This week . . .

Working with hospice means that I spend my days surrounded by death and by life, often at the same time. This week I sat with a family as their mother was actively dying. I provided some education on the dying process and on pain management, I recited some prayers, but mostly I listened. The children held their mother's hand, stroked her forehead, and told stories. They laughed as they remembered family moments and as they spoke, the mother who had been lost to them by dementia over the past years became a vibrant presence in the room, even as her dying body struggled to take yet another breath.

This week I attended a wake. My Jewish sensibilities still make me uncomfortable with open caskets ("She looks so peaceful") no matter how often I've been exposed to them. And yet, going to the wake is a powerful moment of connection. It says to the family that we are haven't abandoned them. We're present for the dying, at the death or the pronouncement, and our care continues as we stay involved with the family for the year after their loved one dies. The wake also gives me the opportunity to view family dynamics and see what kind of support is present for the spouse, the child, the sibling. Knowing what kind of support is there helps us help the family.

This week I arrived at a nursing home just minutes after our patient died. The family was still present. I was able to offer our condolences, to remind them that our care and contact will continue for the next year, to give a needed hug, and to accompany them back to the bedside to offer final prayers. I hope my presence brought a measure of comfort. I know that the staff was grateful for my presence.

This week I wondered, as I often do, what rituals are there for the professional caregivers to help us when the deaths pile up around us. What does a funeral director or a chevra kadisha member do after they prepare a body for burial. How do they make a separation between their sacred work and their daily lives? I know of nurses whose custom when they get home is to strip off their work clothes, shower, wash their hair, and change into home clothes. Only then do they join their family, prepare dinner, read the mail. Others tell me they listen to specific music on their ride home to take them out of their professional caregiver role and back into their family role. I know of many personal rituals that we use to make a transition between what we do and who we are, but I wonder sometimes if we do enough to help us make the distinction.

This week I asked myself: How do I make sure that I am caring for myself and not being consumed by the care I give?

Clergy burnout

Yesterday's New York Times had an interesting article on clergy burnout. The article spoke of the rising rate of "obesity, hypertension and depression" in clergy. There are a lot of reasons - lifestyle changes, the speed of modern life, the need to be present to our congregants 24/7 - but the one reason the article focuses on the most is the need to take more time off.

It can be tough to take time off sometimes, even when you take time off. When I was a congregational rabbi, I had to leave contact information when I went away whether my absence was business (convention) or personal (vacation.) That was a long time ago. I was a solo rabbi of a small congregation. I don't know what things are like now in small congregational life, but I can remember the tremendous feeling of freedom the first time I took a vacation after leaving my pulpit. No one knew where I was going (except family) and no one knew how to reach me (except family.) It was the feeling of freedom that let me know that my previous vacations had not, fully, been vacations. This was before the internet, before cell phones, before BlackBerrys and instant messaging and email, before the expectation of immediate responses to questions or needs. The contact information was for deaths or major crises. Still, the expectation was that in an emergency I'd come back.

I've had other jobs in the Jewish community that also came with expectations of long hours, contact during vacations to deal with crises, and the need for immediate responses to unexpected events. I was definitely burnt out when my last job ended. One of the nice things about the brief unemployment after that job was the chance to relax, reflect, catch up, and go away without worrying what I'd find on my desk when I returned.

Something I really appreciated when interviewing for hospice jobs was the concern about self-care. Our work can be difficult and some days, overwhelming. We're with people at some of the worst times in their lives. We help them try to make sense of what's happening, find meaning in loss, and craft the story of the life that's ending and their new world on the other side of loss. Each hospice interview I've had included questions like: "What will you do to take time for yourself?" "How do you think you'll be able to leave this work behind?" "What do you do for fun?" "When do you relax?"

In my job, when I'm on - I'm on. But when I'm away or off for a day or not on-call over the weekend - I'm off. There's no expectation to check in, no need to leave contact information, no worries about what will be on my desk when I return. We cover for each other. We make sure the work is done. We understand the need to take vacation time; to get away, to recharge ourselves, to rejuvenate. We may not do it as well as we could - we still need help and support to eat healthy food, to exercise our bodies, to challenge our brains, and to look for the everyday miracles that fill our world, but I know that I am much healthier as a rabbi in this job than I have been in others.