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The Place We Are Born and the Place Where We Die – 5/10/2015

I stood beside the open curtain, and prayed. Six feet away, the doctors and nurses did their work. They called out instructions and fragments of information to each other in a code I’d gotten used to but never fully mastered. Tonight’s patient was yet another name I didn’t, know yet another face I’d barely seen: glimpsed from a bad angle as the EMTs wheeled him in. During the initial flurry of loud activity, my role was to be quiet and still – to provide a calm point in the emergency room, and to wait for the moment when perhaps I could do something more.

When I used to work as a hospital chaplain, I spent many nights sleeping lightly in my shirt and tie, with a pager next to my ear to make sure it would wake me. On this particular night when the alarm went off, the screen let me know: car accident. Two adults incoming. Driver and passenger. The patient in the trauma bay now was that passenger. The driver, his girlfriend, had already been cleared through to be x-rayed. In a little more time the man was pronounced stable. The cloud of medics dispersed. He lay on his back, unable to move because of the backboard, waiting to be transferred to a bed upstairs. Now was my chance to actually meet the stranger I’d been praying for, to see if there was anything he might need from a chaplain.

His head, again, was fixed in place, so I leaned over him to look into his eyes. I got his name off of his chart and called him by it – we’ll call him David, this morning. “Hello, David,” I said. “I know you’ve just been through a lot.”

He looked at me deeply, but didn’t say anything. Could he talk? I wasn’t sure.

“I want to let you know that I’ve been praying for you, that I’m here if you need me.”

He moved his lips. At first I thought he was struggling to communicate, but then he spoke very clearly. “Alright…thank you.”

“The woman who was with you is in good hands.”

“…I’m glad to hear that.”

“My name is Kelly, and I’m the chaplain this evening.”

One more long, hard look, and then a smile, and then David proved to be a very chatty guy. We talked for another five minutes: he wasn’t in much pain. He was worried about his girlfriend, but he trusted the doctors to do what they needed to do. And then, after a lull in the conversation, he admitted to me. “You know, the first time I saw you – long-haired guy, looking down at me, with that big light behind your head – I thought maybe the accident was worse than I’d thought.”

For the record, this was all before I even had a beard. While this may seem like a misunderstanding particular to my appearance, and perhaps some poor choices of phrasing on my part, really, this incident falls neatly into a pattern that has little to do with me or with David. Instead, it has everything to do with hospitals in general, and the ways in which people commonly react to the necessity of visiting them.

This year I’ve been preaching once a month or so on common sorts of spaces that make up our lives and world, and what some of their spiritual implications are. Today I’m considering the hospital, which for most modern people ends up being both the place we are born and the place where we die. In between, I believe the majority of us would prefer to stay as far away from the place as possible. In the year I spent as a chaplain, I logged far less time in the hospital than those of you who’ve made your life’s work in the medical field, but still a whole lot more time than most people ever want to spend in such a place. Here, then, are my observations about hospitals in general:

In a good hospital – and they tend to be mostly good, because bad ones get closed or reformed rather quickly – the staff are dedicated to healing people. And doing the work of healing people, in such large numbers and with so many different diseases and conditions and problems, means being prepared for a lot of strange eventualities: things that most people in the outside world would be troubled by. For instance: I didn’t see this myself, but I’ve heard of more than one disturbing sign in an operating room, the most eyebrow-raising of which is, “Emergency Procedure: Fighting Fire on the Surgical Patient.” Fire doesn’t sound like the sort of thing you want to have to face on top of undergoing surgery – voluntarily allowing another person to cut into your body in one way or another because the alternative is somehow worse. It sounds like an unfavorable addition to the calculus of risk vs. reward: “Not only is someone going to slice into my flesh, but now there’s the prospect of my bursting into flames as well?”

But just so that I don’t compound any medical fears you may already have, let me explain why having an emergency procedure for when a patient catches fire during surgery is important. Surgery isn’t just about cutting – in fact it’s as much or more about closing wounds in a safe and careful way. So some of the tools surgeons use put off a lot of heat – they can be used to stop bleeding, or clear diseased tissue. And any time you have something very hot and some other thing capable of burning – such as the gown a patient might be wearing – there is a very small, but still real possibility that the one could light the other on fire. For the average patient, seeing that sign and losing sleep over it is a little bit like seeing the instructions in event of a water landing on an airplane and worrying about that. It’s a very remote possibility, but it’s one you would want the people taking care of you to be prepared for, if it came to pass. By sheer force of volume and its role as a place where people go when they are experiencing some of the most desperate and vulnerable times of their lives, hospitals see a lot of strange things happen within their walls, and anticipating and preparing for some of that strangeness is a big part of what hospitals exist to do.

Slightly related to this is the seeming contradiction between illness and treatment. Modern medicine has a vast and powerful array of tools at its disposal, and the things that can be accomplished in a hospital, particularly the largest and most cutting-edge, are mind-boggling. One family I met when I worked as a chaplain came all the way from Texas because their daughter had been born blind, and there was a doctor at our hospital who had a surgical procedure that could likely allow her eyes to see. There were only two surgeons in the world currently specialized in this particular surgery, the parents explained to me, and the other one was in Germany. Their little girl got to see her mother and father because of that treatment – that’s amazing. And like most approaches through surgery or pharmaceuticals, the treatment required doing something that is normally a terrible idea – like cutting into a human body, or swallowing or injecting something that could kill you if you took too much of it – but in just the right balance so that it solves or mitigates a problem, rather than creating a whole new one. Part of the way that a hospital heals – often how it does some of its most important and amazing work – is by exposing the patient to a carefully managed and measured form of danger. Florence Nightingale, who came from a Unitarian family and was a Universalist herself, said that “The very first requirement in a hospital is that it should do the sick no harm.” In fact, to be effective, much of the time a visit to the hospital does a little bit of harm, in order to create a large amount of healing.

The final quality I would highlight about the hospital is that it always has more than one story going on in it at once. This should seem obvious: even the very smallest hospital usually sees dozens of patients at a time. But it can’t really be understated how broad the gap between these stories can be. At any given time, someone is dying, and someone is giving birth. Families and relationships are coming unraveled under the strain of illness – and often its terrible expense. At the same time, other families are being reunited and drawn back into relationship due to the catalyst of a health crisis. Sometimes the same sort of crisis faced by two different patients might help to heal one family while it tore another one apart. I once watched two men both wait for a heart transplant over a matter of months. For one, it brought him much closer together with his wife. For the other, it reached a point between him, his father, and his sister where none of the three would speak to each other directly, and everything had to go through the mother.

In the daily course of our lives, the hospital is a place where a few of us work, and a few more perhaps have to visit regularly, and or most of the rest of us it’s simply a place we do our best to avoid. But these four qualities of the hospital: its preparation for the unusual, its combination of healing and harm, and its multiplicity of – all of these things apply to religious congregations as well, our own most definitely included. In fact, the current pope described the church as a field hospital after battle, with a duty to address the most serious conditions afflicting those who come to it first, rather than being distracted by its own less pressing concerns.

Strange and unexpected challenges and opportunities arise in congregational life – if nothing else, this prospect now before us of merger with the First Universalist Society of Salem is a fine example of something unlooked for and unanticipated, but which we have nearly finished navigating together, nonetheless. Our congregation seeks to be a place of spiritual healing, but contrary to some of the things we may assume, or even say from time to time, it is not meant to be perfectly safe. Instead, our community strives to contain the dangers of risk and challenge in the right proportions to make its necessary healing possible. Again, like a hospital, a congregation is always made up of many different stories – no matter how caught up a group of religious folks may seem to be in a single issue, or project, there’s always someone in their midst who has something entirely different going on. This is something it’s particularly important to remember as we work together: the person who’s slow to commit to or volunteer for the thing we’re most excited about may still have a lot to offer in some different area.

I heard a story this week about a recent protest in Washington, D.C. Nearly six thousand nurses took to the streets to agitate for a small tax on stock and bond transactions. Rough 50% of the money made in the stock market goes to the wealthiest 1% of the population, and the poorest 50% of our nation see only one tenth of 1% of those profits. So it was a campaign that was – and still is – about raising revenue from the very rich, to help the poor and the marginalized. And on this particular day in Washington, it was nurses who were taking the issue to the streets. The organizer who was there that day talked to some of the nurses in the crowd and asked them: what was it about being a nurse that made this issue so important to them. One woman, who’d come all the way to D.C. from Tanuton explained: every day that she goes to work, she sees the toll that economic hardship takes on the lives of people. How the stress of trying to survive, and the fear of the cost of medical care, isolates them, and frequently literally makes them sicker when they are already unwell, or simply makes it harder for them to get better. The way this particular nurse saw it, she it was her job to help people get better – changing the tax code was just one more way of trying to do that.

This is the final parallel, I think, between the hospital and the congregation. Being part of a spiritual community means learning about the struggles and the hardships of the people around you. We pledge ourselves, each week, to help one another. That can mean a kind word, or casserole when somebody needs it, and it can also mean working to change the world, so that it becomes an easier place for all of us to live in.

I’ll close with another small story, from a different night in the ER. It was a really busy, really hard shift. We had two car accidents, a shooting, and a stroke. After a torrent of urgent activity, we’d reached a lull. The trauma bay was almost empty: all of the doctors, most of the nurses, and even the techs had each left in turn to take this patient or that patient to the OR, or to a scan. Alone with my thoughts for a moment, I was trying to collect myself. As I said earlier, part of my job was to maintain a still, calm point in the chaos. But on nights when I couldn’t do that – when the frenetic urgency of so many people balanced between life and death was too much – I still felt a responsibility to at least appear to be that still point. So I was doing my best to look like I wasn’t completely frazzled and trying to recover from the last wave of crisis, when the only other person in the large room – the chief trauma nurse – did something she’d never done before: she spoke to me.

“Say there chaplain: are you praying for everybody right now?”

I was dazed, and afraid that she was calling me out for just how dazed I must have looked. “Yes,” I said, doing my best not to make it a lie.

“Well can you walk and pray at the same time?”

It seemed like an odd question, but it was so comforting to be faced with what I thought was a safely intellectual question about spiritual practice. “Of course,” I said.

“Good. I can’t leave if I’m the only nurse in here, so I need you to take this blood sample down the hall.”

So that’s what I did. Because in the hospital, people do what needs doing – not always what they expected to do when they got out of bed that morning, but whatever the profound need that is their daily calling requires that they do. So it is also in our congregation: we come together not always to do what is obvious or expected, but first and last, to do what the great urgency in our world and in our hearts makes necessary.

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