Mid CPE Evaluation

     I’m about halfway through Clinical Pastoral Education in Westminster, CO just northwest of Denver. Here’s an overview of what the experience has been so far.

     I have primarily served in the Family Care Center dealing with patients who have acute illness and need medical tests, time for diagnosis, and skilled nursing care. There are also patients who are postoperative from knee, hip, and other surgeries. While some patients have a terminal diagnosis, they are usually currently in the FCC for a corollary illness. Many patients also have family and friends with whom I meet and interact.

     I have also served by either filling in or while on call in the ICU, Cardiac Care, Progressive Care, and the surgical units. On call, I have attended several deaths and STEMIs, assisting families in the trauma of illness and death. STEMI stands for ST segment elevation myocardial infarction or heart attack.

     I have been able to attend rounds about a third of the time on my unit. I have begun to build relationships with the nursing staff by listening to their reports, asking for their advice and direction, and relaying positive comments by the patients. I have decided to carry the ‘compliment cards’ so patients can write their positive comments in addition to my charting them. The support staff has been very responsive to my requests for information so I could assist patients—such as where to plug in phones, where more Kleenex stored is or are there warm bath wipes; how can we turn off that demanding beeping machine, etc. I have some concern that nurses and staff may find me annoying as I relay patient requests and needs, yet I also know that we share the same value of patient care and comfort. I don’t want to be seen as demanding but I also want to have patients be as comfortable as possible and to have these little needs met since there are so many other needs we can’t meet.

     The end of life and death process affects me deeply. Even when I am called for death attendance without having known the patient or patient's family, it is a privileged intimacy. I like being helpful, understanding, and supportive. I am beginning to understand how to hold sacred space for others. The ingredients seem to be listening to both stories and feelings, reflecting back, joining in those feelings from the sidelines-without being consumed by them—in some way honoring all the feelings that are present whether expressed or not. Also included is speaking with and for the gathering in prayer if appropriate. I have used the Book of Common Prayer several times, which I sense speaks to the families by giving form and voice to inner feelings and yearnings.

     I spend most of my clinical time visiting patients. There is a wide range of interactions from a short introduction of the services provided by the chaplains to delightful conversations that feeling like budding friendships, to difficult witnessing of suffering and pain—physical, emotional, and spiritually. This work really tires me out and that continues to surprise me. Even the ‘easy’ days are tiring. I need quite a bite of time alone and time to sleep to feel refueled.

     I treasure my time with patients who are altered mental status, suffering from dementia, or semi-comatose as I read the psalms from the Book of Common Prayer, which feels like it feeds us both. I’ve developed a list of psalms that seem to articulate my feelings and my intuitions about their feelings. I usually spend about 15 minutes in reading and being quiet together. It feels precious. I usually conclude with prayer from the Book of Common Prayer.

     Last week [or so] I’m experiencing a bout of clinical depression. The slide to the ‘black dog’ is slow and I am unaware of the downward movement until I hit something—not really bottom, just when the pain is acute enough to be present in my consciousness. The most pressing and informing symptom was how I could hardly connect while visiting with patients last Thursday. I wanted to be a nursing assistant so I could empty bedpans or something actually helpful rather than go from room to room talking inanely. The idea that my presence could in some way be a gift evaporated. On Friday, I wore the house pager and that helped as ED paged me to assist a family member. With the sharper need, I could respond and it helped put my own needs into a better perspective. Clearly, my own mental and physical health affects my ability to do this work.
     Here are my learning goals, which I established early in CPE.

• To help people connect their stories to the Divine story

I am improving at mutual or joint reflection on stories. I still wonder if I am fluent enough in biblical stories. I hope to increase my metaphorical vocabulary and biblical themes to make it possible to share the connections. This may be more applicable in parish work and preaching but I’m dedicated to pursuing this more fully.

• To increase my evaluation & assessment skills

I think I am learning to be more patient with myself here. As I’ve watched myself, I think I move too quickly to trying to understand what’s going on. My next strategy is to hold quiet longer and respond from some inner sense or intuition. I also have been acquiring skill in asking open questions so I gather more information and create more intimacy.

• To release tension/stress absorbed from pastoral care encountersI have a nightly ritual of watering a plant by the entrance of my brother’s house using water, cares, patients, and prayer. The group helped me design this ritual. I think it is effective. Also, my family has been working long hours and I’ve had time to myself, which is helpful. I can take a bit of time to think and pray about work and release my tensions to God.
  
  
  
  • To expand my theology of suffering
  I’m doing a good job of gathering data about suffering but I need to step back and reflect on what I’ve learned. This might be a good topic for journaling. It certainly would be a great topic for group discussion.
  
  
       How do I think I’m doing? I genuinely like people and I think this is apparent to the folks I visit. I am curious about how they understand their lives and I love hearing their stories. I carry few negative judgments about people’s choices, yet think I can speak about the consequences with truth and love. I believe most of us are doing the best we can at the time. I have a good sense of humor and can laugh at myself. I have done therapy and reflection and I think this increases my empathy for others. I feel like I am a mature person. I have a good understanding of my own shortcomings. I come to pastoral care as a full person and offer a big heart. 
        I think my weaknesses are perhaps the same as my strengths. As I come to pastoral care as a full person that means I bring my occasionally bouts with clinical depression, which limits my functioning; my energy and enthusiasm, which leads me to judgments too quickly; my positive attitude about people, which leads me to naivety; a big heart, which leads me to over functioning on other’s behalf. Because I connect to the world through my emotions I can be empathic and intuitive, but when people are annoying to me it is almost impossible to move to the empathetic position. I am continuing to learn to set aside my annoyances and irritabilities.
       The disruption of hospitalization, illness, or surgery, a snafu, brings difficulties but also gifts. The messiness of illness makes a time or space to see ourselves differently, to evaluate, and to stop in the busyness of life to discover what we value. It also provides opportunities to find out who values us and how they express their care. Being present to these possibilities can be a path to greater growth. This crisis can also help us see what our needs are and new ways to get them met.
       A significant part of the CPE experiences are is the interaction with my cohort or peer group. I am delighted and impressed with the group dynamics. While still at school, I asked others about their CPE experience. I did hear stories of competitive, mean-spirited, and harsh groups. And stories of disconnected and unhelpful groups. I’m impressed with the kindness, open heartedness, and high level of expertise our group has. I have the sense that each of us is pulling for the other’s successes. After crying in my verbatim, I found myself embarrassed the next day. When I shared this with the group, Michael told a story on himself to let me know that tears are part of the process for most of us. I felt accepted.
       The group, and I include Janet, our supervisor, in these comments, demonstrates a range of approaches to the same goals. I think adults learn most frequently in conversation, in the give and take of mutual reflection. I see this in my circle of friends when we discuss relationships. The group conversations, both formal and informal, are focused, kind, and instructive. All of these people are good and great teachers.
       All of my colleagues appear to hold thoughtful theologies based on an authentic relationship with a loving Creator, in which I can find common ground and learn new ways of knowing God. The other most impressive characteristic of our group is the delightful sense of humor, a sincere joy in the paradox of creation. Their playfulness expresses what a good and joyful thing it is to worship God in our lives and our work. Another outstanding quality is the kindness and giving of grace that occurs in our interactions. Perhaps this is because so many of us are artists—writers, musicians, builders and trade workers along with the visuals artists.
       Katie has a wide repertoire of open-ended questions. I find her solid, caring, and kind. She’s taught me about gentle strength combined with perseverance. Katie is generous in sharing her teaching experience.
       Carol is also generous in sharing her experience and unique perspective. I experience her as thoughtful, imaginative, with deep pastoral skills that are part of her very fabric of being.
        Michael brings a confidence in God’s providence that’s impressive as is his ability to express it. His accepting energy must be a salve to concerned patients. He takes what people say seriously and respond with care.
       Elizabeth is out going and intrigued with people and their stories while willing to self disclose. She is precise and a hard worker. I would like to experience her as she makes music. Elizabeth approaches the world with her hands and heart wide open.
        Each week I have an hour of supervision with our supervisor, Janet. I wondered if supervision would be the time when the supervisor would tell me things he or she thought would be too painful for me to hear in our group work. I’m delighted to report that’s not the case. It has been for me a time to focus on my own journey as in spiritual direction with the added benefit of a shared context of work. It’s been an opportunity to delve more deeply into the process of learning and growth that comes with pastoral care. I would like to map out my theology of suffering in the group and perhaps that is more appropriate for supervision time.
       What changes would I make to the program? The biggest improvement to the program would be the addition of therapy dogs to the chaplaincy. I’d be delighted to be the first chaplain with a pooch. Also, we could work with local churches to provide clothing to those who come to the hospital through the ER. If there has been a trauma of any sort, the medical team cut off their clothes, leaving them without clothes when they leave care. The folks at St. John’s help with a similar project in Springfield.
       The other project that might be helpful is to buy several universal cell phone charging kits. Many patients come to the hospital with their phones and without their charges—an easy piece to forget. The cost would be about $10 a charger. We have six units at the hospital so for $180 we could provide three charging sets on each unit.
       The most helpful parts of the program for me have been group reflections on our work, our reading, and our discussions of patient interactions. I am an external processor so this learning style is a great fit for me. I love the wide variety of printed materials and feel like I’m able to create the beginnings of professional pastoral care resources. I’m also an aural learner so listening to the discussions is also a great fit. We have become good mutual teachers, a learning community.
  
  
  
  
  

Home On the Range

    Well, I did see deer and antelope on my trip to Denver. Denver is located at the foothills of the Rockies and part of the Front Range. The animals here are, of course, different from in the Willamette Valley. Most notably and numerous is probably the prairie dog. I live in the suburbs and most of the undeveloped land here is only undeveloped by people, the prairie dogs have developed cities. I didn’t see any of these ‘dogs’ up close until Kathleen came to visit. My brother and sister-in-law bought Kathleen a ticket to Denver as a present for my birthday. So we spent three days together at the end of June. It was wonderful.
    While we were together, we visited the Butterfly Pavilion, located in Westminster, Colorado. The pavilion opened in 1995, and was the first standalone non-profit insect zoo in the United States. The 30,000-square-foot facility is on 11 acres of land. The main exhibit is an indoor rain forest filled with 1200 free-flying tropical butterflies. After visiting the rain forest, we took the .5-mile nature trail just outside the Pavilion along Big Dry Creek. Here we saw prairie dogs up close. They are squirrel-esque without the fluffy tail, clearly rodents and I find them charming. We also saw double crested cormorants in the creek, hunting fish.

Snowy egret

    On my daily commute, I see herons and egrets near the South Platte River. Often as I arrive at the hospital, there are little cottontail bunnies on the grounds. The hospital has nicely kept grounds. Across the busy street in front of the hospital is open land. The prairie dogs have built their homes. On the evenings when I’ve been on call, I’ve watched coyotes trot along the open ground. Twice I think I’ve seen a red tail hawk on the telephone lines.

    And at my brother’s house, there is a red fox that comes by on her night route. Several times a week I get to see this beauty past by the house highlighted in the streetlights. The fox passes through several streetlights like Jimmy Durante did at his show’s closing. If you remember this, it will really date you.



    These creatures remind me that I’m in a new place doing new things. They also remind me to pause and connect with all of God’s creatures. Each time I see these beautiful creatures, I think to slow down and to appreciate my own creatureliness. The little bunnies crouch and become so still as I approach. The color of their fur matches the rocks, the colors of the underbrush. The prairie dogs whistle to each other describing my approach. We are all God’s creatures, connected through our Creator. Noticing the fauna around me enriches my experience. 

Coyote!!

Double crested cormorant

Night Heron in flight

Thurnderstorms and chaplaincy

The afternoons and early evenings bring thunderstorms to the Denver skies. The days are hot—in the low nineties, and clear blue skies. From the chaplain’s office or the deck of my brother’s home, I can see the storm off in the distance. The dark clouds form with streaks of rain connecting them to the earth. Flashes of lightning illuminate the dark underside of the roiling storm clouds.

      I watch the storm travel, often from the west towards the east. Before the actual storm arrives, the winds pick up. The nearer the storm, the stronger the wind is. The temperature has dropped quickly. The first drops come down, and then the storm is upon me. The rain is hard, fast, and heavy, filling the gutters to overflowing in minutes. The lightning is more frequent. I can hear the thunder now and I count the distance, wondering if counting really measures the distance. It has been a long time since I’ve been in warm rain, summer rain. I feel energized by the wind. This rain soaks me in a minute. Not like an Oregon soft rain that you can run through and not get soaked.

      In only a few minutes, the storm moves on. I can watch it move off into the distance. A few days ago, the storm came later, and as it was night, the lightning now illuminated the clouds in the northeast. I could see the lightning strike from cloud to cloud, back lighting the big black cloud between the storm and me. As I watched over time, I could discern the shape of the cloud as the storm continued. It was now too far to hear any thunder. The sky above me was clear, stars shining.

       I thought how being in the hospital might be like experiencing a storm like this. Maybe we can sense the storm or illness coming at a distance, as our bodies don’t respond the ways we are used to it responding. And the turmoil of the storm, maybe it could be a metaphor for the crisis of being out of normal time, of being in the hospital. The storm is so powerful. And it is not in our control in anyway. Illness can hit us, come over us in a similar way. As the crisis peaks and passes, the illness or lightning flashes and illuminates the shape of the cloud, of the new pattern in the sky, of a new pattern in our lives.

     I’m not sure that there is a purpose or meaning in the illnesses of our lives. But I know from the work in the hospital that illness storms into our lives and changes them whether we are the ones who are ill or if we are the ones whose loved one is ill. Hospitalization changes us. It puts us into a space where we are not in control of much if anything. Pain, like lightning, backlights the new patterns in our lives. And illness passes, sometimes bringing us back to our changed lives and sometimes taking us to the life to come.

Intern Chaplains--My team, my colleagues, my new friends

There are four interns, all of different faith traditions—me, the Episcopalian. I’ve just turned 61—I know hard to believe. And now my new colleagues:


Katie, a woman in her 50s, is a Presbyterian and after CPE will graduate from Iliff School of Theology with a Masters in Divinity. Iliff, located in Denver, is a seminary related to the United Methodist Church, but its distinctive character is also derived from its commitment as an ecumenical, inter-religious institution. The largest percentage of students comes from the United Methodist Church. However, more than 30 other denominations and faith traditions are represented among the student body. Katie has a husband along with two adult daughters and is planning a retreat ministry currently. Katie lives in Longmont which is 30 miles north of Westminster so she has a commute similar to mind. Katie is an introvert and has a great repertoire of open ended questions, a grand skill to have for CPE.

Elizabeth, also in her 50s, is a Methodist and originally from the South, obvious in her soft drawl. Sometimes Elizabeth sounds like my Mom. She also attends Iliff and is planning on pursuing a doctorate. She lives in Denver. Elizabeth has great attention to detail and always asks great clarifying questions. Elizabeth and I are the extroverts on the team.

Both Katie and Elizabeth are doing second or third careers just like me. Katie is a teacher and a poet. Elizabeth is a music therapist.

Michael is our fourth colleague. Michael, 30, is on the ordination track in the Catholic Church. He lives in a parsonage attached to a parish in Denver and joins Katie as an introvert. He speaks Spanish which is part of current priestly formation in the Catholic Church and is a great asset here at St. Anthony’s. At 6’ 7” he towers over the three of us! But his height is a good match for our resident chaplain, Carol, and our supervisor chaplain, Janet. It’s pretty funny to see the six of us together—three tall and three short.

Carol, our tall resident chaplain, is completing her certification as a chaplain and sees hospital work as her long term ministry. She is a teacher and art therapist and brings her extensive background with working with children to bear when she’s working with our intern team. She created a scavenger hunt to help us learn our way around the 3 floors of the hospital. Her husband teaches at Colorado State University. Her faith tradition is Seventh Day Adventist.

Janet is our supervisor and fearless leader. She is a Disciple of Christ minister and does a great job of relating our learning in the hospital to work in a parish which is the long term goal for Michael and me. While I know Janet is a married person, I am unsure what her husband does.

Also on the chaplain team is Andy, a retired federal employee who continues to work part-time here at St. Anthony North. He is an active Catholic and uses his skills to teach us about the paperwork required of chaplains.

There are also several chaplains that take the on-call week nights. Our team of four chaplain interns takes turns doing the on-call weekends.

Each week we spend Tuesday 8-2 and Wednesday 8-12.30 in class, reflecting on readings, giving our verbatims [I’ll say more about these], and working through the challenges of assessing and giving care to patients, family and staff at St. Anthony’s. The rest of the week is devoted to actually making visits with patients, attending traumas to support families and friends, and accompanying the family through the death process.

All deaths at St. Anthony's are attended by a chaplain. The chaplain’s job first and foremost is to assist the family and friends to begin the grieving process. We offer prayers, support, Kleenex, a listening heart, and our presence. It is a privilege to be with people as they acknowledge the death of a loved one. I was, of course, very nervous the first times it was my turn to attend a death. I fretted about what to say, how should I pray, what would the family want. I’ve learned that it really isn’t very important what I say. The families want someone to be present with them and reflect back to them the loss they’re suffering. They don’t remember what I say. They might remember that I was there with them as their lives changed. They might remember that I was nice.

Another responsibility for the chaplain is to request tissue donations if appropriate. All families are asked if they would like to give the gift of healing to others. Colorado has donor designation on their driver’s licenses as do most states. 70% of all Colorado drivers are registered donors, the highest percentage in the nation. Since you just check a box when renewing your license, most people don’t discuss this with family. So the nurse calls the donor registry and the chaplain finds out if the decedent is a registered donor and if yes, lets the family know and explains the process. If the decedent isn’t a donor but qualifies medically, the chaplain explains the options and asks if the family if they think the decedent would like to give the gift of healing others.

And with all events in life, death comes with paperwork. The chaplains figure out which of the many forms are necessary, fills them out, and gets the appropriate signatures. Walking the family through this process can be a gentle movement toward leaving the hospital and leaving their loved one.

Introduction to CPE

My clinical pastoral education [CPE] is at St Anthony North Hospital in Westminster, Colorado which is part of the metro Denver area. The town of Westminster is 5 miles north of Denver and 22 miles southeast of Boulder with a population of about 100,000. St. Anthony North is the third largest employer in Westminster.
The hospital website is http://www.stanthonynorth.org/.

This is a small hospital, a total of 130 beds, serving a lower income population. The usual hospital population is about 90-100 patients. My work as an intern chaplain has me doing a total of 300 clinical hours—spent in clinical visitation, time actually with patients, families and staff in the hospital, and 100 hours of group and supervised reflection and learning. Clinical time includes a variety of learning opportunities, including regular visitation during the week, with referrals and introductory visits, and one weekend on-call each month responding to emergency pages and needs within the hospital. Opportunities for ministry and relational care include care to patients, their families and loved ones, and staff. The topics that we are learning about are:
+Empathy & Compassionate care
+Family Systems Theory
+End of life or terminal diagnosis care (Palliative)
+Healing and Meaning-making
+Dying and Death
+Advance Directives
+Behavioral Health
+Grief, Loss, and Mourning
+Trauma and Crisis Care
+Medical Ethics
+Spiritual Assessment
+Worship and Ritual

The purpose of CPE is theological and professional education focused on developing one's skills, abilities, and person to care for the spiritual, emotional, and relational needs of others. CPE is learning and formation through professional relationships with patients, staff members, peers, yourself and your supervisor. And it is learning by doing, a dynamic and experiential model of learning, which works well for me. My cohort is 4 interns, one resident, one part-time chaplain and our supervisor/director of our program. I’ll introduce these folks in the next post.

I’m living with my brother, Pat and his terrific wife Deb. They have set me up in their lovely home with a comfortable bedroom and also a workspace. Plus lots of diet Pepsi. Pat and Deb are working long hours in their custom brokerage firm and I have several evenings a week alone. After the fast pace of the school year and the emotional demands of the hospital work, I am glad for the time alone and quiet.

Pat’s home is out by the Denver airport about 15 miles east from the hospital. The commute is real challenge for this small town girl. My work starts at 8.00 am. If I leave at 7.00 the commutes is about 30 minutes. If l leave at 7.15 then it’s 45 minutes, unless there is a jam. If I leave at 7.30, those 15 miles can take an hour. The evening commute is harder. At least twice a week it takes an hour and a half to get home. My little red roller skate of a car, which usually gets great mileage, shimmies in the traffic and sucks up the gas as I try to practice patience.

I listen to Colorado Public Radio on the commute and those initials, CPR, are used to identify the station. With my time at the hospital, CPR means more than public radio and every time I hear it I think of the hospital meaning. Context is everything!

Poem as a devotion in CPE

On our class days, one of us has the responsibility of opening and closing devotions. Katie, our resident poet, led us through the process of writing a poem as a devotional. Here is my poem.


Listening to my GPS giving directions
I am excited, scared, hopeful, yearning
And yet fearful of acrid assaults and huffing pinging machines

I find the normal inside the absurd
Sharing voices under pressure
Confusion displacing personal anchors
As machines hum
I hear “Can I help you find your way?” and am comforted.

Most frightening I find bodies, eyes closed, mouths open, faces slack
Huffing, pinging machines, where
Words won’t touch or ease
Can I touch her?
Can I hold his hand and pray together?

At its best it is just friends helping friends
Ducklings following momma
Being bridging the abyss
Presence illuminating

Third day of CPE

Orientation was two days of data, vocabulary, maps, procedures, information and people. The people were and are wonderful. The information was overwhelming! I think most of us have had the experience of way too much information in concentrated form poured into us (and over us) for an extended period of time. With orientation to a new job, new place and new faces, my brain felt ready to detonate if I had to have one more new thing stuffed into my head. I went home both nights feeling exhausted from trying to absorb all this new information as I was also trying to create the filing system or overview to absorb and organize everything in my head.

Thursday morning as I walked into the chaplain’s office, proud that I hadn’t gotten lost driving from my brother Pat’s house, had managed metro traffic and freeway driving, and was 8 minutes early, the office phone rang. It was the on-call chaplain asking me to take a page for her. A woman had died in the hospital and the nurse had called her family. My job was to be there for the family, complete the ‘death packet’ which contains the paperwork the chaplains complete, and assist both staff and family. Orientation was over. The work that I am called to do in my internship was down three flights of stairs waiting for me. Could I do it? Deep breath. Quick prayer—God, don’t let me wreck this. Let your love for these people somehow come through me. Open my heart and mind so I can do the work you have for me to do. Thank you, God. Amen.

One of my new colleagues, Elizabeth,  joined me. I’m pretty sure she was praying a similar prayer. The patient’s family had not arrived and the nurse led us through the first steps. Then we went to the patient’s room. The patient was dead. She didn’t look like she was sleeping. She didn’t look terrible but there wasn’t any question about whether she was dead or not. The nurses prepare the patient before the family arrives so she was lying under smooth covers, no tubes, her hands clasped, her hair smoothed. And very truly, really dead. While this was not my first time with a dead person, it was only my fourth. I realized that orientation did not include the question—how many dead people have you met. I was now counting up my experiences. As we waited for the family to arrive, I reviewed all the times I’ve had people I cared about in hospitals. I tried to remember what it had been like, although much was blurred by time and emotion. Gathering those scraps of thoughts, I imagined what I would want to have a chaplain do. I supposed I would want the chaplain to be there as a calm, warm presence and to guide me through the beginning of the burying and grieving process. So I began to pray as much as I could remember of the litany at the time of death from the Book of Common Prayer. I have a small edition of the BCP but had not brought it with me. I made a note to change that. I would have loved to pray the prayers from the Ministration at the Time of Death.

Still the family did not come. Our patient was in her 80’s so her husband would be also. We knew the son was picking dad up. We waited over an hour. I prayed, meditated, and felt my anxieties rise up. One of the gifts of this waiting was to have all those niggling anxieties rise up, examine them, and hand them over to God without the family present. It didn’t take long to become comfortable with our patient, call her by name, hold her hand, and pray for and with her. The room was dark and silent. It was, in fact, peaceful between the spikes of anxiety. I think this allowed me to be with my fears in the best possible way, in the midst of time with God and time out of my control. Often I let busyness and schedules cover over my fears with doing and I don’t take time to be fearful. It was a blessing to not be in charge of time and activity.

When the family did arrive, dad was hard of hearing and broken up. They had been married for over 60 years. The son and his wife had a similar loss of family recently. I felt some envy of what it might be like to have a mom and dad stay married for 60 years and to have these parents so long into one’s own life. My dad died when I was 30 and there is much in the years since then I would have liked to share with him. Then I remembered that not all long term marriages are a blessing to the children. And envy is hard to sustain in the face of death. I got over myself almost as quickly as the feeling came.

I struggled a bit to know what to do. Should I offer prayer? Should I stand by silently? Should I talk about what’s next? Should I touch them? I decided to be silent until I could detect some be restlessness or movement from the family. Then I would ask the family what they wanted and outline some options. That felt right at the time. One of my learning goals in this internship is to build skills of discernment so I can better gauge what the needs are in each situation.

Based on this experience I’ve put together a little kit for myself that includes real handkerchiefs, the Book of Common Prayer, pen, note cards, and change for Diet Pepsi from the vending machines. I also have a clip board so I can take notes. It’s comforting for me to have tools. These things are taking the place of a desk, calculator, and computer. What does remain the same is the connection to the people—tax clients and patients and their families are similar. Both sets have need for understanding, affirmation and knowledge. It is a privilege to be a part of the process with my clients of all types.

CPE in Denver

For several reasons, like permission from the hospital to name my colleagues and also the crush of learning a new job, I haven’t been able to post. Now I have several articles that I will post tonight and over the next week.

I began CPE on May 31st and now it is July 10th. In these 41 days, a lot has happened and I look forward to sharing some of it with you. So there will be a flurry of posting tonight. To all my friends far away, I miss you. To my new friends here in Denver, thanks for being so generous with me.