bustin' my @$$

Oh, wow. I am so sore. My whole body aches. But the good news is that I know I could never have survived Tuesday's work out a mere two weeks ago. I am getting stronger.

Fit

On Tuesday, I began working out with a personal fitness trainer at gym in the hospital where I work. Oh boy, am I ever feeling the "ow" now. She is going to kick my rear end and whip me into shape.

I have been to trainers before. But always at health clubs and never at a health care facility. This gal is good - her assessment unlike any I have ever experienced (she was able to ask me about old injuries before I told her, just from watching me move and seeing how my body compensated). And she is tough.

These next six weeks will be excruciating. But, let me tell you, I am looking forward to it.

Life Before Death

I face death each and every day. This morning, my day began with stroking the hair of a woman who was dying all alone, unresponsive to words but able to be soothed by human touch. Later, I gathered with a large, boisterous family as they laughed and told stories of their loved one, who left life amidst the merriment and celebration of his many years. I held the hand of a young bride as she gave the word to "go ahead" and withdraw the machine that were no longer supporting her new husband's life but prolonging his death.

You ask me how I can do my job, with death and dying confronting me all day long. You may assume it's a heavy burden. Grief is heavy. Pain and suffering, they can be tremendous burdens. But death, in and of itself, is not such a heavy load.

Death is very real. It's all around us. It's the only certainty we have in life - we will die. Denying this reality, I imagine that could be a laborious task. But I can't do that. Mortality is all to present for me, as I hold the hand of a dying patient as she takes her last breath,or embrace a grieving loved one in my arms.

As I watch people die, I realize that, in many cases, we die as we have lived. If we live life in fear, we die fearful. If we live life in anger, we die angry. If we live life in meaningful relationships and connected to loved ones, we end life loved.

You ask if I believe in life after death. I know for many people, the hope of an afterlife, the idea that somehow, in someway, they continue (or that they will be reunited with loved ones) gives them comfort and peace. I also see that for others, the threat of eternal damnation means they spend their lives afraid.

You ask if I believe in life after death. I am avoiding your questions, I know. [we chaplains are trained to deflect]

You ask if I believe in life after death. Well, no. But I don't necessarily disbelieve it. I just don't think it really matters for me.

You ask if I hope that there is more than this life. Well, no. This life, lived well, is all I could ask for. And it is my desire and my calling and my hope to live the best life I can: to be in healthy relationships, to care for others, to work for peace, to create beauty, to make love, to learn, to grow, to laugh, to live...

You ask what I do believe in. And that's easy. I believe in life. Maybe not life after death. But certainly life before death. What about you?

cleansing

I began working in hospital ministry in 2000. At that time, like now, we had to wash our hands before and after every patient visit to prohibit the spread of germs from patient to patient. The difference between then and now was that in 2000, we had to walk to a physical sink on the unit, stop, plunge our hands under a stream of hot water, and scrub. Now, we push a lever on one of the ubiquitous hand sanitizer pumps and get handful of cleansing foam which we rub into our hands as we move to the next patient.

While I appreciate the efficiency of the hand sanitizer pumps, I miss the old way of going to the sink. I know, I know, I sound like an old fuddy-duddy, "Back in my day...". But the pumps take something away. I felt this something missing when I first returned to hospital ministry in 2007. But it took me almost a year to figure out that what I was lacking was the ritualistic element of stopping after each patient, cleansing my hands, and then returning to my work without carrying anything from the previous visit into the next. And it's more than just germs I am talking about. Standing at the sink and scrubbing my hands gave me a chance to breathe deeply, to pause and reflect on my previous visit, and to release the emotional weight of that visit before I went into another room and another visit.

The sanitizing foam kills the germs on my hands, but it doesn't actually remove anything from me. Instead it just builds up. After several visit, I notice that my hands have become sticky; the foam, coating all of those dead germs, is still there, getting thicker and thicker and making my hands feel yucky.

My heart feels much the same way when I don't pause and release the emotional weight of each visit before moving onto the next. I understand how burnout happens. And I understand how the visits themselves build up and get all sticky and yucky if I don't take a moment for cleansing and renewal.

Making Yogurt - Take 2

Success!!!

Doctor, Doctor

For the most part, I have been very pleased with health care in Canada. Having worked in hospitals in both Texas and Virginia, I saw how horrendously unjust the American health care system is. Immediately upon beginning my work here in Canada, I realized that I was not counseling a single patient or family member who was afraid of going bankrupt or losing their home due their the escalating costs of their care. I saw this ALL THE TIME in the States. Canadian health care is not without it's problems. I have heard stories of long waits in emergency rooms, shortages of physicians, and problems with standardized assessments. But everyone here has access to care. Everyone here will be treated, eventually. And your place in the health care system is not determined by your ability to pay.

I have been particularly impressed with the focus on preventative medicine. It makes sense, when you have the same entity, the province, both paying for service AND providing the service, they are more likely to see the long-run cost benefit of preventative medicine. Whereas, if you have two separate entities paying for service (insurance companies) and providing service (physicians, hospitals, et al), both are trying to make/save money, so the insurance company is going to try to avoid payment for treatment for as long as possible, and the physician isn't likely to provide treatment unless s/he is certain of payment. Thus, illness, ailments, conditions, etc go untreated until they become life-threatening (or until the life is taken and treatment is no longer needed, which seems to be the insurance companies' ultimate goal). In my role as a chaplain here in Canada, I have seen people hospitalized for conditions/symptoms that would never warrant a hospital stay in the States (simply because no insurance company would cover it). The reasoning of the Canadian hospitals is that treating the person now will save money down the road. Even if the focus is still on finances, at least here, the patient is treated.

As a patient, I've had no complaints about the health care system, with the one exception that it's extremely difficult to find a primary care physician. Canada has a doctor shortage, so most physicians are not accepting new patients, and one doesn't go to their PCP for immediate concerns (colds, broken limbs, stitches, infections, etc.). People go to their PCP for physicals, paps and the like. For any immediate need, you go to a walk-in clinic (for non urgent medical needs) or the emergency department of the hospital (for the urgent concerns).

My first experience at the walk-in clinic (for an infected cut on my finger) involved absolutely no wait; I was home with my prescription of antibiotics within an hour and a half of walking out my door. I had about a 30-minute wait on my second visit (for a sore throat). Nothing like the rumours of 30-hour waits that fearmongers spread throughout the States to warn people about the "horrors of socialized medicine".

Seriously, the only complaint I have is the doctor shortage. I needed to go for my yearly physical and pap smear. With the shortage of physicians here, you only go to a gynecologist for gynecological problems; you go to your PCP for your routine examinations. Only I didn't have a PCP yet. And with the shortage, I didn't have many options. So I went with the one closest to my home. And he was terrible. He wouldn't look at me when asking me questions. He seemed disgusted at my body and the thought of having to actually touch me. And he answered my questions is a condescending tone as if I know nothing about health, anatomy, medicine, etc. (I am the daughter of a physician. I do work in health care. I am an intelligent woman. And I do know a thing or two about medicine and my own body.) It was such a dehumanizing experience. I refuse to go back to this doctor.

Luckily, I don't have to. For most concerns, I will go to a walk-in (there are about six within a 10-minute walk of my home). And for anything more serious, I will go to a specialist. And I won't have to go to another PCP for a year.

I won't let a bad experience with a bad doctor become an anecdotal justification in support of privatized medicine. The States has bad doctors, too. I have been to a few. (And worked with many more.) While I would prefer a doctor who would actually look at me and treat me as a human being, I will accept a system that actually looks at everyone and treats all people as human beings. Dr. R is just a jackass. And I would rather be abused by a single jackass than an entire jackass system.