My Face Stays the Same, Slight Smile, Head Gently Nodding: A Pastoral Verbatim

[For all the talk of poetry unlocking universes, there is often "technical writing" working on the raw, real edges of the human experience. The following is the written verbatim of a rabbinical student's pastoral visit to a resident in a Jewish nursing home. The names of the student and resident have been collapsed.]



Background: I visited resident twice in the beginning of the year and then didn’t visit him until a few weeks ago when his friend was killed in a plane crash. I visited him two days in a row after the crash happened and hadn’t seen him for two weeks until this visit.

Date of Visit: 3/12/09
Length of Visit: 30 minutes
Time of Visit: 10 am
Visit number: 5

Dialogue

[Pause for a moment. I focus on being a calm, still presence.]
[Knock on door]

C1: M., it’s S.
R1: Hi, S.

C2: Can I come in?
R2: Sure.

[I enter the room and sit down in the chair by his bed. I decide not to touch his hand since he looks quite unwell.]

R3: I don’t feel so good today.
C3: You don’t look too good.

R4: I’ve been feeling worse and worse. My body is just deteriorating. I’ve been having problems with the catheter and with pain. I’m giving up.
How are you? What have you been up to?
C4: M, I just want to note that you just said something really powerful, that you’re “giving up.”

R5: You know me, that I try to be hopeful and try to have a positive attitude, but lately I am just loosing steam. When the body is in so much pain, it’s hard to be happy-go-lucky.
C5: Can you give yourself permission to feel the hopelessness that you feel?

R6: It’s just that I don’t want to burden you. You’re so nice and you listen to me.
C6: M., I’m really grateful that you’re able to share your suffering with me.

R7: But you shouldn’t have to walk out of here with it.
C7: I give it to God, and it’s helping me grow.

R8: I just have you and G., who volunteers here, no, I think she works here, in recreation. My doctor isn’t helping me. He won’t even give me pain medication. Do you see this little tab (points to his chest)? There is so little pain medication here that it’s not even worth taking. I’m trying to switch doctors. Do you know Dr. G. and Dr. R.?
C8: I just see them in the hallways.

R9: Which one do you think is nicer?
C9: Oh, I don’t know… You know many people in our tradition have felt deep loneliness. Many of the psalms are about someone who is suffering so much that the only thing they can do is to call out to God. Can I share a psalm with you?

R10: I’d like that.

[Takes Bible from M.’s table. While turning to psalm 116 says the line “From the depths I call to you God” in Hebrew and then English. Reads the psalm slowly in English].

R11: I like that. That’s how I’m feeling. You’ll have to mark it so I can read it again.
I’m just giving up. Well, I admit that lately I’ve been hoping to not wake up in the morning. I just want to die peacefully in my sleep.
[He looks at me as if to see my response. My face stays the same, slight smile, head gently nodding]
Actually I’ve been praying before I go to sleep that I shouldn’t wake up in the morning.
But I always wake up.

C10: How do you feel when that happens?
R12: It’s just me against the world.

C11: Just you against the world. [Pause] That sounds incredibly lonely.
R13: It is. I’m just afraid that there is going to be pain in dying. I don’t want any more pain. I can’t take any more. Sometimes my muscles have spasms that are so awful. I can’t even move my foot any more.

[As he is saying this I imagine what it would be like to not be able to move my body. I feel very calm and empathetic]

C12: There’s a lot of fear that you’re holding.
R14: I can’t hold it anymore.

[At this point I am aware of how much time I have spent with M. and that we need to wrap up our conversation for now. I thought about how D. teaches that you can’t leave a person in the depths, but that you have to bring them back out before leaving a pastoral encounter.]

C13: Can I share a song with you? [I explain the words—God is with me and I shall not fear-- and sing the last two lines of Adon Olam. While I’m singing I am aware that what I can give to M is this moment of shared holding]
R15: That’s such a sad tune.

C14: [Laugh] There are more upbeat ones. Do you want to hear one?
[Sing the traditional Adon Olam melody]
R16: Oh, I know Adon Olam. I recognize that. [I smile widely and stand up]
Thank you, S. I am so sorry I had to be a downer but I always feel better after you come.

C15: M., know that you bless me through our visits. Did you have coffee this morning?
R17: Yes, G. brought it.

C16: Good, she’s so sweet.
R18: She is.

C17: Bye, M., thank you.
R19: Thanks, S. See you soon.