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The nature of HOPE in an ICU

Hopeedit in the icu
I am a staff chaplain in a hospital with four critical care floors and a cancer unit, and naturally I spend a lot of my time on those critical care floors.  My time is spent with patients and families who are grieving. They are all grieving the loss of their “normal” – life will never be the same. Patients are grieving the loss of health and independence, at least temporarily.  They may also be facing the loss of their careers, which for many people is where they find meaning and purpose, especially if they have no children.

For elderly patients the situation is even more traumatic. For them loss of independence signals the beginning of the end. They know they will quickly lose muscle tone lying in a bed all day, and if they have suffered any kind of fall they are probably told they can no longer live alone, that they may need to move to a “facility” if their family cannot take them in. The staff avoid the words “Nursing Home” because for so many patients these words summon unbidden memories and smells, a foreboding and a sense of horror. Most everyone who is elderly has had a friend or family member in a nursing home, and has left it begging their own family, “please don’t ever put me in one of those places.” And now here they are discussing “Long Term Care Facilities.”  For families who know their loved one’s wishes there is tremendous guilt even having the conversation.

Where can hope be found in that room? As a chaplain I do not claim the right to offer hope. Pious platitudes are an offense to the emotional sensibilities of all concerned. So then what? At first all that can be done is to sit as people digest all they have heard and offer them a supportive presence. At some point a simple question can refocus the emotions in the room to good memories and life’s blessings. It is easier for the people in the room to access “hope” looking backwards. To an elderly spouse or life partner, “How long have you been together?” This often elicits stories of first meetings and life’s milestones, usually accompanied by smiles and tears, both. The next step is harder: Where is hope now, in this room in this moment? A comment or question about the care being offered on the unit often leads to expressions of gratitude. The focus of hope becomes timely assistance when the nurse’s button is pushed, pain medication when needed, the gift of clean bedding, getting the meal that was requested, the kindness and gentleness of staff. Hope can also be present in the person of a relative not seen for years and the opportunity for reconciliations and mended fences.

And then there is the question of future hope.  As a chaplain I make no assumptions about people’s future hopes. Even those who self-describe as “not religious” will ask for prayers of healing, and may want to believe in more than simple annihilation at the moment of death. Even atheists desire a way of making sense of the life and death of their loved one – did it matter that they lived? The scientific understanding of the cycle of birth and death, of the reabsorption and recycling of matter, can provide a sense of immortality – a future hope.  And for everyone in the room the sharing of memories reminds them that the loved one will live on in their stories. Their loved one was part of the great tapestry of human existence and changed the history of the world for all time – another source of future hope.

If they are of the Christian, Muslim, or Hindu faiths, devoted or even loosely affiliated, prayers of intercession are a tradition, especially in times of crisis. People’s beliefs in the efficacy of these prayers can often resemble a child-like, “Santa Claus” view of God. But there is another view that makes such prayers meaningful: prayer doesn’t change God it changes us. In prayer we place ourselves consciously and intentionally in the presence of the Divine – the source of life and healing, courage and hope. That awareness can bring a sense of peace into the ICU room. Physical healing may not be the outcome of these prayers, but there is the possibility of spiritual and emotional healing. The family is reminded that they are not alone. They have a source of strength and courage that comes from the Divine who is present within them, in the room, in the universe, and will support them in whatever comes. And furthermore, the patient is not alone now, and  never will be alone.  All that is remains in the “Hands” of God, and for theists that is the Future Hope.

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Subtropical Storm Alberto, May 26, 2018
An actual picture.

Storm Ending


          Thunder blossoms gorgeously above our heads,
          Great, hollow, bell-like flowers,
          Rumbling in the wind,
          Stretching clappers to strike our ears . . .
          Full-lipped flowers
          Bitten by the sun
          Bleeding rain
          Dripping rain like golden honey—
          And the sweet earth flying from the thunder.


It’s thundering outside and we’re under a storm watch for the weekend. It’s not even hurricane season yet!  I looked for poems about storms and this one struck me, the first line in particular, “Thunder blossoms gorgeously…”  It seems counter-intuitive to speak of gorgeous thunder and to use the imagery of flowers, and it gave me pause.  I was reminded of one of my son Malcolm’s  favorite phrases: perspective is everything.

If we apply that principle to the storms of life I wonder what might result? You might be tempted to counter, Wait, are you telling me to look on the bright side, that every cloud …yada yada yada?  Well, if you put it that way it does sound trite and that’s not what I’m aiming at.  I don’t think one can find beauty in every storm or every tragedy; hurricanes are dangerous and deadly and the aftermath is ugly.  Loss of a loved one is profoundly, excruciatingly painful and life-changing. And yet …

After a newsworthy tragedy one often hears of heroic gestures, lives saved, donations made, foundations established. But after a loss …?

In the hospital room, when the family has let go of the hope for a cure or a miracle and I am asked to pray with them, I pray in thanksgiving. I give thanks for the life of the patient and for the many blessings – for the life they have given to their children, for the love they have both given and received, and even for the struggles that made them stronger and brought them closer to each other. These prayers don’t remove the pain of loss, or the pain of letting go, but they shine a light on the beauty in the storm, and it often changes the mood in the room as people shed tears and share smiles of remembering. After the group prayer I invite people give a personal blessing to the patient (I keep an anointing oil for that purpose) and say their final words close to his or her ears. I start the ritual and hold out the oil to each person. There are more tears and then there is silence.  Then I might make an observation or ask a question about the patient and that’s when the story-telling starts. I don’t remember the stories ever being about bad times. The patient’s character traits and foibles are remembered along with their acts of love and sacrifice. There is beauty in that – beauty in the thunder, as the tears mingle with the laughter.


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female thinker bronzeSo I just read my last blog post again and realized how theistic it sounds. God – the Great “I Am.”   As a Christian one would assume I am a theist. But I find myself in the post-Christian camp, more of a Jesian (from the name Jesus) than a Christian.  In theology class we learned about the two approaches to Christology – the theology of Jesus, who Jesus was. One was the ascending Christology of a man becoming God; one was a descending Christology of God becoming a man. Both are based on the assumption of divinity – divinity attained or divinity revealed. In either case Jesus is The Christ, The Messiah, the Anointed One. But what if Jesus was a man becoming a teacher, a man becoming a martyr, called to follow his God the same way each of us is called from a force within ourselves or outside ourselves to be the best version of ourselves we can be.  Would that change anything? Would it change how we should live?

And if Jesus wasn’t God, but an archetype of the kind of human being we should be if we choose to follow him, then what about God? The Great I Am?  Some days I don’t know. Then some days I am absolutely sure. I know that I don’t accept the traditional theistic, judging God of so much of the Old Testament.  I know that I prefer the image of God that Jesus taught his followers, exemplified in the Prodigal Son story.  The feel good, Dad loves me after all, image of God. But when I think about it, God as a Being, an existing entity, doesn’t make a lot of sense, and neither do the anthropomorphisms that theology and spirituality are replete with, Father or Mother, King, Judge, Savior. On the other hand God as the source of our Being, the source of all Being, the matrix which binds the universe … words fail! That’s the point, words will always fail to name that which is beyond all names. Jews have one name for God but they can’t say it, so they have many titles and descriptors. Hindus have millions of names and a few that are more important than others.  Christian have three, Father, Son, and Holy Spirit, because one just didn’t seem to be enough to explain their experience of the historical person of Jesus and the  spiritual, inspirational presence of Jesus that continued after his death.

Perhaps it has to be enough to say that I believe that God IS. But I may not believe in the God you believe in.

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Be Still and Know

When I was teaching and leading retreats I learnt a beautiful way to pray the breath prayer or centering prayer. Using the phrase  “Be still and know that I am God”  start with the whole phrase, breathing in slowly and saying to yourself “Be still and know” and breathing out say to yourself “that I am God.”  Then with each successive breath shorten the phrase, ending with the word “Be”  (see below). And then just sit with that thought, reflecting – What does it mean to simply “Be,” in the faith that we are not alone. Psalm_46_10-2

Be still and know that I am God

Be still and know that I am

Be still and know

Be still


based on Psalm 46:10   (or v. 11 in the NAB translation)
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The anxiety of loss; the loss of anxiety, Part II


This article has some excellent advice.

Tips For Taking Care of Yourself During Stressful Times

From the NIU Employee Assistance Program

  1. Stop, breathe, and tell yourself:  “This is hard and I will get through this 1 step at a time.”   During an unexpected event or crisis, we are faced with dealing with a new reality and it takes time to incorporate what happened into our every day lives.  Identify the steps you need to take first, write them down, and focus on each step one at a time…if you look at everything you have to do, you will become overwhelmed.  Remember you can only do 1 thing at time and focus exclusively on that 1 thing.
  2. Acknowledge to yourself, what you are feeling.  All feelings are normal so accept whatever you are feeling.  Once you recognize, name, and accept your feelings, you feel less out of control.  You can then find a comfortable place to express your feelings.  During periods of extreme stress and grief, it is very hard to hold back your feelings, particularly your tears and anger.  This is normal so describe this as grieving or sadness or anger…you are not falling apart…you are grieving or feeling angry-sadness.  It is important during this time of intense feelings to own your feelings and NOT hurt yourself or lash out at someone else.
  3. Find someone who listens and is accepting.  You don’t need advice.  You need to be heard.   Sharing our story is how we begin to accept whatever happened and integrate it into our new reality.  It may be that you just need to let go of your expectations of how things should be and talking about your feelings and beliefs is the beginning of that process.
  4. Maintain your normal routine as much as possible  Making everyday decisions…deciding to get dressed, do the dishes, or go to work, for example,  gives you a sense of control and feels comforting as it is a familiar activity.  Be realistic with what you can do and remember everything right now will take you longer to do.  Avoid making major decisions based on the stress you feel right now.
  5. Allow plenty of time for a task.  You will not be as productive as you normally are.  Accept how much you are able to do right now and recognize it will not be this way forever.  During periods of extreme stress, prolonged stress or after a crisis, your ability to concentrate and focus on tasks is diminished and it will take time for your concentration to return so give yourself extra time and be gentle and accepting of yourself and what you can do.
  6. Take Good Care of Yourself.  Remember to:
    • Get enough rest and sleep.  Sleep at least 6 hours and not more than 9 hours.  If you are having difficulty sleeping, listening to peaceful, slow music and/or do progressive relaxation just before you go to sleep.  If you still have trouble sleeping, contact the NIU Employee Assistance Program at 753-9191.  Sleep is how our body heals and strengthens our immune system.
    • Eat regularly and make healthy choices.  Skipping meals, particularly breakfast, contributes to fatigue, mood swings, and poor concentration.  Healthy choices (foods not high in simple sugars) maintain your blood sugars and therefore your energy and concentration.
    • Know your limits and when you need to let go.  Some problems are beyond our control.  If something cannot be changed, work at accepting it for what it is.  Resist the urge to fix the unfixable or try to control the uncontrollable.  Sometimes a mantra helps…“It is what it is, I just need to accept it.”  For things within your control, remember change takes time.  If you are holding on and need to let go, journal about it.
    • Identify or create a nurturing place in your home.  A rocking chair, a nice view, and soothing music are important components to a nurturing place.  Twenty minutes of rocking in a rocking chair reduces both your physical pain and aFront Covernxiety. It is like giving yourself a hug.  Music and nature sounds nurture our being and lifts our spirits.
      [Check out the following book and CD’s ..
      Tune Your BrainUsing Music to Manage Your Mind, Body, and Mood]
      Elizabeth Miles 
    • Practice relaxation or meditation.  Go to your nurturing place and listen to guided relaxation tapes. Time spent in meditation or prayer allows your mind and body to slow down and let go of the stress.  Take a mental vacation in the midst of stress by relaxing your body, shutting your eyes and visualizing yourself in your favorite vacation spot or quiet haven.
    • Escape for a while through meditation, a book, a movie, or taking a short trip.

Created by Nancy Apperson, May 13, 2008

Footnote from Mona: 

  • Youtube is an excellent resource for guided meditations – search meditation or relaxation.
  • There are also FREE PHONE APPS such as Insight Timer which has selections of guided meditations and music and nature sounds.


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The anxiety of loss; the loss of anxiety, Part I


After experiencing a loss – the loss of a loved one or another major loss such as the loss of one’s health – anxiety is going to be a part of the experience. Loss raises questions that we aren’t comfortable with: How can I live without her? How can my life have meaning without him? How can I carry on knowing that I have a terminal illness? Who can I turn to for help? Will I be alone for the rest of my life? Who will care for me when I can’t care for myself?  These are profound questions and often have no immediate answers, making the anxiety even more intense.

How can we move to address these questions? How can we move through the anxiety towards an experience of acceptance and calm?


anxiety_cause_weight_loss-compressedThe first, and I think most crucial step, is compassion for oneself. “I have had, am having, a very difficult time. I need to find ways to nurture myself while I find my way through this.” I think too often we wait for things to calm down, sort themselves out. We wait until we have some kind of resolution, answer, or degree of healing before we give ourselves permission to just take time out and be with ourselves in gentle acceptance. We wait for someone else to step in and give us the answer, support, consolation we so desperately need. The trouble is we might never get it. So what we have to do is find ways, simple, immediate ways to console ourselves, to capture a few moments of peace, to find space to breathe. It won’t solve our problems or take away our grief and pain, but it will help us as we move slowly through the anxiety, stress, grief and loss.

Suggestions to follow in Part II of this post.

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A Blessing for Nurses

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When preparing for a Nurse’s Week Service I searched for an image I could use in a blessing. When I found out it would be outside, I thought of a tree:

Rooted and strong, upright but flexible, reaching out, but firmly grounded, providing support and shade, providing nourishment as it clears the air and replaces the oxygen – helping us breathe better.

So this was my blessing:

Creator God,

We come before you to ask for your blessing on our nurses:

May they find in you the root source of their strength and compassion

May they be grounded in your wisdom

May they be supported by all those nurses who have passed before them

May they be inspired to reach out and risk being vulnerable

May they be kind and gentle with themselves as they work to balance self-care with patient care

May they be healed of the sorrows and stress that often accompany their work

May they be ever nourished and renewed by the beauty of nature

…. May they be blessed


Chaplain Mona Villarrubia


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In Preparation for Ash Wednesday – a Reflection

monkimageAsh Wednesday is a day that unites all Christians. Even though it isn’t a Holy Day of Obligation for Catholics it has become a priority. Why is it so important to us? In New Orleans one could speculate that we are motivated by guilt following all those king cakes and carnival parades. But I think it is more than that. Is it fear of death and judgement?  Maybe it is. But I think what we are really searching for is hope. Hope that we can be forgiven, hope that death is not the end.

To quote Cardinal Pio Laghi, “Every year on Ash Wednesday, the Church begins a spiritual journey, a renewal of her existence and a rediscovery of her life with God.”  The spiritual journey Laghi  describes is rooted in the words Catholics will hear when ashes are placed on their forehead on Ash Wednesday: “Turn away from sin and believe in the Gospel.”  Like the Prodigal Son we should turn away from darkness, evil, and death and begin walking home towards light, goodness, and life. From this perspective the ashes become a sign of turning away from death. This is a distinct change from the older “dust to dust, ashes to ashes” approach that motivated good action based on fear of death and eternal punishment. Jesus did not base his good news on fear: Jesus preached the love, mercy, and forgiveness of God. Jesus gave people HOPE, and this is the message that the Christian faith presents to us on Ash Wednesday. It’s the Christian do-over. And, like the Prodigal Son, at some point we could all use a do-over.

But how do we go about making this change?

Growing up Catholic I learned a ritual performed before the reading of the Gospel. The words are based on the Jewish Shema prayer, the Greatest Commandment. May God be in my mind, in my words, and in my heart: In other words – in my thinking, in my speaking, and in my loving or doing. Jesus connected this Commandment written in Deuteronomy Chapter 6, to a verse from Leviticus chapter 19, “Love your neighbor as yourself.” These two commandments sum up all of God’s law: Love God in your thoughts words and actions, and love your neighbor as yourself.

So this is how we change; this is how we make Ash Wednesday really mean something; and this is how we go forward into Lent. By focusing on God’s love and rejecting negative and destructive thoughts about ourselves or others, by speaking words that are charitable and caring, by acting always for the good.

An easy message to understand; but one that takes a life of commitment and re-commitment: Turn away from death and towards life; reject fear and live in hope.


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Letting Go of the Illusion of Control

In the face of recent flooding in the South and natural disasters worldwide, I offer this excerpt from my book …


After Katrina I heard this comment from a Lakeview resident who had lost everything,

          It wasn’t personal. I just have to deal with it. 

What she was commenting on was the fact that God didn’t chose to hurt her by destroying her house. It just happened. For many of us that seems insufficient as an answer. Weren’t we always told that God was in charge? And isn’t what happened all part of God’s plan? Doesn’t that make it intensely personal? And surely if she had been faithful to God and obeyed the church rules, God would have answered her prayers and kept her and her house safe, right? Apparently not! God doesn’t look at prayer that way, it seems.

I am reminded of that joke about the man who wouldn’t leave his house during a flood because he believed God would save him. As the water rose in the street, a neighbor offered him a ride out in his truck.

           No. God is going to save me, Was his response.

As the water entered his house his cousin came by in a boat and was met with the same refusal. Finally, as the water lapped at his roof, a Red Cross helicopter flew overhead and offered to pull him to safety. Again he refused. And soon he drowned. When he arrived at the Pearly Gates he was really ticked off and demanded an audience with the Almighty.

           You promised to save me! He challenged.

God raised his hands in frustration and replied,

           But I sent you a truck, a boat, and a helicopter!

I have always sympathized with the man in this joke. He exhibits the kind of naïve faith in prayer that my mother raised me on. Pray for a miracle and God will send back the floods. But I have discovered that prayer doesn’t work like that. I have had to let go of my childish understanding of God and my unrealistic expectations for prayer. This too is a form of loss. I have come to accept that I cannot control what happens to me, however much I pray, I can only control how I react to what happens. I cannot control other people’s behavior, or protect my sons from heartache and disappointment. I cannot control the weather, I cannot control who gets sick and dies, and I cannot control God.

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