This verbatim conversation is adapted and shared with the permission of the student who wrote it.

All
identifying information of the patient has been modified for purposes of confidentiality

Verbatim Report #2
HSL/HRC

Chaplain Intern:
CPE Supervisor: Mary Martha Thiel
Verbatim #: 2
Verbatim # on this person: 1
Date of visit: 27 Jun 2012
Visit # with this person: 3
Time and length of visit: 15:30 | 40 minutes
Date of writing verbatim: 27/28 Jun 2012

What I want to learn from writing up this conversation: I have been

finding it very difficult to get into spiritual conversation with men. No
matter how many lines I put out there, it seems that I just can’t bridge
the gap. Having said that, I also know that there is something
comforting about the companionship for the men, and perhaps it’s
just me needing to learn how to be that non-anxious presence and
accepting whatever each man has to give.

The Person

Person’s initials of pseudonym: Max

Institution and unit: NBOC Long-Term Care
Date of admission: 07 Dec 2009
Age: 95
Gender:
Race/Ethnicity: Caucasian
Family status: Widower
Number of children: Two daughters, one son
Religious affiliation/practice growing up: Jewish
Religious affiliation/practice now: Jewish
Home location (local or transplanted): Raised family in Dorchester
and Hull; moved to NBOC from Orchard Cove
Admitting diagnosis: Anemia, depression, HTN (hypertension)
Additional factual information: Born and raised in Roxbury, one of
nine children. Graduated from high school and studied
engineering at the Wentworth Institute. Owned and operated an
industrial pipe supply company which his father founded and is
now being managed by his son and grandson.
His wife developed dementia, received private care at home,
and died in October 2009. He suffered from a lot of depression
then, and I see from his EMR that he’s still on antidepressants.
Meanwhile, he had fractured his hip in June 2009, had it surgically
repaired, and was receiving therapy at Orchard Cove SNF when his

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 wife died. He has 10 great-grandsons! No girls.
He seems to preside over household meals at NBOC. He has
regular visits from family; I noticed visitors twice in the past week.
Summary of any previous visits with this person: My visits before
had been somewhat social – getting to know him. The second
time I sat with him at dinner. He was talkative, but not a very
articulate person. Dinner behavior with staff was gruff, as he only
likes the simplest of foods and didn’t know what he was eating. A
thoughtful, loving family man, but very little social polish.
Occasion of this visit (routine, follow-up, referral, etc.): Follow-up

The Visit

Plan for this visit: To see if I could find a way into a more spiritual
conversation.
Observations: Max was sitting in his wheelchair at a random spot in
the hallway. I’d seen him about 15 minutes earlier in the same
spot, but asleep. I pulled up a chair to sit and chat. Max is
permanently bent over somewhat, so even sitting, it’s hard to
make eye contact with him and his voice is soft and raspy. He’s ill-
groomed.
The text of the visit:
C01: Hi, Max. How’re you doing today?
M01: Fine. How’s about you?
C02: Great, thank God…. (A lot of back and forth social
conversation ensues about family members and about the
business, which is a large family business dealing with
industrial pipe; there are some half a dozen branches around
New England. The business was started by Max’s father.)
C03: So, did you start the business or did your dad?
M03: My dad used to work for my uncle (names him) who was in
the scrap metal business, and then one day he realized that
they were selling all these old pipes for scrap, when they were
perfectly good steel or copper so he started refurbishing
them and selling them on his own. People really worked hard
in those days; my dad could never work for anyone else. First
he tried the ice and coal business, but that didn’t work out for
him. The best thing was to work for yourself and take care of
your family.
C04: I loved that generation of Jewish guys. They were so
inventive, and there was nothing “beneath” them, as long as
they could feed and clothe their families.
M04: Yep. And now I’ve got kids and grandkids and in-laws, all
kinds of people working in the business. Yep. It’s all about
family (gets quiet and a little wistful for a few seconds.)

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M05: My dad was orthodox. They kept kosher and he wasn’t
allowed to do anything on Shabbes. Sent us to Hebrew
School.
C06: Yeah. You went to Hebrew School.
M06: You bet! Twice a week after school and then on Saturday
morning. We all did that.
M07: I wasn’t very religious though. My kids all went to schul and
were Bar Mitzvahed and all that. My wife was really in charge
of all that. You know I just wrote a big check to a religious
school that’s going to be named for her. It’s important that
those schools can keep going. Yeah, I once was at this schul
and, you know, the roof was leaking, and I said, “What’s with
the roof?” And they said they couldn’t afford to replace it. So
I told them to get a new roof and to send me the bill.
M08: Yeah. My wife and daughter would go shopping together
every Saturday. They were a real team those two. They’d
come back with so many packages (chuckles), and then she’d
ask if I wanted to see the things and I said that I’d wait to see
it until it was on her. That it’d look much more beautiful that
way. I just asked her to give me the slips, and then I’d pay
them, whatever she spent.
C08: Smart man.
M09: Yeah. I was blessed that money was never a problem. I
always seemed to have a lot of luck in business and, you
know, with my investments.
M10: She was the most beautiful girl I ever saw in my life. We never
went to bed angry. If we’d had a fight about something, I’d
always be happy to apologize. You never want to go to be
angry. I’d get into bed every night, kiss her good night, and
we’d fall asleep holding hands.
C10: You must have nothing but good memories about her if you
never went to bed angry.
M11: Absolutely. I never slept on bad feelings. She was the most
beautiful girl I ever saw, and she was the best mother. Sort of
the center of our family. She loved to wear white all the time.
She just looked so beautiful.
C11: She must have looked like an angel dressed that way. (He’s
quiet.)
M12: Yeah. (Says the company’s name and slogan, a regular
interjection throughout all the conversations we’ve had.)
Now we’ve got branches all over the northeast. Every kid
who joins the company wants to run their own branch, so we
keep opening new branches. (Chuckles.) And you know, they
all really do a good job too!

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C12: (This is a long visit, and I really need to stay very focused
because of the lowness of his voice. It’s also physically
straining because I have to stay bent over as his head is
always pointed down. I’m getting a little loopy and know I
need to wrap up.) So, Max, I’ve got to go do some
paperwork now. You know what that’s like!
M13: Yeah. There’s always paperwork, whatever your job is.
C14: So, I’m going to scoot out now. Thanks for your time.
M14: It’s always a pleasure talking to you.
C15: See you soon.
M15: Any time!
Analysis of the Visit

Dynamics of the visit: Max has a very narrow range of affect, and is,
therefore, difficult to read. Also, he speaks with his head down,
which only adds to the difficulty. He smiled three or four times during
the visit and definitely kept up his end of the conversation, though,
when he didn’t know what to say he seemed to go back to repeating
the name of his company and its slogan.

Theological Issues:
The person: It’s hard to read this. I know Judaism is important to
him, but I don’t have a sense of how important. It’s been a not
insignificant part of his whole life and the naming of the Hebrew
School for his wife – and I think for him as well, though he didn’t
say that – has deep importance. I tried to get in through the
discussion of his wife dressed in white looking like an angel, but no
response. Probably too raw.
I, the Chaplain: I feel like I’ve been unsuccessful in bringing
theology per se to our visits, though clearly presence is important
to him.
Psychological Issues:
The person: He gets a lot of his identify from his business and from
his wife, and he’s been treated for depression since her death.
I, the Chaplain: Frustrated. I’m watchful of my need to be liked by
an older man given the strain and unfulfilled relation with my own
father.
Sociological/Demographic/Cultural Issues:
The person: Not very socially polished, and always looks messy and
badly shaven. Always in the same flannel shirt. But he clearly
welcomes my visits.
I, the Chaplain: No comment
Ethical Issues:
The person: No ethical issues that I can identify.

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 I, the Chaplain: No ethical issues that I can identify.
The institution: No ethical issues that I can identify.
Critique of my function:
Strengths: I’m not sure. I think I’m somewhat impatient, and feel
like if I haven’t gotten to what I consider the core of the discussion
(a discussion of God and end-of-life), then I must be failing. I also
realize that relationship-building takes time, and that this
conversation was more intimate and much longer than previous
ones.
Weaknesses: See “Strengths”
Future plans: Keep at it.
Spiritual Assessment:
Love and belonging. I think Max has a lot of both from his family,
though he longs for the one he loved the most
Trust. I don’t sense any issues
Meaning. I don’t know what gives his life meaning. He clearly gets a
big kick out of 10 grandkids, but they’re not that present in his life
or his conversation. The quality of the relationship with his
deceased wife seems to bring him the most meaning.
Gratitude. Again, his wife. His family, the fact that he never had to
worry about money and always found a way to bring it in.
Other.