Hospice Patients as Human Persons: Where Does Professional Distance Fit?

[The following is my "Reflection" for this coming Tuesday's Inter-Disciplinary Group (IDG) meeting at which we will again discuss and pursue the best possible care for our agency's hospice patients.]

Kathy Reichs is the forensic anthropologist whose life and novels are the basis for the television series Bones with Emily Deschanel starring as Dr. Temperance Brennan. In her first novel, Deja Dead, Reichs writes about the challenges of considering her “patients” as the “persons” they were before they ended up in her care. It reminded me again of what it means to continue seeing our patients as persons.

 Here’s some of what Dr. Reichs writes about that:

 “Day after day I cleaned them up, examined them, sorted them out. I wrote reports. Testified. And sometimes I felt nothing. Professional detachment. Clinical disinterest. I saw death too often, too close, and I feared I was losing a sense of its meaning. I knew I couldn’t grieve for the human being that each of my cadavers had been. That would empty my emotional reservoir for sure. Some amount of professional detachment was mandatory in order to do the work, but not to the extent of abandoning all feeling.”

Shortly after, she adds:

 “I felt for these victims, and my response to their deaths was like a lifeline to my feelings. To my own humanity and my celebration of life. I felt, and I was grateful for the feeling. That’s how it was personal. That’s why I wouldn’t stop.”

 On behalf of this past year of patients, families, and all the other members of the Bridge Hospice Central Coast team whether present or gone, thank you for continuing to care, to feel, and to be human persons together. My hope is that we never stop.

 

“Job Security in America” - A Poem during my own personal COVID-19 quarantine (December 2 through ??, 2022)

The rumor they spread is this:
If you give us
one-hundred-and-ten-percent,
you’ll always have a job.
 
Perhaps that’s true.
 
But you’ll always have a job
that pays you ten percent less
than they promised.
 
Still, it’s only four free hours a week.
An extra forty-eight minutes a day.
One less weekend per month.
 
Where do you find the time?
 
Make sure that the
bodily functions humans require
occur off-the-clock.
Or at least urinate
as quickly as you can.
Be sure to sign-out at lunchtime,
and occasionally forget
to sign-in again.
But don’t do it so often that
you endanger the company
if the auditors come to check.
(Do the auditors ever check?)
 
Mostly, though,
just stay focused,
stay diligent,
stay busy.
Stay.
Anxious.
(Shorten your life
by that ten percent too.)
 
It’s easier
if you’re salaried.
You can sip your coffee slowly.
You can meander to a meeting,
arrive “well-prepared,”
and then stay
and chat beyond the agenda.
You don’t punch a time-clock.
There is no time-clock
that covers a
work-week that has
no beginning
and no end.
Use as much as you need of that
one-hundred-sixty-eight-hour
work-week.
Just make sure the job gets done.
Even if the job is never done.
 
But the rumor is:
If you give us
one-hundred-and-ten-percent
you’ll always have a job.
 
Perhaps that’s true.
 
But when your injury
or your illness
or your grief
or your age
exceeds what the
Human-Resources handbook
says you’re allowed?
No matter how many
years you’ve given
one-hundred-and-ten-percent
you don’t earn the right
to be ten percent slower.
To take ten percent longer.
To get ten percent distracted
when you think
of how empty
the house is
now that they’re
gone.
 
When they’re gone,
by the way, it’s
seventy-two-hours for
bereavement leave.
And, if they’re enlightened,
a sympathy card.
And, if your supervisor
has known a similar loss,
perhaps a week or two,
maybe even a month or more
of adjusted expectations.
 
If they remember
your previous habit
of giving them
one-hundred-and-ten-percent,
they think,
you might do so again.
 
But find closure.
Adjust to the new normal.
Move on with your life.
Because “company policy
doesn’t allow us to accept
anything but your all
for very long.”
Get well soon.
Get over them soon.
And get back to work.
Soon.
 
And then,
unless you can give them the
one-hundred-and-ten-percent
they’ve come to expect,
get to your retirement,
or get to your disability,
or get to your next employer,
soon.
 
Or they will need
to get another
who will give them that
one-hundred-and-ten-percent
for the partial pay they promise.
 
 

-Wm. Darius Myers

Salinas, California

December 10, 2022

Happy Authoritarianism Day!

Ironically, those carrying the Trump banner...have it all backwards.

One year ago today.

Authoritarian supporters of Donald Trump sought to exclude anyone from American society whose necks do not match their hats. Their goal and their tactic have been employed repeatedly throughout history. The conflict between supporters of a governing minority and the governed majority (though only a small segment of that majority spoke up for the excluded) was perhaps most starkly contrasted during the rise of Nazism in Germany.

I had recently been asked about Dietrich Bonhoeffer's three levels of response to governments attempting to impose similar restrictions. About that same time, another friend had posted a meme stating that “you can pray all you want but eventually David had to pick up a stone and act against Goliath.” When I commented, “Try Bonhoeffer's first two steps before we resort to the third. But when it becomes necessary, aim well.” In response, she asked, "Who was Bonhoeffer?" When I saw that question today, I wrote the following.

----------------

Dietrich Bonhoeffer; Christian Pastor, Theologian, and Pacifist - murdered by the Nazis in 1945, just before the liberation of the camp in which he was imprisoned. 

In his 1933 essay, "The Church and the Jewish Question," written just after the Nazis had invoked into their rule over Germany "The Aryan Paragraph," effectively excluding Jewish people from the right to participate in society, Bonhoeffer wrote a recommendation for three levels of response to such actions by the state:

"There are thus three possibilities for action that the church can take vis-à-vis the state: first (as we have said), questioning the state as to the legitimate state character of its actions, that is, making the state responsible for what it does. Second is service to the victims of the state's actions. The church has an unconditional obligation toward the victims of any societal order, even if they do not belong to the Christian community. "Let us work for the good of all." These are both ways in which the church, in its freedom, conducts itself in the interest of a free state. In times when the laws are changing, the church may under no circumstances neglect either of these duties. The third possibility is not just to bind up the wounds of the victims beneath the wheel but to seize the wheel itself."

The more traditional English translation for decades was "to drive a spoke through the wheel itself," but the concept is still the same. In a Constitutional Republic, we have had recourse through various means of holding the state accountable for its actions. Many of us engage regularly in various means of mitigating the damages done to those Bonhoeffer would call "victims of the state's actions." But to take the stone to Goliath's head? That requires careful aim, and careful consideration of whether or not the prior efforts have been attempted and exhausted. 

One year ago today, our Constitutional Republic teetered on the brink of Authoritarianism. We have not stepped back very far from that precipice. And while many of us believe in answered prayer (as my friend's post of the Goliath's head meme suggests), most of us also believe that God answers prayer through motivating our actions toward the good...even when that means violent action against the oppression, domination, and exploitation championed by Authoritarianism.

Cancel Student Loans - For Your Own Good

Per CBO: Industry size in
Billions of Dollars.
Almost $1.4 TRILLION

In the United States, we are continuing to participate in an increasingly fraudulent system. We are continuing to benefit from continuing to entrap students in this growing bait-and-switch scheme. Therefore, until we repent and repair the system, we should at least mitigate the damage done to individual citizens sucked into the so-called 'student-loan' process.

Loan adjustments, forgiveness, or canceling could be more accurately viewed as a matter of victims' compensation. But consider this more self-interested motivation for the American majority: We would greatly improve our entire society's economic health. How? Because the primary beneficiaries of this profiteering are The Wall-Street-One-Percent. Restoring income to individuals results in better profits for Main Street businesses instead of bigger stock portfolios for Wall Street bankers. 

And moving money back to Main Street is foundational to funding our communities’ recovery.

So, whether we support it because it’s the right thing to do, or whether we support it because it’s simply better for local business and thus the more personally profitable thing to do, we should all support “student-loan” adjustments, forgiveness, or even canceling.

  

(As an officially "very-smart-person" duped into "student-loan" circumstances I cannot comprehend, much less control, I endorse this message.)