Gratitude

Sunday morning is a time for thanksgiving. OK I know that feeling gratitude every moment of every day is ideal; but Sunday morning quiet invites it and worship gives voice to it.

This morning I am incredibly thankful for this past week. The focus was on UP banquet program preparation – I tried to do other work this week but with having a role in the program, all I could think about were my lines, and whether the 2 kids I was to be up on stage with would come through with memorizing theirs. First there was John – a 13 year old gentle soul who would speak of fishing, of his father in jail and of what was “caught” on the last fishing trip of the season (I am going to save that catch for another post). I could tell John would do well enough…if he would just focus long enough to stay in the room for the entire practice!

Then there was Richie. An adorable girl who whispered her age to me (12), she was a bundle of energy who spoke her lines at the speed of light, was forever disappearing backstage, and promptly froze, refusing to speak, when she was on stage Wednesday night for the dress rehearsal. She had 7 paragraphs to recite about her story of being a dental assistant for our celebrity Manhattan dentist who works on our kids for free. It was an awesome story, but only if she could slow down – and actually deliver it. And it remained touch and go right up to curtain time… our back up plan was to have just John and I speak, which would mean I would have to remember which of my 12 paragraphs I would need to combine.

So the theater filled, and Bruce Main invited the audience to show their enthusiasm for the upcoming performance…650 people can make a lot of noise! Our first performers delivered well, the 4 poets before our piece were incredibly moving..and we were on. Standing in light so bright you couldn’t see anything. We each delivered our first lines, the audience expressed delight, I saw the kids’ faces light up and I knew we were golden. It was a perfect moment. When I think of how lost I felt at last year’s banquet, wondering what I was getting into, wondering if I would be mentioned this year…well, it is humbling to see how far this has already come.

Here are my lines – I am sharing them because Jake, the program director, captured my story from an interview with me in a way that no one else has. Also because I can’t get them out of my head!

For 20 years I saw patients as a primary care nurse practitioner, first at a practice in Camden, and then in Cherry Hill. For 5 years I taught at my alma mater, the University of Pennsylvania School of Nursing. And I loved my work. I never imagined I would land someplace like UrbanPromise. But now being here, I can’t imagine having not.

I am also a member of First Presbyterian Church, Haddonfield, where Bruce Main comes to speak every now and again. And on those Sundays once or twice a year, I might have donated to the special offering. But other than that UrbanPromise was not on my radar. That all changed the spring of 2010, when our daughter Aubrey was earning her Girl Scout Gold Award and her project led us to UrbanPromise. We got to know some of the kids and staff, and I was impressed with the campus and the things going on there. In conversation I asked about health care, and I found out they had a school nurse who visited once a week. Well I figured there had to be needs that weren’t getting met. I mean, they worked in a city stricken with poverty and violence; how could there not be health needs? On the way home I said to my daughter, “Wouldn’t it be cool to work at UrbanPromise?” And the thought never left.

A vision statement, a few lunch dates, many meetings and MANY prayers later and it began to happen. And so with the full support and partnership of my congregation in Haddonfield and of our pastor, Bill Getman, we launched the UrbanPromise Wellness Center in September of 2012. (hear the applause? I do)

The initial concept was to add a health care lens to everything that UP was already doing. So Jodina and I go out for coffee, and I launch into talking about the effects of stress on the body – you know, hormones, visceral fat, that sort of thing – but what she is hearing is a little different. She is hearing the talk of trauma, even more than I thought I was saying. And so quickly the focus began to change. The wellness center would be about reducing the impact of toxic stress on the UrbanPromise community.

What was needed was a paradigm shift. To have a staff that was trauma informed. So that when a child isn’t learning or is acting out, instead of thinking, “What’s wrong with you?!” You pause and ask, “What happened to you?” The reason why trauma has such a profound effect on kids is that they don’t yet have context. Adults can put their pain and the bad things that happen to them into the larger context of their life and experiences. Kids don’t yet have that ability – they just know that something horrible is happening. And hearing kids – not fixing them, just hearing them – helps them to gain context. It helps them to let go of the guilt and the sense that they in some way caused it. Hearing stories validates experience. (This is where John spoke of his father).

As I look back on my time as a nurse practitioner working with the general population, one of the biggest insights I’ve gained is that I had so many patients with so many issues – like obesity, smoking and alcoholism – and I didn’t ask the childhood trauma questions because I didn’t know about them. The research is so profound – I can’t believe it wasn’t a part of my training. I feel like I have discovered what was likely at the root of so many of my patients’ issues. And it’s amazing – it can be healing just to hear what happens to the body during times of trauma. When a child or an adult hears that – well, it can be therapeutic to know that they aren’t losing their mind. That stress and trauma have real and significant effects on the physical body.

The work moving forward to to help kids realize that they can make different choices from the ones the adults in their lives have made – and to promote resilience. Yes the first question is “What happened to you” but then quickly we need to ask, “And what got you through it?” or “Who was there to help you?” Focusing on resilience helps kids reframe their experiences. Then we look to give them the tools and experiences they need to manage their traumas moving forward.

Another significant component of what we are trying to do is to prevent compassion fatigue on our staff who are working the front line. The trauma kids experience has been likened to a leaking nuclear power plant – all who work with wounded kids are affected. It’s called vicarious trauma. Now don’t get me wrong – the work folks do around here is incredibly rewarding – it’s just that the emotional labor takes more energy than we realize (THANK YOU CREDO!). So it’s about kids and staff – the entire organization – giving everyone permission to name it, teaching self care, and offering resources.

An organization I work with outside of UrbanPromise talks about how everyone should have a BHAG – a Big, Hairy, Audacious Goal. And it should have several things to qualify it as such: it should be something you can’t do on your own; it might seem impossible and yet still you feel driven; and it takes time. For me, this wellness center is my BHAG. And it has come a long way: 17 raised garden beds in the shape of a labyrinth, both functional and sacred space. Educational pieces like resilience training, self exploration courses and mindfulness. Physicals, urgent care and volunteer counseling; Yoga, acupressure and massage. A full time nurse practitioner on staff. Yes we’ve come a long way but we still have much to do. For many among us, healing is their audacious goal. It’s going to take time; it might, at present, seem impossible; and it’s not something they are going to do on their own. Fortunately, they won’t have to.

AMEN!

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