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Hap, do you
want some calming music?

Do you prefer it quiet?

You prefer the quiet?

Okay.

You want the pen?

No?

You wanna show me something?

This is in the way?

Okay.
Do you want me to move this?

It's fine here?

Okay, can I hold your hand
for a minute?

What?

Can I hold your hand?

There we go.

Hap, I'm sorry it's so difficult

to communicate right now.

And I hope
your body's intelligence

can bring you back.

And I have no understanding

of what your body is
going through right now.

I'm doing my best, okay?

All right,
so let's take a moment

to get ourselves centered

and ready, bringing your
energy across the boundary

into this time and space.

You're welcome
to close your eyes

or let your eyes
fall in front of you.

And I would just invite you
to check in with yourself

at the center of your being.

What are you feeling?

What is your experience?

Could be anger, grief,

distraction.

And when you're ready, you can

slowly lift your eyes

and begin to make eye
contact around the room

and just let the group
know when you're here.

Here.

I'm here.

I'm here.

I'm here.

Okay, so the
table is open if anybody

wants to share their experience.

Would you guys
mind if I went first?

All right.

So I just had the call
at noon for the family,

the patient I've been following

for probably
four or five visits now.

Patient took a turn
for the worse yesterday

and now is actively dying.

So, yeah, that's what I'm

coming to the group with today.

So, Michele, take
a moment to really connect

because you're holding a lot.

You're holding a lot

and I want you to be able to
bring in the experience

that you're having right now.

So as you close your
eyes, as you look down,

what are you feeling
inside of yourself?

I think kind of two
things are coming to me.

One is sadness and the
other is just feeling

a little bit of helplessness
at being in a system

that, pardon my language,

but creates kind of a really
shitty experience for people

at the end of life.

He's just in this nondescript
room on a medicine floor,

spending the last few hours
of his life.

Yeah, and I'm wondering
about if helplessness is,

when you start to elaborate,
I get a sense for your anger.

Yeah, there's anger underneath.

Okay, let's see
if you can get a subgroup.

You can just say anybody else.

Anybody else?

That was a lot.

So the subgroup
is really around the anger,

the frustration.

It doesn't have to be
about patient experiences,

could be about anything.

I can join you
in your frustration and anger

because of my experience

of not being able
to see my mother

in a hospital when she was dying

because of COVID restrictions.

I was very angry,
I was very frustrated.

I can join you.

Yeah.

And what's your
experience right now, Fumiko?

Let me go, let me go
see my mom, so that's...

- Okay.
- Let me hold her hand.

Good, good.

Anybody else?

Fumiko, I hear, um...

loss of agency.

The feeling of hitting
a wall and trying to like

just get to the person
you love or...

to the place
that your heart wants to be.

I... I can join in...
in feeling, um...

stunted or blocked

by something out of my control.

Yeah, I just wanted
to reflect that back.

I don't know that
I fully grasped it, but...

I think that's
what I said, thank you.

Yeah.

Thank you.

There's an old adage,

"Don't just stand there,
do something."

And we flip that.

We say,
"Don't just do something,

stand there," or "be there."

Because there's connection
and healing in that.

Thank you for
calling Pacific Interpreters.

This is Katherine. I'll be
your Polish interpreter today.

This call may be monitored
for training and quality.

Are you calling from the
main hospital or from FPA?

From the main hospital.

May I have
your employee number please?

829-8613.

- Okay?
- Okay, hi.

Hi, so my name is Margaret,

I'm a chaplain
here at Mount Sinai.

I offer spiritual care
and emotional support

to our patients.

Oh, okay.

Okay, if I wake up tomorrow.

Yeah, yeah.

How are you feeling right now?

- On 19?
- 18.

18. Sunita B.
Same step down.

So the first name
I didn't catch.

- Sunita.
- No, for eight. Eight.

So eight is Nagafna.

How is the 24 now?

Not ready
yet, that's why I'm asking...

- Okay, okay.
I'll go later, that's okay.

And I'm Margaret.

Oh, hi Margaret.

Hi, oh, now I get it.

I thought I saw someone
on the job.

- Yeah.
- Okay.

Hi, can I come in?

Can I close the door?

What are you
making of your diagnosis?

How are you relating to it?

I have a distance from it.

- Yeah?
- It's like, okay, it's this,

but I don't know what that
means, on a living level.

What do you mean?

So they have this diagnosis of

adenocarcinoma.

Which is a fancy
way to say lung cancer?

A particular kind
of lung cancer.

- Okay.
- Okay.

What does that mean?

I know my life is gonna change,

but I don't know how and
what, you know, in what ways?

So I really have...
sort of waiting to see,

and yeah,
my intention is to live,

but I also want a certain
quality in my life, so...

I really do have
to wait and see.

I have to be in this moment
and go to the next moment,

the next moment, and I'm
very clear from my past

that it will be revealed to me.

It is revealed.

And then I'll know, do
this, don't do that.

Do that, don't do this,
you know.

The mechanics of it
will be taken care of.

But that's mechanical.

Yeah.

What I'm looking for is...

and there's a question
of blame here and guilt

'cause I did smoke.

I was gonna
ask you about that one.

Twenty-five years, so
on one level it's like

this is the consequence
of your behavior.

My mother smoked
for much longer than I.

She didn't get lung cancer.

My brother smoked for longer.
He didn't get lung cancer.

And you quit for...

And I quit for 30 years
and I get lung cancer.

That's what's so...

Yeah.

So... I am
looking at this whole

question of unfairness.

I wanted to ask you,

and you might wanna take
time to think about this one,

but a question that's been
percolating for me to ask you

is what are you most proud of

in your life?

Because you've lived
such a thoughtful life.

I've been true to myself.

- Your integrity.
- My integrity, yeah.

Been true to myself.

Wherever it led I went.

Crazy as it was,

you know.

Okay, no this is not the
way, let's go this way.

And so maybe this comes back

to the question before,
that decision making, right,

because that's where our
integrity might be questioned

or, you know, shaped further.

Yeah.

How do you know when
you're acting with integrity?

What are you listening to
inside of yourself?

Oh, inside of myself
I know for sure.

There's a kind of knowing
in my solar plexus.

When I'm like, not sure,
it's like:

so that gives me that clue.

And the other thing I do,
'cause I have,

I discovered as an adult,
I have ADHD.

'Cause I, there's a list
of things and I said,

Oh, I have all of those.

And so I've learned with
meditation and stuff,

slow it down, pay attention.

Those are things I focus on.

So when you feel settled.

- Yeah.
- And steady.

- Then I can make a decision.
- Yeah.

Or the decision comes,
it's just like, this is it.

I heard you say before, like,

there's like a small voice.

- Yeah, definitely.
- That told you to get out

of that relationship.

Like a small quiet voice.

The still small voice
does come to me.

Still small voice, yeah.

So we're going to be
looking out for that now.

- Now, right.
- Right?

That's what I'm looking for,
and I'll know when I hear it.

Right.

So no being told to go
faster, quicker than you...

That's really, I'm usually
pushed along by everybody.

This is really interesting
for me to see myself go,

"You're not letting them
push you around."

You're sticking up for yourself?

Yeah, yeah.

So that's kind of exciting.

I think so.

So going slow.

- Yeah, going slow.
- To hear yourself.

Yeah, yes.

- And maintain the integrity.
- Yes.

- Thank you.
- Your own pace.

I go at my own pace in order
to hear my own small voice.

Yeah.

Yeah.

Yeah I have patients to call,
but I'm not in the mood yet.

I think I'm like
running on empty.

It's maybe like one o'clock,
I don't know.

From your role as my
supervisor and, you know,

the time that has gone by,

where would you like to see
me next in terms of growth?

What talents have come
through or certain skill sets

either that you would want
to be improved on or like,

just like, where would you
put me next

if you had like any say
or choice in that

from what you've seen of me?

I'm thinking about your
emotional boundaries.

A lot gets through and
that can really drain you,

deplete you, and I think um...

whatever you can do
to try to close

those boundaries
a little bit more

so a little bit less
gets through.

So it's not an all or nothing,
it's not open or closed.

It's how open, how closed
are those boundaries.

So you can manage your empathy.

I feel it within me

that I wanna
go deeper or further

or go in this direction and,

ah... should I,
or should I not

at this point?

And what are the risks
and what are the rewards?

What's the potential fallout?

Because it seems like what's
lurking in the background

is what is the price
that you will pay

in terms of exhaustion?

There's a lot of effort
that goes into holding back,

and there's a lot of effort
that goes into saying it

and then dealing with what
comes after it's said.

So it's not... I say that to
acknowledge the challenge,

the difficulty
of either direction.

And that's gonna live
on beyond the residency,

I think, and that's
not a failure

of yours or the residency.

I think it's just one of those

larger issues that we all,
if we're lucky,

we identify them
at some point and we say,

Oh, okay, this is one
of those long-term things

that I'm just gonna have
to continue to grapple with

and develop over the long haul.

Would it be possible
for me to ask you to

keep an eye
on that learning goal,

and kind of
be more forward with me

where you see me doing that well

or like where I could
have been tighter.

I hear that.

And the feedback could be harsh.

Don't be, like,
soft on me there, okay?

Okay, yeah, yeah,
well, yeah, I mean,

I don't know that I...
It's hard for me to get harsh,

so I don't think you have
to worry about harsh.

I think what I'm hearing
you say is

Step it up on the feedback
in this specific area.

- Yeah.
- Give me more.

I'm so terrible at this.

Run in circles.

- I love it.
- Or I'm the best!

There you go.

How many of these do we have?

That's pinball.

Watch that second bounce.

How's the morning been going?

Anything from the weekend,

anything of note
for the week ahead?

Mati, you want to start us off?

I mean, Thursday night...

You had a big case in the PICU

and I read there was...
That was huge, yeah.

So an 11-month-old
came in for surgery

and unexpectedly died

in the operating room.

Yeah,
the parents were 17 years old.

Oh my gosh.

It was heavy.

So yeah,
that was part of my weekend.

Yeah.

Thank you for going
and being there

and just so you know,

there was so many emails that
night and the next morning.

I appreciated getting
to read your chart note

and having all the
information at my fingertips.

So thank you so much.

- Hey, all right.
- All right.

- Okay.
- Okay, all right.

I'd like to look at the
calendar and see if we can get

more frequent consultations
scheduled.

We're, you know, we're
meeting pretty infrequently

and I'd like to meet more,
if possible.

That would be great.

Okay. Cool.

So why don't we take a moment

and get ourselves centered then.

Okay, sounds good.

Yeah, just take
a couple breaths.

Feet on the floor.

And gathering up your energy

and bringing it to this context.

So are you here?

I'm here.

- Great.
- Yeah.

- Me too.
- Good, good.

Okay.

One of my primary
goals for all of this work

is to... just really,
sit a little more easily

in the...
in the role of authority.

Okay.

Yeah.

You know, I don't know,

I'm just gonna associate
here for a moment,

but what comes to mind
is my first supervisor...

I was telling somebody
the other day...

who I, you know, I still love

to this day and respect greatly.

Some of the approaches
were really threatening.

You know, it was like I
saw him walk out angrily.

Hmm.

- I s...
- So that kind of provocative...

- Okay.
- Yeah, yeah, I saw,

I don't know if it was him
or one of the other educators,

but ripping up a verbatim
at some point.

Just kind of tossing it back
to the student, This is crap.

Whoa, whoa.

You know, that kind of thing.

And then with my
first presentation,

I was very nervous and guarded
and my supervisor said,

"You're really
guarded right now.

I don't know if I should
tear down your guard

or let you take it down."

And in that moment I was like,

Oh, well, I don't want
him to tear it down,

I'll do it myself. So I said,
"I'll just do it myself."

And I, you know,
proceeded and tried to,

you know, be more vulnerable.

But looking back on that,
I mean that,

that was, it was
a threatening intervention.

Certain actions
were modeled for me

and that's sort of
the range of options,

you know,
yelling and walking out.

Yelling and walking out.

And that being, like,
what is the point of that?

The point is, I think,

to be one up
rather than one down.

That's not how I wanna be
in this role.

Yeah, I had a student
once who said...

This was pretty cool.
She said,

she wanted to see me
like the black belt

and she knew she could throw
punches and it wouldn't hurt.

I thought it was
a really great image of...

Yeah.

You know, like a child in
a karate class, you know,

and the sensei like really,

you know, firm and comfortable.

Muscles in their belly,
you can kick...

Yeah, relaxed and know that
it's aiding the development

of the student, to do this
sparring and whatnot.

Exactly right.

So really I do hear
the next step, David,

is to be able to do the work

to be in your authority, right?

Yeah. Yeah.

Fully. You can have
your full experience

and you're not gonna be
destroyed by the student.

Right.

And you're not gonna be a bully

that you have to
destroy her either.

Yep, that's it.

It's really, yeah, staying
away from those extremes,

trying to be
more measured, in the middle,

which to me is more courage.

It's like the courage to
stay with the discomfort,

the anxiety, and work
through it,

you know, in a present
kind of way.

That's what I really want.

And you not feel threatened.

But to be able to hold
that structure for them.

Right, right.

Yeah.

"The eternal
providence has appointed me

to watch over the life and
health of thy creatures.

May the love for my art
actuate me at all times.

May I never see
in the patient anything

but a fellow creature in pain.

Grant me the strength,
time, and opportunity

always to correct
what I have acquired,

always to extend its domain.

Oh God, thou has appointed
me to watch over

the life and death
of thy creatures.

Here am I ready for my vocation

and now I turn
unto my calling."

Even though the
person who wrote this prayer

is a physician,
he's identifying, like,

I'm called to this work.

Acknowledging, like,
he can't do this alone.

For me, I'm the same way.

And I've had conversations.

I don't know if you and
I have had it, David,

but I've had it
with other persons.

Like, I can't do this
work if I don't pray.

Like, for me, I think,

just for me in my practice,
it's impossible.

How is that for you?

Like if this is something
that you wanna flesh out.

I have no idea
where my prayers are going.

My inheritance and
life experience is like...

if...

There's... there's like
a sense of malnourishment

or like lacking of, like,
an immanent god.

Like, I'm, yeah...

My grandfather had a wife
and three kids

murdered by the Nazis.

My grandmother was in
Auschwitz for a year,

and just like a starving woman,

like in the cold,
walking among the dead,

and survived
the gas chambers twice.

And yes, the question is,

where...
where the hell are you?

And, like, how much of
a beating should we be taking?

And how obligated am I to you

if I don't feel you,
I don't see you

and like, you've...
you weren't protective.

That trauma is so profound
and so deep

that it almost like
exists for me on that, like,

transcendent level of
just, like, I do not get,

like, what do you make of this?

I don't... I don't...
It's heavy.

But that's like
my child self saying that.

So there's still like a...

How can I conceptualize
this differently or like

what does it mean to
have like a more adult

relationship with the divine?

I'm like grasping
for like a different,

a different kind of knowing.

Thank you for sharing that.

When you make space like this,

it doesn't surprise me when
significant things emerge.

So who knew with this oath
and prayer of Maimonides

that we would wind our way
through your family history

and where you wanna be
and who you wanna be

in the midst of all of that.

I didn't say much because
mostly 'cause I'm really fatigued.

I was up 'till two this morning.

It just it hit me in this hour.

I have been thinking, I wonder
what would it be like to,

I don't know, go to the park,
end early?

I feel like we're all exhausted.

I do have that impulse as well.

You're welcome to go
do whatever you'd like.

Go home.

I'm gonna go get a snack
and take a nap or something.

I'm exhausted.

You could look at religion as,

like, a psychological crutch

because it's way easier
than confronting reality.

But then at the same time,

I can't throw all of this out
because there's too much here

that is nourishing.

Iced tea,
KIND bars, essential oil.

Okay, essential oil.

- Essential oil?
- Yeah.

Whatever, tea, I don't
know, what's that one?

That's an iced tea.

- Okay.
- So let's start with that.

I don't think I've met you yet.

- No, Jermaine.
- Margaret.

Nice to meet you, Miss Margaret.

Nice to meet you.

I'm running low on ice, but
you have ice on this unit

so you could get more
if you want, yeah?

Okay.

Do you take sugar?

I'll try it plain, I'll try
to do it bland. Let's see.

Okay, you know. You know.

Okay, so essential oil.

How you feeling?
What do you need?

Oh man. I feel sluggish...

You need, sluggish, so
do you want some citrus?

Okay.

Ooh.

This is just what I need, yes.

- Yeah?
- Yes.

Yeah, to help to
clear out my airway.

- Good.
- Like, be able to breathe.

- Breathe. It's important.
- That smells good.

Yeah, that one gives you a kick.

Like it.

And then you
can put it over here.

Yeah, you want iced tea?

Yes, please.

You could keep sniffing.

Yeah. This is actually good.

This is like literally
what I need right now.

How much time do you guys take

to check in with your
own body when you're here?

Oh man, never.

- Okay, there we go.
- Okay.

- There we go.
- Right.

- You want sugar?
- Yes.

Okay.

Last one.

- Okay. There we go.
- All right.

Hello.

Hi, Elana?

Hi.

Hi, it's Chaplain Margaret
calling. Is now a good time?

Yeah, I remember.
I have your number saved.

Yeah. I am so sorry
for your loss.

I am so sorry.

Thank you.

I know he passed away like
30 minutes after I left.

Yeah.

And he also seemed very,
very calm and not in pain.

Yeah.

Not that that lifts
anything, but...

Yeah, at least
he wasn't hurting though.

Yeah.

Yeah.

Oy, I am so sorry.

Thank you,
I appreciate you calling.

Of course, and how
is Alla doing?

I was just on the phone with her
when you called.

She is devastated.

Yesterday was the funeral

and, ah...

she's like, just really,
really worried about me

'cause like I got really,
really, really, really,

excuse my language,
fucked up yesterday

and she's just scared that
I'm gonna like spiral.

Do you share
the same concerns as her?

I don't really
care about myself right now.

What do you care about?

I don't know.

Mmm...

Okay.

Is this your first
experience with a major loss?

- Yes.
- Okay.

So... I just wanna
give you permission

for being in the unknown
and having no expectations

for how you should feel

or what you should be
going through, or

whatever is, is okay and enough.

Thank you.

Okay?

What do you believe,
like, happens after death?

I'm not too familiar with,
like...

Uh, Judaism.

Yeah. Um...

Well, I could speak
from my own perspective

and then I could speak somewhat

from like a Jewish
theological perspective,

but I'm gonna differentiate
those two, okay?

Okay, I'd like to
hear yours first. Definitely.

I don't always choose to
share private information

or personal information
with my patients or family,

but in this moment it feels,
um...

it feels appropriate.

Thank you.

I lost my father pretty suddenly

and I would also say tragically.

- I'm so sorry.
- In 2016.

So I have my own
experience and relationship

with profound grief

when it's unexpected
and quite complex.

Yeah.

I will say that it has
turned my life upside down

in ways that, while I
was going through it,

it felt like hell,
but now that I am somewhat

on the other side of it,
I realize was a gift.

Um...

I... I have come to

kind of like a place
of comfort in feeling,

and this is more of an intuition

or I guess a personal belief.

I can't
back it up with any data,

but it's a personal
belief and perspective,

um, given my line of work,

that when a soul is
finished with its work

and its...

its reason for being
alive in its body,

in its current body,
is complete,

death is okay.

What you said earlier

about the reincarnation,

like if the soul's work
isn't done,

then they come back
in another body or form.

Ben was so scared of that.

Hm.

Like he just,
he told me that um...

he was scared that like
he would just keep coming back

and living the same life.

Yeah, I mean,

death is scary,

because it's unknown
territory, right?

Yeah.

If anybody tells you they
know an answer of where we go

or what happens, I would
say don't believe them.

- We don't know.
- No one knows.

We have ideas, intuitions,
maybe like traditions,

but what I can say is
that when I was with him

before he went to the ICU,

he was at peace, he was calm

and he was well-supported.

And um...

I guess...

just let the tears come.

It's love. Right?

Yeah.

It's love and things
will change and shift

and just allow, allow, allow
whatever comes.

There's no right way to grieve.

There's no specific way
to grieve.

It will come, it will go,

and there are ways to honor
him while you're here.

Yeah.

Good morning.

Okay.

Um, I'm just gonna lift

that I still have a headache

and I'm gonna go slow,
and as usual,

there's always a lot of content.

So I'm gonna pace myself, okay?

"So I knew
that the primary medical team

had been experiencing
great difficulty

with the patient's family
and their communication style.

This was evident to all
given that the patient's wife

was often hysterically crying
very loudly on the unit,

both at bedside
and in the hallways.

She would move around
her husband's bed,

placing aloe vera leaves
all over his skin."

I wrote patshing.

It's kind of like a Yiddish
way of saying hitting,

but that's what it felt...
that's what it seemed like.

She like hitting her husband
like that to make him wake up,

which was kind of disturbing.

So transference,
countertransference.

"The patient's wife
reminded me of myself.

It reminded me of my
three-year-long acute grief

after my father's death
and my inability

to live without my heart
feeling like

it was falling out of my chest.

I would often come home
from classes

and all I could do
was get in the bath,

the closest feeling
to being held in warm

and compassionate hands
when far from home

and community of origin.

The wife's hysteria
reminded me of my mother

when she first left the
ultra-Orthodox community

and did not have access
to certain cultural

and educational resources
and literacies,

and often found herself
struggling to protect

her voice against
institutional systems

that were
more powerful than her.

She would use her
hysteria to move mountains

when all else failed.

Lack of desire to live
any longer due to acute

spiritual and
emotional distress."

That's my dad.

That's something that was
triggered here as well.

So the whole thing
felt very frightening.

Very disturbing.

Complicated. So what do
you need from this verbatim?

This is one of these cases
where I wanna be able to like

make like a protection
around myself.

Like these are cases
that like I hand off

because it's too close to
home, it's too triggering,

and this person is
weighing on me because like

I actually believe her
when she says,

I will go and kill myself.

And I cannot just like put
up a boundary and be like,

Well, my working hours
are from Monday to Friday

and I'm on PTO on this day,
and so therefore, like, no.

- This is one of those...
- Why not?

Life and death, no.

It's against my personal
moral code of ethics.

If somebody's in a life
and death situation

where they might take their
life, I will answer the phone.

So how do you...

You chose to answer the phone,
but you can't know

what's gonna be conveyed to you

- when you answer the phone.
- No.

So why did you answer
your phone on your day off?

Because I won't know what's
gonna be conveyed to me

if I answer the phone and that
person might hurt themselves.

You're very insistent right now

on not setting
certain boundaries

and I think that merits

serious consideration
on your part

because it's connected to
the other serious concern

that you've been raising,
which is your depletion.

And I don't think
you can have both.

It felt like there was nobody.

The social worker was like,

Discharge, discharge,
discharge, I don't care.

Like, the wife is not suicidal.

It doesn't matter
that she had a plan.

It doesn't matter that
she said all those things.

We're not even
gonna chart it as that.

But that doesn't address
the boundary-setting issue.

It does for me, it does.

Because it would harm me to know

that somebody took
their life because nobody else

was available
to pick up the phone

and I was technically on PTO.

Right, but that assumes
that you're the only person,

and you're not.

So I'm looking for structural
ways for you to set boundaries

so that you can preserve
yourself and not hit the point

of fatigue and depletion
that you've been expressing

over the last several weeks.

So that's where I'm coming from.

I also wanna challenge
what might be some sort

of unconscious
mental model of yours

that sort of presents itself as,

I'm the only one
who can fix this problem.

And I don't think
that's the case.

So that's a part that I
want you to reflect on...

and we can take it up more in
individual supervision on Thursday.

Can I ask you a question?

Mm-hmm.

I'm curious if you, from
your perspective, feel like

this residency has been
successful both for me

and for my placement
in the cohort.

Successful, hm.

Well, that's
an interesting question.

I was kind of... it's a
surprising question to me.

I don't know if I would
evaluate it in those terms,

success or not successful.

I'm wondering if we have
mutually agreed upon goals.

- Yeah, me too.
- For you, okay.

Yeah, I am
wondering about that too.

Yeah, and I can tell you
what my goal is

and then we can see
if it's similar to your goal.

The fact that the issues
have surfaced,

I think are a mark of success.

Now we have a couple of months.

What can we do?

What I want you to do,

what I wanna do with you
is I want you to explore

rather than explain, because
I know you can explain,

I know you have hypotheses,

I know you have a mental
model and I think sometimes

those get in your way

of exploring
the experience right now

and learning something new.

Okay, I can join you
in the assessment

that I'm quite good at
explaining and need more

experience and spaciousness
for exploring.

That pivot feels very accurate.

Keeping my thoughts and
my statements open-ended,

question mark at the end.

I need more information. Yes.

Okay, curiosity, good.

It's a join
and a difference here.

You know, Tuesday was a
really meaningful day for me

in many ways and very
frustrating because I did feel

your care for me or space
for, like, maybe holding

my intensity, like, was waning.

It did feel like
there was a fissure

or like a breaking of trust.

- Mm-hmm.
So my communication...

sounds like really
closed your boundaries

and caused you
to start questioning.

I'm not sure exactly what
our relationship, my...

- I would say your empathy.
- Hearing.

Okay.

It felt like the rules went
up, the empathy went down.

That's what I experienced.

Mm-hmm.

And sometimes that happens

when there's
stress in the system.

Yeah, for sure.

That is true.

Yeah, but receiving
that was very difficult

because it felt like I
didn't feel cared about

and I didn't feel invested in,

and I feel like I'm
being blamed or shamed

for ringing the bell when I say,

this feels too much for my body.

Or the ride is going too fast,

it needs to
slow down a little bit.

Or something's not right.

And it could be that
there's learning goals here

that relate to like, you
know, the core issue.

It could very well be,
and I'm receptive to that.

But it felt like the care,
the empathy, and the curiosity

was replaced with rules

and, Sit down
and eat your broccoli.

And make sure
that you clean it up

and put it in the dishwasher
and chart it.

Mm-hmm.

You know what I mean?

I do, I do, I do know
what you mean.

I'm not laughing at you.

I'm laughing in recognition
of what you're describing.

It really resonates.

Yes. So you're reminding me

of my stepdaughter's feedback

and, ah, that's just
an acknowledgement.

Sometimes I do get rigid and
it comes across as uncaring,

different from the
relationship that we've built,

so I'm saying that to
validate what you're saying.

I hear you and it
resonates with me and...

I got tense

and I'm sorry that it
had that impact on you.

First floor.

Are there specific words
that you say during a baptism?

Yeah.

Do you know them by heart?

Do we have like
a card or something?

We have a book.

- We have a book?
- Yeah.

Okay, it's an emergency

so I'm gonna grab the holy
water while that gets located.

Is it there?

Well, yeah, but
I mean it's 15 pages long.

Well, I'm just
gonna take a bit of it

and I'll improvise.

Yeah, I mean you'll figure out

what to skip
and what to include.

I do the same thing.

Okay.

- Yeah.
- Awesome.

- 127.
- Oh my,

I was just about to
like, my heart dropped.

If you can't tell, I'm nervous.

Can you tell?

I get really nervous

every time I do a baptism.

Very nerve-racking.

Okay.

Let's go.

Adding this to the fanny pack.

And this.

See ya in a bit, thank you,
thank you.

- Oh, okay, good luck.
- Thanks.

Okay, the chaplain
is here at the front desk.

Where should I meet her?

Where should she meet you?

It was, uh, twins
and one passed away.

Okay, so one made it
and one's passed.

Do we have baby names?

Yeah, one is Isabella
and one is Aurora, I believe.

The one that's with us now
that passed, what's her name?

So the one that passed
Aurora, I believe.

Can we confirm that?

Yeah, I can confirm.

- And mom's name is Layla Sue?
- Yeah.

- I think it's Leila.
- Leila?

That's the way
she pronounces it.

That's very helpful, thank you.

Mom, do you wanna hold Aurora?

Is it okay?

Okay.

Okay.

Okay, so I'm gonna baptize her.

Okay?

Let's just take a couple deep
breaths together and center.

Beautiful, okay.

Okay, we got this.

We got this.

It's okay if I begin?

- Of course.
- Okay.

"The sacrament of baptism

is an outward and visible sign

of the grace of God

and as much as
the promise of the Gospel

is not only to us,
but to our children.

Baptism with water

and the Holy Spirit is the mark.

Baptism is a sacrament
through which we are united

to Jesus Christ and given part

in Christ's ministry
of reconciliation.

Baptism is a visible sign
of an invisible event

as though thou art alive."

In the name of
the Father, the Son,

and the Holy Spirit.

I bless you, Amen.

And Dad, I would like you to
do the same if you can. Okay?

In the name of
the Father, the Son,

and the Holy Spirit.

- Amen.
- Amen.

Beautiful.

Okay.

She had life in your body.
Right?

Yeah.

- She had life.
- Yes, very lively.

And she had purpose
in your body.

And we don't have access
to what that was about.

But we did our part
and you did your part.

You delivered her.

And she's beautiful.

Yes.

She's beautiful.

- Thank you.
- You got it.

Is there anything else
I can do for both of you?

You don't have a Bible, do you?

I do, I do, do you want...

Jeremiah 29.

You wanna, yeah,
go for it, go for it.

"'For I know the plans
I have for you, '"

declares the Lord,
'Plans to prosper you

and not to harm you.

Plans to give you
hope and a future.'"

Mm.

Yeah. You know, I think
that's, you know, for all of us.

We have hope in the future

and I know she does in a more...

celestial plane, let's say,

and you know,
we're excited about her sister

and her big brother and everyone

in the family, feels blessed.

At the same time, we feel
extremely heartbroken

that she couldn't make
it out with her sister.

Yeah.

Lord, our God, Eternal One,

please bless this family.

Bless this family
to know and to hold

the complexity of life

in their bodies
as they have known

for these last several months.

To be able to grieve,

to be able to celebrate,
simultaneously,

is one of the hardest
tasks you have given us

and we take it on.

We ask you, God, to bless
Aurora.

Bless her life, bless her heart,

bless her to know
she always has a sister,

always has a companion that
she shared the womb with.

Bless her to know that her
parents are only stronger

and more fortified
by this experience

and that Aurora will
remain an eternal teacher

and have a place
in our home to reside

whenever her spirit
wants to visit.

We thank you, Eternal
One, for the complexity

of this experience and
the ways that Aurora

has taught us and will
continue to teach us

how to be great parents,
community members, mother.

We thank you and we will
grieve and we will celebrate

simultaneously, at once,
as we are obligated.

We thank you God, amen.

- Amen.
- Amen.

Amen.

Okay.

- Mom, you good?
- Yeah, thank you.

- Yeah, thank you.
- Okay.

- All right.
- Okay.

- Okay.
- Technical stuff, all right.

All right, now are ya here?

I'm here, yeah,
yeah, I do feel here.

All right, good, okay.

So David, what method would
you like to use today?

You wanna use "My
problem is I" or another?

Hmm.

Exploring.

I think I wanna use,
ah, a different one.

That one's always tough,
although I see the merit.

- And it can be, yeah.
- Yeah.

Well, let's, before we
begin then, how are you?

Let me say hello.

Yeah, thank you.

Well, that's where I wanted
to begin anyway, is uh...

is that I've got a mishmash

of things that I think
we can probably...

they're probably related, but
we can probably tease them out.

Okay.

My, whatever you call
it, my filter is down,

my bandwidth is stretched.

I don't have the room
inwardly to metabolize

the harder stuff that
comes at me right now.

Okay.

I'm telling myself right now,

I don't wanna
do supervision anymore.

And I don't think that's
exactly the truth.

Okay, but right at the moment,

you don't wanna do supervision.

I don't wanna do it.

Okay, anymore.
You don't know the future.

- Yep.
- At the moment,

you don't wanna do supervision.

- Yeah, I don't wanna do it.
I dread it.

If I can cancel it, I cancel it.

I would've
canceled it yesterday,

but we haven't met
in several weeks

and then it's like,
there's only five...

after this week
there are only four more weeks

and it's like,
you gotta supervise.

You have to.
You have to do this.

It's... first of all,
it's your job.

It's... they need it.

Like, you can't stop doing this.

But I wanna stop.

Okay.

All right, so let's pay
attention to, you know,

this piece of you that
wants to stop and you know

what's going inside you,
David, right now

that you wanna stop?

Like, what about the supervision

do you wanna be done with?

Well, it hurts.

It hurts, okay.

And I wanna stop hurting.

Wanna stop hurting, of course.

That's the motivation
is it hurts and,

man, my shame triggers
are so triggered right now,

but I don't have the um...

I don't have the fortitude
at the moment

to really, um...

provide the supervision
I wanna provide.

That's why I'm, you know,
I'm thinking,

Okay, you need a break.

Well, what I'm really
hearing, David,

when you say it hurts,
right, and you know,

this work does hurt if
we don't have the fortitude,

which we don't always have.

Yeah.

Yeah.

And you don't wanna hurt,
of course.

No.

Who wants to do
something that hurts?

Yeah.

It's hard to know.

I can see what I need to do.

Okay.

And I can't find
the strength to do it.

Okay.

I see it, I know what
needs to happen, but I just,

I don't have
the gas in the tank.

It's like...

Okay, so I think that
this is so important, right?

You see it, you know it,
here, what needs to be done

and you don't have
the gas in the tank.

Okay.

My guess is that you are

absolutely a voice
for the group.

No one in this group has the
gas in the tank right now.

Lord, our God, Eternal One,

we come before you today,

to celebrate the devotion

and the love between
a daughter and her mother.

We do not want to miss
this opportunity to love

because we are
stuck in the past.

Lord our God,
we ask that you guide us

in this very challenging
and dark moment,

and let us remember...

that when we think we're
at the end of the rope,

there's always something
that appears

that keeps us
desiring life, desiring you,

and desiring to serve, amen.

Amen.

- We can't redo the past...
- Yes I know

We can't redo the
past, but you know what?

I'm more afraid that you're
gonna miss the present

because you wanna
replay the past.

We cannot save our parents.

We cannot save our parents,
okay?

These things happen.

It's natural.

And we're also in COVID, so
you're, everyone's foggy.

Nobody's thinking straight.

Everyone's in a stress response.

I don't want you to be
shouldering this guilt

because it's not
your responsibility

to fully shoulder that.

Whatever people are
saying about negligence,

you don't let that in.

You love your mother
and you continue to love her

while she's here now.

But I tell you this as
somebody who lost somebody

with no warning at all, none.

You do not know
what's gonna happen.

You do not know

and I could tell you that
now from the other side,

being somebody stubborn who
thinks she knows everything

what's gonna happen
all the time.

So let me be that stranger
that tells you it's dark,

but you have no idea
what's gonna happen.

Okay?

You will have time
to decide how to make meaning

of the past, but I don't
want you to lose the present.

Your mom is still here.

You're not dumb.
You're not negligent.

You just can't
control everything

and this is shocking

and COVID is very,
very stressful.

I have a little bit of
a cold, but don't worry,

it's nothing serious.

For today,
Karen is on call? Yes.

And, um, Jason, Sophia,
and Fumiko are off today...

and I'm...
I don't see Mati on this call,

so my last email...

I'm gonna check in with her

on whether she's
in or not today,

but I'll confirm that for now

I will list Johnny for her,
Mati's units,

and if that changes,
I'll let you know, Johnny.

I also have Johnny
listed for the SICU/TICU.

Good morning, Mati.

Wanted to follow up.

Thought you'd be here,
that you'd...

- Hey, Mati.
- Hi, both of you.

- Hi
- How are you?

I guess I've just
been feeling like resistant

because, like, my body
doesn't feel okay.

When I woke up,
I was just like, I can't.

I can't imagine doing this
five days a week in a row.

I don't have a marathon
in me right now.

And maybe, maybe others do...
personally, I don't.

- No, I don't.
- Like, legit.

Like, pal care
took a lot out of me

and my body was breaking
down during pal care

and I was like,
You can't get sick right now.

Yeah.

I feel kind of angry

that my body's being
asked to produce

at a certain level
or standard that I am...

- That's true.
- ...not willing to do.

And I can't do it.

I don't wanna do it.

So you really escalated
this situation unnecessarily

by asking about HR.

You always have a privilege
to go to HR.

I took the privilege
today as well.

I talked to labor relations

and you are not
being mistreated.

That is a gross exaggeration
of the situation.

You have two options.

When you say you're gonna
be here from 12 to eight,

you come in from 12 to eight

or you notify me and Amy
in advance.

I took grand rounds,
but I was on the phone,

I was listening. I was
present, my name was on there.

I made sure that it was present

and then I came here as soon
as I could after I finished

doing some of the work at
home which I had to do.

Are you hearing what I'm saying?
The two options.

You brought
this to labor relations

and now I have to figure out
what to do with that, yeah.

No, you're hearing
the wrong thing.

I've said I need to know
in advance.

What does advance look like?

Before twelve o'clock.

Your shift is 12 to eight,

you notify me at 1:08 that
you're gonna be in at two...

I went to labor relations
to make sure

that you're not being
mistreated and you are not.

That's how you made
sure I'm not being mistreated?

That is a gross exaggeration.

By taking it to labor relations.

Unnecessarily escalating
the situation.

That's how you made
sure I'm not being mistreated.

Listen, I said...

I don't feel
safe with you in a room.

- Fine, good.
- I've said what I'm gonna say.

I'm gonna send you
an email to put it in writing

and that's that.

This truly is
a bittersweet week.

You know, bitter in the sense
that I always feel some grief

about saying goodbye to the
residents as they're leaving

and really sweet because
it's such a celebratory time

because you've accomplished

and achieved something
so hard. So hard.

As we all know, it really
takes a lot to be open-hearted

and to keep going back
again and again in this work

and to build those
muscles and that capacity

and wanna thank each
of you for your tears,

for your laughter.

Jessica, that you've
been able to join us

as a staff chaplain.

Michele, that you'll
be able to join us soon.

Fumiko, that you're leaving now,

but we hope to welcome you back.

Mati, who had to leave early
but really gave so much

of herself through the
course of this year.

I think I'm trying
to hold my own integrity with,

you know, not feeling closure
in certain goodbyes

and not pretending either.

But also leaving an
opening for until soon.

I recall you saying,
I cannot believe

I cannot believe
what my body can endure

and I just needed
to share that with somebody.

To let them know.

And what I felt in that moment,

through the tears, was awe.

It was this quiet strength.

I checked in for one thing,

I got four other things
happened since I've been here.

You got pancreatic cancer,
COVID, then liver failure,

aneurysm, bacteria
in the stomach?

Did I get that somewhat right?

Yeah.

Girl, your body...

it's been through a lot.

Yeah.

God, you are a waymaker.

You are such an awesome God

that makes ways out of no ways

and we thank you for that, Lord.

God, I also thank you
for the power of yes.

I thank you for allowing
me to wake up every day,

allowing us to do
what you call us to do,

knowing that yesterday,

there's nothing
that we can do about it,

but learn for today.

God, we thank you
for your great expectations

over our lives.

We thank you for giving us
a window into the complexity

and intelligence
of the human body.

We know that better than many

because we have
been through so much.

Lord our God, we ask
that you make it clear

what is the teaching you
wish for us to receive

in our suffering.

What is the teaching?

How might we receive it

and give it as a blessing
to others,

holding and standing our
ground with full integrity,

as a way of service to you,
as a way of service to spirit,

and a way to keep our temple
alive, breathing and well.

Once again, you came
on time, Margaret.

- Thank you.
- I was having a hard time

today, this morning,
to be honest with you.

And I was like, God, why?

Like, what's good?

Like, what's really good?

That's how I talk to him.

What's really good?

Like, what's going on?

Because I know you say you,

you won't overbear us,

but did you really mean that I
could go through all of this?

He does amazing things,
that's why I can't be angry.

Because if I think about
all the things

that I've been through,

I lived through
every single one,

so it's not my time.

You know,
it's not your time, girl.

Now be quiet, get some rest

'cause you gonna have work to do

when you get outta here.

And that's how I look at it
and I found my joy.