Tuesday, July 31, 2007

Moi, A La Meyers Briggs

Click to view my Personality Profile page

I took the Meyers Briggs Personality Test some 20 years ago. Seeing my buddy Cheesehead had just done it, I was tempted: would it be the same or different after so long? I'd heard one's results could evolve over time. No such luck. I'm exactly the same classification I was back then. What's an INTJ like? See below:

"...approach reality as they would a giant chess board, always seeking strategies that have a high payoff, and always devising contingency plans in case of error or adversity." - The Portrait of the Mastermind Rational (iNTj) (Keirsey)

"...observer, values solitude, perfectionist, detached, private... does not talk about feelings, hard to impress, analytical, likes esoteric things..." - Jung Type Descriptions (INTJ) similarminds.com)

"To outsiders, INTJs may appear to project an aura of "definiteness", of self-confidence. This self-confidence, sometimes mistaken for simple arrogance by the less decisive, is actually of a very specific rather than a general nature; its source lies in the specialized knowledge systems that most INTJs start building at an early age. When it comes to their own areas of expertise -- and INTJs can have several -- they will be able to tell you almost immediately whether or not they can help you, and if so, how." - INTJ Profile (TypeLogic)

"At work, INTJs use their conceptual strengths to analyze situations and then develop models to understand and anticipate through relentlessly to reach their goals. They will continue on with their plans, even in the face of adversity and data that might suggest to other more practical types that their goals are no longer feasible. By nature, INTJs are independent individualists." - INTJ - The Free-Thinker (Lifexplore)

"INTJs are natural leaders, although they usually choose to remain in the background until they see a real need to take over the lead. When they are in leadership roles, they are quite effective, because they are able to objectively see the reality of a situation, and are adaptable enough to change things which aren't working well. They are the supreme strategists - always scanning available ideas and concepts and weighing them against their current strategy, to plan for every conceivable contingency. " - Portrait of an INTJ (The Personality Page)


I suspect that my CPE peers would agree with much of this. I think it makes me sound more more strategic than I think I am, but who knows? Just call me Macchiavellian Mama.

ADDED ON: Now I've taken the multiple intelligences test, too. No surprises there : musical, verbal/liguistic/naturalist. Glad to know my suspicions about myself are confirmed.

Monday, July 30, 2007

Open Heart Surgery

Today, instead of our regular CPE duties (our supervisor is out of town for three days), I got to sit in on open heart surgery. For those in the know about such things, it was a Fontan procedure. The big daddy cardio-thoracic surgeon did it (actually he did part of it - more about that later). The patient came from halfway around the world for the surgery, which is actually the third in a sequence. This was a very chubby two year old, who was very unhappy with the world when wheeled into the OR, but silent shortly thereafter when the anesthetic kicked in.

Two other surgeons started the operation. Because of the past surgeries, there were a lot of adhesions connecting the lungs to the pericardium (at least I think that's what I saw) and they had to dissect them so that big daddy could do his thing. Took them over an hour with the scalpel, electric saw to the sternum, electro-cautery, and various other tools including a zillion clamps and retractors, to get the patient ready.

I'm not squeamish. That's a good thing, because this kind of surgery seems a cross between a butcher shop and plumbing work.

Big daddy surgeon came in after the initial prep work, finished separating out the artery that needed to be re-routed, got the kid on heart-lung bypass, stopped the heart with potassium (never realized how comfortable I'd become with the beep-beep of the heart monitor until it was silent), did the graft with a length of Gore-Tex flex tubing, put in pacemaker leads, reconnected all the appropriate arteries that had been sidetracked to the bypass machinery, and then unclamped. The blood started in to the repaired heart, and it started beating, slowly at first, then faster as the child was warmed up. When he determined that there were no bleeders, big daddy surgeon left the room so the two assistant surgeons could wire the sternum back together and stitch the muscles and skin. Unlike our newborns who undergo open-heart surgery, the patient's chest was big enough to accomodate the heart, even though it was swollen, so they could close her immediately.

Remarkable that the human heart can undergo such manhandling and holes and stitches, and come back, beating stronger than before. This child's future is still uncertain, but may be a lot better than it was before this surgery. It will be a trip to follow the patient in the CICU in a couple of days, and know I've seen that little heart, beating under halogen lights, bravely chugging along.

Metaphors abound.

Saturday, July 28, 2007

Assorted Stuff

I'm on call through tomorrow morning, so my day consisted of various short errands close to home so I could dash to the hospital if need be. I intended to visit a dear friend who has terminal pancreatic cancer, but she had had a bad night, was waiting for the hospice doctor to come, and was not up to company. Please keep her in your prayers.

So the morning was a trip to the farmer's market for good local produce and cheese, a trip to Costco for large quantities of coffee (locally roasted!), cat food, and shrimp and scallops, allergy medicine for PH, and dishwasher soap, then off to the regular supermarket for the rest of the "normal" stuff we need to survive the week. Yes, I know. More than you wanted to know.

I got home and, after putting the groceries away and making a marinade for the mozzarella balls, plopped down on the couch to finish off Harry Potter.

I didn't get off the couch for the remaining 500 pages.

Great book...the woman knows how to spin a tale.

PH is off at a dinner party with friends from his MK days. Unfortunately, the home at which the party is being held is out in the 'burbs a ways, too far from the hospital to get there in the requisite 30 minutes should I get called in, so I'm having a solitary evening, which isn't really a bad thing. I finished another book that I'd started earlier this week, and the second load of wash is in the dryer. I may go to Blockbuster and pick up a movie...but then again, that would require I get up from the couch. Accio DVD!

Monday morning I'm supposed to observe heart surgery. The nurses in my cardiac unit said nothing was scheduled for Monday morning, so I may get in there Monday morning and have nothing to do, but sometimes things get scheduled at the last minute, so who knows? Our supervisor is out of town for three days, and we aren't supposed to see patients when she is not there to supervise us, so outside of the surgery, I've got three days off. Bliss. I've got a presentation on child abuse and our responsibilities as clergy in congregations on Thursday, so I'm not entirely without work to do, but being able to sleep in for Tues and Weds is a luxury. Monday, though, I've got to get into the hospital by 7 a.m.

Just twelve more days of CPE to survive. The last two days will be evaluations and such, so it's really more like ten days. I can do this...

Wednesday, July 25, 2007

CPE Related Notes

The car is fixed, so if I get called in while I'm on call, I can use my own vehicle. It turned out that I didn't spear the oil pan with a random stick - said stick merely shredded the serpentine belt, which then whacked the whoozis out of the oil lines. The resultant mess required a new serpentine belt and oil lines, but no new oil pan. It did require a spa treatment to get all the oil off the Saab's engine, but now it's clean and well-moisturized.

In our group work today I accomplished something major for me - I told someone they were exasperating me. Shocking, aren't I?

Still not breaking through in conversation with the teen AIDS patient. If I were the patient, I'm not sure I'd feel much like talking with anyone either. It may be clinical depression. Slow going.

I'm leading a prayer and meditation service on thankfulness tomorrow. Once that's done, I have a presentation to make on child abuse in the congregational setting and one more verbatim to write. Remarkable it's almost all done.

Time to go upstairs and read Harry Potter. Don't know if I'll get through the full 100 pages I've been allowing myself nightly, since I'm pretty tired. Gosh, it's a good book! My daytime reading is Harriet Lerner's "The Dance of Anger." I'm getting in touch with my inner exasperatedness...

No matter how challenging the day has been, I still am so high over the birth of the grandbaby, nothing can get me down!

And it's Ben!


Herewith, grandbaby #4, who arrived yesterday, all 9 lbs 2 oz of him! To GrandM's eyes, he looks brilliant, alert, and ready to play linebacker for the Redskins.
God is good!

Tuesday, July 24, 2007

Random Dots of CPE - 16 Days to Go

...not that I'm counting.

Much.

  • I'm on call this week. This was complicated by the fact that my car died in a dramatic way on Saturday. The shop called today and the good news was that it wasn't the most expensive problem, or the moderately expensive one, just the modestly expensive one. I'm hoping it will be done by tomorrow afternoon, so I can pick it up. Thus far this week, I've been holding my breath hoping I wouldn't be called in to the hospital until PH got home and I could use his car.
  • I did get called in tonight (just as PH was finishing up grilling the burgers), to baptize a baby who will be operated on tomorrow morning. I'm told the survival rate for the surgery is less than 10 percent. Makes you look at the baptism in a different way.
  • Being on call, and getting called in, has gotten so much less stressful. Having survived working in the ER and being on call before, I was surprised to discover that I was feeling grateful to be able to provide this support as I was driving in tonight. The first week on call, I was simply a basket case of nerves the whole time. Maybe I'm learning.
  • I've given up on feeling personally attacked by the prickly member of our group. It's her problem if she misreads me and doesn't ask me what's up. Of course, when I notice her acting funny, I always have the option of checking it out with her as well. It took me a while to figure out that I don't have to stop being who I am just because I don't do things in her style. Old dogs can learn new tricks.
  • A baby whom we didn't expect to live (multiple congenital birth anomalies) has opened her eyes and is looking at us, is being weaned off the ventilator, and may leave the intensive care unit to go to a step-down unit on Friday. For a kid one of the nurses said was as good as dead, this is pretty darned close to being a miracle for me.
  • We have a new baby on the unit who was born with active leukemia. She is two days old and on chemo. Sheesh.
  • I'm working with a teen AIDS patient. Hardest work I've ever done, even harder than with dying babies. It makes me wish for miracles and/or magic wands. Expelliarmus!

It was good having family visiting this weekend. I feel back in touch with my own world, rather than just focusing on the hospital. My house got clean, I ate and cooked good food, enjoyed conversation about things other than diseases and accidents and death. Next Monday I get to observe open heart surgery, and yes I am looking forward to it. Then I have Tuesday and Wednesday off - a mini-vacation. I am sooooo ready for a break. Actually, I am soooo ready for this to be over, but I can hang in there for the remaining days.

Oh, and I'm preaching a week from tomorrow. Just to keep the pressure up a little bit more...don't want to lose the edge, dontcha know...

Thursday, July 19, 2007

Processing

...attending the death of the little one I mentioned in yesterday's blog. It was my midday's work. It was heartbreakingly sad, and I was so privileged to be able to support the young mother in her grief. At the last, when it was done, the little one looked so at peace, and so very far away. Of course, he was far away; only his tiny (2.5 lb) body was still with us, a sweet boy at the last.

Of course, the chaplain then has to find a way to process it all.

My solution (one I've used since I was a teenager) was to clean the house when I got home. I'm a lousy housekeeper the rest of the time - my dust bunnies are unto the second and third generation by now - but when my heart aches, I clean.

Doing something tactile and finite seems somewhat Zen-like. It is something I can actually know I did, and completed, or something like that. And I used the real mop, not the Swiffer. There's a metaphor in there somewhere. I just can't think of it right now.

Tears do a good job of washing a kitchen floor.

Keep watch, dear Lord, with those who work, or watch, or weep this night, and give your angels charge over those who sleep. Tend the sick, Lord Christ; give rest to the weary, bless the dying, soothe the suffering, pity the afflicted, shield the joyous; and all for your love's sake. Amen.

Wednesday, July 18, 2007

Probably a Good Idea...

...to share something OTHER than just peeing and moaning.

I spent time today doing a commendation for a little one from whom care is being withdrawn tonight. He never had a chance, although he's undergone three surgeries since his birth two weeks ago. I spent a long time at his bedside, just stroking his head. He has been in an isolation room because he has been so ill and is (frankly) a little scary looking. I was thinking as I was saying the prayers of commendation how little I've seen anyone touching him, not prodding or poking, but touching him the way babies need to be touched. So I stayed, and held his hand, and stroked his tiny head, and thought a lot about the meaning of such a tiny, brief life, just a flash of a shooting star across the sky. I truly believe he is going to a better place. This work is such a privilege.

I also visited a youngster who has suffered brain-damage from lack of oxygen after a near-drowning. The family is hoping for complete cure. It seems unlikely. So today we prayed for a hundred little miracles, like him gripping his grandpa's hands, or moving his legs a bit, or appearing to looking meaningfully at his brother. We also talked about how God's time is not our time, as much as we'd prefer the big bolt of lightning that fixes everything right now, and how we also need to pray for patience.

I'm thinking a lot these days about how, when one of our children is desperately ill, we become children ourselves, petitioning our Father God for a parental fix. We think as a child. At some point, if it is an extended recovery, or less than hopeful prognosis, we become grown, and we put away childish wishes. Our interactions with God seem to change.

Another mother and her child (who is HIV positive) are struggling to balance hope with reality, and the child's kidneys are failing. The miracle talk has shifted into simple requests for strength.

Neither is good or bad, or right or wrong. It's just an evolution as we process the suffering.

Four babies have died on the intensive care unit in the past two weeks. My heart aches.

Extremely Crabby

I'm having a major-league problem with another group member in CPE. Can't talk about it - that would be a violation of the group covenant, but I'm crabby. I guess I'll have to address it during our next group session on Friday. Not fun to deal with someone who's unreasonable and extraordinarily prickly.

Damn.

Tuesday, July 17, 2007

A Bit of Harry Potter Silliness..Which Potter Alter Ego Are You?

You scored as Hermione Granger, You're one intelligent witch, but you have a hard time believing it and require constant reassurance. You are a very supportive friend who would do anything and everything to help her friends out.

Hermione Granger

75%

Albus Dumbledore

75%

Harry Potter

75%

Remus Lupin

65%

Ron Weasley

60%

Ginny Weasley

55%

Sirius Black

50%

Severus Snape

45%

Draco Malfoy

35%

Lord Voldemort

35%

Your Harry Potter Alter Ego Is...?
created with QuizFarm.com


Yes, it's silly. but it was a long day in CPE, with a movie on racism and a presentation of one of my most challenging and frustrating verbatims...

I find it odd that my answers yielded the same percentage for Hermione, Dumbledore and Harry; that certainly says something about the scientific nature fo the survey!

Besides, the book arrives on Saturday!

Sunday, July 15, 2007

Random Dots of Counting Down

  • 23 more days of CPE. Not that I'm counting down the days or anything...
  • lovely in-laws are coming for the weekend next weekend. Although I should be stressed about getting the house clean etc., I'm just so happy to have them here, I'm not worried about the state of the house (at least not much).
  • I survived mid-unit CPE review. The perception of the group seems to be that I'm some great energetic mamma bear. My own image of myself is one of the Israelites murmuring in the wilderness and complaining about the manna.
  • it was a blessed relief to go someplace different for church this morning and not have to answer questions about CPE. PH preached at a church I've never been to before (he was serving as supply clergy) and it was great to just be quiet and listen.
  • I'm preaching at Big Old Seminary - we have Wednesday night Eucharist during the summer - on August 1st. First time I've preached there. It's the passage from Luke about Joseph of Arimethea retrieving Christ's body, putting it in the tomb, and the women anointing the body. I think I'll do a reflection on the way the ritual of the handling of the body is dealt with by the hospital when a child dies, and the power of ritual in that liminal space between death and the reuniting of the soul with God. Nothing like something heavy...the key will be the pivot into that joyful moment when the mortal body is left behind and the soul is with God. Don't want everyone to be going from the Eucharist to the post-Eucharist cook-out in tears.
  • I'm also preparing a seminar for my CPE group on child abuse and how we address it in our parishes/congregations. If any of you out there in the blogosphere can recommend some good resources, I'd appreciate it.

So let's see, I've dealt with two deaths of babies this week, I've presided over an interfaith service on children who were victims of violence, I'm preaching on death rituals in two weeks, I'm teaching a class on child abuse. The upside of all this is that I'll be so cheerful when it's all over, the start of school (with Systematics, Homiletics, Church History, and Pastoral Theology) will seem like lots of happy talk!

Friday, July 13, 2007

Words fail me...

The little one I baptized a few days ago died last night. It shouldn't have been a surprise - she had many physical problems - but she had seemed better. I had seen her with her mom at her bedside yesterday at 5 pm.

This has been a bad week on the unit, with two babies who were in beds right alongside each other dying within a day of each other. Teen Mom (see below) whose little baby girl is still in many ways a medical mystery to the docs with her many congenital problems, didn't come in to sit by her child's bedside, as she usually does. I fear she's been shocked and horrified by the two deaths, and it is finally dawning on her how sick her baby is. I hope she'll be there on Monday so we can talk.

I've been assigned an additional unit, since one member of my CPE group has dropped out for medical reasons. I'm picking up the Respiratory Care unit (think asthma, cystic fibrosis, that sort of problem). Sick kids, usually past the baby stage so I can have some conversations with them, not so acute as the babies downstairs. Different challenges that will be good for me.

As much as I'm learning, I will be glad when these last five weeks are over. Poor PH is patient with my every-night tears, but I feel badly that his wife dumps all her emotions on him over dinner.

The cure? I had frozen custard after dinner tonight. I'm much better, even though my jeans are tighter.

Thursday, July 12, 2007

Tod und Verklarung


One of our sickest babies died last night. She was born with many congenital defects, and in her ten months of life underwent a number of surgeries to try and help her. She finally could hold on no longer, and as she was about to be coded, her mother stepped to the bedside and said, "enough." So they undid the many tubes, and let her lay in her mother's arms. The pacer wires were still attached, so her heart kept beating. After a while, her mother said to remove the pacer wires. Her heart stopped immediately. They sat quietly with her for a long time, and after the last of the various pieces of equipment was unhooked, they bathed her and dressed her and continued to hold her in their arms. It was a moment of terrible poignancy.

This is a ritual that often happens in this unit when a baby dies - and babies do die here frequently because we do the most radical of surgeries, the true last-ditch efforts - that the parents stay with the baby, bathe the child, and spend time quietly holding their little one.

In the case of the baby that died last night, for the past few weeks, the mother had often said, "I just want to be able to hold her." There were so many tubes and wires it was impossible for her to be lifted off the bed and into her mother's embrace. Last night, finally, she got her wish.

I wonder about these rituals of washing and waiting. Certainly Scripture speaks of them after Jesus' death on the cross. Joseph of Arimethea collects Jesus' body, lays it in the tomb, and the women come to wash and anoint the body.

I belive that some of it is to lend tactile truth to the death. When you have touched a dead person, child or adult, you know they are dead. You can feel there is no life in them. Some of it, too, is an honoring of the person by washing them, anointing them, preparing them to step away from this world and into the next. It is the last gentle act of love you can do.

I used to think that rituals like wakes (I grew up in an Irish Catholic family, and the wakes were Joycean) were barbaric. The number of times I heard someone say at the side of the casket, "Doesn't she look good?" is more than I wish to count. Spending time sitting with a body? Having the dead person dressed up and laid out for all to see? Awful!

Now I start to see the wisdom of ritual to lend reality to what has happened, although the embalming and making up of dead bodies still seems wrong to me. I wonder if we can visualize a going up to heaven without the rituals that bid the person, or at least the person's mortal body, farewell.

I believe in another place after this one, a place of peace and rest. I don't know what it is like - none of us do - but I know it's there. When I die, I hope my loved ones can bid my body farewell as gracefully as these parents did, knowing that I am well and truly gone from them, and know, too, that the "I" of me is gone on to that other mystery for which there are no words.

Rest in peace, little M. Rest in peace in that mystery place for which there are no words.

Saturday, July 07, 2007

Whoa!

So Friday the CICU was rockin' - lots of sick babies plus a couple of sick adults with congenital heart defects. I had spent some time with new anchor mom (the beautiful, fully made up one) and we talked about grieving the perfect birth and homecoming she had planned for her little boy. When you're a master (or mistress) of the universe, you think everything's going to go your way, and when it doesn't, it's a shock. A long and interesting conversation, and she was able to cry about it, which was a very good thing. The good news is that her son's problem is very fixable, and although the start of his life was not what she hoped for, the rest of his life most likely will be. On the other hand, mye xperience with my own children tells me that they tend to do follow their own path, not the one I laid out for them. Nevertheless, she is fortunate.

Then the social worker came to find me and said "We need you to do a baptism NOW." It was a baby I had prayed with before - the family is Catholic and Hispanic, and mom speaks very little English. I suggested she might prefer to have the Catholic priest come down...and was told that the baby was crashing and they were about to rush her up to the OR to try and fix what they believed was the problem (the baby had already had several heart surgeries and was recovering from her latest) and there was no time to page the priest. So I baptized the little one (who had every square inch of her body covered with tubes, leads, etc) reaching past the four nurses who were packing her up with all her equipment to go to surgery. Even with all the work they had to do, they stepped aside for a moment to give me access, and a few said some of the prayers with us. One of the nurses said to me, as I was by the crib, "You better do some extra prayers for this one. It's really a long shot." Nothing like a little pressure. We had an interpreter translate as I baptized the baby, and they recited the Lord's Prayer in Spanish as I did it in English. Then we brought in the two siblings, aged ten and six, to kiss their baby sister before they took her up. We had to gown and glove the brother and sister, which they thought was great fun. The only thing they could reach to kiss was her little foot.

Suffice to say it blew me away, and I had to step out after they took the baby up to compose myself.

An hour later, she came back down from surgery. The problem was not as acute as they feared, and was fixable. The baby still has a long road ahead of her, but she got through this one. I'd like to believe the Lord (and my clumsy baptism) helped. At the very least, it was a comfort to the mother and to the staff who (remarkably) thank me when I pray with a baby.

Intense.

The other biggie: the newborn baby of a teen mother (both baby and mom have a raft of problems) was taken up for surgery unexpectedly - we thought she would be waiting until next week for her repairs. She was in surgery for twelve hours, on heart bypass for over five. She will still need more surgery down the road. It's miraculous that they're able to do these repairs, but it raises a number of ethical questions as well. Teen Mom has been leaning on me (as has her mother, a grandmother at 36) so it has been a challenging week. I expect this family will be with me for the rest of my time in CPE this summer, and I already feel very close to them. I don't know whether their reliance on me is a good thing or a bad thing, but I'm certainly learning a lot in the midst of it.

Plus we have a preemie who has just had his first heart surgery despite the fact that he weighs under three pounds.

Whoa, indeed!

Six more weeks.

Wednesday, July 04, 2007

Movie Recommendation

If you love to cook, or love to eat, or love general good-hearted silliness, may I recommend you go see the new animated picture "Ratatouille?" Beautiful animation, charming story with a good message, and lots of good stuff for the foodies amongst you. Ian Holm as an evil chef, Peter O'Toole as a mean-spirited critic, Brian Dennehy as the ghost of a famous and big-hearted chef. It's my understanding that the writers and animators spent a great deal of time with renowned chef Thomas Keller of the French Laundry, Bouchon, and Per Se, and it shows. Not for under 7-year-olds, I think, even with the G rating, but otherwise even your Great-Aunt Sadie would find nothing objectionable.

I'm still smiling...

Tuesday, July 03, 2007

CPE Random Dots - Week Four +

Today was a short day - I had a funeral of an elderly friend this afternoon. I spent the morning doing clinical visitation. I've got tomorrow off, too - a blessed relief.

Here's what's happening:
  • more very sick babies on my acute unit. We are all braced for the inevitable sadness with a few of them. It affects the whole unit.
  • I am getting a rep as a "baby whisperer," good at calming down fussy little ones. I claim to have grandma hands, and I can sing a whole bunch of lullabies. And yes, I do pray a lot with them.
  • the dad of one of our babies is a news anchor, and he and his wife are too gorgeous for words (the baby was born less than a week ago, and she is back into her original jeans, and shows up on the unit in full makeup - the only sign of recent birth is a luxurious bosom, which makes her hips and tummy even tinier). We all feel like schlumps in comparison. On the other hand, they're not surgeons or nurses or repiratory therapists or baby whisperers, so I guess even in our schlumpiness, we're useful.
  • a baby with (literally) half a brain, can still look in your eyes and you can feel the connection.
  • I'm getting better at talking desperate parents off the ledge when things are getting really rough. And I'm getting braver at asking the hard questions (do you understand your baby is really sick and may die? kind of questions) plus the follow-up hard questions (what's happening in your relationship with God with all that's going on?). No one has smacked me literally or figuratively yet.
  • anointing a sick child is the most transcendent thing I've ever done.
  • teen moms are not necessarily immature. Mothers of teen moms are not necessarily mature. No generalizations, just an observation.
  • some of the staffers are so goal-oriented, they forget they're working with people.
  • if I trust my instincts, I'm generally okay. If I worry about what someone else thinks, I'm generally not.

Tomorrow should be a quiet Fourth. PH is going on a long bike ride with his buddies, I'm going to attempt to sleep in, and we're going to see "Ratatouille" in the afternoon, then grill some steaks on the Weber. I should do my ethics project, but somehow I think I need a completely non-CPE day. Gosh, this is exhausting work.