Sermons from St. Paul’s Episcopal Church

The Fourth Sunday of Lent, Year B
Deacon Richard Buhrer

Melissa has told me that she and others in the parish would be interested in learning more about what I do with my time at the hospital. My work there is part of my ministry as a deacon as I understand it, so it’s fitting that you should know about it.

But nurses are often reticent about speaking about their work with people who are not nurses. Their responses are all too predictable. I remember one occasion when I was very new to nursing: I had been sent, with several of the nurses I worked with, to attend a conference in Las Vegas. At the end of the conference we were all going to the airport together to come home. At the time, in the Las Vegas airport they had shuttle buses running passengers between various terminals. We were all on the same shuttle bus and began to have a conversation about which moist body substance was hardest for each of us to deal with. As you can imagine, the responses were vivid, to say the least. We then remembered that there were civilians riding with us on the bus. You could recognize them by their pale green coloring. So we hastily changed the subject. So I will restrain myself in the pulpit today and do my best not to drive anyone from the room.

When nurses share about their work, they tend to understate the amount of science that they need to master to do their work. I remember I had to take chemistry before I could get into nursing school after I left the Jesuits. Remember the periodic table (that list of all the elements surround by little numbers representing their molecular weight and the number of electrons they contain). After all the years I had spent studying philosophy and theology, all the years of wrangling and controversy over dogma and belief, I found the periodic table a great comfort and I thought it was actually beautiful—here was something that was true and worked out and there was no room for argument about it.

Nursing (according to the American Nurses Association) is defined as the diagnosis and treatment of human responses to actual and potential health problems[1] Rehabilitation nursing (my specialty) is defined as the diagnosis and treatment of human responses to disability and chronic illness. So to practice nursing well, one needs to master a lot of science: pharmacology (we aren’t supposed to administer a medication whose effects and side effects we do not understand) as well as a certain fundamental understanding of medical science—to the point of knowing the standard treatments for the conditions of the patients we treat.

If a doctor’s order falls outside of the realm of the usual and standard, and if we are not sure that it is safe, nurses are obligated ( by the state nurse practice act) to refuse to carry them out. Mind you we learn to be discreet about how we bring a question up to physician. It usually best to start by playing dumb—beginning with a request to be educated about a particular condition—“What are the usual approaches to treating x.” Then if the physician mentions the treatment we are questioning, we can say “but I thought it was customary to do x?” And the physician can explain why his order diverges from the standard and the nurse can appear as though she wasn’t really questioning the physician’s judgment (even though she was). My experience is that younger physicians often resent this but more experienced physicians are both less prone to making errors and less annoyed by nurses working with them collaboratively.

After the two decades in which I have practiced nursing, there are memories that remain with me. So here are some stories from my career:

I work mostly with men who have spinal cord injury. When a person is newly quadriplegic, the thenar eminence, this little mountain of flesh in the palm of the hand at the base of the thumb wastes away and leaves the hand skeletal. Every time I see this happening to someone, I feel a deep sadness recognizing the permanence of his loss.

I have had to struggle over the years to retain my emotions. I have been tempted to blunt them under a steely façade and to not feel the impact of the horrors that I have to confront in the day-to-day of my work. One of my specialties is treating bedsores. Sometimes I have to allow myself to leave the room and pause at the door and take a deep breath and remember how horrible what I have just seen really is; then I have to hold myself together and go back in the room and do the things that must be done (to quote Garrison Keeler).

Another area of specialization of mine is the management of incontinence. When I mentioned in one of my Christmas sermons that the baby Jesus pee’ed and pooped, everyone laughed as I meant them too. I am a very bright man (most of you have noted that); I was a bright light in the community when I was a Jesuit, being groomed for a PhD in theology. But here I am using all this intelligence of mine to help people get over being constipated and to keep from wetting themselves in public. That sometimes strikes me as an amazing paradox, what God wants me to spend my life doing.

I remember a man with AIDS; his name was Peter. He had had a freak accident associated with a medical test to diagnosis Kaposi’s sarcoma in his lung and was paralyzed with only one arm that worked. He was in the intensive care unit for a long time and I got to know him and his parents very well. Although I often cared for him, one night another nurse was assigned to take care of him. During the night, my colleagues noticed on the heart monitor that his pulse kept increasing. Finally they asked me to go into his room to try and calm him down. I went in and sat down and held his hand and we talked (one gay man to another) about all of the things troubling him—his illness, his family, his lover who was also sick with AIDS, all of the friends he had lost. As we talked his pulse slowed and he calmed and finally went to sleep because he felt safe with me watching over him.

I have carried a regret for a long time about Peter: he did not like laying on his side and I did not demand that he turn enough, so he developed a bed sore on his lower back and unfortunately remained in the hospital for months before he died. I still feel sad that I allowed him to develop this complication under my care. Several months after he died, his parents came from the Midwest to visit the hospital and to thank others and me for our role in the last months of the life of their son. They and their bleak courage remain burned in my memory after almost twenty years.

Another patient, more recently, who is still living so confidentiality is an issue: He had a catastrophic abdominal wound that took months to heal. He had several trips to the operating room and only recently has he lost the last drain in his stomach. I called him, one day at his home in another state. He had to wheel to another place in his home in his wheelchair to get something we needed to discuss. I remember hearing him whistling a tune as he did this. I moved to hear this evidence that he had won through from great suffering to regain “normalcy” and joy in his life.

So why am I telling you all this? It’s most definitely not so you can come up to me afterward and tell me what a wonderful person I am. I would find that pretty embarrassing, frankly. I remember hearing Mother Teresa saying that she didn’t like being called a saint because that absolved the people using the term from imitating her.

My work is part of my overall effort to imitate the Lord Christ’s life in my own life. All of us are called to this. We are, in fact, the bronze serpent lifted up in the world to heal all those around us bitten by serpents. This is my little effort to live out what Paul mentioned in the epistle: “We are what he has made us, created in Christ Jesus for good works, which God prepared beforehand to be our way of life.”

I remember hearing John 3:16 in Sunday school when I was very young, less than six years old. I can still rattle it off from the King James Version: “For God so loved the world that he gave his only begotten Son, that whosoever believeth in him should not perish, but have everlasting life.”

We are called to be the love that God shows to the world in our time and all of us in whatever little sphere of the world we move in do, in fact, struggle to do this, no matter what our professions might be.

So today, let’s give thanks for the great vocation, God has given us, “the good works God prepared beforehand to be our way of life.” I have shared a bit of how I struggle (and it continues to be a struggle, an effort to aim for this high goal). But since this is something we all do, during this holy season of Lent, let us pray to become more like Christ, that through us his love may be poured out on all flesh.