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Posts tagged ‘expectations’

The Provider

** this post was written under the influence of Vicodin

Today I went to the ER for severe abdominal pain. I accepted long ago that pain is just a part of being a woman, but when it wouldn’t go away and I broke out in chills, I decided I needed to rule out Appendicitis and other things I hadn’t dealt with before.

David called a friend to meet me at the hospital around the corner from the church and then took the kids with him to Sunday school and service.

The ER was empty, the waiting room was clean. It was so calming. I felt more relaxed in this adult environment where I could be the patient and not Margaret. So what if I wanted to crawl into a ball on the newly waxed floors, at least it was my own teeth I could grin with and bear it.

We immediately went to a room, took vitals, blood work, etc. I met the RN, the clerk, the ultrasound tech, and the PA. From the beginning they kept referring to the authority behind the plan of care as “The Provider.” “The Provider” has ordered these tests. “The Provider” will look at the results and then decide if you need a CT scan. There was never mention of a doctor. There was never a promise of a visit by a doctor…although it was not ruled out either.

When “The Provider” was first introduced, my friend and I immediately remarked how eerie that idea was. We felt watched, like someone was sitting in a sky box or at a call center across the Pacific making judgment calls based on the 5 symptoms I listed on the in-take survey. She guessed “The Provider” gave the hospital more flexibility so I could see an NP or MD without getting my expectations for one or the other. I felt “the Provider” was the hospital itself, an institution, the one that had taken on the liability and therefore responsibility to care for me and could send whomever they pleased to do this. (Our best nurses at home are LPN’s with 20 years experience in the field. I was not miffed at being cared for by nurses). The term felt so abstract as to not refer to anyone really. It didn’t matter who was making the decisions, Kim (RN), Aleisha (PA) were the ones caring for me. Who is “The Provider”? Is it anyone? Or everyone?

Maybe because I was missing church to be in the ER, I started to imagine “The Provider” as a theological term. Was it really so different than the other terms I use to address G-d in a pastoral prayer: Creator, Holy One, Gracious Lord, Loving G-d? Doesn’t “Provider” fit right into the Trinitarian language: Creator, Redeemer, Sustainer?

Over the last 4 years, I’ve faced a lot of false idols I’ve built up when sick and vulnerable and at the mercy of doctors and healthcare systems. When Margaret’s first surgery by a renowned heart surgeon went badly (we only discovered this 2 weeks later, when she wouldn’t extubate because her left vocal cord was paralyzed), I stared down that need for complete trust in your surgeon as god and expectant trust in G-d as a perfect surgeon. When you turn your back on your newborn in the OR and walk to the waiting room, what choice do you have but trust? But what does that trust feel like? Is it tied to the moment of surrender or to the outcome of the process?

As unlikely risks and undiscussed side effects piled up in Margaret’s NICU and home care course, I found trust to be a liability, especially with healthcare staff. What could they really know in the 5-15 minutes they spent with you, the 3 hours they trained in your home, the trach change they may have only done on a doll? What if your surgeon (or his fellow) had been up all night or had just fought with her partner leaving her angry and nervous? There were so many variables, how could you rule them all out and relax as they needled, gassed, and cut your child? I began to wonder if trust and faith were really synonyms or something else entirely. Must you experience trust in others to have faith in something larger?

A pastor I worked with often said “God has already provided everything you need.” This rings differently to the mother of 2 struggling with homelessness than it does to the parents trying to afford school tuitions or the former athlete faced with cancer and the loss of his competitive life. I heard some people focus on the “already provided” and wonder what gems or safety nets they’d overlooked. I heard others focus on the “you need,” and set a regiment of greater simplicity.

It’s an interesting concept–“to provide.” It’s more about the act of giving not what actually is given or who gives it. It’s impossible to look around at this earth and not feel something is being provided all the time, to every living thing.

In the end, I decided I was alright with my trust issues. Trust was attached to results. To certain deliverables: good care; meticulous, skilled surgeries; adequate and accurate follow ups. Faith, as I would search for it now, would not be attached to certain things. Good and bad outcomes fell on everyone, everyday. Who were we to expect only the best? Faith would be about finding provisions all around me. To miss what didn’t come through for us, but to believe the act of giving never stops.

I never did see a doctor, but I got a diagnosis and enough pain and anti-nausea meds to treat me. As I waited for my friend to pull the car around, I caught a television segment on “mind over medication.” The attractive young doctor in a blue wrap dress cited two studies about the power of the mind to fight pain. There were holes in her argument, places she invited leaps of reasons to reach conclusions but the concepts of healing through giving to others and through receiving care resonate with me.
The first said “giving to others” produces chemicals in the body that alleviate pain and in the case of one man with MS allowed him to live 11 years after he ceased his 12 prescriptive drugs to treat MS (The doctors said he’d live only 1 year without them). The second study showed that the presence of a doctor you trust and who shows a belief in your ability to get better (a healer she called it) is as important as the treatment itself. “A doctor is the placebo effect.”

Every day I get a medical bill and I am floored by the rising costs, the increase in tests for diagnosis (more items on the bill) and yet the decrease in time we ever interact with another human being. The system is broken. The costs are too high. ($10,000 for our last Children’s ER visit, to be left for 8 hours in a room, with me doing all the work of suctioning, nebulizing, oxygen monitoring, etc). The doctors can’t fight the economics of it anymore. No one can tell you in advance what a procedure costs and good luck getting clear answers afterwords.

Perhaps it is more accurate to call whoever or whatever cared for me today: “The Provider.” I never saw their face but I did benefit from the provisions. If I saw a “healer” (one who believed in my worth and ability to get better) it was in my friend who stayed with me those five hours.

That was enough for today. Will it be enough for tomorrow?

For those commenting: Have you heard this term “The Provider” in lieu of the doctor?
What term do you use to describe G-d when you pray?

Lessons in Empathy from Cheryl Strayed

When fatigue leads to compassion fatigue?
I read...

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The Ineffable

What is beyond language? How do I put words to it? Do I even want to try?

A post about why I stopped talking about G-d. It came on gradually really.

These questions weren't just theoretical for me. They weren't about getting my theology right or even about you or someone else following this line of thinking too. They were personal. They were about my experience of relationship. These were the questions I faced when the attempts to save my daughters life paralyzed her vocal cords and took away her voice. Our relationship was born out of a deep silence. We learned to communicate in facial expressions and gestures. We stared at each other a lot. Every parent of an infant experiences this to some extent. I did with my first-born. The difference was when I stared at my daughter's inscrutable face, I did so with little hope that I'd ever hear her speak. A life of unknowing hung over us and informed how we would begin to get to know each other in whatever ways we could.

When I began sign language classes at the Atlanta Area School for the Deaf, I learned how much the face mattered in communicating not just tone and emphasis but varied vocabulary. For instance, the hand motions for "awake" and "Surprise" are the same. The emphasis is with the widening of the eyes and opening of the mouth. Those who speak and sign are considered "bi-modal." Spoken and written words are symbols that stand in for objects and concepts. Communicating with the body requires you to inhabit what you say. It eschews some of our detachments. What we say is no longer symbolic but corporeal. It takes muscle as well as thought. In the beginning my fingers hurt a lot. The joints would feel stiff by the end of the two hour class. When I tried to finger spell words with the letter "K," I accidentally made lewd anatomical references. When I tried to order "chicken," I ended up cursing my partner.

I began to feel helplessly misunderstood and mourned the intimate mother-daughter conversations I felt would never happen. Without a shared fluent language, I imagined I would never know the internal life of my daughter. I felt the pain of the spaces between myself and those I loved with whom my words always missed the mark. I began to wonder if like color-blindness I was seeing green when everyone else saw red, I associated the wrong meanings to words I thought I knew. I left conversations feeling more baffled than before, even when I spoke with my husband or colleagues. I wondered how stuck inside our bodies and minds, how alone we all really were.

I compared these widening gaps between me and loved ones to the black hole I felt when I tried to define G-d or Love or anything that had no obvious antecedent. And yet these shimmering concepts preoccupied that yearning space inside me. When I tried to pin anything I felt or experience down, I watched as whole words flew out of memory. I felt my feet slip underneath me where I walked. I no longer trusted gravity or felt a hard surface underneath me. We all seemed to be hovering over something bottomless. Far from creating "doubt," this reality created more of a sensation of living with faith. Losing language for something is not the same thing as losing faith. Without the ability to define, without a sense of mastery over my surroundings and thought processes, I had to face what kept me from trusting and develop that ability to trust more.

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