The Art and Spirituality of Dying – Culture Makes a Difference

                               
The following item is taken from Baylor Scott and White's North Texas' intranet site and describes a recent symposium in a series of offerings of which, as an employee and member of the Mission and Ministry Community, I am very proud.  It details the 2016 Symposium on improving end of life care through greater cross cultural awareness.  Enjoy! 
Mark
    
July 5, 2016:  A Nigerian mom, who was one of our patients, was dealing with the death of her baby. The Labor and Delivery staff was following the established approach of trying to allow the mom to hold her baby, but the mother kept resisting. One of the nurses took the time to pause and wonder if that had anything to do with the mother's culture. They explored further and found that there were significant cultural differences; it wasn't reluctance to process her grief or anything pathological. By being curious and caring, the staff was able to understand how to meet her needs in the most sensitive way possible.

Improving end-of-life care

On June 14 on the Baylor University Medical Center (BUMC) campus, Robert Hunt, PhD, director of Global Theological Education and director of the Center for Evangelism and Missional Church Studies at Perkins School of Theology at Southern Methodist University (SMU), presented "The Art and Spirituality of Dying." He stressed both modern and non-modern worldviews, and the significant differences between individuals of each worldview when situating themselves in the face of their own mortality. "I think it's very important in a hospital setting for everybody to constantly have a consciousness of cultural diversity, so that they can respond favorably and positively to it," Dr. Hunt explained. "This will provide the best care for the patients and will allow us to obtain the best outcomes for patient health."


With the help of a facilitator, Tia Jamir, PhD, BCC, and a panel had a chance to respond to Dr. Hunt's presentation and educate health care providers about their own faith and beliefs, and how to act around dying patients and families of similar backgrounds. This panel included Dr. Marygrace Hernandez Leveille, PhD, RN, ACNP-BP, Dina Malki, MA, and Pravrajika Brahmaprana.
  

Being sensitive

Dr. Leveille is a nurse scientist for BUMC and is responsible for nursing research. She started off by speaking about the importance of having a nurse next to a patient who is dying. "The nurse will hold your hand and will be there with your body and your spirit," she added. She went on to talk about her personal experience of being diagnosed with a brain tumor, and how the only thing she could remember after her surgery was praying. "I was sitting in a dark room with no recollection of who my parents were or where I was. I remember the nurse walking in to make sure everything was fine," said Dr. Leveille. She told the nurse that she thought she was praying. "The nurse told me that I was praying the Our Father and the Hail Mary, and began to pray with me. I then realized how strong and powerful that really was."


She continued to talk about the importance of being sensitive and inclusive, and addressing family needs. Dr. Leveille added that staff members and nurses must avoid being culturally insensitive. She shared a story about when she was a traveling nurse at a Jewish hospital, working in the emergency room. They brought in a Hasidic Jew who was covered in blood. Dr. Leveille decided to shave his beard and payot (ear locks). "All I knew was that as an ICU nurse I wanted that face to be cleaned so that an ET tube could stick well and I could do oral care. I didn't know I was being culturally insensitive," said Dr. Leveille. "As nurses, we have to make sure that the patient remains spiritually intact and that we are there for them and their family members." Addressing spiritual care plays a significant role in a nurse's life.

Muslim traditions

Dina is a Muslim American who has lived in Texas for 25 years. Dina discussed how to avoid hurting the dignity of dying Muslims, such as not forcing a patient to take medicine against their will or without the family's permission (depending on the situation), and to allow a dying patient to perform his or her ablution—the act of washing oneself—and to pray with or without the help of the family.
"I came here with the intention of educating the audience about the sensitivities of the Muslim culture and to talk about the spirituality of death," said Dina.

Hindu practices

Pravrajika is a sannyasini (ordained nun) and is currently the resident minister of the Ramakrishna Vedanta Society of North Texas in Dallas. She spoke to the audience about Vedanta, which is one of the six orthodox schools of Hindu philosophy. She went on to educate the group about Mantra initiation, which includes the "practice of constant remembrance to raise one thought in the mind—a chosen ideal—to the exclusion of all others, which grows into a strong current and becomes a mighty river of spiritual power," Pravrajika explained.


"In the early 1980s, when I was in Santa Barbara, Calif., a man named Tim used to frequent our bookstore. A period of time went by where we did not see Tim, and then one day I met him outside of our temple. He told me he had been diagnosed with AIDS, at a time when it was a social death far before a physical one. He began to come to our temple, and we watched Tim over a painful three-year transition. Every day became precious for him. He had received Mantra initiation, and told me that his disease had become his teacher. He lost all his friends and was abused in the hospital when being treated. At the end of his life, he began to visit the temple once a week, twice, thrice, and then once a day.


On the last day of his life, I went to visit him in the hospital, where he was abused again. The stench in his room was overwhelming and there were syringes and bloodstained pads everywhere. The nurses had neglected him. Tim was in a semiconscious state, he was in pain as though his soul was yearning for God. It is a Hindu custom to bring Ganges water from the sacred river. My senior sister told him that the Lord had come to take him, as he opened his mouth to receive the Ganges water. We began to chant the name of God, Tim's chosen ideal, aloud. Minutes passed and suddenly we saw Tim's mouth moving—he was silently chanting with us. Suddenly, from a semiconscious state, he lifted himself up and turned to face us with eyes that could not see, but his face was wreathed in a blissful smile. He was at peace."

Cultural heroes
The director of Pastoral Care at BUMC, Mike Mullender, PhD, BCC, presented the Cultural Hero Award recipients. This special highlight recognized staff members who were nominated after meeting specific criteria, such as helping to advance cross-cultural understanding in their own service line, helping their floor or unit to be more welcoming to people of various cultures and faiths, advocating for an individual patient to make a significant difference in that life, and showing an appreciation and a lifelong commitment to learning about cross-cultural issues. The award recipients included:

• Deborah Gordon, MSN, MHA, RN
• Courtney Golden, BSN, RN, CCRN
• Stacy A. Tackett, MS, RN, ANP-BC
• Juanita C. Tarango, LMSW
• W. Mark Armstrong, MD, MACP
• Jay A. Allport, DO

On Creating The Life We Want

My friend and sister in Christ, Joanne has a wonderful way of encouraging all of us to know that what we do about our circumstances, how we respond to them is a matter of choice. She is a wise woman.  Misery lives in that dark, soul-less place where our lives are justified only in terms of the things that others or circumstances "made us do."

Portia Nelson's little parable, There's A Hole In My Sidewalk, adds to Joanne's wisdom. Go ahead!  The video is only three minutes long.

Learning to make a real choice, if you believe that Portia's parable is accurate, is a process. 

Too many of us think that we will wake up tomorrow and just begin to make new choices, with no reflection, no assistance (from God, for instance), and without making a mistake. 

We could all use a little encouragement and good orderly direction from Portia Nelson. Deciding to do something different may be a step in the right direction, but most of the time it is only a step toward a new mistake, and if we are blessed and attentive, we will have the privilege to learn from that mistake, until one day we make a REALLY different decision. 

All the not-so-innocent bystanders in our lives will inevitably stay, "Yeah, but she has it so easy. She doesn't have the problems I have." 

No kidding. Life tends to get easier, and our circumstances become notably different than those of the people around us, once we learn the art of learning from our mistakes.  

In the meantime, be forgiving of your mistakes. Don't take them personally. Like a musician with great potential, you can hear the way your life is supposed to be sounding, and it is discouraging to hear how far you are from making your life sound like that. Keep working at it. Make a project of it. Expect to make bad decisions, but resolve, right now, never to lose the lessons that are in your mistakes. And if I may say so, try surrendering your efforts to God's loving care. I think that may make the greatest difference of all. 

Blessings

Mark

A History of Violence In One Word

Noelle
Photo Credit: R Mark Grace

BITCH
1. a female dog:
"The bitch won first place in the sporting dogs category."
2. a female of canines generally.
3. Slang: a malicious, unpleasant, selfish person, especially a woman.
a lewd woman. Disparaging and Offensive: any woman.
4. Slang: a person who is submissive or subservient to someone, usually in a humiliating way:

For some reason unkown to me, I've been thinking about my personal history with this word. When I was a child it seemed mysterious and more than a little threatening. It was not a word I heard often, certainly not in my immediate family. When I did hear it came rolling like a thundercloud, a portent of violence. Somehow I associated it with a strange woman's battered face, a drunk male's heavy breath. I've never been able to shake that association.  

In my extended family and in church, and most of all in books I read, the word invariably referred to a female dog, usually hunting dogs or coon hounds. It was spoken in a matter-of-fact tone, often mixed with notes of affection or pride. "That bitch will hunt 'till she drops if you let her. She won't back down from anything."

I've had several female dogs as pets during my life, and counted them all as loyal, solid friends.

Linda and I share our home with a bitch these days by the name of Noelle. She was the bravest, most loyal mother any puppy could ever want. It is clear that someone beat her cruelly when she was a pup- she cringes instinctively when a hand occupies a certain space above her head.

Noelle can also present a frightening demeanor. She has scared the pants off of our pool guy and assorted other people on more than one occasion, backing them into corners and holding them at bay. Yet she has never bitten anyone that I know of. On a few occasions early in our relationship, when she was protecting her puppies, she took my hand in her mouth and held it there while snarling at me, but never so much as broke the skin. I look at her some days and marvel. I love that bitch. She gives the title honor, depth, intelligence, dignity.

I don't like to hear the term thrown around the way it is these days. I realize it is mostly a cultural thing, but I have to tell you a part of me instinctively reacts to the person flinging that word as though they were displaying an embarrasing ignorance about life, about the world and their place in it. Perhaps that reaction is just another form of prejudice, but there it is.

Maybe a bitch is just an assertive woman, or a subservient man, or a verb meaning to complain. Maybe a bitch is just a female you hang out with, one of the gang. But I know first-hand that word still carries a dark, shameful mystery at its heart. It still predicts battered faces, children staring in confusion and horror at thundering hateful drunkenness that wants to reduce a female to a battered rag of bleeding submission.

And I know some bitches are beautiful females with hearts that won't quit on the ones they love, no matter how many times they are battered. I know some bitches who are unbowed by words or blows or heartache. And they all deserve so much more. I pray with all my heart that God gives them love, and support, and a way out of the dark corners in which they find themselves.

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How Can We Hear the Voice of God? Here Is One Way

So many of us long for healing from something, but if my experience and the experiences of so many people I have talked to over 31 years of chaplaincy is any indication, most of us spend far more time giving ear to our pain and our despair than we do in listening to God's promises. 

50 Healing Verses

Have you got twenty-three minutes to listen to God speaking about healing- your healing?  If not, then listen as long as you have time. Let us know what your experience was by leaving a comment below.

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Mercy More Than Life: A Memorial Day Prayer

Our Challenge Is Not Merely Whether We Remember Our War Dead, But How We Remember Them and What those Memories Compel Us to Pray

An American soldier holds the hand of a young Afghan girl. [Afghanistan War, 2010]

My favorite song about the United States of America is America the Beautiful. It is my favorite because of this single verse, which has become an oft-repeated prayer of mine for this country. I have many friends and more enemies who think I am a hopeless, idiotic romantic when I express my hope in these terms. No one seems to think this country can become what, in many ways, it has never really been, not for all of its citizens at one time. 

Still it is my prayer, not because this country deserves it. We don't. Not because we have achieved it. To this day from the very beginning of this country we've only ever seen glimmers of it. 

Plenty of people have shown us the way, but we are still toiling up a mountain of failures that stand between us and the ideals we sing of. Still, I don't see how it will ever happen if we don't pray for it.

O beautiful for heroes proved 

In liberating strife. 

Who more than self their country loved 

AND MERCY MORE THAN LIFE. 

America! America! 

May God thy gold refine 

Till all success be nobleness 

And every gain divine.

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In Place of Despair, A Song

“The canary began to sing again. The sun had struck it, and its throat and tiny breast had filled with song. Francis gazed at it for a long time, not speaking, his mouth hanging half opened, his eyes dimmed with tears."The canary is like man's soul," he whispered finally. "It sees bars round it, but instead of despairing, it sings. It sings, and wait and see, Brother Leo: one day its song shall break the bars.”

― Nikos Kazantzakis, Saint Francis

Dreading the Next Political Season? Parker Palmer Has a Tonic for Your Heart

Healing the Heart of Democracy: The Courage to Create a Politics Worthy of the Human Spirit by Parker J. Palmer

My rating: 4 of 5 stars

Parker Palmer is a man with one good idea. In many ways he reminds me of my father, who was a remarkable preacher day in and day out, but who also had a song in him. Every now and then my mother or one of the deacons who had heard him in times past would press him to sing a "special," as it is called in my religious tradition.  So Dad would eventually acquiesce and mount the dais to sing.  He never varied in his choice of sacred music. Every special I ever recall hearing him sing was the same. "How Great Thou Art." He sang it well, not perfectly, but his heart was in it and I loved hearing him sing that song.

And so goes Parker Palmer. His one great special sung over and over again is his song of the Quaker meeting.  He wants to take the genius of that gathering out of the meeting house and into the streets, to executive offices, board rooms and places of business and even, as he so ably does with this book, into the public square.

Palmer quietly but passionately tells and retells the story of a meeting of equals, of those who are endeavoring to become true friends as they observe the Gospel Order.  He witnesses to a determined faith in a process that will not run ahead of nor lag behind the guidance of God's Spirit and that of one's friends.

Palmer's song is worth singing over and over again. Never mind that the basic structure is simple, because it is also profound.  This Quaker convert who discovered the genius of a spiritual process devoted to listening deeply to one another, eschewing pat answers and quick fixes, refusing to be satisfied with premature foreclosure, really has discovered something rare but much needed in our modern world.

Palmer fashions a strong lodgepole for this book by means of his development of a central metaphor. He compares our experiences of having our hearts broken into pieces due to our disappointments in the political process with the alternative possibility that our hearts might be broken open to redeemptive and restorative experiences by those same disappointments. Palmer suggests that the current focus on winning and losing leads us in precisely the wrong direction.  Instead, he beckons us to take our experiences of bitter defeat and unsatisfying victories and to use them as touchstones to deepen our understanding of ourselves and our political enemies. In Karen Horney's apt terminology, Palmer is helping us to let go of our reactionary instinct to constantly move against one another so that we can move toward each other in genuine dialogue.

Palmer's exposition of De Tocqueville's book, Democracy in America, is one of the most thoughtful and revealing essays I've read on this subject. Palmer manages to turn what I imagined would be a boring rehash of one of the most quoted books on U.S.-style democracy and turned it into a lesson in thoughtful and informative exposition. I listened to this section several times over, so delighted was I with the insights he brought to the text.

Perhaps the most boring part for me was the section on education, if for no other reason than the fact that I've read literally dozens if not hundreds of papers on this aspect of Palmer's thought.  He is an educator and so it is to be expected that he would include a section on education, but I did not find new ideas here, just what felt like an obligatory attempt to address something he's already covered in great detail elsewhere.

All in all, however, I came away from listening to Healing the Heart of Democracy with something that felt very much like genuine healing for my heart. Like my father's special, Palmer inspired me, comforted me with familiar themes and reminded me of the beauty that can guide each of us through the perils of this dark political quagmire through which we are toiling.



View all my reviews

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"One Nation Under God? Be Careful What You Ask For

Please pray for this man and his family. He doesn't belong in prison.

Quintin Alonzo

I've known Quintin- QT's- story for nine years and it still scrapes the skin off my soul every time I pause to consider it. Convicted more than ten years ago of shooting another teen at a West Dallas party, in spite of the fact that evidence did not add up to a guilty verdict, he has languished in prison while he, family and friends have made attempt after attempt to have his trial reviewed and numerous wrongs set right.  If you want to read about the particulars, you can go here: Recreating a Murder. I don't understand a country like the US that won't do everything within its power to to see that EVERY innocent human being is released from their chains. It seems to me that we trot out the doublespeak about liberty and freedom only when we want to send people off to kill and be killed.

We wave the bloody shirt when one US citizen gets killed while we lock up thousands without due process or a chance to genuinely redress their wrongful convictions.

A System Unable to Face Its Mistakes

To watch the television one moment while listening to a Texas politician scream about freedom and liberty then to hear on the phone THE VERY NEXT minute about an open admission by a state functionary that an innocent man's case won't be heard again because the state sees but will not admit its own faults-- that is the kind of thing that turns my blood cold.

It is almost unimaginable to contemplate what QT is suffering through.  I am most in touch, however, with the intense, no-end grief that has been foisted on his mother, his siblings, his cousins, grandparents and aunts and uncles.  In the words of one aunt, Joanne, 

"It's been a long time since I've woken up from a dream crying, but this morning was my turn. I dreamed of my nephew QT when he was about 2/3. . . . The dream was so real and clear his voice sounded just like when he was 3 and his hair I touched his hair and his curls were so thick and his eyes so big! . . . the smell of him, the smell of a baby...woke me crying with an aching in my heart so bad. He said, "tia don't leave me" Wow what away to start the morning."

Disillusionment

Witnessing the suffering QT and his family have been made to endure has shaken my belief in one of the dearest rituals of democracy I have engaged in, the pledge of allegiance.  Since I was a child I have treasured the moment of taking the pledge a thousand times in classrooms, on football and baseball fields, and at civic events.  Thinking of it now brings back sense-memories of hot summer breezes, purple horizons brought about by setting suns, freshly mown grass and most of all the physically palpable sense of belonging to a community that stretches from "sea to shining sea."

My friends' experience, however, makes it very hard for me to believe in the pledge of allegiance nowadays. The fact that some people are livid about the slight possiblity that "One nation under God" may get taken out of the pledge makes me want to laugh. And to cry.

Condemning Ourselves

Because EVERY TIME we mouth that false promise we are condemning ourselves for our failure to dedicate ourselves to liberty and justice for every human being, so help us God. 

I believe even now that God is judging this country.  I believe with just as much conviction that our judgment is not based on the negligible sins of some "others." I am convinced that we stand in the dock today because of our hypocrisy in claiming that we are a "Godly nation" while simultaneously turning a blind eye to the every-day promise of justice for all.

So, Christ follower, faithful church goer, bible thumper, advocate for putting the ten commandments on the courthouse lawn, be careful that your zeal does not carry you right over the precipice of a false and sadly deluded piety.  We will surely reap what we sow.

People who believe most deeply in God should be rushing to take that phrase out of the pledge because we are condemned by it each and every time we speak it. "I hate your solemn assemblies, your sacrifices and your religious services," says the Lord God. (Amos 5:21)

Who Is The Hero and Who the Villain?

Meanwhile QT Alonzo remains in prison, not the only person by far whom our state has required to pay for the sins of others, but one more flesh-and-blood reminder of the cruelty that comes of mouthing phrases we do not have the courage to back up with our sacred honor- we "free people" who freely pledge to defend the rights of freedom "for all."

And what, might you ask, has QT's response been to the steady grinding of a system that so carelessly took away his rights as a citizen?  Read for yourself:

"The day the verdict was gonna be handed down I remember it so clearly that I got on my knees in my cell and I said "God you know the truth, I know I have done alot of things wrong in my life.. I'm not perfect but you know that I am not guilty of this but if this is where you want me to be send me I will go".. I remember seeing all of my family there and Santos family and friends there too.. Sometimes people ask me if Im angry, if Im mad, is there hate in me . . . I thank God for my family and friends who have stayed on their knees, praying not only for me but for the family of Santos Gauna (the murder victim), because I know I serve a God who is just."

It isn't that the phrase "One nation under God" is empty of meaning. Quite the opposite. It is overloaded with the true meaning of our hypocrisy, our cruelty, our failure to pursue justice and liberty for ALL.

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"And what does the Lord require of you? That you do justice, love kindness and walk humby with your God."  (Micah 6:8)

Happy Belated Earth Day

Photo Credit: HD Wallpapers

“We need the tonic of wildness—to wade sometimes in marshes where the bittern and the meadow-hen lurk, and hear the booming of the snipe; to smell the whispering sedge where only some wilder and more solitary fowl builds her nest, and the mink crawls with its belly close to the ground. At the same time that we are earnest to explore and learn all things, we require that all things be mysterious and unexplorable, that land and sea be infinitely wild, unsurveyed and unfathomed by us because unfathomable. We can never have enough of nature.”

– Henry David Thoreau, American author, poet, philosopher, abolitionist, naturalist, tax resister, development critic, surveyor, and historian

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Give A Little Bit

"Linda and I have often talked about how grateful we are to give to our government at tax time. I don't agree with lots of things the government does- separating children from their families in border detention centers, giving handouts to robber barons while denying basic necessities to the people on whose backs this country was built and spying on its own citizens being chief among them.

HOWEVER, I've made a covenant to live in this place with my fellow citizens and as far as I'm concerned, everything I can do to keep the roads paved, to get food to families who need it, to see that the soldiers who protect me and my family at least get something to help them with the basics of life, and to fund education for the people who will be making decisions for me when I am in a nursing home- EVERYTHING I can do to make those and many other things possible comes to me as a sacred privilege.

I believe it enlarges my heart and makes me a better patriot. There is so much more to be doing beyond that- way more than enough work to go around- but I refuse to complain when Uncle Sam taps me on the shoulder and tells me that it is time to contribute.

I'll take the good with the bad until the day I am convinced there is no hope, then I'll move on to some place where I think I can do some good, but until that day comes, I am more than happy to give.

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