Friday, August 31, 2007

She's no Father Mulcahy

What is it they say? Be careful what you wish for?

Well, for a long time I've been saying that my dream is that chaplaincy will become so accepted (and expected) by everyday people that no one would dare put together a hospital TV show without having a chaplain in it. Well . . . .
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Reiko Aylesworth Joins ER
And the casting news continues! We’ve got Kristen Bell joining Heroes, Janeane Garofalo joining 24, and now a 24 alum is joining ER in its 14th (!) season. TV Guide’s Michael Ausiello reports that Reiko Aylesworth (Michelle Dessler on 24) will be joining ER’s cast as the new chaplain of County General Hospital.
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But, in all seriousness. even if the character ends up being not the most stellar representative of spiritual caregivers, I think (on the "there's no such thing as bad publicity" principle) that this will probably be a real plus for the profession. . . . I'm wishing for more TV chaplains!!!

PS For those who don't know, Father Mulcahy was the chaplain in the M*A*S*H movie and TV series.

Wednesday, August 29, 2007

He never got justice -- death of a profilee

I was deeply saddened, today, to hear about the death of Richard Jewel. I remember how the media viciously hounded him. But the real fault was the FBI's. Why did it take them nearly three months to tell people what they knew from the beginning -- that there was never a shred of evidence against Jewell in the Olympic park bombing. All they ever had against him was the fact that Jewell was an unmarried, low-income guy, which matched some FBI desk jockey's "lone bomber" profile.

In fact, the FBI should have been hailing Jewell as a hero he was for spotting the bomb and getting dozens of people out of the way of the deadly blast set by racist Eric Rudolph. I'll never understand why the FBI allowed the injustice of Jewell's torment to go on so long. I just don't get it.
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Richard Jewell Dies at 44; Wrongly Linked to Olympic Bomb

ATLANTA (AP) -- Richard Jewell, the former security guard who was erroneously linked to the 1996 Olympic bombing, died Wednesday, the Georgia Bureau of Investigation said.

Jewell was initially hailed as a hero for spotting a suspicious backpack in a park and moving people out of harm's way just before a bomb exploded during a concert at the Atlanta Summer Olympics.

The blast killed one and injured 111 others.

Three days after the bombing, an unattributed report in The Atlanta Journal-Constitution described him as ''the focus'' of the investigation.

Eighty-eight days after the initial news report, U.S. Attorney Kent Alexander issued a statement saying Jewell ''is not a target'' of the bombing investigation and that the ''unusual and intense publicity'' surrounding him was ''neither designed nor desired by the FBI, and in fact interfered with the investigation.''

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It won't bring back the two who were murdered, but I'm so glad to hear that these people are finally being released.
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August 29, 2007

Taliban Will Release Hostages, South Korea Says

SEOUL, South Korea, Aug. 28 — The Taliban agreed Tuesday to release 19 South Korean church volunteers held captive in Afghanistan since mid-July, the South Korean government announced, signaling an end to a wrenching hostage crisis that had gripped the country for almost six weeks.

Members of the Taliban movement seized 23 Christian volunteers from South Korea on July 19 while they were traveling by bus from Kabul, the capital, to the southern city of Kandahar.

The Taliban killed two hostages, both men, after a series of deadlines passed in July. But after South Korea entered direct negotiations with the militants later in July, the Taliban freed two women on Aug. 13 as a gesture of good will.

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Tuesday, August 28, 2007

Stepping up to the organ donation plate -- a High Holidays plea

The High Holidays -- that time when the cycle of Judaism asks us to consider the implications of our own mortality -- are rapidly approaching. This year, I ask you to consider a possible gift that can come out of your own death: the possibility of organ donation. If you haven't checked the organ donation box on your driver's licence, for example, it's never too late.

Jane Brody -- the author of the Personal Health column in the New York Times -- has an excellent story today entitled, The Solvable Problem of Organ Shortages. Here's an excerpt:

When the wife and younger daughter of Rear Adm. Kenneth P. Moritsugu of the Navy were fatally injured in separate automobile accidents, he authorized the donation of organs and tissues from both of them.

Dr. Moritsugu, acting surgeon general of the United States, calls organ donation “the ultimate act of human kindness.” But the number of donor organs falls far short of the need. As of June, 97,000 people awaited lifesaving transplants, and each day the waiting list grows five times faster than the donation rate.

People typically wait three to five years for donated organs, and each day 17 of them die.

But, as Dr. Moritsugu noted recently in The Journal of the American Dietetic Association, “The shortage of donor organs is a medical problem for which there is a cure.”

At one time there was a lot of concern among Jews that organ donation would be a violation of Jewish law (as Jewish law forbids desecration of the dead body). Most religious authorities have moved past such a position. In my movement (the Conservative Movement), most authorities hold that not only is organ donation permitted but that Judaism's high regard for life as a religious value actually requires it. In the Orthodox world, however, authorities are more reluctant to give a clear green light to organ donation; they do, however, allow it in some cases where it is clear it would save a life.

The real savior

Doctors -- especially surgeons -- have long been accused of tending to acquire a "God complex." But I was still surprised, today, to see one turn up on the pages of the New York Times, especially because the physician in mind is part of a center of biomedical ethics at a world-class medical center:

"I saved your life!" Dr. Larry Zaroff reports telling a man he had treated while years earlier when that man demanded $300 from him in a business dispute. Before Zaroff made this pronouncement, the man, who had been unconscious at the time, had no idea Zaroff had ever treated him.

First of all, in my opinion, it's an act of incredible arrogance for any physician to credit his or herself with saving a life. Zaroff could have shocked this man's chest a thousand times and it wouldn't have helped one bit if the Blessed Holy One hadn't decided to make it possible for the heart to start again.

Second of all, to try and influence another person in a personal business dealing based on what you may or may not have done for them in a professional setting strikes me as a deeply troubling violation of ethical boundaries. Zaroff does say that now that he's "older" he would not do the same thing. But he does not seem to acknowledge the ethical problem. Nor the arrogance of claiming to save a life.

I'm curious what other folks think.

Here's an excerpt from the story:

During surgical residency, I’d learned to control the startle reaction. Don’t raise your head from the exposed heart even if the orderly knocks over the rinse basin or the nurse drops a tray of instruments. I had learned that calm worked best. I was not perfect the day we faced our prospective landlord. My head jumped back, my eyes widened. He did not notice; he had no idea we’d met the day his heart stopped.

After my shock passed, I had the same thought I’d had back then: “Why tell him? Surely he has suffered enough.” . . .

We had left a deposit when we signed the lease. Now the landlord checked the apartment like a lion after a wildebeest, zeroing in on the fireplace . . . He turned toward me. He became adjacent and angry. “You owe me $300,” he snarled, shaking with each word. . . .

I took a deep breath, and I gently asked him if he remembered his heart attack.

“Yes, sure.”

“Do you know your heart stopped?”

“I think so.”

“Well, I was the one who saved your life, brought your heart back.”

He hesitated. “I didn’t know that.”

He turned to the door, distressed, in pain. Turned again. “You still owe me $300.”

Sunday, August 26, 2007

The darker side of Facebook

I've only recently joined Facebook, the wildly popular social networking site that started out just being for college students. It's mostly just been a fun way to reconnect with some old rabbinical school classmates and other friends.

But apparently people use it for other reasons, including the spread of hate. Today, a friend asked me to sign a petition demanding Facebook shut down the "F**k Islam" group on the site (and, no, the real group name does not include the asterisks).

I am just appalled that anyone would form such a group and give it such a name. Sure, you can hold opinions criticizing a faith tradition. You can even talk about those opinions on a place like Facebook -- that's what we call free speech. But, if we really do all want to "get along", we have to express our opinions in ways that are respectful, especially when we are dealing with things that others consider most Holy. This goes way too far. It's disgusting and it has to stop.

I really hope this sort of thing is not what Facebook is really all about -- because if it is I'm most definitely not staying around.

Friday, August 24, 2007

Never despair!!

There has been a lot of press about the new book of Mother Teresa's private writings and how she spent the last decades of her life in a deep spiritual crisis where she could not feel the presence of God. Some people are shocked to hear that a woman seen as such a great symbol of piety and service to God could suffer such a crisis of faith.

But Teresa is hardly the first spiritual leader to have a "dark night of the soul." Last week, I spent some time reading Art Green's biography of the hasidic master Rav Nachman, a book that he entitles "The Tormented Master" precisely because Nachman struggled so much with his faith and -- like Teresa -- often felt God to be very distant.

This distance, however, is not the legacy Nachman left. Green concludes his book with an account of some of Nachman's final words to his followers. "It is forbidden to despair!," Nachman is reported to have said despite his weakness from his final illness. "Gevaldt! Never despair!”

It is the spirit of this statement that Nachman left to his followers, Green says, and is why they continue to follow his path to this day.

As we head into this Shabbat that prepares us for the fast-approaching High Holidays, I leave with with these words from the Psalm for the High Holidays,
Psalm 27:

שְׁמַע-יְהוָה קוֹלִי אֶקְרָא
Hear, Lord, my voice when I cry

וְחָנֵּנִי וַעֲנֵנִי.
And be gracious to me and answer me.

לְךָ, אָמַר לִבִּי--בַּקְּשׁוּ פָנָי; ׁ.
For Your sake, "seek My Face", says my heart

אֶת-פָּנֶיךָ יְהוָה אֲבַקֵּש
Your Face, Lord, I seek.

אַל-תַּסְתֵּר פָּנֶיךָ, מִמֶּנִּי:
Do not hide Your Face from me.

May God be with you in all that you do, and may you never know despair.

Shabbat Shalom.

Wednesday, August 22, 2007

Working the midrashic muscle -- imagination, the search for God, the path to action

I was heading up a steep wooded trail last week when I saw Daniel Matt -- one of the world's greatest scholars of the Zohar and of Kabbalah -- coming down the other way. He surprised me by stopping to talk. "It's easy to miss the turnoff to the overlook," he said. "Look for the tree shaped like an ayin with a little tzitzit hanging down."

It was a beautiful moment that said a lot not only about what a beautiful man Matt is, but also about how we can make Torah a living thing in our lives: Matt was clearly walking through the woods with his imagination -- an imagination primed to see the things of Judaism and the Torah everywhere -- alive and at work. But this mystical imagination was doing anything but taking him away from the world and his responsibilities to other human beings; he was still very much ready to stop and take the action of helping a person in need on his way.

I've been thinking a lot lately about the role of imagination in our spiritual lives. With my chaplaincy students this summer we did something called verbatim as theological event (VTE). Here, a student shares with a group the story of a visit with a patient. Then the group searches for images that describe the "heart of the matter" in the encounter with the patient.

I don't think of myself as a very visual person, but this summer I found myself growing in my imaginative abilities (what I call, exercising the midrashic muscle) through my participation in these seminars. I saw one encounter as a boat tossed in a storm with somebody on a larger ship reaching out trying to save the person inside, but unable to reach that person. In another encounter, I saw a glass wall standing between two people desperately trying to connect with one another. [Click here for a step-by-step description of how to carry out a VTE seminar.]

If this process stopped with image-making, it would just be an intellectual exercise. But what makes it about faith is that it is in fact meant to lead to action -- action inspired by where we see the hand of God in the encounter and what that tells us about how we can better walk in God's ways in what we do. This process of moving from examining an intense personal experience to taking action inspired by God and Torah is sometimes called theological reflection (see The Art of Theological Reflection by Christian scholars Killen and De Beer for an excellent description of a general approach to this process). But I prefer to call it Midrash HaHayyim, or Living Midrash (I first wrote about this in May).

Midrash, traditionally, was the ancient and highly imaginative process of interpreting the Bible. The ancient rabbis especially loved to "fill in the gaps" in places where the biblical story is especially terse. They did so in a way that often related to the situations they saw around them -- including the injustices from the oppressive empires they lived under. In this way they linked up their experiences with the wisdom of the Torah text. [See what I wrote about in May for a more detailed description of how the Rabbis did Midrash by filling in the gaps.]

This is exactly what we do in Living Midrash. We take an experience that was meaningful or deeply troubling in our lives. By ourselves -- or better, with a group -- we examine our feelings about this experience and the images that arise in our minds from that experience in our search for the heart of the matter. And then we look for what Torah tells us about this kind of experience. What stories in Torah are like our story? What characters in Torah are like us or other people in our story? How is the Torah the same or different from what happened for us? What can we learn from how it was the same or different?

It's the Torah component that makes Living Midrash different from some other kinds of contemporary Midrash. Sometimes people think Midrash is just about imagination and they will call any sort of imaginative process Midrash. But that's not enough. Midrash -- in order to be truly living -- has to be linked back to the tradition, to Torah. It's the link between imagination and tradition that makes it Midrash.

But in order to be truly Living Midrash it also has to follow in the spirit of this famous debate recorded in the Talmud (Kiddushin 40b):

תלמוד גדול או מעשה גדול

What is greater (as a way to serve God), study (Talmud) or action?

נענה רבי טרפון ואמר מעשה גדול נענה ר"ע ואמר תלמוד גדול

Two rabbis disagreed: Rabbi Tarfon says action is greater and Rabbi Akiva says study is greater.

נענו כולם ואמרו תלמוד גדול שהתלמוד מביא לידי מעשה

The Sages answered and said -- study is greater for it brings one to action.

That is, the study we make in this process of Living Midrash should inform us about what the Torah informs us about how to run our lives. It's not enough to stop at insight and imagination. It has to also lead to action.

But we do indeed need to cultivate our imaginations to be able to do our own Midrash and make it alive. That's what I learned from Dani Matt. Not only did he bring his imagination into the woods with him, but the heart of what he teaches has to do with the Jewish imagination. Few works are more imaginative in the Jewish tradition than that great medieval mystical work in which Matt specializes, the Zohar.

The Zohar imagines God and our relationship with God in incredibly fantastic ways. The Zoharist stares at a candle flame and sees not just the blue, white and red of gases combining, but also images of God and Israel and Moses. God sits above the flame in another invisible light. Israel cleaves to the blue-black light below, seeking unification with God. Moses is in the white. (Zohar Bereishit 1:51).

Unification is in fact is a key concept in the Zohar and in Kabbalah. One of the top three contributions of the Kabbalah, Matt taught, is the idea that it is human action that brings about the unification of the "divine couple." That is, the Kabbalah imagines God as having both feminine and masculine attributes (sometimes called Shekhina and Tifferet) and that the great task of the human being is to help bring the unification of these attributes through the actions of the mitzvot.

For me, the great action where I am involved in the unification of God involves my work with patients and my effort to help bring them comfort and healing. It is a form of Tikkun, or repair of the world.

But I could not do it if I did not know that God was there. I could not do it if I did not have the faith that I am serving Torah. I just couldn't do it on my own. It would just be too hard to stand. I just would not be able to stand before the death and pain and suffering I find in the hospital's halls. I need God.

And it's my need of God -- and my desire to draw God in -- that is truly really the only source of what it is that I have to offer patients. I can't transform bodies. I can't work magic. I can only offer the rewards and comforts of faith. I only have my example of how I have tried to invite God into my own life. That's all.

It is the kind of Torah study I did with Dani Matt -- and my own processes of Living Midrash (including VTE) -- that invites God in and makes my work possible.

That's why it's Holy.

Wednesday, August 15, 2007

Refilling the tank -- the loneliness of the caregiver

I was sitting on the floor in a circle in a yurt this morning with a bunch of other Jews interested in spiritual direction when one person asked the teacher if it could be lonely being a spiritual director (a person who helps guide people on their spiritual journeys).

The question sat with me all day. Loneliness can be a very serious issue for people who make their living -- as I do -- by caring for people in crisis or who spend their days immersing themselves in other people's spiritual issues and concerns. Back in the spring I was working our hospital's cancer units. I was talking with dying people and their families every day, trying my best to offer them comfort by lending a compassionate, non-judgmental ear to hear their fears and concerns.

When the day was over, I was full of all the energy from those encounters and really needed somebody to talk to about it. But I quickly learned what it mistake it was to try to talk to my girlfriend about it. The overwhelming nature of these experiences threatened to crowd out everything else -- including the best stuff -- in that relationship. And so I was left in this strange lonely place where I couldn't connect with the person closest to me about the things that were foremost on my mind. This is the loneliness of the caregiver. And it's why we spiritual caregivers need to do self-care.

In chaplaincy, we talk a lot about "self-care". But, I think people get confused about what that really is for us spiritual caregivers -- sometimes we talk about it as if all it was about was making sure to take time "off" and not working all the time. But no amount of time off alone will renew you in the way you really need to be renewed if you are going to be able to keep doing the work and keep your heart open to people. Self-care also has to mean at least two other things.

First, it means allowing yourself to be cared for -- to be cared for in the same way you offer care to patients and clients. Your friends and family -- as I suggested above -- can't do this for you. You need other spiritual caregivers -- whether it be peers, a psychotherapist or a chaplaincy supervisor -- to be there for you and to hold you (figuratively, usually) in the way you need you, and your experiences and grief from your work, to be held.

And second it means "refilling the spiritual tank". That's what I'm trying to do this week. I'm at a great place -- the Isabella Freedman Jewish Retreat Center -- for the week. I'm here for a lot of reasons. Some of it is indeed time to relax. But mostly it's about Torah. It's about studying Torah in community and, through that, reminding myself of all the different ways to connect with God. To remind myself of everything that God means to me. To remind myself of what it is that called me to service -- to become a rabbi and a chaplain -- in the first place. To remind myself of what means to feel God wash over me. To remind myself what it really is I have to offer people who are suffering and hurting.

I'm taking a great class with Daniel Matt -- one of the world's greatest scholars of Jewish mysticism, and the Zohar in particular -- and his wife Hana. Today, Hana led us in a powerful chant of the second half of the sixth verse of psalm 30:

בָּעֶרֶב, יָלִין בֶּכִי;
In the evening, I go to sleep crying.
וְלַבֹּקֶר רִנָּה
But in the morning, I arise singing in joy.
I went for a bike ride after the class and as I was plunging down this one long hill -- feeling the exhilaration from the air rushing by my flesh and the pull created by the gravity of God's earth on my body -- I suddenly realized that I was singing these words to myself over and over again. It's the brilliance of Judaism in the face of life's hurts and wounds. We can't avoid the hurts that inevitably come as long as we walk this green earth. But hope does not die in us. We remain ready to accept that morning of רינה, of joy. What a comfort knowing that the psalms' author -- thousands of years ago! -- felt the same things we do. Suffered the same things we do. And overcame them in a way we still can.

I have so much more I want to write about from this week. So much great learning. So much Torah. Most of that writing will have to wait.


One of the main things I am here for is the Jewish spiritual direction class I opened this blog entry with. It is part of the Lev Shomea program led by Rabbi Howard Avruhm Addison and Dr. Barbara Eve Breitman, DMin. It's been a great introduction. I'm considering seeking spiritual direction training as something to augment my pursuit of becoming a certified Clinical Pastoral Education (CPE) supervisor. I hope to write more about that soon.

Tuesday, August 07, 2007


There is nice essay in the New York Times, today, by a reporter who suddenly found herself a patient in a very noisy hospital room. She writes:

Grand Central Terminal may be synonymous with noise and haste. But as I recently discovered, it can be a lot quieter than a hospital bed.

Just a few weeks ago, the Times had another interesting article about how a Bronx hospital has tried to address this problem through a "Silent Hospitals Help Healing" program:

The walls along the floor are filled with “SHHH” signs, and workers wear buttons that show a nurse with her finger to her lips. Patients and visitors are also given buttons.

Pieces of equipment like medication carts with squeaky wheels have been repaired, and sound-absorbing ceiling tiles and curtains have been installed.

Workers are encouraged to wear softer-soled shoes and to keep hallway conversations to a minimum. The volume on intercoms has been turned down, and beepers have been turned to vibrate mode. Patients now have the option to wear headphones while watching television.

The reality of noise and interruption is a major part of the patient experience, and, thus, something chaplains need to be aware of.


Monday, August 06, 2007

You don't have to go home, but you can't stay here

At hospitals throughout the country, Clinical Pastoral Education (CPE) summer programs are starting to come to an end this week. After 11 intense weeks walking the halls of a hospital and talking with patients about life and death and suffering (and where God might dwell amid all of that) many students are feeling deeply attached to their summer "homes".

But they will soon have to let go. The hope is that this summer will end up being more than just a source of "war stories" for them to tell in the years to come about the overwhelming intensity of it all -- the hope is that the students will be able to take the transformation and learning of the summer with them and that they will use it to have a positive impact whatever work they may choose to do in future (whether it be from the pulpit, in chaplaincy, or somewhere else). I have the same hope for myself -- this was my first unit supervising students. I was overwhelmed much of the time, but I hope that I will be able to move past feeling overwhelmed and instead be able to focus to identify and consolidate my points of learning.

My supervisor talked to our students, today about part of this task of consolidating this learning (otherwise known as making "closure"). He used a useful metaphor from one of his supervisors -- a metaphor of investment and making sure to get your return on your investment (ie, interest).

In the CPE context, the investment you make is in the time and energy you put into various relationships. Few if any of those relationships will continue after you leave the program, so if you don't withdraw the investment you will lose it (and the interest -- learning in the CPE context -- that you earned on it). Closure is about making these withdrawals from your CPE relationships.

The way you do it is by seeking out the staff and peers, etc. with whom you formed relationships that had meaning to you. You ask them if they are willing to have a conversation with you. And then you tell them:

  • What it meant to know them.
  • What you gained from knowing them (ie, what you learned from knowing them).
  • What you missed (ie, your regrets of what you weren't able to do with them or learn from them).
Then you listen and see what they say back to you. That is, you give them an opportunity to do the same withdrawing, etc. you are trying to do with them.


This approach to closure can also be understood through Mueller and Kell's three-part framework (from their classic work Coping with conflict; supervising counselors and psychotherapists):
  • 1) Anxiety approaching
    • This would be the person who is willing to face up to the task (of saying goodbye) and all the concerns, anxieties and grief associated with it. Mueller and Kell consider anxiety approaching to be the healthiest approach.
  • 2) Anxiety avoiding
    • This would be the person who tries to avoid the task altogether. A typical way of doing this would be "slipping out" early before anyone has a chance to say goodbye to you. (I have often been guilty of this one!!)
  • 3) Anxiety binding
    • This would be the person who denies there is any anxiety or change at all. A typical anxiety binding behavior around saying goodbye would be to pretend nothing has changed ("Don't worry, we're not really saying goodbye; we'll stay in touch all the time"). Anxiety binding is the worst approach according to Mueller and Kell. The problem regarding the task of saying goodbye is that all the energy that went into the (now ending) relationship gets binded there and thus cannot be withdrawn to reinvest in building new relationships. Put another way, this person is not able to "move on".


One of the things I have been learning over the course of the summer is about the expected pattern of a CPE unit over time. Students at the very beginning of a unit, for example, are likely to try and reassure themselves (in the face of the unknown and the anxiety they are facing) by trying to reassure the supervisor -- that is, by telling the supervisor how wonderful the program and the supervisor are and how impressed they are by it, etc. A week or two later, some kind of push-back and resistance ("you're asking me to do too much!!!!!") can be expected. This manifests somewhere later in the unit in the "point of peak frustration". How a student copes with that crisis often is the key determiner of what their most important learnings will be for a unit.

Here are some posts I made that commented on the development of these sorts of things during a unit:

And here are some other posts that came out of the work we did this summer:


It really has been a great summer. My prayer is that my students will be able to take the Torah we imparted to them this summer and carry it within their hearts to help foster healing wherever they go. May it be the will of the Blessed Holy One that their congregants, patients, clients, families and friends will all be enriched by their spiritual care and growth.