and thoughts: the hard bit is to stop thinking. A mystic is quoted as hearing from God, ‘I will not have thy thoughts instead of thee.’ As we grow older, prayer becomes less wordy, less brainy, more like the peasant whom the Curé of Ars used to see in his church, ‘I look at the good God and the good God looks at me.’

I began to wonder how the ‘sacrament of the present moment’ connects with the sacrament of the Lord’s Supper … I began to think of what is happening in the Mass, and began to realize that the sacrament of the Lord’s Supper, is itself a moment of engagement, of meeting with Christ and his Body, suspended in time AND eternity. Thomas Howard, in his book, If your mind wanders at mass, writes of this, saying:

This is the famous ‘communion of the saints’ on which we count so earnestly when we pray. The Church teaches that, in a mystery, the veil hanging between time and eternity is drawn back, as it were, in the liturgy, and that we really are one worshiping body ‘with angels and archangels, and the whole company of heaven’ (Preface for Epiphany)  (p. 38).

Let the Mystery and the Moment begin!

Sacrament - Part two

I have been reflecting on the Last Supper, and what 'do this in memory of me' means to those within traditions of Christianity that have Sacramental tradition and those that do not. I am not seeking to drag up arguments about transubstantiation, although these views drive the way we practice our faith and how we 'do this in memory of me.' What I am seeking to do in these two blogs is simply to offer my heart's reflection during the past week. 

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Packaged jesus

Somehow in the craziness of our drive-through,

instant potatoes, texting world,

we have succumbed to the packaged jesus.

There he is: minimalist, tidy, sterile elements

separated by non-permeable membranes.

Fortune cookie for a Christian economy;

treasure to be discovered a century from now.

Can you see them? Bright shiny archeology students

 digging,

 discovering,

 deciphering,

 decoding the message in jetted ink within the faded tiny circle of grain:

This is my body which is broken for you,

Take, eat: do this in remembrance of me.

In our world, no one is troubled this morning—

No rushing of buying or baking of loaves,

No wine to uncork, pour out to the masses,

No hand to heaven blessing of elements

No eye-to-eye lock and the words, ‘… for YOU,’ host pressed firmly on the palm.

Yet, somewhere, with head-coverings (hard hats or hair nets),

a factory of workers, seven days a week, file in to take their places beside rows of machinery:

 cooking, cutting, stamping, printing, wrapping, shipping, marketing …

Somewhere there stands a row of white coats doing quality control on the packaged jesus’ riding past on the conveyer belt before them.

For this is what we pay for, what we value:

convenience, cost-effectiveness, sterility, and invisibility of effort.

Today, there are no lines of sorry sheep stretching down our aisle,

seeking what-they-do-not-know.

No Mystery, this packaged jesus,

except, perhaps,

where they hid the list of ingredients,

and the expiry date.

Sacrament - Part one

I have been reflecting on the Last Supper, and what 'do this in memory of me' means to those within traditions of Christianity that have Sacramental tradition and those that do not. I am not seeking to drag up arguments about transubstantiation, although these views drive the way we practice our faith and how we 'do this in memory of me.' What I am seeking to do in these two blogs is simply to offer my heart's reflection during the past week. 

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Body and Blood

Body and blood.

They speak of life rough-hewn, raw.

An old West etching of caskets:

side by side by side, eyes penny-ed shut.

There is no room to duck these silent images of black and white death.

Body and blood.

A strange legacy to leave these small soldiers of a new world order

organically grown from the stillness of star and stable.

Eternity sliding beams of sterile light through golden straw?

No, instead birth is chosen.

Blood and water mix,

there is a wrestling of flesh and spirit,

lungs stretch, aching to learn the lesson of air and earth-life,

there is the sting of night, the shock of wet,

and the omnipresent scent of sorrow.

Perhaps that is why the kindness of bread and wine is what he gave

to this raggle taggle group of guardians. See them

reeling at the thought of treachery amongst them.

Side bars of conversation cease,

now they are mouthing, tasting,  slumped in puzzled wonder

at this solemn elevation of bread and wine.

They do not feel the roll and pitch underfoot;

like the Sea of Galilee, their world rocks, quakes, boils.

Body and blood they are to see prolonged.

No awe-full act of birth awaits them,

instead, a slow separation of flesh and spirit.

But, that day, he gave them bread and wine.

Staff of life and heartening cheer—Remember Me:

from the fields of parables they traveled, imbibed Him, embedded that living Word,

bruising grapes under their sandals,

the crush of grain between the Master’s hands,

they walked and talked and tasted.

Bread and wine. An echo through ages,

eons of understanding that this is essential essence of earth-living.

Now, eternity-infused;

there is an awe of things at once so simple (essence) and profound (eternal).

In Memory of Me.

This kingdom of bread and wine;

eternity-infused, transformed,

transforming body and blood.

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Voice and agency

Janna, my Dalmatian, is a talker. She has always grumbled, moaned, sighed, barked, yodeled, and done this weird, uncanny half-whine, half chant when she is very excited about something amazing like finding my sock on the laundry room floor. Her sister, Maggie, is much quieter and very much the slightly-sneaky observer who notices everything. Most of the time, all that talking gets Janna what she is after—the lion’s share of attention. From her, much more than all that nursing literature out there, I’ve learned the deep connection between voice and agency. We are able to act as our own agents when our voice is heard; when we are marginalized, our voice is dismissed, or ignored, or simply drowned out by louder voices, and our ability to act as our own agent is negatively impacted. Our ‘vote’ is not counted. That toddler, sitting on his mom’s lap for an immunization, was clearly registering his vote. Thankfully, for his greater health, we shifted that vote with our distraction technique of bubble-blowing, otherwise his voice would have given rise to the agency of running out of the room!

As nurses we take this connection between voice and agency, between vulnerability and marginalization very seriously. On a daily, an hourly, basis we care for people who are made vulnerable by situation and have a voice, and people who are made vulnerable by society and have little-to-no voice. We see their disparate outcomes in recovery. For nurses, social justice is an integral component of practice: health and wellness outcomes are connected to voice and agency, vulnerability and marginalization.

Traditionally, nurses have always stood shoulder-to-shoulder with their patients, identifying with an equal plane of social power, acting as translators of ‘orders’ and advocates seeking to catch the ear of the white-coated medical elites. I cannot count the times that I have sat beside patients helping them think through and jot down questions they will take on their next doctor’s visit, seeking to give voice to their personal concerns and to have agency into their care. We act to empower these patients by coaching them to use their voice to gain ground in that short eight minutes they have the ear of their physician.

The dynamics of nursing have changed with time. We are now all-too-often fiscally restrained by time and outcomes not of our choosing; we are also moving up the ladder professionally and are beginning to sense the power distance growing between patients and ourselves. Along with the health care system, we are becoming ‘bigger’ and patients are becoming smaller. It is difficult to have your voice heard in the vast system that is the business of healthcare.

We cannot lose this innate call within nursing to identify voice, agency, vulnerability, marginalization in our care. To do so, would change the core of nursing. The pressure of practice today, however, is to move toward programs of interventions and guidelines of practice based on outcomes. There is everything right in this move, except that the decision to keep or axe a program or produce a guideline of practice is only as good as the evidence supporting it. Much of the evidence of which we are basing these fiscally-imposed decisions is from data that has failed to adequately capture the impact of nursing care interventions on patient outcomes.

For example, nurses’ care is often reduced to ‘tick sheet’ documentation that speeds up our world and is much easier to digitally record, however fails to record most of the actual care encounters that make up our shift. Narrative charting does not translate well to a digital world. The narrative portion of the chart (Nursing Notes) is helpful for communication between providers during an episode, but is disregarded after discharge. There is a huge component of nursing that has increasingly become invisible to decision makers, policy writers, and program evaluators. Two things happen with invisible voices: marginalization and lack of agency. We also forget who we are—a loss of identity because the new generation of nurses lose the connection of the ‘way things were.’

Doom and gloom for our profession? Of course not. We do need to acknowledge that change is the only constant in healthcare :-) … and we will continue to change with the needs of patients and populations. That is nursing and that is good. However, I do believe that to keep our strong core of advocacy and this commitment to social justice that informs our direct care and practice, we do need to strongly advocate for nursing sensitive indicators to be included in EHR systems so that we can document our care in a more complete, meaningfully manner. We need to raise our voices about what our direct and indirect care has contributed to outcomes of individual and groups of patients, of our communities and patient populations, or we will lose our ability to do what we do best. We need to learn to clearly articulate our needs as a profession and as individual professionals in our unique contexts of care, because if we cannot give voice to our needs this directly impact our ability to act, to be, nurses. Our agency is on the line.

God speaks as a still small voice. He also gets our attention by speaking in diverse ways (not necessarily louder). He speaks so that we can become bold in the knowledge of his great love for us and our neighbors. There is no exclusivity about such love. There is no circle of immunity to marginalization. We are called as nurses and as people of God to hear and to care. Let us support one another in continuing—and increasing—our ability to do so.

Hearing that voice

Hearing voices … this phrase conjures so many thought-directions. Nurses are all-to-familiar with patients who are tortured by the voices in their heads—as are Chaplains, for other reasons! Devout believers from diverse religions, sects, and cults yearn to hear and discern the voice of God … the Universe … or, Gaia herself. Everyday people driving to work, eating in diners, scrubbing their showers, tending their kids, long to discover the voice within—that proclaimed wise voice who knows who we truly are, why we are here, and what we are meant to do. For isn’t that the meaning of the current pop-wisdom rolling from cable to TV screen to living room: “Follow your heart … listen to the wise intuition residing deep in your … body … mind … heart … soul … spirit (depending on the originator)?” 

The voice is everything in our culture. No, I’m not talking about American Idol and the entire pantheon of spin-off talent shows across the networks. I’m talking about our culture’s unified fixation with THE voice—ours! Or so our individualism would say … Although we are driven to have our voice heard, we tend to hear that individualistic voice of ours simply echo back to us the voice of the majority—or the loudest, most media-drenched segment of the ‘majority,’ anyway! It seems we have ambivalence about voice: we want to have our voice heard and yet, like middle-schoolers, we want to fit in. We find it almost impossible to stand out against that media wave we identify with as the majority voice. Perhaps our fascination with trend-setters and cultural icons is a sign of this ambivalence of longing to be heard yet wanting to be one of the crowd. Perhaps our intoxication with celebrity status is a symptom of our yearning to have our very own voice ‘stand out.’

That said, our culture prides itself on its individualism: we see ourselves as pioneers, trailblazers, and our nations as having been forged on the backs of single-minded leaders who subdued the wild frontier. We, the colonizers of the West, have difficulty understanding any culture that does not cultivate individual voice over communal identity. To our Western minds, having a ‘voice’ means having a vote; raising your voice is an ability to protest, to have your needs made known, and presumably, met. To be ‘voiceless’ means to not have a say in the matter; the voiceless are marginalized, made invisible and helpless in our world.

We continue to have our challenges with raising our voice and listening to voices and most of our problems probably come from frantically trying to do both at the same time. Judge Judy is forever citing the old saw that says something like this, “We have two ears and one mouth for a reason—listen two times for every one time you open your mouth.” I am amazed at the graciousness of God that he did not give us ten ears and one mouth … Interestingly, the voice of God in Scripture varies from ‘still and small,’ to the roaring of a lion and a tornado, to the braying of a donkey, and the blowing of horns. Apparently, we don’t hear ‘so good’—and God finds it necessary to get our attention by mixing it up! I immediately conjure up the image of ourselves as the so-easily-distracted toddler who is wailing, ‘NO!’ one minute and staring mutely at a cascade of bubbles the next … As nurses, we are lightning-fast quick draws in pulling out those bubble wands during immunization encounters! 

My dissertation research project is called, ‘Lift up Your Voice.’ There are voices within our society that we have difficulty hearing within healthcare and as a society. This may be due to loss of capacity or functionality from the speaking, or voice side of things, or inattention and marginalization from the hearing end of the conversation. Individuals that live in residential care face huge challenges in being heard in our frantic, technology-driven society and our over-stretched, assembly-line healthcare system that cannot afford to pause to listen for indistinct voices. I am noting the many ways individual nurses and other direct care givers seek to incorporate the individual voice of residents in daily care; and I am seeking to hear the voices of these residents to shed light on what we are doing right and how we can better hear their voices.

Over the next few entries, I will be exploring the concept of voice and reflecting on themes that are emerging as I begin to listen. My hope is that I will learn to use my two ears and only one mouth in my own daily all-encompassing practice of care. 

from Palms to Passion

The crowds preceding him and those following

kept crying out and saying:

"Hosanna to the Son of David;

blessed is the he who comes in the name of the Lord;

hosanna in the highest."

Matthew 21:9

Today is Passion Sunday, now combined with, and sometimes better known as Palm Sunday. The Passion of Christ is read following the reading of Matthew noted above. The Sunday School illustration of Jesus riding on a donkey as he enters Jerusalem, his way lined with cheering people who create a carpet of palm fronds and robes for him to pass over (no pun intended!), is burned in my mind. I’ve always loved Palm Sunday, although I suspect that as a young Sunday School pupil, my interest was more in the donkey and the palm trees rather than the earth-shaking theology being played out in that simple event, so long ago. As a kid, what I saw was truly an oh-so-fun triumphant entry—how amazing to get to ride on a donkey and have a crowd of fans waving and yelling out a welcome. The irony of the utter humility of the King of Kings riding on a donkey, rather than on a steed, a rag taggle of humanity instead of a mounted legion surrounding him, the complete absence of dignitaries, trumpets, and royal reception, completely escaped me. 

From palms to passion. The link between these passages so close in time, yet so far apart in action escaped me as a kid. I did not get that the crowd that enthusiastically greeted Jesus’ entry into Jerusalem, days later, called out, mob-like, for his crucifixion. I didn’t want to believe it, and still wish to believe that there were simply a few bad eggs in the crowd who were easily swayed. That the rest were loyal friends to the end; friends that somehow deserved the passion of Christ. However, I since have learned that crowds are incredibly fickle; easily blown by the wind of emotion and situation. That I, as well, can be driven by that wind; that all-to-often the amount of sleep I have had, the level of back pain I am experiencing, the number of dishes that have gathered in the sink, the race I am losing to complete deadlines, the wait for the computer to update … all conspire to blow me away from my center. At times, the sudden, overwhelming wind of despair, stress, grief, loneliness, helplessness can pivot me around like the Dalmatian weathervane we have on our gazebo. Would I have been one of the bad eggs in the crowd if the wind had blown the wrong way that morning so long ago?

I lately have been reading Joan Chittister, O.S.B. In this reading that I would like to share here, I again was reminded of how our patients are our teachers, even in this struggle to abide in the center and not be swayed with the fickle wind that blows around us all.

We are surrounded by people who struggle through terminal diseases and live years beyond any reasonable prognosis because they refuse to give up. They simply go on as if life were normal. They simply insist on living … There is, in fact, no struggle that does not develop to the point where a person must choose between the fact of defeat and effects of quitting. Everyone is defeated sometime. Many then simply quit the fray. But the really strong, the really committed, do not. They decide instead whether or not the mountain is worth the climb. And if it is, no amount of wind can force them from the face of it. They endure for the sake of enduring. They live to finish what they began. Endurance is not about being too stubborn to give up on the impossible. Endurance is about having heart enough to keep on trying to do the possible, even if it is unattainable. We nurse the dying through years of disability. We begin projects for the poor even when they don’t begin to make a dent in the problem of poverty. We hold on against opposition for the sake of the principle of a thing. Those endure who seek to do what is deeply important to them, no matter how difficult it may be (Joan D. Chittister, Scarred by Struggle, Transformed by Hope).

The wind that blows our Dalmatian weathervane back and forth and all around will continue to blow, the weathervane will continue to spin. Instead of being afraid of the wind of emotions, sorrows, memories, and physical annoyances that blows through my day, I am learning to see this wind from a different perspective. The palliative and trauma patients that I have nursed over the years have taught me how the essentials, the core of life is clarified by illness, pain, limitations. Perhaps the lesson in the crowd is that the wind blows and we are given the terrible gift of seeing what is truly at our core. Thank God we are not alone when we see ourselves for the fickle cowards we can be—for in that split second of truth we are given the choice that the thief on the cross was given; we may cry out, again and again, “Jesus, remember me!”

Blessings on your journey as we walk with Christ through this Holy Week.

of bridges and dams, fields and fortunes ...

“Religion is meant to be a bridge to God, a vehicle to understanding. It is meant to plumb the depths of the human soul to the source of the spirit. Instead, religion can sometimes even be an obstacle to union with God. As the wag put it, “in order to sin properly it is not necessary to break the rules. All you need to do is to keep them to the letter.” Joan Chittister, Welcome to the wisdom of the world and its meaning for you.

Although I'm not immune to the pathos of the return of the prodigal, I’ve always, always had a soft spot in my heart for the eldest son. You will recall that wonderful-awful story Jesus told of the prodigal son (Luke 15). The older son makes his way home from the fields after working hard all day and walks into a party for his no-good, thankless younger brother. I can see him now: trudging along the dusty trail, thinking of a million things that still need doing on the farm, visioning a nice cool shower to wash away the day’s endless grit and the sun’s boring heat. Then, the sounds of merriment stop him in his tracks. What? Has he forgotten some event that his father had ordered for the day?  He summons up his energy, brushes the most obvious dirt of his clothes, pulls his collar straight, runs his hand through his hair as he adjusts his face in the most welcoming smile he can muster, given his work-weary demeanor, for his father’s guests. He beckons to a servant, seeking to find out what’s up … begins to ask,  who are the guests? Can I slide in the back door unseen to clean up before my father needs me? In his mind he is walking through the door and entering the dining room, an apology for the lateness of his arrival on his lips, his father’s approving eye on him. Even as the servant begins to bubble over with the news, even as he sees his father walking, nearly dancing, upright and merry to his core, stooped and careworn no more, he knows. His charismatic, sweet-faced, younger brother has returned. The news stops him cold. Dead in his tracks, lips still curved into a smile of welcome, freeze, then curl into contempt. What mischief is he up to now, he thinks. Thankless, good-for-nothing heart-breaker, he thinks, watching the nearly tangible joy leaping in his father’s eyes as he comes closer. What good is it? His heart aches, watching such joy, it is for him, it says to him, for the other, for the one I lost. His eyes die but almost immediately, a new flame is lit in his belly, a flame fueled by anguish that rises to his eyes and erupts into words, “All these years, all these bloody years … nothing! Never have I so much have questioned your orders! Worked nonstop for you! Nothing! He drags his sorry ass back home—obviously broke—always …  he just smiles at you and you just hand him the farm ... the farm I work, not him! …” The anguish floods the flame, and like a choked engine, he is left cold. Empty. Heart-dead.  Not enough for me.

What is it about us that in our core believes that love must be discrete, parceled out to the deserving and is somehow tainted, watered-down, or made meaningless if it falls on the other as well as ourselves? Love deeper than the ocean, bigger than the sky, love that does not ‘run out’ seems to us to not be as worthy, or as special as love that is narrowly  applied, that must be earned by a select few. We are elevated when we are one of those select few. We stand apart, special, uniquely identified as the beloved’s. We will always have enough as long as we hang onto it for ourselves. What a God we have created in our own image. For this god who jumps to and rewards our small obediences is forced to ignore the plight of those not in our circle of knowing.

“Religion without the spirit it is meant to preserve can become positively irreligious: we put the weak, the wounded, the addicts, the religious others outside the boundaries of our perfect lives, fearful of touching what might pollute us. Religion—who hasn’t seen it happen? –can be a very sinful thing.” Joan Chittister, Welcome to the wisdom of the world and its meaning for you.

I have empathy for that big brother who worked day in and day out building the farm for his father, only to see it slipping away (or so he thought) through the open-fingers of a pleasure addict. He was not evil in his thinking, only small. Like me, he fails to understand the Mystery of a love so vast that it can blanket all of creation without a stretch, without the persons at the sides needing to grasp at a corner to keep covered. The mystery of such love continues when we are told that such vast love recognizes the particular, the individual, the tiniest sparrow. There is enough, even for the great greed we have for love. The elder brother was not short changed by the love his father poured out over the undeserving head of his younger brother. There was no yank of the blanket off him when covering the other with love.

In our world, we live in the context of scarce resources. As nurses and health care providers and policy makers, we must ration services because of there their finite nature. How we do this very much demonstrates our values. Who is worthy, who is less worthy? What about earned worthiness: those who are productive and pay into the system? Those who are making healthy life choices? Who is truly vulnerable?  What portion of our meted lot goes to them? How we approach these questions of social justice and health delivery in many ways demonstrate our heart-understanding of this parable. Although the limited nature of our resources is indisputable, the vastness of our greed is just as indisputable.  Could it be that our greed has more to do with the allocation of scarce resources than the scarceness of these resources themselves? Profit is all well and good, until one realizes that ‘profit’ is to the haves, what ‘loss’ is to the have-nots. Wouldn’t be amazing if the demise of the profit/loss sheet in health care actually accorded more health and less loss to real people?

I want to think that the elder brother eventually moved past his brokenness and got it. That he learned, by looking even more deeply into his father’s eyes, that the joy did not stop with the younger son; that the love flowed free, and wildly-vast: limitless. I want to believe that ‘fairness’ is bigger than one son or the other can see … and that it is no matter, because all of us, no matter our task, our daily toil, work in our Father’s fields anyway.