Stepping Inside (The Circle)

This weekend, I had the good fortune of working alongside a most compassionate nurse in the ICU where I work as an American Sign Language Medical Interpreter. I’ve written about the stability and presence of this remarkable nurse in a previous blog article. When I entered ICU, we greeted each other and touched base. He looked fresh and alert, his shift having just started. 

As we turned towards the patient, my knowledge added to the mix. I had known the patient for over 30 years and knew preferences and idiosyncrasies such as: the dominant signing arm upon bending to communicate, will occlude IV fluids, memory loss impacts tolerance for uncomfortable tubes, opening the window a crack to let in “cool, refreshing Lake Tahoe air,” is a personal prescription for healing, etc. Walking into the patient’s room was like taking on my “second skin.” I voiced the distress clearly etched on the patient’s features and signs as the care team listened attentively, asked questions and administered life stabilizing care. Respiratory came in and hooked up a suction wand. She asked, “I don’t know if this is appropriate, but with patient’s cognition, the wand will be forgotten. Do you mind reminding and encouraging?” I took a moment to check in with myself—how fully do I make contact with my patient’s experience? There was no resistance to this added role outside my professional parameters, no conflict, so I answered, “Yes. I sure can.” 

Foundation One of the Eight Foundations of Caregiving by Jonathan Prescott is described as, The Balance Between Self and Other. Do we consciously touch into the experience of those receiving our care or do we remain on the outside of their experiences? Exactly when is the point of contact? Every moment of care is a decision point. If we jump in with both feet, we leave behind our resources and our wisdom. To say it as directly as possible—we abandon ourselves in the care equation. However, if we consciously make a decision to touch in, allow the experience of the other person to penetrate our understanding, then we, who have a stable mind and compassionate heart, can be a wise and skillful foundation.

Just as importantly, there are times when rooting ourselves in our own resources is beneficial. Take for instance a painful procedure done only with local anesthesia, which happened this weekend in the ICU. If I touch my patient’s experience too viscerally, jumping two feet in, I will not be an effective interpreter passed out on the floor! It’s a constant dance, an interplay of myself and others. We are one and…we are also two. 

Caregiving Contemplation: This week as you meet people experiencing suffering, can you become aware of the point of contact? When and what is being asked of you? It may not be as direct as the question asked of me, it may be in a vacant expression, a movement, or your own fatigue sapping your strength. As you meet people experiencing happiness, can you be aware of  the point of contact? What draws you in? Every moment is an opportunity to decide, to connect with the joy and pain in ourselves and in our care circles. What is the balance as we ride the scale of wise compassionate care, self and other?