Kirkepiscatoid

The non-compliant patient

(Picture of pocket lint courtesy of Wikimedia Commons)

(This post originally written for Daily Episcopalian on December --, 2011)

When we demand satisfaction of one another, when we demand any completion to history on our terms, when we demand that our anxiety or any dissatisfaction be taken away, saying, as it were, “Why weren’t you this for me? Why didn’t life do that for me?”, we are refusing to say, “Come, Lord Jesus.” We are refusing to hold out for the full picture that is always given in time by God.

When we set out to seek our private happiness, we often create an idol that is sure to topple. Any attempts to protect any full and private happiness in the midst of so much public suffering have to be based on illusion about the nature of the world in which we live. We can only do that if we block ourselves from a certain degree of reality and refuse solidarity with “the other side” of everything, even the other side of ourselves.

--From "Preparing for Christmas with Richard Rohr," pages 5, 7

One of the odd roles of the inner office space of the hospital pathologist is best described as "pastoral space for physicians under the guise of coming to get biopsy results." I can't remember the number of times the conversation on the other side of my two-headed microscope started out being about "the biopsy," but by the time the other physician leaves, I've heard way more than what I needed to make the diagnosis about the patient. I've heard a shaggy dog story about the patient's family, the chain of events that brought the patient to this place, and mostly, the physician's own frustrations about it all--particularly when the patient is what we call "The non-compliant patient."

I particularly find myself functioning in this pastoral role with the young interns and residents and clinical medical students--young and eager and full of knowledge, oh, so very sure what the patient needs to do, and incredibly exasperated that the patient is not doing it, or was in such denial that things are a total mess at the time the patient is admitted. Yet it's the rare patient who is even 50% consistent with the instructions the physician gives. My mind often wanders back to bits and pieces of the hundreds of prospective medical student admission interviews I've conducted over the years. I've yet to hear a candidate for admission say, when asked to describe a day in what they think life will be like as a doctor, "I'll go to the office some days and have to deal with patients who don't listen, patients who are late for their appointments, patients who are upset about the bill, and patients who display drug-seeking behavior." Without fail, they always describe a shiny, happy practice, with a waiting room filled with people, who, as my late grandmother used to say, "have sunshine streaming out their butt."

It's interesting that, even though the doctor-patient relationship is really a covenant, we use that term "compliant"--as if the patient's responsibility is the sum total of the relationship.

Although Rohr's quote above is intended for the setting of Advent, and Lent is nipping at our heels, it's very appropriate when we ponder that little demon of "failed expectations." All we see is a sliver of another person's life at the time we encounter them--and in the case of the non-compliant patient, we have little to no clue of the complexities life has dealt that person. Perhaps the patient missed the appointment because she was up all night with a sick child. Perhaps the patient isn't listening because his thoughts are distracted by the worsening health of an elderly parent. Perhaps the drug-seeker is so enmeshed in his addiction that he is becoming violently physically ill. Perhaps the person angry about the bill just lost a job, or cutbacks are coming.

We tend to be pretty quick in judging "the other"--probably because, as with all complexities in this life, there's just enough of a kernel of truth in there to affirm our judgments. The fact is, a certain percentage of the time, the non-compliant patient is, indeed, non-compliant because (s)he hasn't learned a certain core set of life responsibilities, or doesn't want to learn them. The fact is, sometimes people smoke and drink too much because sometimes they simply would rather smoke and drink than change. The fact is, some people are morbidly obese because they like eating too much to stop. The mistake, however, is believing these attitudes are carved in stone for a lifetime, and the worse mistake is claiming any power or authority to fix them. Although being a doctor gives me insight in how to live a healthy life and a call to spread a gospel of the good news of health, it gives me no authority whatsoever in forcing my beliefs and choices on others.

As my spiritual director pointed out to me one day, when I was annoyed at someone not living up to my expectations, "You said yourself this person isn't normal in this regard; so why are you angry when this person doesn't act normal?"

The non-compliant patient, in this view, becomes a mirror--what do I need to consider about my expectations of others in light of a God who probably finds me rather non-compliant?

Dogs in Heaven (and other angels dancing on the head of a pin sort of things)

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(Photo of Will Rogers courtesy of Wikimedia Commons)

"If there are no dogs in Heaven, then when I die I want to go where they went."--Will Rogers

I had to chuckle at both this story and the mention of it in The Lead. We recently had a bit of a theological quandary about the prayer list. Without going into the story too deeply (I really don't care to "out" anyone, because I think it was all done with a sincere heart and great earnest-ness) the short version is this: I am the editor of our parish weekly e-news and one of the "keepers of the prayer list." What is a person supposed to do about a dog showing up in the prayer list requests?

Now, bottom line was that the dog was not placed on the prayer list, but the owner was. But there was a staggering amount of discussion I ended up entering into and a discovery that this was a very visceral topic. I found out a lot about who in my parish thinks that dogs and cats at least, have souls. (We did not extend this conversation beyond dogs and cats, so mercifully, we did not get into the eternal ensoulment of white rats, goldfish, and boa constrictors.)

But what this discussion did was really ask me some very basic and unanswerable questions about the nature of the soul, the nature of my relationship with God's creation through my pets, and what it really means to be a keeper of the prayer list and the trust I have been given about the souls of the individuals in our congregation.

Let me start with my own viscerally held belief. I truly believe that my dogs have souls. I believe that all created beings have them. (One of my friends and I can be irritated at the drop of the hat over a line John Spong once used in one of his books about saying dogs didn't have souls. We laugh that out of all the controversial things John Spong has said over the years, that's the one we want to fight with him about.) Unfortunately, the Bible is rather mute on the topic. It's clear that the Bible speaks quite openly about people having them, but it's a little vague about the rest--only a couple of references like in the Psalms with lines about man and beasts being saved, things like that--which tells me whatever we choose to believe on the topic is not a deal-breaker with our own salvation.

However that belief comes with some incongruities, then, on how well I acknowledge the ensoulment of all living beings. It means I believe cows have souls--yet I eat them. It means I believe skunks have souls, yet I shoot them when they are too near my house. It means I believe mice have souls, yet I gleefully set out mouse traps and live to hear the snap of their demise when the little boogers have invaded my house. It means I believe ticks and spiders have souls, and I squash them with no guilt or shame whatsoever.

What it all boils down to, I think, is that we are not simply stewards of creation--we are all part of creation and we interact with the rest of creation in a variety of ways. Some of these interactions are good, some bad, but probably most are rather indifferent, really. Perhaps it's not so much about the brass tacks of that interaction than it is how we change our interaction with humans as a result of these intersections with creation.

My two dogs are a window into what I'm capable of in loving others, and the unconditional love that dogs have for "their" people influence me in how to love unconditionally. Worrying about their ensoulment (or not) should be a lesson in how we cannot control and micromanage others. Are we ready for this kind of radical inclusion?

Amanuensis and community

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(German woodcut of a monk using a scribe, courtesy of Wikimedia Commons)

(Originally written for Daily Episcopalian on January 9, 2011)

“There were times when I was amazed by my own boldness in expressing my views about the novel, and still more amazed by the indulgence with which a brilliant writer used to listen to these almost childish remarks and opinions.”

--Anna Grigorievna, transcriptionist for Dostoevsky's book The Gambler, from her Reminiscences

Not long ago, I began to realize in a new way that "Dictation and transcription" is fast becoming a lost art.

I'm pretty spoiled in my little office. I have a transcriptionist who has been translating spoken ruminations from behind microscopes into surgical pathology reports for over 40 years. Really, she knows what I say, and how I say it on the most common types of specimens, that on occasion she will stick her head in my office and go, "You said such-and-such on that skin lesion you dictated but when I heard the description, didn't you mean this-and-that?" and most often she is right. She and I also both have the skill of starting to read through an old report and, before we get to the signature line, know which pathologist signed out the case--even when it's an old case done by my former associates. We have both worked so long paying attention to what folks say and how they say it, we know things between the lines. I can go back through one of my present associate's reports and tell if she is feeling hesitant or edgy about a diagnosis. She can tell the same with me. There's an odd little intimacy in how we speak words for the world that betray bits and pieces of ourselves.

Modern voice recognition software, and transcriptionist work outsourced to transcription pools in India, is changing this into a less intimate production in some ways. Yet I can see a trend moving back to a few old things in communications in general--the business of speaking our words rather than keying or writing them.

Many of the memoirs penned until the invention of the typewriter were not penned at all--they were spoken to scribes. I even discovered a great term from antiquity for this function--amanuensis--from the Latin servus a manu, literally, "Slave at hand." The slave was literally supposed to write exactly what was said. I suppose, ideally, the slave was supposed to do this with no input, but my guess is it was more what Grigorievna described--or what my own transcriptionist does--stop and go, "Say WHAT?" I am sure a good amanuensis created a layer of community and accountability to the speaker. It might also surprise us that many cultures at the time of the Bible used female slaves as scribes. We tend to think of women of that time as largely unable to read and write, but for slave women, this was a pretty good job, I imagine, and it brings an interesting possibility to light--that some slave women became more educated via osmosis of their job description than the more privileged or "free" ones. The relationship they had with the person doing the dictating would possibly have been a position of influence.

Now, our modern permutation of this, via things like Dragon Dictation for the iPhone, doesn't do this (well, it does excise the curse words...) but it does bring back an old, almost lost distinction in communication--the notion that what communication that springs from our mouths is different than what comes from our hands.

What the modern permutation lacks, however, is what I'm going to call "the amanuensic process." Things like Dragon Dictation only have a twice-removed human layer in which the programmer worked on certain assumptions that may not be true in an individual case.

It dawned on me that when we read or study the Bible, we don't really consider the amanuensic process of how it came to be, very much. We also tend to forget that these stories were told to each other multiple times before anyone bothered to write them down. I think many of us have this notion that these words shot out of God's mouth into the author's ears and they were transcribed verbatim (in King James English, of course.) Even if we don't really believe that, it's a pervasive mindset that these were a series of solitary inspirations.

Thinking about the amanuensic process of how the Bible came to be, really opens up an interesting door in how we understand it. It means that from its very beginnings, this set of books that we come to regard as the heart, soul, and backbone of our faith, were forged in relationship with each other, even if these relationships carried a power differential. It also raises the reality that these relationships weren't perfect--I am almost certain there are probably spots in the Bible that are the equivalent of Celie spitting in Old Mister's lemonade from The Color Purple. But I'm just as certain that there are places where the "good scribe" looked up and said, "Are you SURE you want to say it like THAT?" and a discussion ensued, that made those words more understandable.

Could it be that, as we begin to return to the idea of speaking our words to the electronic scribes in our smartphones, that we are going to become more attuned to the relationships that created the words of the Bible? Could it be that this notion was the part of the Bible we were supposed to understand more fully rather than quibble about the words themselves? It's an interesting proposition, isn't it?

Let there be light

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(Logo courtesy of Wikimedia Commons)

(Originally written for Speaking to the Soul, January 8, 2012)

Readings for Sunday, January 8, 2012:

Psalms 146, 147 (Morning)
Psalms 111, 112, 113 (Evening)
Genesis 1:1-2:3
Ephesians 1:3-14
John 1:29-34

Evolutionist that I am, I can still never say enough about the story of the Creation in Genesis, and never fail to hear it as a story of absolute beauty. It is still one of the most marvelous set of strings of words in all of written thought, both for its simplicity and complexity.

So my next sentence is going to sound incongruous: I believe in the story of Creation with all my heart.

Oh, not in the sense of days and order and "Poof! There's a horse!" but in the sense of believing in a God who is intimately in the creation business. Every time I read this passage, there's something new to see--not just what is said, but what is not said.

Ever notice the one big "no comment" in this story? It's here:

Then God said, “Let there be light”; and there was light. And God saw that the light was good; and God separated the light from the darkness. God called the light Day, and the darkness he called Night. And there was evening and there was morning, the first day.

We see that the light is good--but the darkness is "no comment." Now, we are not told the darkness is bad, either. The darkness just is. Two paragraphs in, God separates the two. The illustration is that they are two entities--one good, one neutral. But then a few more paragraphs down the road we see:

And God said, “Let there be lights in the dome of the sky to separate the day from the night; and let them be for signs and for seasons and for days and years, and let them be lights in the dome of the sky to give light upon the earth.” And it was so. God made the two great lights—the greater light to rule the day and the lesser light to rule the night—and the stars. God set them in the dome of the sky to give light upon the earth, to rule over the day and over the night, and to separate the light from the darkness. And God saw that it was good. And there was evening and there was morning, the fourth day.

The darkness does not remain entirely separate in this story for long--it is punctuated by light. Oh, there's still an ultimate separation of light and darkness of some sort, but where the Earth is concerned, there is never total darkness, but only periods of greater and lesser light--which, as far as Earth is concerned, insures that light will always prevail. It reminds me of the words of the Taizé song La Ténèbre, "Our darkness is never darkness in his sight, the deepest night is clear as the daylight."

Each of us have a different notion of what we fear about "total darkness," but for me it's this: In total darkness, one cannot even tell if one is alone or not. I could be six inches from someone else, but enmeshed in the delusion that I am alone, deluded in a lie that I am separate from all creation, and from God.

In this story, we are reminded of one of the most simple, yet profound truths about the relationship between God, creation, and us--The Light of God is always with us, even if it's a mere trickle from our vantage point. Believing in the story of creation has far more to do with believing in the constancy of light and the presence of each other in it, than it does worrying about literal days and disappearing dinosaurs.

What changes for us, in our relationship with God, and our relationships with each other, when we accept the truth that there is no darkness, only greater and lesser views of light?

Magi Musings

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("The Three Wise Men Going to Bethlehem," by Franz Xaver Merz, fresco on the ceiling of Windberg Abbey Church, courtesy of Wikimedia Commons)

For Those Who Have Far to Travel
An Epiphany Blessing

By Jan Richardson

If you could see
the journey whole
you might never
undertake it;
might never dare
the first step
that propels you
from the place
you have known
toward the place
you know not.

Call it
one of the mercies
of the road:
that we see it
only by stages
as it opens
before us,
as it comes into
our keeping
step by
single step.

There is nothing
for it
but to go
and by our going
take the vows
the pilgrim takes:

to be faithful to
the next step;
to rely on more
than the map;
to heed the signposts
of intuition and dream;
to follow the star
that only you
will recognize;

to keep an open eye
for the wonders that
attend the path;
to press on
beyond distractions
beyond fatigue
beyond what would
tempt you
from the way.

There are vows
that only you
will know;
the secret promises
for your particular path
and the new ones
you will need to make
when the road
is revealed
by turns
you could not
have foreseen.

Keep them, break them,
make them again:
each promise becomes
part of the path;
each choice creates
the road
that will take you
to the place
where at last
you will kneel

to offer the gift
most needed—
the gift that only you
can give—
before turning to go
home by
another way.

We've known about the Magi since childhood, if only from singing "We Three Kings." (Or, the version I used to entertain myself with as a kid: "We three kings of Orient are, tryin' to smoke a rubber cigar. It was loaded and it exploded, that's how we got this far!") But do we ever think much about the Magi except for part of the supporting cast of the Christmas story--and what, really, do they have to do with us?

When I sit and ponder the Magi, I often think of how their journey parallels our own journeys "looking for Jesus"--sometimes started off by people we later learned we should not have trusted, sometimes convoluted and slow, sometimes with unexpected results. Their gifts to the Christ Child remind us that we desire to give God our best--the treasure in our hearts. They came from the East and moved westward--it's an American tendency, because of our history of westward expansion, to see "West" as looking towards a vast expanse, filled with potential.

But lately, I've been thinking about how they wise about one thing in a practical sort of way. They knew enough not to return to Herod when they realized the magnitude of what they saw. They returned home by another route.

Gregory the Great probably said it best: "...having come to know Jesus we are forbidden to return by the way we came."

We may return "home" many times in this mortal life of ours, but we never get back by quite the same route. Each time we encounter the living Christ, and experience transformation, we are changed in subtle, yet profound ways. It's impossible to go back with the same heart and mind we had prior to the transformation.

In addition, our desires to seek and find Jesus lead us to recapitulate this journey in other ways--namely by seeking and finding Jesus in each other. As I think back, I have been visited by many Magi in my life--people bearing their gifts of the Spirit, who found me and wanted to give me their best. It seems these people only rarely become a fixture in my life, but, like the Magi, head off into the horizon. Yet I think fondly of them from time to time.

A more difficult concept for me is the possibility I have been one of the wise people for someone else. That one's always a little hard to swallow, because I don't think of myself as overly wise. But it's certainly a very real possibility.

Who have been Magi in your life? More importantly, when have we been the Magi for others?

New and not so new

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("How e-mail works," courtesy of Wikimedia Commons)

2 Corinthians 5:17-21:

So if anyone is in Christ, there is a new creation: everything old has passed away; see, everything has become new! All this is from God, who reconciled us to himself through Christ, and has given us the ministry of reconciliation; that is, in Christ God was reconciling the world to himself, not counting their trespasses against them, and entrusting the message of reconciliation to us. So we are ambassadors for Christ, since God is making his appeal through us; we entreat you on behalf of Christ, be reconciled to God. For our sake he made him to be sin who knew no sin, so that in him we might become the righteousness of God.

I read this recent post by my blogging friend Ann in Daily Episcopalian and it certainly made me give pause, the idea that the days of e-mail possibly being numbered. Oh, I don't disbelieve it. I remember the time I first recognized that my wonderful stacks of record albums were going to be useless. Oddly, I kept them long after I no longer had a turntable, then finally parted with them when I felt I had enough of a CD collection that I had the bulk of my album collection I cared to keep. I recently got rid of all my CD's, too--same story. I only felt comfortable going digital with all my music when I had enough of my collection digitally available.

Those of us who fancy ourselves as "techier than most baby boomers" may someday be faced with the real possibility that all we have stored on hard drives, as technology continues to chug along, will not "make the cut." Some day I'll have to make a decision on what I'll keep and what I'll let go...again.

Where we seem to be moving in the electronic communications world is a place where real time rules, via social networking and messaging. "Saving what we said" will not automatically occur. "Instant discussion" will become an expectation, if it hasn't already. I am unusual in that I don't always immediately answer an e-mail. Sometimes I want to think it over before I reply.

I have read reams and reams of things about how all our various new communications technologies intersect with the church--and quite honestly, too much of it is of the "Chicken Little" variety. Oh, oh, the sky is falling. The sky's always falling. But it still seems we have plenty sky left.

I really appreciated Ann's candor in the article, where she speaks of both the enjoyment she gets at being a "techie grandmother" and her unease of her prospects of keeping up. I get parts of that. I am a person who is always slow to embrace the new--I have to go through my obligatory period of scoffing first--but when I do, I run off the dock and cannonball right in, sometimes finding myself over my head very quickly. Like our friend the disciple Peter, I jump out of the boat with a "Hey, y'all, watch this!" and do okay until the winds pick up, then find myself in need of a bit of saving. But I almost always come out of the water wiser and ready for more. I suppose if I have a fear of the rise of the new, it's that one day I will actually drown, but I haven't yet, so I have to trust that.

But here's my testimony to all of this, despite the abundance of "Chicken Little" stories--I truly feel that my involvement in the Digital Age has enhanced my life as a Christian, and made me a better person. Oh, not that I haven't made some whopping mistakes--I have fallen victim to helping things go viral that shouldn't a few times, and I have learned the hard way that e-mail is for disseminating, and only judiciously for seriously discussing, and that face to face is always the gold standard. But I have also learned to truly be more hospitable and social through social networking, and I have been able to provide and receive many kindnesses via these types of media, and I am convinced it's the biggest mission field we've ever seen. In a world where more people are of the "no religion" persuasion than ever, it's a wonderful place to simply live the Gospel rather than tout it. Social media has become a place where I've been unafraid to step into my own priesthood as one of the baptized believers, and allow people to be gathered with me and provide a safe place of hospitality.

Yeah, I get a little afraid of the new same as everyone else--but I also know if I allow it in, I will continue to be made a new creature in Christ. What's not to like?

Dangers of Naming

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(Igbuzo child naming ceremony, Washington DC, courtesy of Wikimedia Commons)

(This post originally written for Speaking to the Soul, January 1, 2012)

Readings for the Feast of the Holy Name of our Lord Jesus Christ, January 1:

Psalm 103 (Morning)
Psalm 148 (Evening)
Isaiah 62:1-5, 10-12
Revelation 19:1-16
Matthew 1:18-25

Names are all over the place in our readings today. Our Psalms call to bless and praise the Lord's holy name. No fewer than five names for Israel and her people are mentioned in the verses of Isaiah 62. The rider of the horse in Revelation 19 is named Faithful and True. In Matthew, Joseph hears the name of Mary's unborn child--Jesus--in his dream.

The more we read and study the Bible, the more we recognize that "the business of naming" is an important thread that weaves through both the Old and New Testaments. I've always been especially intrigued how, when one picks Biblical names apart, they have a meaning within the name. Take Jesus' name--Yeshua--"The Lord is salvation." It's as if we are told within the name of Jesus itself, Lesson One in "Understanding Christianity 101."

The mistake, however, is in thinking once we pick the names in the Bible apart, that this knowledge is the be-all and end-all of the message. Human nature has the destructive habit of "Once we know the name of something, once we know how it works, once we have disassembled it and post-mortem'ed it, we're finished, with no further action necessary."

Nothing could be further from the truth.

The danger of understanding names is that we tend, once we know the name of something, to use our definition to define the world, rather than letting the world shape and mold us. We tend to use it for the control of things we don't understand. Invariably, this fallacy leads us to placing God in a smaller box than God is capable of occupying. Once we think we fully understand a definition, we fill the air with the aerosol mist of a spray can chock full of of the delusion of control. Instead of letting the names churn our passions, we try to shut our passions down

What would happen, instead, if we let these names shape us instead of us telling them what they are? In Matthew, Joseph's hearing and obedience to his dream saves his new family's lives. What would grow in us if we allow God to speak to our dreams, our hopes, our passions? Our passage in Isaiah gives us a window into restoration and renewal--a journey that begins forsaken and desolate, and becomes formed into a joyful wedding between the holy incarnation of God, and the mundane existence of our lives. We move from a God "out there" to "God with us." We discover salvation when the rest of this cold hard world would rather separate us with a chasm of despair. We move from a state of spiritual insomnia, afraid to dream, to one where we eagerly dare to dream.

On this day proclaiming the name of our Lord Jesus Christ, dare we listen to our own dreams, that, at times, speak the most profound truths to us? Are we ready to accept the new name God has bestowed upon us? It begins with hearing God speak the name of salvation to us in our dreams.