The College of Pastoral Supervision & Psychotherapy is a theologically based covenant community, dedicated to "recovery of the soul" and promoting competency in the clinical pastoral field.
As a hospital chaplain, George Hankins-Hull, Spiritual Care Coordinator and Clinical Pastoral Education Supervisor for LRGHealthcare in Laconia, NH has assisted many patients in the preparation of their Advance Directives. In addition to assisting new patients he has provided orientation to new nursing staff on Advance Directives at LRGHealcare.
He has prepared an informative document (Word: Download file PDF: Download file)on Advance Directives which I think you will find helpful with patients and staff. He generously provides this in the spirt of also wishing to hear what other health care chaplains are doing and the resources that are being used for Advance Directives. -Perry Miller, Editor
Posted by Perry Miller, Editor at 9:40 PM
Jane Babin, who lives in Laconia, NH and has been teaching at Plymouth State
University, not very long ago was diagnosised with ALS.
she gave a presentation which follows below, at Williams College, to the Williams pre-med students. Jane has encouraged me to share her talk, with anyone that might find it of value.
What helps Jane to cope with this horrible diagnosis is discovering that she
has a valuable contribution to make through sharing her experience with
others... -Rev. Dr. Bill Zeckhausen, Pastoral Psychotherapist
I am the face of disease. I am the voice of disease. I am one of millions of faces and voices that need to be heard, hat wants to be known. I am one of many, and yet, like others, I am unique. My story is different from theirs and yet the same. Listen to my story and see the faces, hear the voices of the many, and remember………
My journey began in August of 2003. It had been a wonderful summer. I was off on summer break from my job as a university professor. I was enjoying time with my then 6-year-old son at our neighborhood beach on a lake in central New Hampshire. Oftentimes, my friend Dan and I would go down to the beach and sit on a large rock that protrudes out into the lake. Dan was blessed with a fantastic rhythm and blues voice and writes his own songs, to which I would add harmony. We would perform his new material to kayakers and canoeists who would stop and listen, applaud and give feedback. After 4 years of divorce, although still unattached, I was finally starting to have fun again, to enjoy life once more. Then, a simple fall when dismounting my bicycle – a very simple fall – changed the course of my life. At first just one fall, but then I experienced a second and third one. Dan, would laugh and remark on what a “klutz” I was becoming. I would laugh, too, acknowledging my lack of coordination.
It wasn’t until I was walking the short distance home from the beach a few weeks later that I realized something was wrong. I had to keep stopping. My left foot was not able to flex properly. It was now September; I was on sabbatic leave from the university and teaching an on-line graduate course from home. I called my sister, a nurse practitioner, who advised me to call my physician immediately. My sister was soon to become my greatest ally in my quest to get answers.
Although I did not know it at the time, those simple falls, the difficult walk home were to be the beginning of the end of my life. Over the course of the next few months, I went from one doctor to another, attempting to find a name for what was happening to me. In January of 2004, I was referred to a well-know clinic outside of Boston, to a neurologist who ordered a painful test consisting of sticking long needles deep into my muscles and sending an electrical pulse to measure the ability of my nerves to communicate with those muscles. Unfortunately, they were not speaking to each other.
I remember two important things about that visit to this clinic:
1. The neurologist recently had knee surgery, was in discomfort, and left to go home before my appointment was finished. He left the testing to technicians and to a physician who came in near the completion of the tests. I remember lying on the examination table, frightened, in pain, tears running down my face. The substitute doctor compassionately rubbed my arm, trying to comfort me. After the tests, she very calmly told me that she could not say definitively, but that it might be amyotrophic lateral sclerosis, ALS, Lou Gehrig’s disease. I drove home to New Hampshire with my sister, in shock, in silence.
2. The physician who went home with the aching knee called me the next morning to tell me, over the phone, that I, in fact, had ALS, and he gave me 3-5 years to live. I was alone to take this call. I remember thinking then that no one should ever have to hear the news that they are dying over the telephone.
Needless to say, I did not return to that clinic, but chose Massachusetts General Hospital’s neurology department for a second opinion. As luck, or fate, would have it, my niece, after graduating from Dartmouth College and before she left for Africa with the Peace Corps, worked as a research assistant at Mass General for a Dr. Cudkowicz, an ALS researcher and clinician.
When my niece learned of my diagnosis, she spoke with Dr. Cudkowicz, who agreed to see me.
I steeled myself emotionally for another physician without personality, without feelings, without compassion. I was wrong. Although Dr. Cudkowicz confirmed the diagnosis of ALS, she prefaced it by saying three simple words, “I am sorry”, and I believe she was. I believe she is sorry every time she has to tell a patient that he or she has a terminal illness. I could see the compassion in her eyes; I could hear the concern in her voice. And it was comforting. I was soon to discover that this, unlike my other experience, was the norm.
Before I became a victim of this dreadful disease, I knew nothing about it. I was vaguely familiar with the Lou Gehrig story, but I knew no one with the disease. I did not know that it slowly paralyzes its victims. I did not know that it is a rare disease or that it strikes men more frequently than women. I did not know that it is a motor neuron disease, that it is fatal. Once diagnosed my ignorance put me on an accelerated learning curve, a roller coaster like ride from which there was no escape. I would learn about ALS because I had no choice – it was about to redefine me, the person I was; the person I was about to become.
All traumatic events change people. I was now different. I had changed. I was now a person who could not look forward to a future. I was now a single mom who would not live to see her son graduate from college, advance in his career or get married. I was now a mother who would never hold her grandchildren, tuck them in or read them a bedtime story. I would never dance again, or run, or swim. I have forgotten now how it feels to walk normally. I have forgotten what it is like to be able to snap my fingers. I am changed, but not all for the worse.
I have often heard from, and read about, people suffering from serious illness who have made statements such as, “God blessed me with cancer”, or, “I am a better person, a happier more fulfilled person because of this disease”. It was shocking to me how someone could feel “blessed” by a disease, or conclude somehow that a disease had made them a better, happier person. That was before I became ill. I now understand. I feel that I have not known true compassion, have not experienced pure emotion prior to being struck with ALS. To say that I have met the most incredible people since my diagnosis would be an understatement. To say that I have witnessed the most profound changes in my friends, my family would be to underestimate them. Disease changes us all.
British physicist Stephen Hawking once said that he was “happier now” than before he became ill. Diagnosed with ALS in the mid-1960s, Hawking once told an interviewer, (quote) “Before, I was very bored with life. I drank a fair bit, I guess; I didn't do any work... When one's expectations are reduced to zero, one really appreciates everything that one does have." A long-time victim of ALS, he miraculously lives, but he is changed. He is unable to move most of his body, yet he is happier. He expects nothing, yet appreciates everything.
We are changed by disease, we are all changed, not just the victims but those around them as well. People with terminal illness often fear abandonment. Will my friends, family still be there for me as the disease takes its course, as I become more debilitated? I can tell you from my experience that yes, family and friends have changed. My oldest sister and I have grown closer because of my illness. She often comes over to do laundry or to buy groceries for me. My brother in California, whom I have seen maybe ten times since I was sixteen years old, came back east with his family this summer to spend a week on the lake with me and my son. I travel to Santa Barbara next month to spend one last time with him, to say goodbye.
My relationships with my friends have grown deeper and truer. My friends have witnessed the physical changes in me. Yet, they know I’m still the same quirky person with the weird sense of humor. They don’t leave me behind or take no for an answer. I remember one evening standing outside of a local jazz spot in our town, not wanting to go in for fear I could not negotiate my way around the crowd in the restaurant. With this disease, I have no sense of balance and can fall easily. My friend, Jaylene came outside, took my arm and said, “You’re coming with me”, then proceeded to help me through the crowd to our table. My dear friend, Phil, will often pick me up, bring me to his house for dinner, and then drive me home. And we live on the same block! My friends allow me to express my fears and also my humor regarding this disease. And ALS can provide some very humorous moments! They are real in spite of this disease. They accept me with all my challenges. And, they will be there for me as this disease progresses. My friends are all into the arts – Bob plays pipe organ, His wife, Jaylene is a beautiful soprano. Steve is a poet and is in theatre, his friend Ginny plays flute and sings. Phil plays piano, keyboard and oboe. I often joke with them that my funeral will be more like a Broadway revue than a funeral. And I’ve no doubt that it will be.
My relationship with my healthcare providers has also evolved. Besides Dr. Cukowicz at Mass General, I also have a primary care provider, a local neurologist, a counselor, a spiritual director and others who monitor me on a regular basis. I never knew there were so many people involved in the process of a person dying! I am fortunate. They have all acted with kindness and compassion over and above my expectations.
My counselor has been by biggest supporter in my times of crisis and despair. He has helped me to realize that the stages of dying, denial, sorrow, anger, and acceptance are not mutually exclusive. I don’t go through these stages; they go through me, time and time again. He has unfailingly been there for me. He has suffered with me through the moments of anger, cried with me through the moments of pain and despair, and laughed with me through moments of absurdity. He has taught me, through example, that I am not alone with this disease. There are those who care.
They have all given me reason to hope, not for a cure, but for an opportunity to contribute, for quality of life. And hope is central to my ability to deal with dying.
To quote Martin Luther King, Jr.:
“If you lose hope, somehow you lose the vitality that keeps life moving, you lose that courage to be, that quality that helps you go on in spite of it all.” And so today I still have a dream.
The Trumpet of Conscience.
As my night grows darker, my hope grows brighter –I still have dreams, I still have hopes. I hope for the opportunity to love and feel love from those closest to me; I hope for moments of brilliance and creativity, to be able to meaningfully contribute to this world; I hope that I will have quiet moments with my son, to help him through the changes that mommy will experience and to help him realize that I am still the same mommy inside, even though the outside is changing. And, finally, I have hope that when my mission here on Earth is completed, that I make a peaceful transition to a place of comfort and love.
Yes, I am the face, the voice of disease. I am an advocate for those without voice. I cannot explain why I got ill, why I am dying, for it defies explanation. But I can find purpose in what remains of my life. I can make contributions that I hope will bring fulfillment and joy to me and to others. And, I can make sense of how I leave this earth, how I relate to others and how they relate to me in this important process of dying.
Lastly, I can remind the medical community that those with disease have faces, voices, families, hopes, joys, fears and a need to be treated with compassion and respect. I am not just a body with disease. I am a spirit about to fly.
Posted by Perry Miller, Editor at 9:18 PM
The Annual National Plenary of CPSP will meet in Columbus, Ohio rather than in Virginia Beach. In order to assist many who would like to attend, the S.I.T's at Episcopal Health Services and St. John's Hospital Far Rockaway have taken on the responsibility of arranging for bus transportation.
David Henry, one of the organizers states, "We have tried to make it as convenient as possible for those who may be traveling with us by making three pick up stations. It is important for you to indicate your intentions for seat reservation on the bus as soon as possible. We will be traveling from the New York area over night and will arrive in Columbus well ahead of the afternoon session which begins at 3.00 P.M."
Barbara A. McGuire, CPSP Registrar has provided a flyer (BUS FLYER:Download file) you can download and return to Henry in order to reserve a seat on the bus traveling from New York to Ohio. If you have additional questions please email David Henry.
Posted by Perry Miller, Editor at 9:54 PM
The Executive Committee has appointed George Hankins-Hull to be CPSP
representative to the Liaison Network of the Joint Commission on
Accreditation of Healthcare Organizations (JCAHO). This appointment is
made following an invitation from the President of the JCAHO for CPSP to
sent a representative to the network. (1-25-05)
Posted by Perry Miller, Editor at 5:32 PM
Roger Mace, CPSP Accreditation Chairperson, wishes to bring to the attention of all CPSP Clinical Supervisors the necessity that they provide the Accreditation Commission a completed Annual Report and the Accreditation fees by the February 17, 2005 deadline. This applies to all accredited CPSP training center. No longer is a training center considered "accredited" by virtue of its being under the direction of a CPSP Diplomate. If a Diplomate's training center is not accredited but wishes to become an accredited center, a site review can be established.
Posted by Perry Miller, Editor at 10:45 PM
John deVelder's 97 year-old father, Walter deVelder, died January 22, in
Saratoga. He was a life-long missionary to China, Taiwan, Hong Kong, and
the Philippines. A memorial service will be held Saturday, March 19, at
1:00 p.m. in Old Saratoga Reformed Church, 48 Pearl Street,
Schuylerville, NY 12871
Posted by Perry Miller, Editor at 9:56 PM
If you were on 42nd and 8th Street in New York City you would see a huge 1300 foot screen projecting images of Martin Luther King, Jr. capturing his times and his extraordinary legacy as he fought for justice, equality and freedom for all.
We who are not in NYC can see the same stunning sideshow of MLK on our computers.
If you have trouble viewing the this pictorial, you simply need to install the free Flash Player Software from Macromedia. -Perry Miller, Editor
Posted by Perry Miller, Editor at 10:42 PM
The 2005 CPSP Plenary will meet in Columbus, Ohio on April 6-9 with Pre-conference seminars beginning 3:00 p.m., Wednesday, April 6. The Plenary will convene the following day on April 7th.
The Governing Council meets Wednesday evening. All Chapters are encouraged to make plans insuring their Chapter will be represented at the Governing Council meeting.
The Plenary Brochures will be posted on the PR shortly as well as mailed out.
Posted by Perry Miller, Editor at 12:54 PM
Please note that the next deadline for submitting ratification requests to the CPSP Ratification Review Committee (CRRC) is February 15, 2005.
Any Chapter which has certification candidates to present for ratification at the next meeting of the CPSP Council in April 2005 should submit the request to the CRRC on the appropriate face sheet by February 15.
The CRRC respectfully reminds CPSP Chapters and Conveners that the CPSP Standards currently require that a CPSP Diplomate from outside the Chapter participate in each certification review.
Please send the completed and signed face sheet(s) to the following address:
The Rev. William D. Carr, D. Min., Chair CPSP Ratification Review Committee 10222 S.W. 228th Street Vashon, Washington 98070
The CRRC regrets that we will not be able to process requests unless they are submitted by February 15, 2005 on a completed and signed face sheet. If there are any questions or concerns about this process, please email Bill Carr or phone at 206-463-2667.
Best wishes to you and your Chapter members for the New Year. We look forward to reviewing your requests and seeing you at the April Plenary meeting in Columbus.
Bill Carr, Chair CPSP CRRC
Posted by Perry Miller, Editor at 8:21 PM
The circle is a prominent symbol in our life. It is the reality of our physical environment. If we toss a stone into the pond, the ripples flow out from the center in growing circles. If you watch a leaf fall from a tree, very often it spins in circles before it lands. Not only are the sun and moon circular but they too move in circles. Life itself moves in cycles. The four seasons are a continuous circle, and the life cycle itself begins at birth, goes to childhood, adulthood and then old age.
Life is a constant reminder that we are unalterably linked to each other. No matter how we may try as humans we cannot change this simple yet profound fact. As a pastoral care and counseling community, organizations such as CPSP can now move forward with this victory for collegiality and mutual respect that Raymond Lawrence speaks of in his article, “News From The COMISS Annual Meeting”. (This can be found at www.pastoralreport.com). The circle of life continues.
In the Lakota society, within the Native American culture, the medicine wheel is one of the most popular designs seen on art or cultural artifacts. The Lakota word for it is cangleska, “spotted wood.” This literal description is from the four colors painted on the wheel. The shape and colors used represent the power of life, hence the translated term medicine wheel; having pejuta or medicine can mean possessing a certain power or ability.
The medicine wheel is circular with a balanced cross of two intersecting lines in its center; the ends of the lines connect with the wheel at four points. The circle, of course, represents life, and the two intersecting lines represent the two roads in life; the good road, usually painted in red, and the bad road, usually painted in black. The good road is also referred to as the Red Road; it is the most difficult to travel. The bad road, the Black Road is wide, it is an easy road to travel. These are the two basic choices in life, and we choose one in every situation; the good or the bad. The four sacred colors of red, yellow, black, and white are included in the medicine wheel.
The medicine wheel incorporates another important symbol in Lakota tradition and spirituality, the number four. Like the circle, the number four represents certain realities in life. There are fours seasons; winter, spring, summer, and autumn, the four directions; east, south, west, and north; and the four basic elements of life; Earth, Wind (air), Fire, and Water.
The equality that applies to all forms of life is the greatest symbol for me. No one form of life is greater or lesser than any other. We are different from one another but different is not defined as ‘greater than’ or ‘less than’. We all
share a common journey in our life on earth, this breathtaking Circle of Life.
There is a reality of life that makes us all equal, no matter who we are, or where we come from in life, we are all born and we all die. This is such a simple and hushed reality we humans tend to ignore.
The decision at COMISS to maintain an inclusive posture was not just a victory for CPSP, though we certainly did step forward to claim our birthright. It was a victory for the generosity of a wide embrace based on mutual respect. It is so hopeful to see the process work when done with respect and clarity of heart. Together we are connected as we begin life in the womb, each of us has been birthed and given new life; as this life evolves so to do new beginnings.
When we acknowledge that we are connected to all living things we can together share the burdens in life as well as the victories, giving strength to one another rather than depleting it.
The sun comes up each morning, offering new opportunity and hope. No matter what kind of mess we have made the day before, no matter what victories we have celebrated, each day is a new chance to set the record straight, make amends for any mistakes, achieve another victory, while taking one more step in the journey of our lives. Each day is another opportunity to be a part of that circle of life knowing that it is a journey, not a race and we never travel alone.
I would like to thank Joseph M. Marshall III, the author of the lakota way, Stories and Lessons for Living. Joseph was kind enough to allow me to use some excerpts from his book.
Posted by Perry Miller, Editor at 8:05 PM