Blog Post: Pastoral Burnout…Yes, It Does Happen, but Not Forever!

It begins with a whisper in the back of your mind, a body ache, or a nagging physical symptom, and then all of a sudden…PASTORAL BURNOUT!!

Well, lets back up. Perhaps it isn’t this extreme, especially for me, a hospital chaplain who has only been in ministry eight months, but given how much I am “in ministry,” and lets face it, everything I do is ministry – pushing an elevator button for someone who is unable to reach it, holding the elevator door for someone, offering directions in the massive hospital community I am apart of (now that I am no longer completely and utterly lost on a day to day basis…what an accomplishment!), offering to pay for someone’s coffee when I notice they don’t have enough to pay for their own at Starbucks, even offering grace to the cashier at my “local” Target when she needs to ring up my entire order again (a large one at that…) after I have put it all in corresponding bags, and in the midst of the process, she mentions she has only been working there (rather woefully, I might add…) for a week. All of this is ministry, and after a while, these little ticks add up, especially after doing five 24-hour on call shifts with advancing Cardiomyopathy (a fancy name for my heart condition), and as my Cardiologist in NY hypothesizes, the cold I had in January likely put me in the early stages of Heart Failure (given that my EF went from 65% – normal!, down to 50%, not so normal…).

All this to say, regardless of the baggage (physical, emotional, or spiritual, or any combination of the three), pastoral burnout happens! But it isn’t a permanent condition. As Ministers of Word and Sacrament (myself included in this unique and special club), we are called to be giving, selfless, and attuned to the needs of the world at every moment, and yet, this often times means that we are less attuned to our own needs. As the last few months have worn on, however, I have made it my goal to be more attuned to my own needs, understanding that I cannot be attuned to the needs of others if I am not serving myself. This harkens back to the charge I was given by a special Minister mentor in my life at my ordination. She charged me with the following words:

“Endure suffering: This can be a tough job. God is a pretty demanding boss at times. The church is even more so. Take God seriously, take God’s people seriously, but do not take yourself too seriously. As you are diligent in your studies, also be diligent in your play. Make time for rest. Make time for fun. Stay connected to the people who lift and nourish your spirit. Resist the ever-present temptation to be everything to everyone. Spend time alone with God every day. Take your work seriously, but also take time away so that it does not consume you. Take your vacation time. Take a day off every week (and by off, I do not mean returning emails and writing a sermon). Get enough sleep…take care of yourself. In order to endure suffering, ministers must be strong…strong in spirit, in mind, and in body. God has entrusted you with he care of those God loves…and that includes you.”

I distinctly remember sitting there, staring into the eyes of a woman I admired, who had also endured a great deal of suffering, much of which I had not known, do not know, and likely will never know, but understand that as a result of this suffering, she was standing before me, commanding me to be a firm and strong woman of God, as she is, but not fall into the temptation of perfection and overfunctioning that would lead to pastoral burnout. On the day of my ordination, just a few months ago, this Minister of Word and Sacrament, who I deeply and completely respect, was calling me on my stuff, before a congregation of others, and holding me yet again accountable, as she always had, and asking me to hold myself accountable.

I have “stuff,” and “stuff” that likely places more limitations – physical and at times deeply emotional and spiritual – and if I don’t take stock of the fact that I cannot be Paul (be all things to all people), I will suffer from pastoral burnout. I have had inklings, especially in the last eight weeks, as my on call shifts have doubled (and nearly tripled), and have called out to God for strength, courage, and even at times wondered whether it was physically and emotionally possible for me to continue this work. But I have been gifted time – days off, and by the grace of God, my very first set of TWO CONSECUTIVE DAYS OFF in a whole month (this may sound trivial to some, but for me, this is a blessing…).

Pastoral burnout – and the beginnings of it – is so totally preventable, but only if I am able to admit that I have human (very human) limits, and cannot do this ministry thing without taking taking time for myself. As I head into my fourth unit of CPE (and have extensive Cardiopulmonary Testing on 4/3/15, this coming Friday – including PFTs and an Arterial MV02 test…google it if you’d like to know more), I am deciding to live into my mentor’s Ordination charge – to minister to myself, and thereby be a bit more selfish in my taking of personal and vacation time, to not expect to be all things to all people (Sorry Paul, but I think you got that one in the bag…), and hopefully, when all is said and done, I will have taken the time to recharge, better understanding what self-care means to me (a process that has been underway over the last 8 months, but I have come to believe will be in place over the course of a lifetime!). I distinctly remember a dean and fellow woman in ministry saying to me in seminary that ministry is a marathon, not a sprint, and even 3 years later, that piece of advice sticks with me.

So. Burnout. Whether it appears in the itch to travel, the desire to run from ministry entirely, or the desire to change forms of ministry, burnout is real, and is a sign that ministry to the self is necessary, lacking and disproportionate. Ministers too are deserving of self-love, self-care, and deserve the equal care they dole out toward others…a lesson I am learning as I spend more time in the field, and as God works in and through me, and as I receive a great deal of love from others (families, physicians, nurses, social workers, etc.) that I never expected.

So. Be selfish, with your time, with your love, and with your need for self-care. I sure am, especially as I realize that my health requires it – emotionally, physically, and spiritually. I don’t want to claim that God doesn’t blame me, as that isn’t theologically sound, but I would believe that the God who has created me, and has called me to this work, would desire for me to do the same work on myself, as I am doing on others.

And then…back to work on Monday!

Amen.

Blog Post: For the Love of a Chaplain: Transplant Edition

For those of you who don’t know, I am a heart and lung transplant chaplain, and a heart patient, and at times, it is difficult to distinguish which is which. I believe that God has called me to be both, and that 99.9% of the time, the two are congruent with one another, and today was yet another example of this congruency. Tuesdays are Transplant Listing Meeting Days, which means that my afternoons are consumed with the lengthy and at times overwhelming details involved with the pros and cons of listing a patient (and their family) for a transplant (or transplants, as the case may be). As I have learned over the course of my seven months of full time chaplaincy, I have so very much to offer, and have been gifted the expertise of both head and heart, theology and pastoral wisdom, dogma and emotional verbosity, and perhaps these are all of the things I was struggling to put words to when I was seeking for a concretization of and validity for my call in the Ivory Tower that was my seminary community.

Now that I have been serving a critically ill – a tertiary care community, as you will – population for seven months, I harken back to my own experiences in the hospital, and all the experiences I have had (both good and bad) with chaplains, and how it is that I got to be here, a less-than-Bible-thumping, rather rebellious, at times theologically unsound yet God-seeking Reformed-tradition-loving Hospital Chaplain. My very first experience with a hospital chaplain was three weeks into my first year of seminary, and I truly and completely believe that God predestined (see what I did there oh wise RCA mentors? A good dashing of Calvin is necessary at this point of my blog post for the sake of the reduction of theological heresy…), or rather knew that I needed comfort in the midst of what likely was the beginning of both the most enthralling and traumatic saga of my life thus far, and guided a man so incredible and equipped to handle my Enneagram “8-ness” (at the time, unhealthy, mind you), but also could handle my “stuff,” as a dear friend calls it. This chaplain, I’ll call him, “R,” a fellow PTS grad, knew exactly what to (and not to say), and in the midst of a crisis – I was about to be intubated, was decompensating rapidly, and was very scared – said a prayer and read Psalm 121, all the while holding my hand. I don’t remember any of this at the time, but he told me this much later on…several years in fact.

“I lift up my eyes to the hills –

from where will my help come?

My help comes from the LORD,

who made heaven and earth.

He will not let your foot be moved;

He who keeps you will not slumber.

He who keeps Israel

will neither slumber nor sleep.

The LORD is your keeper;

the LORD is your shade at your right hand.

The sun shall not strike you by day,

nor the moon by night.

The LORD will keep you from all evil;

he will keep your life.

The LORD will keep

your going out and your coming in

from this time on and forevermore.”

This chaplain followed me through half a dozen heart surgeries and procedures,  new and changed diagnoses and changed prognoses.

The role of the chaplain is not to convince a patient of anything, but rather to cling onto hope for and with them – to know nothing of the diagnosis other than that God is with and for them in the midst of that family and patient’s suffering, whatever the outcome is. Clearly God is with and for me in the midst of my suffering, as I am still here, despite my congenital heart disease, despite my Cardiomyopathy, despite my declining Ejection Fraction, despite the fact that a year after my pacemaker implantation, I no longer can exercise, and am collecting fluid in my ankles, legs and abdomen. Despite all this, it informs my ministry in ways I never imagined in that I am the hope chaplain – I hope in the LORD who helps, who moves my feet toward crisis, who gives me words to speak, moves my lips in prayer, and gives me the proper words to say to those in the deepest of pain and suffering, just as God did for“R” when I was in need of God’s grace and presence so many times throughout my three years of seminary.

May the words of my Heart, and the Meditations of my mouth, thanks be to the faithfulness of God in me, be acceptable to the God who has had faith in me, and given me purpose and continued new life, and pleasing in the sight of the Triune, our Rock and our Redeemer. Amen.

Blog Post: Ministry Isn’t For The Faint of Heart

Much like I would imagine a first-time new parent might feel on the eve of the arrival of their new child, my call to Hospital Chaplaincy didn’t come with an instruction manual. In the months preceding my move to San Francisco and the start of my CPE residency, I began to have doubts – doubts that my 3000 mile move was indeed what God had in store for the next year of my formation, that my residency was the right place for me, and most of all, that working hip (and at times shoulder and ear-) deep in the stories, suffering and grief of the ill and dying was what I was supposed to be doing. As I worked in the advancement office of my seminary during the day, and packed boxes at night, I said deep, breathy prayers to my God, asking for courage and strength, discernment and clarity – never once asking why, but always asking for the courage to jump into an experience that all at once felt filled with doubt and fear.

In the Gospels, Jesus’ ministry begins with weeding through people to call his disciples and earthly ministry compatriots. [I should pause here to distinguish that I by no means perceive myself as a disciple in the traditional, scriptural sense.] In the Gospel of Matthew, a disciple approaches Jesus, but makes certain demands of Jesus before he is able to follow him: “Now when Jesus saw great crowds around him, he gave orders to go over to the other side. A scribe then approached and said, ‘Teacher, I will follow you wherever you go.’ And Jesus said to him, ‘Foxes have holes, and birds of the air have nests; but the Son of Man has nowhere to lay his head.’ Another of his disciples said to him, ‘Lord, first let me go and bury my father.’ But Jesus said to him, ‘Follow me, and let the dead bury their own dead.” (Matt. 8:18-22) Christ emphasizes that those who dedicate their lives in the service of the almighty must understand that it comes with sacrifices – whether they be physical (homes, geography, physical property, items, etc.), emotional (separation from family, friends, community bonds, etc.) or otherwise, but it doesn’t come without the companionship of God.

I can relate to this passage from Matthew; never did I expect that my ministry as a hospital chaplain would involve holding the small hand of an infant as she passed away, baptizing a premature baby, offering a blessing for a Left Ventricular Assist Device (LVAD for short) before a patient went home at their request – understanding the new life this device will provide this person with, and discussing the deepest of life’s issues with heart and lung transplant patients in the depths of the night, a time when things seem most pressing, and the heart seems closest to the Divine. Excerpts of the work God has done in and through me are not sufficient enough to explain the weightiness that is the work of the chaplaincy, and yet also, the joy.

As a transplant chaplain, I am often called to be present with families in times of desperation, when all things seem fraught with fear, and treatment options seem so totally futile. Physicians speak about the futility of life and medicine, and yet, this is precisely the moment when clergy and chaplains edge in – to hold frail and IV-scarred hands, to offer up verses of Scripture, to ask, “what may we offer together God in prayer in this moment?”and most often, to feel completely comfortable in the painful silence that accompanies panic, pain and grief. This past week, I was called to the bedside of a young mother who was told she would not be receiving a lung transplant; no longer able to speak because of a tracheostomy, she wrote out that she still believed in the possibility of a miracle – a Lazarus moment of her own, but was also not afraid to die. Together, we read the story of Lazarus in the Gospel of John, and as I did so, tears began to fall from her eyes (and mine).

Hospital Chaplaincy is not for the faint of heart; I have experienced many Lazarus moments, and have also experienced many Matthew 8 moments, where God has firmly told His disciples that the service of God is not an easy path to walk, frequently filled with many difficult choices. Over the course of my more than 6 months as a chaplain in San Francisco, I have wandered and tread upon paths that could only have been created by the Sacred. A phrase frequently used in Chaplaincy is, “sacred space,” and I have felt that much of what I have experienced in my interactions with patients and their families over the course of the last almost 7 months has occurred in “sacred space,” created only because my previously faint heart has been filled willingly with the Holy Spirit, ready and willing to do God’s Work for the Good of others.

Even though the Lazarus moment doesn’t come for everyone in the physical sense, it does indeed come for all at some point (physically, spiritually, emotionally, theologically, what have you), and the role of the hospital chaplain is not to convert/convince/change an opinion, but rather to stand in the midst as a grounding point when all else is disorienting and chaotic.

By the grace of God, I have been called and equipped to this ministry, and the hesitancy, doubt and fears of failing all fell away after the first month or so. I realized that God was requiring of me to jump into my call, trusting as I had so many times before that God’s call was authentic, and therefore, am equipped with the tools and skills for such a time as this, but only if I remember that it is God’s work, not Liz’s work, and a partnership.

As I begin my fourth unit of CPE on Monday, my prayer is that I continue to hone in on the still small voice of God – not only for myself, but also for my patients; I came to the conclusion midway through last unit that if I cannot do that for myself, there is no way that I will be able to do so when I am standing in the midst and in solidarity with the patients and families I work with on a daily basis. May I have compassion for myself, a discerning ear, and continue to listen for God’s will for my own life so that I can listen compassionately to the concern of others in crisis.

Amen (or as we say in CPE, “may it be so…”).