Opinion
A PIECE OF MY MIND Chris Adrian, MD, MDiv Columbia University College of Physicians and Surgeons, New York, New York.
Corresponding Author: Chris Adrian, MD, MDiv (ca2597 @cumc.columbia.edu). Section Editor: Roxanne K. Young, Associate Senior Editor.
Ash Wednesday This past April, I was asked by my hospital’s Pastoral Care Department to help out with their Ash Wednesday services. Ash Wednesday is the busiest day of the year for pastoral care, a sort of spiritual Black Friday, and the office phone started ringing at 6 AM, nurses and supervisors calling in states of high anxiety to make sure that the ashes were coming for the patients or employees under their care. That’s when it’s all hands on deck, getting feet and thumbs attached to those little pots of palm ashes and sending them out into the wards and waiting rooms and cafeterias. As one of the six chaplain-interns that year, I was one of about two dozen people in the department who might have distributed the ashes—it’s not actually required that one be ordained to do this. But I’m an atheist, and an ex-Catholic, so the idea of drawing an ash cross on people’s foreheads, reminding them of their mortality, and urging them to repent of their sins, gave me a terrible combination case of the hypocriticals and the creeps. So I announced that, aside from actually imposing the ashes on somebody, I’d be happy to help, which is a little like saying, As long as I don’t have to lift or carry anything, I’d be happy to help you move into your new fourth-floor walk-up I happened to be the chaplain on call that Shrove Tuesday night and got an unusual request very early Wednesday morning from one of the adult intensive care units. I had already been back and forth between home and the hospital once that night, so I was cranky and fussy when the pager went off. And as I called back I silently asked (of no one, since I don’t believe in God), Please, please let this one be for the priest! “This is going to sound a little strange,” the nurse told me. “But do you have such a thing as … you know … a secular chaplain?” “Maybe,” I said slowly. The thought of returning to the hospital again made me want to bang my head on the table, but this was the call I had been waiting for since I had started working as a chaplain-intern in October. “Do you mean … like … an atheist chaplain?” I asked, as if that were actually a thing. “Sure,” she said. “I have a patient who just died, and his wife has asked for someone secular but spiritual to come and sit with her.” “I’ll be right there!” I said, and I was practically bouncing in my seat in the car on the way, imagining that somebody had finally shined the chaplain bat-signal in the sky for me. But when I got to the ICU and met the new widow, I discovered that there had been a misunderstanding. Though the nurse had said secular, the widow had actually meant Buddhist and had in mind when she asked for a chaplain a particular someone, an amiable monk whom she had met the week before. She said that he had brought her a few moments of peace in the
middle of the worst time of her life, and she hoped he could do it again now. Later that morning, a little deranged with sleeplessness, and anxious and sullen over a notion that I would never actually get to do something as a chaplain in the way my nonatheist peers did, I started to experience rather complicated feelings, as the ash crosses started blooming on foreheads all over the hospital. Then I wished I had said yes to helping out. In the interest of being a team player and of getting to do something, I might have just held the breath of my perceived integrity (over and over and over) for the few seconds it took to draw the cross and say that distinctly Christian motto. For that matter, might I not have spread atheist ashes throughout those same wards and waiting rooms and cafeterias? What could be more delightful or affirming, after all, to someone who denies the existence of an immortal soul, but a physical reminder of one’s mortality? I might even change up the ceremony a little: From dust thou were made, to dust thou shalt return, I could mutter, and then draw, not a cross, but a smiley face on someone’s forehead, and then we could trade European-style air kisses, and shrug. I came to recognize, every time I saw another one of those marked faces (and how they proliferated, throughout the late morning and the afternoon) that I was being pouty and jealous over the ashes exactly because my experience of atheism is religious, and because I felt excluded from what seemed to me like a hospital-wide religious practice. I spent the day feeling alternately like a sad little Muggle, envious of the magical affinities of others, and a refugee extra from Invasion of the Body Snatchers, shocked and dismayed by the hard truth of just how many people are actually pod-people. I was jealous and disdainful first of my Pastoral Care peers who were imposing the ashes, and then I was jealous and disdainful of my hospital peers who received them. Atheism organizes my life, drives its flourishing, and retards its stagnation. I believe in the absence of God, which is something different from merely not believing in God. This I believe puts mandates on my behavior in the world, and puts me in community with others in a way that transcends time (if not mortality), and I am sometimes sustained by the human effort to discern and make meaning out of life in the absence of any God in a way that feels, like grace, entirely independent of my own striving. Of course, the I believe actually makes me a pod-person too. And I suppose it ought to get me into Religiosity Hogwarts, since it allows me to do the existential magic of responding not solely with despair to life in the world. I think what bothered me most usefully about Ash Wednesday in the hospital this year
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JAMA October 15, 2014 Volume 312, Number 15
Copyright 2014 American Medical Association. All rights reserved.
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Opinion A Piece of My Mind
wasn’t feeling excluded from the great repentant fun of the Ashapalooza, but how much (and yet how imperfectly) the ceremony looked like something I want desperately for my hospital and for all hospitals, namely, a way to mark us to ourselves and to others as a community that knows (and lives professionally in) not just the daily mechanics but the daily metaphysics of illness and death. Because you have to believe in something, don’t you, in order to stand it in here? Whether you’re a patient or an employee, anybody whose name tag or wristband marks him or her as somebody not merely visiting, don’t you ultimately have to try to stand it somehow? When I got past my jealousy, discomfort, and disdain, when those crossed-up faces started to seem lovely to me, the ash began to mark just that kind of effort. Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for the Disclosure of Potential Conflicts of Interest and none were reported.
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So I wouldn’t ever want the crosses erased from all those foreheads, but I wish there were other symbols that we could wear, some way to mark, every single day, our individual and collective commitments to standing it, and to express a solidarity with our patients as they try to stand it, a way to mark our wonderful commitments to the uncanny and the spiritual, to the religious and the marginally real, as nonchalantly and as ostentatiously as all those Wednesday Christians. A smiley face? Sure, but who knows what else? We might find marks as distinctive as each mortal soul. There are, after all, whole extensive geometries available to us to represent ourselves to ourselves. So that we and our patients, and everyone else in this awesome and awful world, might remind ourselves, at least one day out of every year, that there’s more to our lives than just the ordinary experience of suffering.
Correction This article was corrected on October 14, 2014, for a typographical error in the second paragraph.
JAMA October 15, 2014 Volume 312, Number 15
Copyright 2014 American Medical Association. All rights reserved.
Downloaded From: http://jama.jamanetwork.com/ by a University of Wisconsin Oshkosh User on 06/06/2015
jama.com
A PIECE OF MY MIND Chris Adrian, MD, MDiv Columbia University College of Physicians and Surgeons, New York, New York.
Corresponding Author: Chris Adrian, MD, MDiv (ca2597 @cumc.columbia.edu). Section Editor: Roxanne K. Young, Associate Senior Editor.
Ash Wednesday This past April, I was asked by my hospital’s Pastoral Care Department to help out with their Ash Wednesday services. Ash Wednesday is the busiest day of the year for pastoral care, a sort of spiritual Black Friday, and the office phone started ringing at 6 AM, nurses and supervisors calling in states of high anxiety to make sure that the ashes were coming for the patients or employees under their care. That’s when it’s all hands on deck, getting feet and thumbs attached to those little pots of palm ashes and sending them out into the wards and waiting rooms and cafeterias. As one of the six chaplain-interns that year, I was one of about two dozen people in the department who might have distributed the ashes—it’s not actually required that one be ordained to do this. But I’m an atheist, and an ex-Catholic, so the idea of drawing an ash cross on people’s foreheads, reminding them of their mortality, and urging them to repent of their sins, gave me a terrible combination case of the hypocriticals and the creeps. So I announced that, aside from actually imposing the ashes on somebody, I’d be happy to help, which is a little like saying, As long as I don’t have to lift or carry anything, I’d be happy to help you move into your new fourth-floor walk-up I happened to be the chaplain on call that Shrove Tuesday night and got an unusual request very early Wednesday morning from one of the adult intensive care units. I had already been back and forth between home and the hospital once that night, so I was cranky and fussy when the pager went off. And as I called back I silently asked (of no one, since I don’t believe in God), Please, please let this one be for the priest! “This is going to sound a little strange,” the nurse told me. “But do you have such a thing as … you know … a secular chaplain?” “Maybe,” I said slowly. The thought of returning to the hospital again made me want to bang my head on the table, but this was the call I had been waiting for since I had started working as a chaplain-intern in October. “Do you mean … like … an atheist chaplain?” I asked, as if that were actually a thing. “Sure,” she said. “I have a patient who just died, and his wife has asked for someone secular but spiritual to come and sit with her.” “I’ll be right there!” I said, and I was practically bouncing in my seat in the car on the way, imagining that somebody had finally shined the chaplain bat-signal in the sky for me. But when I got to the ICU and met the new widow, I discovered that there had been a misunderstanding. Though the nurse had said secular, the widow had actually meant Buddhist and had in mind when she asked for a chaplain a particular someone, an amiable monk whom she had met the week before. She said that he had brought her a few moments of peace in the
middle of the worst time of her life, and she hoped he could do it again now. Later that morning, a little deranged with sleeplessness, and anxious and sullen over a notion that I would never actually get to do something as a chaplain in the way my nonatheist peers did, I started to experience rather complicated feelings, as the ash crosses started blooming on foreheads all over the hospital. Then I wished I had said yes to helping out. In the interest of being a team player and of getting to do something, I might have just held the breath of my perceived integrity (over and over and over) for the few seconds it took to draw the cross and say that distinctly Christian motto. For that matter, might I not have spread atheist ashes throughout those same wards and waiting rooms and cafeterias? What could be more delightful or affirming, after all, to someone who denies the existence of an immortal soul, but a physical reminder of one’s mortality? I might even change up the ceremony a little: From dust thou were made, to dust thou shalt return, I could mutter, and then draw, not a cross, but a smiley face on someone’s forehead, and then we could trade European-style air kisses, and shrug. I came to recognize, every time I saw another one of those marked faces (and how they proliferated, throughout the late morning and the afternoon) that I was being pouty and jealous over the ashes exactly because my experience of atheism is religious, and because I felt excluded from what seemed to me like a hospital-wide religious practice. I spent the day feeling alternately like a sad little Muggle, envious of the magical affinities of others, and a refugee extra from Invasion of the Body Snatchers, shocked and dismayed by the hard truth of just how many people are actually pod-people. I was jealous and disdainful first of my Pastoral Care peers who were imposing the ashes, and then I was jealous and disdainful of my hospital peers who received them. Atheism organizes my life, drives its flourishing, and retards its stagnation. I believe in the absence of God, which is something different from merely not believing in God. This I believe puts mandates on my behavior in the world, and puts me in community with others in a way that transcends time (if not mortality), and I am sometimes sustained by the human effort to discern and make meaning out of life in the absence of any God in a way that feels, like grace, entirely independent of my own striving. Of course, the I believe actually makes me a pod-person too. And I suppose it ought to get me into Religiosity Hogwarts, since it allows me to do the existential magic of responding not solely with despair to life in the world. I think what bothered me most usefully about Ash Wednesday in the hospital this year
jama.com
JAMA October 15, 2014 Volume 312, Number 15
Copyright 2014 American Medical Association. All rights reserved.
Downloaded From: http://jama.jamanetwork.com/ by a University of Wisconsin Oshkosh User on 06/06/2015
1515
Opinion A Piece of My Mind
wasn’t feeling excluded from the great repentant fun of the Ashapalooza, but how much (and yet how imperfectly) the ceremony looked like something I want desperately for my hospital and for all hospitals, namely, a way to mark us to ourselves and to others as a community that knows (and lives professionally in) not just the daily mechanics but the daily metaphysics of illness and death. Because you have to believe in something, don’t you, in order to stand it in here? Whether you’re a patient or an employee, anybody whose name tag or wristband marks him or her as somebody not merely visiting, don’t you ultimately have to try to stand it somehow? When I got past my jealousy, discomfort, and disdain, when those crossed-up faces started to seem lovely to me, the ash began to mark just that kind of effort. Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for the Disclosure of Potential Conflicts of Interest and none were reported.
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So I wouldn’t ever want the crosses erased from all those foreheads, but I wish there were other symbols that we could wear, some way to mark, every single day, our individual and collective commitments to standing it, and to express a solidarity with our patients as they try to stand it, a way to mark our wonderful commitments to the uncanny and the spiritual, to the religious and the marginally real, as nonchalantly and as ostentatiously as all those Wednesday Christians. A smiley face? Sure, but who knows what else? We might find marks as distinctive as each mortal soul. There are, after all, whole extensive geometries available to us to represent ourselves to ourselves. So that we and our patients, and everyone else in this awesome and awful world, might remind ourselves, at least one day out of every year, that there’s more to our lives than just the ordinary experience of suffering.
Correction This article was corrected on October 14, 2014, for a typographical error in the second paragraph.
JAMA October 15, 2014 Volume 312, Number 15
Copyright 2014 American Medical Association. All rights reserved.
Downloaded From: http://jama.jamanetwork.com/ by a University of Wisconsin Oshkosh User on 06/06/2015
jama.com
