Come in! Come in!

"If you are a dreamer, come in. If you are a dreamer, a wisher, a liar, a Hope-er, a Pray-er, a Magic Bean buyer; if you're a pretender, come sit by my fire. For we have some flax-golden tales to spin. Come in! Come in!" -- Shel Silverstein

Sunday, September 16, 2018

Bean Counter Culture

As I prepare to walk the Camino from San Sebastian to Santiago and then on to Finisterra, our group leader keeps reminding us that, at this point, the spiritual discipline is even more important than the physical preparation.

So, I'm being especially intentional about doing a "walking meditation" for today's walk. I'm not going to focus on distance or time or other metrics. In fact, I'm not using any metric at all.

I'm going to focus on what I hope will happen when I reach the "end of the earth" at the end of my pilgrimage.

And, that's the point: We are pilgrims. I am a pilgrim. Not a tourist.

My plane leaves for Madrid, Spain, on October 6th. I arrive October 7th in plenty of time to check into my hotel and catch Mass at the Cathedral around the corner from my hotel.

We start the pilgrimage at 8 AM on Monday, October 8th and end Saturday, October 20th. I'll attend Mass at the Cathedral Santiago on Sunday. I'll leave for Finisterra on Monday and then take the overnight train to Madrid that night.

My plane leaves for home the afternoon of Tuesday the 30th.

I will have walked approximately 167 km on the trail which promises breathtaking vistas of the coastline of Spain.

My friend, Linda MacMillan has written a brilliant blog today which has these lines:
That is not the end of the story, though. In fact, it’s only the beginning. . . .. It’s what happened in the meantime that’s significant.
That is such an important reminder, not only when we read scripture but when thinking about the significance of the holiness of our own personal narratives.

The beginning is important. The end is important. Of course.

It's what happens in the meantime that's significant.

I don't yet know what will happen "in the meantime" of this pilgrimage.

My prayer is that I will return from The Camino with a deeper appreciation for what happens - and has happened - in all of the "meantimes" of my life.

This has become even more important to me this past year. I work for a Hospice Agency that is one of the oldest in the country, which is to say that it was one of the first.

I am completely fascinated - when I'm not utterly annoyed - by the culture of this corporation. They are obsessed with numbers and counting. Seriously. Obsessed.

They count everything. Every. Single. Last. Damn. Thing. The number of patients who have experienced a fall this month. This quarter. This year. Compared to last month. Last quarter. Last year.

The number of patients who have had an infection - and where it is and how it was treated.

The number of patients who had a visit from the Social Worker or Chaplain in the last 5 days of life.

Some of this is required by Medicare, but managers and administration don't seem to mind. Indeed, there is a certain enthusiasm for the task which is completely lost on me.

There is a numbered code for the great variety of tasks one performs in the course of the day, some classified as "productive" (direct patient contact) and others "non-productive" (administrative work). The number of "productive" vs. "non-productive" hours one works in a pay period are counted.

Seriously, what professional person even THINKS this way? Well, I think I have an answer.

But, wait! There's more!

Mileage, of course, is calculated but only from the office to the patient's home and from one patient's home to the next. Exceptional mileage - say, going from a patient's home to a case conference at an Extended Care Facility or Hospital, must be calculated separately and entered in with a special code.

Every patient has an MR# - a Medical Record Number - which, because the computer platform for patient documentation is being revised and revamped, this necessitates printing the patient name and patient MR# on every. single. last page of every. single. last paper of every. single. last page of the volumes of paper one has to complete per patient.

Because of the sheer volume of paperwork required, this means that the chances of making an error - which can be as simple as writing a "5" in such a way that it looks like an "8" or just copying the MR# or spelling the patient's name incorrectly - is great.

Believe it or not, there are people employed for the tedious task of checking for errors (sort of like the task of separating fly shit from pepper) and there is a company policy for correcting that error - and a protocol for how that error is corrected. If the correction is not made ... well, correctly... there is a whole process for dealing with that.

Again, because of the sheer volume of paper that crosses one's desk every day, the chances of papers getting lost or misplace is also great. So, one must paper clip (NOT staple, for goodness sake whatever were you thinking) all of the patient's papers together and, on Monday, Tuesday, Thursday and Friday, place the documentation in a file folder with your name on it.

On Wednesday, however, one must hand all of one's paperwork into the actual hand of the person in charge of the paperwork.

But, because the papers could get lost or misplaced, one must zerox a copy of the charts for one's files. Which means unclipping, zeroxing, then re-clipping all of the charts.

I am not making up any of this.

It's often maddening and deeply annoying but I've come to understand that this "Culture of Corporate Bean Counting" is simply and sadly this: It is a defense against facing the truth about death.

It is a way of managing the anxiety between the expectation of death and reality of life.

The hint came when so many professionals - nurses and doctors - refer to a patient's death as anything but a death.

It is said that the patient "passed" or "passed on". Or, when they want to sound clinical, they say, "expired" - like a carton of milk or a bottle of medicine.

I think we hit a new low on Friday when the weekend on-call nurse (yes, an RN) put out a call for extra help this weekend by writing this:
"It is going to be a busy and challenging weekend but our customers need us and we are up to the task."

Some of us have been texting each other all weekend about this. Eyes are rolling so hard, you can hear it all over Sussex County.

I've been explaining it as a defense mechanism against anxiety about death. And, I think that's right.

It's easier, I suppose, for some people to deal with "the expiration of a customer" than the "death of a Hospice patient".

I rush to add that his particular language is not limited to this particular Hospice agency. I hear it from other Hospice professionals around the country. I've just never heard a Hospice nurse use it before. Then again, this particular nurse doesn't care directly for patients. She just triages and assigns those who do.

I have come to understand that this is what can happen when one does not believe, as we say in the Eucharistic prayer during a funeral, that "life is changed, not ended."

It's what happens when your theology of life does not include belief in life eternal. Or, perhaps it does but deep down somewhere inside, in the middle of the middle of what makes you who you are, you really wish you would but you really don't believe it.

It's easier to manage your anxiety when you are counting things and repeating tasks.

I mean, after all, isn't this really what prayer beads are all about? Repeating and counting, counting and repeating?

Doesn't chanting a mantra repeatedly help to reduce stress caused by anxiety?

Isn't repeating "the comfortable words" week after week designed to do the same?

The secular, corporate world manages anxiety by creating a "Bean Counter Culture". Well, at least, this one does.

I've come to manage my own frustration and anxiety about this by changing my perspective. I now see all of these annoying policies and protocols as a form of "Secular, Corporate Prayer".

Except the goal of this particular secular exercise is to have "positive outcomes" which are designed to result in "job satisfaction".

Which makes me laugh right out loud because I recognize the religious parallel.

I mean, let's be honest. At some point in our spiritual lives, didn't at least some of us believe that if we said the rosary enough times on our knees, or lit enough candles, or faithfully did the Stations of the Cross every Wednesday and Friday in Lent, or lit enough Votive Candles and said enough Novenas in front of them, that we'd get what we wanted or needed?

I know I did. So, I really have no room to criticize this form of "Secular, Corporate Prayer".

I do have the responsibility, however, to tend to my own soul.

Which is why I pray for the spiritual strength and maturity to learn to live not so much about the beginnings and endings but the "meantimes" of my life. To drop more of my expectations and live more fully and deeply into my reality. And, in doing so, to derive more "satisfaction" with my life.

I don't know if it can be done, but this is the spiritual energy which is animating my pilgrimage.

I hope to let go of how many steps I've taken or how many kilometers I've walked or how many miles that translates into and just "walk the walk."

I hope not to count the minutes or hours or days of walking and just walk for the sake of walking, to feel the earth under my feet, feel the ocean breeze on my face and take it into my lungs while I open the eyes of my soul to the beauty that surrounds me at every turn.

I hope to take courage from standing in the town of "Finisterra," what the Spaniards considered "The End of the Earth" and knowing that it is just the beginning.

The beginning is important. So is the ending. Of course. But it is the meantime that is signficant.

It is said that a pilgrim is never ready for The Camino but The Camino stands ready for every pilgrim.

May it be so.


Jerry said...

Language ... As I often think, we behave as though the Creed said "was crucified, passed on, and was interred."

Elizabeth Kaeton said...

That's very funny. Thanks for the giggle.

I sorta like ".. was nailed to a tree, expired and his ashes were scattered outside a manger in Bethlehem."

Lindy said...

Oh, you are going to have such a time! I just know it. I can almost feel the sea breezes myself. So much love goes with you. Jai-yo, as the Chinese say.

Elizabeth Kaeton said...

Thanks, Lindy. At this point, I'm six days from take-off. I'm so excited-anxious-thrilled that I have to work hard to stay focused on the tasks before me. LOL. I carry you in my heart.