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My Life in the Cuckoo's Nest
Well, I reached a milestone in my chaplain internship at the Oregon State Hospital today: my first warning that one of the forensic patients has fixated on me and I need to steer clear of him. Joy. I don't even know the guy; never heard his name before, couldn't pick him out of a crowd if my life depended on it. Apparently, he heard me singing in chapel and liked my voice. You can imagine how warm and fuzzy this makes me feel. Not.
My supervisor is a great guy who really knows his job, both as a chaplain and as a teacher of Clinical Pastoral Education (CPE). If you're having a problem dealing with a patient he's a great resource. He's also good at teaching chaplains. The main point of CPE is to help the interns work through any issues they might have that might get in the way of their pastoral care, and Roy's good at getting to the heart of things. We have about 16 hours of class with Roy per week (the rest of our time is spent on the wards in one way or another), plus homework such as weekly reflection papers designed to make us really think about what's going on and how we interact with other people. Roy is pretty good about getting to the heart of what's really going on, and he doesn't take any BS. At all. He's nice about it, but he doesn't let it get past him. I find myself torn by this. On the one hand, I know I'm going to learn a lot. On the other ... CPE would be a lot easier, and a lot more comfortable, if he wasn't so good at this. I've never been on the receiving end of things, but that'll change as the program goes on.
The main thing that's bothering me, though, is one of the patients in the geriatric ward I'm assigned to. She's 75, but in excellent physical health for her age (a rarity on the ward), intelligent, and perfectly aware of her surroundings (an even greater rarity). Her main problem is severe clinical depression, one of the main components of which is a fixed delusion that she is such a horrible sinner that God can never forgive her. And I mean fixed. There is no budging her absolute certainty. Even ignoring the fact that her "sins" aren't sins at all by the most stringent definition I can imagine, there is no sin that God cannot forgive if the sinner truly repents (in layman's terms, "turns away from"). And boy, has she repented. As a pastor, I am called to preach the Good News of God's grace and forgiveness, which she desperately needs. But she doesn't listen; her depression is so severe she cannot possibly conceive of any possibility of forgiveness--not even a glimmer of hope. There is a psychiatrist assigned to the ward, but his hands are full (more than full!) just keeping the patients properly medicated (or at least trying to figure out the right balance of meds) and seeing to their physical health. There is a part-time psychologist in the ward two days a week, but he's got his hands full just running the group sessions, never mind individual therapy (which she needs--groups just ain't cutting it for her). The social worker and the nurses and the mental health technicians do their best but they're swamped--they're very understaffed, and only get by on lots of overtime. Basically, there's no one but me, a first-year seminarian, to minister to this woman. Everybody's very nice and helpful and has lots of advice, but that doesn't change the fact that it's up to me to implement that advice.
My supervisor is a great guy who really knows his job, both as a chaplain and as a teacher of Clinical Pastoral Education (CPE). If you're having a problem dealing with a patient he's a great resource. He's also good at teaching chaplains. The main point of CPE is to help the interns work through any issues they might have that might get in the way of their pastoral care, and Roy's good at getting to the heart of things. We have about 16 hours of class with Roy per week (the rest of our time is spent on the wards in one way or another), plus homework such as weekly reflection papers designed to make us really think about what's going on and how we interact with other people. Roy is pretty good about getting to the heart of what's really going on, and he doesn't take any BS. At all. He's nice about it, but he doesn't let it get past him. I find myself torn by this. On the one hand, I know I'm going to learn a lot. On the other ... CPE would be a lot easier, and a lot more comfortable, if he wasn't so good at this. I've never been on the receiving end of things, but that'll change as the program goes on.
The main thing that's bothering me, though, is one of the patients in the geriatric ward I'm assigned to. She's 75, but in excellent physical health for her age (a rarity on the ward), intelligent, and perfectly aware of her surroundings (an even greater rarity). Her main problem is severe clinical depression, one of the main components of which is a fixed delusion that she is such a horrible sinner that God can never forgive her. And I mean fixed. There is no budging her absolute certainty. Even ignoring the fact that her "sins" aren't sins at all by the most stringent definition I can imagine, there is no sin that God cannot forgive if the sinner truly repents (in layman's terms, "turns away from"). And boy, has she repented. As a pastor, I am called to preach the Good News of God's grace and forgiveness, which she desperately needs. But she doesn't listen; her depression is so severe she cannot possibly conceive of any possibility of forgiveness--not even a glimmer of hope. There is a psychiatrist assigned to the ward, but his hands are full (more than full!) just keeping the patients properly medicated (or at least trying to figure out the right balance of meds) and seeing to their physical health. There is a part-time psychologist in the ward two days a week, but he's got his hands full just running the group sessions, never mind individual therapy (which she needs--groups just ain't cutting it for her). The social worker and the nurses and the mental health technicians do their best but they're swamped--they're very understaffed, and only get by on lots of overtime. Basically, there's no one but me, a first-year seminarian, to minister to this woman. Everybody's very nice and helpful and has lots of advice, but that doesn't change the fact that it's up to me to implement that advice.