Don't forget the rose

Sometimes when you ask Jesus to help you see people through His eyes, He gives you some heartbreaking perspective.

Recently at the hospital we had a patient who came in late one night. During our staff huddle on Christmas morning, we were all warned about her—“She yells at people, calls them names, hard of hearing, complains, talks your ear off, etc…” She was dependent for most of her care, but it was very difficult to help her because she was so painful in certain areas. She ordered us not to touch them, but it was impossible to tell where we could and couldn’t put our hands to turn her. The process was complicated by the fact that we had to literally yell for her to hear anything we said. When someone accidentally touched the wrong spot or did the wrong thing, she lashed out verbally. All of the things I heard at huddle were true—except it was achingly obvious that it all stemmed from great physical pain, psychological distress (and some mental illness), and the knowledge that no one cared.

This patient was anxious, painful, and had lost nearly all control of her life. She was very particular about little things like having her box of tissues in the exact right spot, and having all the bedding just right. We figured out how to roll her with less pain (though still not how her own caregivers did it) and everyone was kind, but slowly and surely each staff member got a little irked.

I was in and out of her room a lot, and I tried to love her like Jesus did. We didn’t have many extended conversations due to her hearing loss, but I was able to get to know her a little bit and saw numerous smiles. Somehow it came up that I loved Jesus. She told me that she was an agnostic even though she grew up Protestant, but she still believed in the power of prayer and that it got her through her last hospitalization. She asked me to say a prayer for her, and I agreed. I didn’t do it there, because I didn’t think of it, but it was probably better since I would’ve had to shout it. I asked her if she’d like me to sing, and she requested Hark the Herald Angels Sing. In hindsight, I wish I had sung more—she really appreciated it.

She had a number of concerns about her health, and she felt like none of them were addressed during her stay. From the medical team’s perspective, I think that they didn’t see any acute problems that needed to be treated, especially given her baseline condition. But that doesn’t discount the fact that she felt ignored. That is a horrible feeling, especially when you’re in the hospital.

The next day she continued to express concern that no one was listening to her. Her paranoia was certainly partially a result of psychological issues, but her feeling of being unheard was legitimate. While taking her vitals that morning, it hit me that she was knowingly leading an existence where everyone resented her. Her volatility got her caregivers so unruffled that they forgot she was a person. She was just a bother. Each place she went was happy to see her go somewhere else. When talk came of her discharge, everyone was relieved.

She had a rose sitting in a cup on her bedside table, delivered on Christmas by the family of another patient. As I was helping her get ready to go back to wherever she lived, she mentioned that she wanted to be sure to bring her rose. I fixed up a little contraption with a hospital water bottle and some tape to make a watertight container she could hold. She kept insisting it wasn’t going to work, but when I was done she was pleased. She came with no belongings at all, but when transport arrived, she repeated over and over not to forget the rose. “I need my rose!” I was struck by her attachment to her flower—something bright in her life, something that she owned and wanted to care for, something that made her feel valued.

After she left, I couldn’t take it anymore and I went to the break room and cried for her. I was (still am) absolutely heartbroken. I literally cannot imagine what it would feel like to bounce from one place to another, knowing that she was utterly alone. I just hope and will be praying that Jesus will reveal His great and intimate love to her. She doesn't have to be alone because God is always at her side. He is so real and He loves her more than anyone else ever can.

Given that the majority of our patients are old people, homeless, and drug addicts (and often all three), it’s pretty easy to get disillusioned with the completely broken system. Addiction, trauma, poverty, damaged families, and mental illness produce hurting people that are hard to save. We can’t fix these problems at the hospital. Instead, we discharge patients back to the street in sub-freezing temps, or maybe to an intermediate facility first. We get frustrated at the endless requests for pain meds and the creativity of addicts, and struggle to distinguish between real pain and drug-seeking behavior. We run out of ideas for helping those who suffer from mental illness. We lose patience when dealing with crazy people. We release patients back into abusive relationships, and they go because it’s the only love they know, even though it’s fully conditional. Our compassion is tainted.

I went to a Christmas Eve service this year, and the message was about waiting. When the people were anticipating the first coming of the Messiah, they waited through many generations. Many lost hope after living their whole life and seeing no sign of the Promised One. But when the first Christmas finally came, it showed that God does keep His promises. He “writes dates on the calendar.” There is a lot of good in this world, but also a great amount of pain and brokenness. It’s so easy to feel hopeless and discouraged, and there’s no doubt that God is sad with us.

But each Christmas reminds us that God DOES write dates on the calendar, and He is still sovereign. He gave us Jesus, who allows us to live a life of freedom if we choose Him and take up our cross daily. He gave us the Holy Spirit, who enables us to be representatives of His all-surpassing love and peace to His people. God loves this broken world more than we can ever imagine, and His heart breaks too.

Sometimes when you ask Jesus to love through you, He opens your eyes to the unloved.

Caring for people is hard. Seeing the despair is disheartening. But God is powerful, and HE IS WORKING. He brings healing. He gives us hope. And while we wait for Him to return and fix the brokenness, we can love His people.

Humble pie

Recently I've been thinking about how to make God truly the center. I want to live a life fueled by His grace which makes everything possible. A life where my successes and accomplishments pale in comparison to knowing Him. I'm currently in the midst of PA school interviews all over the country, and it is beyond exciting that all my hard work is finally paying off. I've been reading Philippians a lot lately, and though I've read that book countless times this is one of those examples where all of a sudden a familiar passage has new meaning.

In the third chapter, Paul talks about all of his great accomplishments and righteous qualities (which, despite his point, many people find somewhat arrogant), and then goes on to say that he considers it all nothing compared to the surpassing greatness of Jesus.

All of a sudden, I understand much better where Paul was coming from.

Last week I had my third interview, at a school that is not my top choice but still a strong option, and I was really impressed with the program. I came away feeling confident that my interview went well, and I felt that I would be very happy and receive a great education there. I really thought I would get in, and I was excited to have my first acceptance so I could stop wondering, and know for sure that I was going somewhere.

Well, I heard back from the school yesterday. They have put me on a hold status, which means that they will reconsider my application with each new group of interviewees and I could receive an offer (or the alternative) at any point after the remaining interviews. It's funny, I was actually more disappointed to hear that than I was when I got the denial from OHSU.

After mulling over the program's response for a while, I started to see God telling me something: I have gotten a little too confident. Please bear with me, as I run the risk of sounding just like Paul in the following sentences. I know that I am a competitive applicant, and I have to be aware of all the reasons why so I can "sell" myself to each program. I've been blessed with qualities conducive to medicine, like a passion for science and learning, an unmitigated commitment to my goals, and the ability to relate to people. God has given me amazing opportunities to travel, serve, gain interesting experiences, and explore various areas of medicine. And I have worked HARD to get to this point--interview invitations are not easy to come by, and it's still crazy to me that this season of life I've been dreaming about for so many years is actually reality.

Because I have put years of time and effort towards getting into PA school (and spent so much time writing about my qualifications in seemingly endless application essays), I have started to feel a little entitled. A little cocky. I didn't realize the direction I was heading until this week. I was so sure that I was going to get my first offer, and I think that God knew that I needed to back up and eat some humble pie.

No matter how amazing my application is, I won't get in unless God wants me to. (And no matter what kind of mistakes or weaknesses I bring, I can still get in because nothing is too great a barrier for Him.) Certainly, things happen in life that God does not want. We are not His puppet show, and for that I'm grateful. I believe that there are many God-honoring directions my life could have gone (and could still go) and I have worked hard for the path I've chosen. There is no denying that.

But this email yesterday was a reminder that I am NOT entitled to go to PA school. I cannot have so much confidence in myself that I forget my God who has made all this possible.

When I get an offer, I don't want to think, "Yes, finally! Someone sees what a great addition I'll make to their program!"

I want to say, "Wow, God, you are so good. Even though I am a fallible, prideful human who doesn't always make you a priority, you are making my dream come true. What amazing grace you extend to me."

Perspective

As I write essay after essay for PA school apps, I've been reading a lot of my journals from impactful experiences over the past few years. I realized that one of those experiences somehow never got posted on my blog, and it was one I will never forget. My senior year of college I spent spring break at Mel Trotter Ministries in Grand Rapids, staying in the women's shelter and interning in the public inebriate clinic, which provides a safe place for highly intoxicated homeless individuals to sober up and sleep. I wrote an article about my time there, and since I have hardly posted at all this year, here it is.

I grew up in Portland and homeless people have never been scary or unfamiliar to me. I’ve always made an effort to say hi or offer a meal, and growing up I enjoyed periodically serving at local shelters and ministries, but before my stay in the women’s shelter I had no idea what it actually felt like to be homeless.

I was not in Grand Rapids to have fun, but to get a small glimpse of homelessness. My roommates in the women’s shelter were wonderful and the ladies were welcoming (though they thought I was crazy for choosing to stay there), and through conversations I realized how incredibly privileged and blessed I am. I also realized how isolating it must feel to be homeless. When I looked out the window and saw families out for a day on the town, I felt separated, like I was in a completely different level of society. One day during a meal, I felt very self-conscious and inferior compared to the family serving the food, simply because they were giving and I was receiving. They had no reason to think that I was anything but a regular shelter guest, and I wanted to go strike up a conversation so I could slip in the fact that I wasn’t really homeless. But I kept my mouth shut, and let myself feel the difference.

Even though we don’t technically have class distinctions in the United States like in other countries, I find it quite disheartening that there is such a clear line between “them” and “us”—a line I did not understand until I was on the other side. During my time in the PI clinic, I saw many intoxicated men, often the same ones day after day. But when they started to sober up, I got to know them and they got to know me. I was able to develop initial relationships with them, and even though we are at very different places in life and our time to get to know each other was short, class separations were irrelevant because they, just like me, are people who love and hurt and need a Savior. I went out to lunch downtown with a friend after a few days at the shelter and clinic, and as we walked and drove around I saw several men that I knew or recognized from the PI clinic. It was heartbreaking because I knew them. I saw them every day. And they live on the streets. They’re not just poor forgotten homeless people. They’re dads, brothers, and husbands, with names.

Wherever I live from now on, I’m going to invest myself somewhere where I can get to know the homeless on a personal level. I never want to forget the perspective that I gained during my spring break, and I am so grateful to Mel Trotter for allowing me to stay in the shelter and work in the clinic. I also want to remember that even among the brokenness, God can bring redemption and hope. I pray that I never forget this experience, and never forget His healing power. I pray that I can be rooted and grounded in His Word so I can be His hands and feet, and be a light to everyone I interact with, wherever I may be. 

God closes doors because He is good

It's funny how God always seems to knock me off my feet with His goodness and sovereignty by shutting doors to things I thought were my greatest dreams in life. Maybe you remember last year when I didn't get the OHSU job I hoped for because of the possibility of starting PA school soon, and then ironically found out shortly afterwards that I didn't get in. Instead of giving me what I wanted, God opened the doors to a completely unexpected job in hospice home care. Over the following nine months, I was challenged to trust and depend on Him on a whole new level. I was blessed to work for an amazing company with great, compassionate coworkers who really cared about each of our patients and their families. I learned how to balance a full-time job, a time-consuming anatomy and physiology series, and the detailed PA school application process (and later job applications on top of everything else). I was able to sing and talk about my Jesus to many of my patients and their families.

It was a good season in a lot of ways, and I am very grateful for the lessons I learned in hospice that I will certainly take with me as I continue to pursue becoming a PA. But it was also one of the hardest, most stressful seasons of my life so far. The extensive driving, geographically spread-out appointments, and discontinuity of my days was exhausting, and while I loved many aspects of the job, I struggled to find energy during the week and de-stress on the weekends.

I had been considering reapplying to OHSU for a hospital CNA job, and one day in early May I decided to check their job site. There were quite a few openings, and all of a sudden I knew that God was giving me permission to leave my job and begin to pursue OHSU. I gave a five week notice and started to say my goodbyes to coworkers and patients. It was bittersweet, but I was excited about starting at the hospital (I was able to get hired before my hospice job even ended--God provided!) and being able to do something about my stress level. I ended my job, submitted CASPA to eight PA programs, and finished my A&P class. Finally, my stress started to dwindle. I had to learn how to relax again, but slowly I started to adjust.

I will get back to my intro soon I promise, I just had to give a quick life update. Anyway, I was ecstatic to have finally submitted my application to OHSU (Oregon Health and Science University for you non-Oregonians :), an amazing institution with a top-notch medical school and #5-ranked PA program. I have dreamed of going there since before high school. I was also beyond thrilled to begin a CNA job there, which I just started two weeks ago. Even though I've only been orienting on the floor in my unit for three days (which is a full 36-hour week), I absolutely love it. The hospital is where I've always wanted to be, and it is as great as I'd imagined. I hoped that I would get into PA school at OHSU and just stay on there forever.

Long story short, I found out a couple days ago that I did not get in. Not even an interview. It's weird to think that the school I'd always dreamed of attending is now out of the running. But when I got the email, I wasn't devastated, nor did I feel like my dreams were crushed.

I felt like God was saying, "I have a different plan, and it will be way better than what you could have envisioned."

He shut this door to my plan so gently and graciously, and instead of grieving my rejection, all I could think about was how beautiful and sovereign and trustworthy and good He is. Maybe I won't get into any PA program this year. Maybe (hopefully) I will get to try out a new state starting next summer. Maybe God has an idea that's altogether new.

But you know what's not a maybe? God. He is my refuge. My counselor. My wisdom. My peace.
He is my center.

Today in church the sermon was about prayer. Being in "constant, conscious, communion" with God the Father. This trains us to be dependent on and obedient to Him.

God used this closed door to remind me where my primary passion should lie. He has blessed me with the gift of trust, which is why I was able to read that email and see Him working. But I want to seek Him so deeply and consistently that in everyday moments, whether they be frustrating, joyful, sad, or quiet, my thoughts turn immediately to prayer.

I want the Spirit to be present and pervasive. I want to be in constant, conscious, communion with Him.

I will leave you with the words of the always-relevant Rend Collective:

I come in simplicity, longing for purity 

To worship You in Spirit and truth,

Only You.

Lord strip it all away, till only You remain 

 I'm coming back to my first Love,

Only You.

Jesus is alive!

The ministries that God has placed me in don't always get a lot of return, and sometimes I feel like the message of Jesus is just not getting across. But God blessed me this weekend with a few really meaningful encounters.

I teach the three-year-old class at church, and it is a lot of fun. But it is also chaos, and when we sit down for story time usually only about two-thirds of the kids gather, and out of those most of them are standing, talking, or trying to hold my props. I have to admit, I don't spend as much time prayerfully preparing as I should, but I always try to be spiritually ready to represent Jesus. This Sunday, it was my third week in a row teaching and I was exhausted. We only had eight kids, which was a blessing in and of itself, and we did lots of singing and dancing before sitting down to reiterate the Easter story. I was blown away by the fact that, for the first time, every single kid sat down and quietly listened as I opened Easter eggs with various props and told them about the death and resurrection of Jesus, and what it means for us because He loves and forgives us. We then proceeded to make little megaphones out of paper cups, to proclaim "Jesus is alive!" Usually the kids don't get into that kind of stuff, but today they were running around with their megaphones repeating that truth over and over. I think they really got it, and I got it too--because Jesus reminded me that He is working in their hearts, and they are really hearing how much Jesus loves them and wants them. (Also I want to remember forever that one of the kids, during storytime, said that the monsters who killed Jesus should go to time-out. Well said.)

Then today, I had a special moment with one of my most difficult patients. She has severe dementia and is very hard to work with because her sense of reality is very twisted. But today she was much calmer than usual, and when I finished she asked me to come to the facility sing-along activity with her. I had time, so we went together, shared the lyrics, and sang along with ~15 other residents. She was more coherent and lucid than I've ever seen her, and when I had to go she gave me a kiss and a big, genuine smile, and I got a glimpse of the real lady inside sans dementia. It was pretty powerful.

It sure is cool to see how God works in me, through me, and despite me. It is amazing to see Him writing the story of my life one day at a time, and no one can predict it--especially me.

'Tis So Sweet

A very special patient of mine died last night. When I started visiting him almost four months ago, we immediately connected because we are both musicians (though he was a professional). He was also one of my few patients who did not have dementia, so developing a relationship was actually possible. We chatted about his music, tours, and performances, he provided an endless supply of corny jokes, and I started bringing a friend's ukulele and singing for him every week. I sang Nat King Cole, Ella Fitzgerald, Frank Sinatra, and others from that era (which produced some of my favorite music) and he often sang or hummed along. Soon our visits became the highlights of both of our weeks.

I didn't bring up my faith with him for a while, and when I mentioned it the first time he was not interested. So I kept praying that God would open doors for Himself to be revealed. A month or two ago my patient (my musician guy as I called him to my family) began to get weaker and more painful. Sometimes it's easy to forget that hospice means that every patient is technically dying, but when a person begins showing signs of decline you remember again. I will never forget the moment when I realized that he wasn't going to be around much longer as we sang these lines together, to each other.

That's why, darling, it's incredible, that someone so unforgettable, thinks that I am unforgettable, too.

At one point he mentioned to me that his mother used to sing the song In the Garden, so I jumped at the chance to bring back a sweet childhood memory and proclaim the promise of Jesus in the process. The knowledge of the presence of God is powerful, and I prayed that my guy would begin to realize that He was there for him, even if it'd never felt like it before.

I’d stay in the garden with Him,
Though the night around me be falling,
But He bids me go; through the voice of woe
His voice to me is calling. 

And He walks with me, and He talks with me,
And He tells me I am His own;
And the joy we share as we tarry there,
None other has ever known.

Eventually I realized that he probably knew other traditional country hymns, so I started singing Leaning on the Everlasting Arms, 'Tis So Sweet to Trust in Jesus, and Softly and Tenderly. He did, and we enjoyed these together.

What have I to dread, what have I to fear,
Leaning on the everlasting arms?
I have blessed peace with my Lord so near,
Leaning on the everlasting arms.

Last weekend I made an extra visit because I knew that any day could be his last. I stayed for a long time. He was very sleepy and completely bedbound. I sat by his bedside, holding his hand. I sang every song I could think of and prayed that the words would speak to him. When I sang Softly and Tenderly, I couldn't stop the tears.

Softly and tenderly Jesus is calling,
Calling for you and for me;
See on the portals He's waiting and watching,
Watching for you and for me. 

Time is now fleeting, the moments are passing,
Passing from you and from me; 

Oh, for the wonderful love He has promised,
Promised for you and for me!
Though we have sinned, He has mercy and pardon,
Pardon for you and for me. 

Come home, come home,
You who are weary, come home;
Earnestly, tenderly, Jesus is calling,
Calling, O sinner, come home!

I cried because I was losing a friend, and because I wanted so desperately for him to know the Friend that gives life. I asked my guy if I could pray for him, and he said he would like that.

I didn't want to pull myself away because I didn't want him to die alone. But finally I decided to go, and after I said goodbye, he called me back to his bed. He said, "I'm going to live now." I wasn't sure what he meant, and when I asked for clarification he repeated this several times.

Then, "I am at peace with God." The words I had been praying for.

I received a text from his nurse last night letting me know that he had breathed his last just moments after she arrived to visit him. I had processed his death during our visit last weekend, but it's such a weird feeling to know he's actually gone. I heard a song today and for a split second thought, "I can sing that one to him next week!" But I can hope that he is with the Father now, and maybe we can all sing together again one day.

I am so glad that he didn't have to die alone, thankful for the boldness and wisdom to minister through song, and humbled and awed by God's power and presence transcending fear and death.

’Tis so sweet to trust in Jesus,
Just to take Him at His Word;
Just to rest upon His promise,
And to know, “Thus saith the Lord!”

Yes,’tis sweet to trust in Jesus,
Just from sin and self to cease;
Just from Jesus simply taking
Life and rest, and joy and peace.

Fundamental

Happy New Year!!! :)

You know how I say that God works in themes in my life? The theme for this post-grad season is His steady and strong presence. In college, I experienced a lot of change and God became my home, my refuge. But last year (2015) brought some spiritual turmoil. I began by getting baptized on January 4th, and then experienced spiritual dryness so deep that I doubted my salvation and commitment to Christ. I wanted God, but I didn't know how to reach Him.

Slowly, I began to seek more earnestly and He graciously began to reveal His presence. He opened the door to a job in hospice home care, an area I never dreamed I would find myself. He has shown Himself to be faithful over and over, even though I continue to think that each new misfortune is unsolvable. My job is amazing but hard in so many ways, and I have to completely depend on God.

I often work long days and I have evening commitments, and when time to relax was limited or nonexistent and sleep deprivation was on-going, He was the only thing I could count on. When patients were frustrating or I was running late the whole day or I had a migraine (which I did for three straight weeks), He was my strength. When I felt like I was never going to get it right and I wanted to give up, I trusted that He had placed me in hospice care for a reason.

I've now been at my job for over three months, so I'm not really new at it anymore, and it shows. I am growing and being stretched so much. I have always had a hard time with transitions--for example, I can't make a spare 20 minutes between things productive because it's impossible for me to effectively switch my brain (and body) in and out of something that fast. So when I started a job that is based on 5-10 major transitions per day, in a time crunch, naturally that was challenging for me to say the least. Instead of one facility or hospital floor to familiarize myself with, I had 15-20 different locations in a week, over 20 patients, and even more caregivers to learn.

Sometimes I thought I was never going to learn all the sets of details for each patient and all the caregivers' names and where everything is kept or put away in each different place. But like I said in my last post, I learned to give myself grace and time to get better. And you know what? I have. I can get an appointment done faster, I've memorized lots of details (including all the addresses I visit), I am efficient, and I have developed relationships with my patients and their caregivers. I have gotten better at going with the flow when things turn upside down (though this is often tested), and I recognize that this job will constantly teach  me. I really enjoy working as a team with the nurses, social workers, and other staff, all of whom are patient-centered and just generally great.

It's exciting because not only am I learning how to be fully reliant on God, I am also gaining valuable skills that I will use as a PA for the rest of my life. Being able to keep track of multiple patients and pertinent details, working with other providers and keeping in the scope of my training, interacting with family members, and so much more. I am learning a lot and I love it.

One major lesson that I've learned has caused me to decide that I believe every person going into medicine should work as a CNA (certified nursing assistant). Sure, the job is not explicitly "medical" in the sense that we don't perform procedures or diagnose anyone or make major decisions or create disease management plans, but it is undeniably healthcare.

I spend my days giving people showers or bed baths, brushing teeth, clipping nails, and getting them dressed. While hygiene is important for preventing infection, these things are even more important for a person's psychosocial health, and dying and dependent people are no exception. We don't think about what a privilege it is to be able to take a shower or use the toilet until we interact with people who've lost those abilities. Caregiving comprises tasks that are physically difficult and can easily be embarrassing or awkward--but they don't have to be, and they are so important.

Helping individuals with basic human functions, which is the main purpose of a CNA, teaches you how to take care of people. That is the lesson, and I think it is critical for healthcare providers to learn because that is what medicine is fundamentally about.