The Chaplain and the Doctor: A Podcast with Betty Clark and Jessica Zitter

Eric 01:03

Welcome to the GeriPal Podcast. This is Eric Widera.

Alex 01:05

This is Alex Smith.

Eric 01:06

And Alex, we are going to be talking about parts of a new movie that I just watched not too long ago called the Chaplain and the Doctor, and how we think about that in the hospital setting and the importance of the movie, but also like in a professional care and tons of stuff. Who do we have with us today?

Alex 01:26

We have the Chaplain and the Doctor.

Eric 01:28

The Chaplain and the Doctor from the movie.

Alex 01:31

First, I’m delighted to introduce Betty Clark, who’s a chaplain on the palliative care service at Highland Hospital in Oakland, California, where she also supervises palliative care chaplain trainees who are volunteering and learning to be volunteer chaplains. Betty, welcome to the GeriPal Podcast.

Betty 01:48

Thank you.

Alex 01:49

Delighted to have you. And we’re welcoming back Jessica Zitter, who is a pulmonary critical care doc and palliative care doc author and filmmaker, also works at Highland Hospital in Oakland. Jessica, welcome back to the GeriPal Podcast.

Jessica 02:03

Oh, great to be here again.

Eric 02:05

Yeah, we were talking about giving the people who are returning to our podcast a lot, like giving him a…like on SNL…they give you a special jacket if you’ve been on a number of times. So. But we’ve got a lot to talk about. We’re going to be talking about the new movie that you have. We’re going to be talking about how we should think about that and lessons learned. But before we do, we always ask for a song request. Betty, I think you have a song request for Alex.

Betty 02:27

It is a song from the movie and it Is really about my life.

Eric 02:33

Is this an original song or is this…who?

Betty 02:37

Yeah, it’s written by our director.

Jessica 02:39

Producer. Producer.

Betty 02:41

She took the words, listened to what I’ve said over the years and put the words down and then someone put it to music.

Jessica 02:48

And I have to just tell you that she called me at three in the morning and said I just came up with the song for the film and she read it again because she knew I was awake. Anyway, it is her song.

Alex 03:02

And what’s the song called?

Jessica 03:04

What’s it called?

Betty 03:05

What is it called? The Nasty Now and Now.

Alex 03:09

And is there a story behind why it’s The Nasty Now and Now?

Betty 03:12

Well, the pastor who trained me, Dr. J. Alfred Smith, always said that a lot of clergy talk about the sweet by and by, but they forget about the nasty now and now that’s good in real life, that it’s not all the.

Eric 03:32

Just the really nice stuff, but everything else. Let’s hear it, Alex.

Alex 03:36

Well, I’ve kind of folkified this from the version in the movie that scrolls over the opening credits. So here’s a little bit. The opening verse in the refrain.

Alex 03:51

(singing)

Eric 04:39

That was lovely.

Betty 04:41

Thank you.

Eric 04:44

Okay, Betty, I’ve got to ask. So I, I love this concept of the nasty. Is that part of your teaching? As, you know, you’re teaching these, you know, chaplain volunteers. Do you bring that up with them, like exploring the nasty?

Betty 05:00

Well, yeah, they got to listen to the stories. And many of our patients are underserved and under resourced and they come from the streets, they come from homeless encampments, they come from poverty, they come from struggles in life. And it’s not always pretty. You got to hear that and you got to understand that you hold it, but it’s not you, it’s not yours, it’s theirs. As many times people get angry at the people who are angry, but they’re angry for. Because they’re living in a nasty now and now. And so we have to hold that while providing comfort and care and support.

Eric 05:43

I love that, Jessica, for our listeners, I think a lot of people who have worked at Highland visited Highland. It holds a very special Place in many people’s hearts. Can you just give me a very. Like, what is Highland Hospital? Because a lot of this movie is focused around this hospital and the people like Betty who work in this hospital, especially Betty. Like, it is focused on Betty and your relationship. Tell me about Highland.

Jessica 06:12

Well, I think it’s. I think Betty and I have, you know, different entry points into Highland. Tell me if you disagree. But, you know, Betty lives with many of the people. We had patients who are her daughter’s classmates. We’ve had patients that she goes to church with who, you know, there’s a certain communal feel, I think. And again, you can speak to that. But for me, I don’t live within that community. I’m coming in as an outsider. I care. I care about, and I have a lot of compassion, and I really do. I am moved by the stories. I’m pained by the stories, but they’re not my stories. And so I think that’s a difference between us in a way. Uh, would you agree with that?

Betty 06:50

I agree, but I think Jessica has. Has learned, and she has. She’s seen me. She’s experienced my feelings with. From looking at it from the outside, but now she’s had some experiences from the inside, Someone that she could identify with. And then she began to realize. So it’s really all about learning. We all have learned. And so, yeah, I know a lot of people in Oakland. I’ve been here quite a long time. Since 1968. Yeah. Yeah.

Jessica 07:27

And I would say not, you know, that Betty, for me, has been a bridge to, number one, getting past some of the biases that we’re going to talk about on the show, but also to really connecting, having people trust me in a way that they wouldn’t trust me otherwise. I mean, there are, in fact, in the film, you see a story where I was kicked out of the room the day before. He did not want anything to do with me. And as soon as I walk in with Betty, there was a connection. And then I was able to make a connection with him in a way that I don’t think I would have been able to.

Eric 07:58

Where did you two first meet? Was it in Highland? Like, were you part of the same. Like, you joined the palliative care team and Betty was on the team. Like, how did this happen?

Betty 08:07

Well, in the old hospital, and we were on the fifth floor 15 years ago. Fifteen years ago, and we have. The palliative care team has a rounding meeting where we come together every morning and we support one another and we talk about the patients that we’re going to see. And that’s where I met Jessica. She had come in for the first. I don’t know, but it was my first time meeting her. And so that’s where we met long time ago.

Eric 08:38

It was on the Pal of Care team. And was it like Instant Connection besties like we saw in the film I loved, by the way? First of all, we’re going to talk about the film but like Jessica, how can people watch the film? And we’ll talk about this at the end but we’ll have a link to some of the stuff. But real quickly, where are we with being able to watch the film?

Jessica 09:02

Well, we’re. Thank you for asking. We’re really excited. We’re just beginning to roll out the film and what we’re right in now is the festival circu. There’s like a whole concept like a windowing process. So we are starting with the festivals. Betty’s been to more of them than I have. She’s going to Virginia tomorrow.

Alex 09:17

Oh great.

Jessica 09:18

And we’re getting a lot of film festival attention. And now what we’re doing is we’re starting to plan our national screening tour. We’re doing events here and there for places that request us to come and show the film. So, you know, sort of events for a hospital or events for a hospital organization. But we’re going to be really sort of bringing the screen out to about 20 to 30 cities starting around beginning of April. And we’re just planning which cities and we’re just looking for all of the supporters and champions that we can find in Pittsburgh and LA and all the places that we’re going to go because we really want to attract the healthcare audiences on top of a general audience. So people should join our newsletter. This is the way to if you want to sort of either follow us on social media @JessicaZitter or join our newsletter, which is probably a better way at thechaplainandthedoctor.com and you will be a kept aware of that.

Eric 10:05

And we will have links to that on our show notes. One thing that I loved about the movie kind of because it’s kind of like a buddy movie in some ways like is like you both were driving. I forget where you were driving to but you were arguing about which was the right route to take which felt very like really matter that much but it was just like it was a perfect setup for and I think Betty was right at the end. But like when you, when you first met was it like that? Like there’s this instant connection?

Betty 10:40

No, but it. I think it was a different connection for each one of us.

Eric 10:45

How so?

Betty 10:46

I just kind of generally connect with people, and I don’t get upset because I’ve encountered a lot of prejudice and so forth. So prejudice don’t bother me. I don’t get upset with the person, and I’ve learned to look beyond that and look at the person. So I like Jessica right away, but I don’t think we hooked. We connected, and until she called me because of something that I wrote in the chart about a patient that she had a different opinion about.

Jessica 11:21

Wait, wait, you’re not. You’re skipping over the part that makes me look bad.

Eric 11:26

What was the part that made you look bad?

Betty 11:27

Jessica, you want to.

Jessica 11:30

I’ll tell that part.

Betty 11:31

Okay.

Jessica 11:32

The part is really important to think about, which is that we had a patient come into the hospital, and he had been shot. He was a young African American man who had been shot, and we hadn’t seen him yet. And we were doing morning rounds. We had been consulted the day before to help support him personally psychologically and with pain management. And I don’t. There were several of us at the table, and the word gangbanger came up. I don’t know who. Doesn’t matter who said it, because we all took it as fact. And we were getting up to go and round, and Betty was sitting still, and she kind of looked up and she said, you know, that’s racist.

None of you has even met this man. And I got like, oh, my God. What are you saying? You’re saying I’m racist? What are you talking about? I work in a public hospital. I care about people. I want to take care of people regardless of the color of their skin. And I kind of got very defensive, and I kind of huffed out. And then now Betty can finish the story.

Betty 12:34

So I just. I didn’t say anything really much about the man, but I went down to see him, and when I got down there, I said, so tell me how you got shot. And he said, I was on in the wrong place at the wrong time. And I said, where’s that? And he said, on the freeway. I said, well, I’m on the freeway every day. I said, so tell me about. He had tattoos all on both arms. I said, tell me about the tattoos. And he said, I have seven children, and I have their names and birthdays, tattoos.

So I remember. And I said, what kind of work do you do? And he said, I work in a warehouse and work with my hands. So I went back to the desk, and we had to write the chart, and I wrote the story in the chart. And so I’m on my way home, and I get a call from Jessica. And she said, how did you do that? And I said, how did that do what? She said, how’d you get that story? And I said, I just asked. And Jessica said, well, I don’t know how to do that.

Jessica 13:33

11 years ago or 12 years ago, probably. I’ve grown.

Alex 13:40

Yeah. It’s just such an important lesson. Sometimes you shouldn’t assume. Well, always you shouldn’t assume. Just ask. There’s no shortcut here. You can’t assume.

Betty 13:51

But, you know, I think people are afraid to ask. And it’s more comfortable to assume than it is to ask.

Jessica 13:58

Well, you said something to me really important about six months ago. You said, and even if he wasn’t a gang, then what?

Betty 14:07

Yeah.

Jessica 14:08

So even if he wasn’t a gang, even if he had shot someone else, even if. Even if. So what is our obligation to figure out where the connection points are without discarding people, Even if you think they’ve done something heinous? You know, what is our obligation as doctors and what is our obligation as human beings?

Betty 14:26

Yeah. Yeah. We had a young man in the hospital, and he was standing at the nurse’s station in the old hospital, and he was in pain, and he was in agony. And I said, what is wrong? And he said, they won’t give me my pain medicine. I’m hurting. And I said, well, we’re going to. We’re going to see about that. And so I’m walking him back to his room, and I said, what happened to you? And he. And he was paraplegic. And he said. He said, I made it out of my community. He said, there was a gang in my community, and they wanted me to join, and I refused. And I made it out of high school, and I got a job at the post office.

And he said it was my grandmother’s birthday. I lived with my grandmother. Lived with my grandmother because he couldn’t live with her anymore. And he said, I was on my way to get her a birthday gift. And I saw the gang leader when he pulled up beside me, and when I turned my head, I knew exactly what he was going to do. And he shot me because I never joined the gang. And I said, well, did you report it to the police? And he said, I did. I told him who shot me. And they. They brought him in and he said he was in San Diego and they just let him go. And he said, they Treat me like I’m a gang banger here. They treat me like I’m in a gang, like I’m a thug.

Eric 15:43

So it’s. It’s because. I mean, it feels like it’s not. Feels like. We often make up stories that we. We think about people. So we have these cognitive shortcuts, these biases. We see things. And I am. I just had experience with this. You see something like a tattoo on someone, maybe multiple tattoos, face tattoos. Your brain is already like. You can’t help it. Your brain is making up stories. Cause we are like story beings. We like. We feed on stories. We will make them up. How do you think about the stuff that we bring into these encounters, these cognitive shortcuts, these biases, these sometimes fictional stories that we make up? How do you think about that? Because I feel like a lot of the movie is about this.

Jessica 16:29

Totally. Totally.

Betty 16:30

Yeah.

Jessica 16:31

You have alluded to this actually, earlier, Eric, that we all bring our histories. You sit, you see a patient in a room. You think you’re dealing with that patient in that moment in that acute setting. The fact is, you’re dealing with the past 10 generations of their family.

Betty 16:46

Yeah.

Jessica 16:47

Dealing with all of the things that they are moved by or that is even genetically implanted in them. And I think that’s really important. So you come into a room and someone kicks you out. Like I just mentioned. You could just say, oh, well, screw that. I’m not. I tried to help him. And. But if you can kind of come up with an understanding that this person has a lot behind them, they have a lot of stories about themselves and about you and have some patience for that, and if you can particularly dig into your own touch points and hurt points, like I did in the film, and it can give you a little bit more of an ability to cross over and to understand that someone else is experiencing the same thing.

Eric 17:27

Yeah, well, let’s talk about that, because again, we. We bring in. We talked before we started the show. It was talking about, like, baggage. Like, we bring in baggage to encounters. Like, baggage isn’t always bad. Like, if you go on a vacation, baggage is really, really helpful. Um, you need those things. So we bring in stories, we bring in life experiences, we bring in biases into this clinical encounter. Often those biases are potentially harmful. Sometimes they’re potentially helpful. Jessica, in this story, in this movie showed. One example, is that there was older Holocaust survivor. So similar faith background as Jessica.

Jessica 18:05

Right.

Betty 18:05

Yeah.

Jessica 18:07

You’re where my family was killed in the Holocaust.

Eric 18:09

Yeah. And that there was a trope that people tell me about what the trope was that you saw.

Jessica 18:14

The trope was that this woman has resources, that she must have resources. So let’s figure out what else we can do for her.

Betty 18:21

Because she’s Jewish.

Jessica 18:22

Because she’s Jewish and she had no resources. She was living on food stamps. She lived in a. Yeah, she had no resources. And so, like, oh, my gosh. You know, first of all, that trope is harmful to me. It’s hurtful in a personal perspective, you know, from a personal place. But also, we risk not giving this woman support that you would give to another patient because you just assume she doesn’t need it or she can take care of herself.

Eric 18:44

And it’s interesting because you had this connection, this shared connection with her, this, this affinity, this bias. You were able to see that, find it out, share it, and then learn from that. That maybe like, and correct me if I’m wrong, that, like, this is something that Betty experiences every day at Highland Hospital. And people experience this every day in every hospital.

Jessica 19:07

Yeah. Yeah, that was really important for me.

Eric 19:10

Yeah, tell me about that.

Jessica 19:12

Well, yeah, I mean, I say to Betty in, in the film, I say, yikes. You know, we came out of that room and I was. I was really upset. I was. I was really upset because these are my friends and nobody there is anti Semitic. Everybody. It’s not about not liking Jewish people or not liking black people. It’s about the story that’s in your head about certain things. And so I came out really, you know, upset. And I kind of had this realization that, like, I was the person standing between this well meaning team and this patient who I felt very protective of. And then I thought, oh, my gosh, that’s what Betty goes through every single day, multiple times a day.

Eric 19:48

How did that feel to hear that from Jessica, Betty?

Betty 19:51

Well, I think it added to our connection. Cause now I. I looked at her and I thought, okay, now she gets it a little clearer. You know, I had a question at one of the film festivals about have I ever encountered racism in doing the work? And I shared the story of a man who was known. This is not in the hospital, but known by his family and the staff. I was a hospice chaplain at the time, that he was racist. And so they. The staff told me, and I’m usually the only black in. So anyway, they said, well, you might not want to go see him because he’s really racist. And I said, no, that’s okay. And so I get to the house and the son meets me at the door and he says, well, you may not want to come in because my father’s racist.

And I said, it’s okay. I’ll come in. And so I came in. As soon as I saw him. He said, you know what I don’t like? And I said, no. He said, I don’t like black men kissing white women on tv. I said, I don’t much like that either. He said, you don’t? I said, no. And he said he went on to something else he didn’t like. So when I get ready to leave, I said, would you like a hug and would you like me to come back? He said, might as well. So I gave him a hug and I kissed him on the cheek. And I said, now you’ve been kissed by a black woman.

And we. I saw him every week. We had some interesting conversations. And just before he died, he asked three. Had three sons. He asked all three of the sons. He told them, I want Betty to do a funeral. So, I mean, I. I just feel like, you know, it’s getting to know people that breaks down the barriers and breaks down all of that that stands between us. And what I say is, there’s one race, only one race, and that’s human. We’re all in it. Everything else is culture.

Jessica 21:52

And if you know Betty’s history, which we only get to tell, you know, obviously, like, she’s 81 years old, and the re. I didn’t divulge that. That’s in the film. But if you know, you know, a fraction of what Betty has been through when it comes to racism, you know, integrating, being one of six African American students to integrate her white. Huge white high school. And I have actually photos of Betty. She said they didn’t want me there, but I was gonna be in every single club. She was in the Key Club, Future Teachers of America, Glee Club, whatever. She did everything she could. She just went in there and she gave people, ironically, the benefit of the doubt, even though people were horrible to her. It’s amazing.

Eric 22:36

I gotta ask this, Betty, because, I mean, the story you just shared, you know, people saying, he doesn’t want you there, he didn’t want you there. Your life story, which we learn about in the movie, a lot of places where they didn’t want you there. I wonder, as a chaplain working in a hospital, do you feel like doctors, other health providers want you there?

Betty 23:05

Not for a while, but now it’s different, but not for a while.

Eric 23:11

Tell me about that. How did it. What was it like? In the beginning?

Betty 23:15

It was hard to go out with the doctor and see patients together. Even though we were supposed to be.

Eric 23:20

A team and this is on the palliative care team. This is like us saying, hey, palliative care. We’re interprofessional. Like we, rah, rah, rah, palliative care.

Betty 23:30

But I don’t hold my tongue. And just recently, I told one of the doctors, you’re talking to the doctor in the room, but not to the rest of us. You need to talk to all. We’re. We’re a team. You need to share with all of us. Not just. You’re just looking at the doctor and talking back and forth as if it was just the two of them, you know, and so it, it hasn’t completely changed, but it has changed a lot. Doctors are now praying with us, praying, hold. At least they’re holding hands

Betty 24:05

and, and, and, and getting hugs and getting support from me. And I even was in a room where we were taking life support off, and the family was not going to be there. So just the doctor, myself, and a nurse. And we were waiting for the patient to die because they were going to die. Didn’t want to leave the room and let have them die alone. So we stood there, the three of us, and all of a sudden the doctor started talking about his mother. What. What was happening when his mother was passing. And then the nurse shared, and then I shared, and then we all three hugged. And so that’s. That’s quite different. That’s a big change.

Alex 24:41

There’s so many themes in this movie. It’s such a rich movie. We’ve talked about, touched on several of them, the implicit bias and overcoming bias and ways to address it and learn from it. And one of the most admirable things about the whole film and process and story we’re hearing today is that the initial reaction is defensiveness, right, from Jessica. But you flipped that on its head and you went there and dived into such a deep way. You made a film about it. I mean, it’s incredible, right?

Jessica 25:11

Betty made a space for me that was safe. You know, most people won’t have a chaplain, Betty Clark, you know, in their lives. And, you know, Betty, even after that moment where I, I really huffed out of the room and I was really. Betty was just there to say, okay, let’s move forward, you know, and that’s not typical. Let’s go to lunch. And that’s, you know, we have a very polarized society on many, many, many levels, obviously, but certainly around race. And it’s scary. It’s scary to Talk about it, and we don’t. And I just had a special person who could.

Betty 25:44

Well, Jessica would come into. To the meeting, because we have the meeting first time in the morning, and she would come.

Jessica 25:51

I’m sorry.

Betty 25:52

I’m sorry, I’m late. I’m sorry. And I said, love means never having to say, you’re sorry, you’re not late, you’re here. Or she’d come in some more and say, my children hate me. You know, I said, no, they don’t. She.

Jessica 26:08

You. You. You talk about that scene when we’re driving and we’re kind of arguing about the way to go. And I. For me, Betty is another mom, and she. No, I. She is. And I think grandma. Well, no, you’re the same age as my mother. I know you’re younger, a little bit. But that’s the relationship I feel. I feel extremely safe with Betty, and that’s what’s allowed me to explore these really, really difficult topics that otherwise you just push away.

Alex 26:34

Yeah. And that’s just shown through for me in the movie. This, like, interprofessional friendship deepening of relationships and how it allows you to work together better when you really get to. It’s not just getting to know the patient, as Betty’s wonderful story illustrated just a moment ago. It’s also getting to know each other on the interprofessional team in a really deep way. Your histories, your family stories, your life stories.

Betty 27:02

You know, people come together, like in school or at work, but they never see each other in a personal life. And I experienced that when I integrated the school. There was a young woman, that young girl that lived across the road from me, and we would play together as kids, but when we got to school together, there was no connection. And so Jessica invited me into her home to meet her family and her children. I’ve known them since they were young, and now they’re med school and their family. And Jessica’s met my family. And we have to. If we’re going to live together as people, as human beings, we have to be interconnected and not just work. This is. I work with them, but I don’t know anything about them, you know, or I go to school with them, but I don’t know anything about them. And. And so we won’t grow. We have to grow as a society and as a people. It’s been too long.

Eric 28:06

So can I ask about that? This whole, like, we’ve talked a lot about our podcast about, like, structural racism, the structures that we put in place. I wonder, like, when we think about our interprofessional teams that we put in place, the hospital cultures, the hierarchies, like Betty, you’re describing, the doctors are just talking to the doctors despite any. Everybody else in the room. Like, is there structural. What’s the right word? Structural. Anti. Interprofessionalism. Like, what, what are these things even in professions like geriatrics and palliative care that we deeply hold, like, we value interprofessional teams. Maybe sometimes our actions are not. Or maybe the structures we create are not conducive to that. Your thoughts on that?

Jessica 28:52

Yeah, I, I mean, I, I’m used to the concept of hierarchy. There are a lot of things in my medical career that have made it starkly obvious. First of all, I’m a woman. Although that’s become less of an issue, it’s still an issue even today when men talk to each other and there’s this sense and even, frankly, sometimes, you know, nurses or patients just think that the man is going to know more and be smarter. That’s an issue. Another one is the hierarchy of professions, of specialties. In medicine. I’m an ICU doctor. I’m also a palliative care doctor. And there’s a huge hierarchy there.

Eric 29:31

Do people talk different to you depending on which role you’re playing? Yeah.

Jessica 29:37

And you know what? I think of myself differently in those roles, which I think is really interesting and important and something I should be exploring a little further. And then, of course, there’s racial hierarchy for sure. And then there’s intra palliative care, interprofessional hierarchy. So there’s hierarchy everywhere. Let’s not pretend there isn’t.

Betty 29:57

And not just with you in the past. I’m a pastor in the ministerial place. I’m a woman. A lot of pastors, men will not let a woman come in and preach in their church. I started a church without going through the red tape that they want to put you through. And it’s sort of like Jessica built my own reputation. And so I don’t mind fitting into places that I’m not supposed to. There’s an organization called the St. Luke Society, which is made up of African American doctors and clergy. There was no woman in that organization. I joined. A lot of the pastors quit because of me.

Jessica 30:48

Really?

Betty 30:49

Huh. And then I became the first woman president, the only woman president of the group. And so, you know, just, just, just go. If, if you don’t care what people say or think, but you do what is right, what you think is right in Your own mind. You do what’s right. It doesn’t matter.

Jessica 31:14

Right.

Eric 31:14

But you.

Jessica 31:15

You are a combination of incredible bravery and strength and resilience. Because you say it’s that you don’t care, but you just move forward in this. You know, I’m here. I’m here. I’m in. I’m in your key club.

Betty 31:29

I mean, what are you gonna do at it?

Jessica 31:32

But you do. But the other piece of it is you’re strong, but you’re also willing to accept other people for their weakness. And you’re. You look at your own weaknesses and. And it’s just this sort of. There’s a certain resilience to you that I think is extremely remarkable and inspiring to me. I wish I was more. I wish I was more like you, Betty.

Betty 31:53

Could I ask.

Alex 31:53

I. I was just at. We were at the National Palliative Care Research Center Foley Retreat in Banff. We had a podcast there, and there was a testimonial from a African American woman researcher. And part of what she said was just like, it’s exhausting. Like, you know, the experiences of everyday racism, the implicit. The explicit biases, and just, you know, especially in the current federal environment, it can be just so discouraging and hard. And I wonder, Betty, what you would say to those people who are really hurting right now and suffering. And what would you say to them?

Betty 32:38

I would. I would say, did she move that? But I was going to say, what’s on that paper?

Betty 32:45

I’m. I was going to say. And put the paper back.

Jessica 32:48

Okay. Just don’t rustle it.

Betty 32:50

I won’t rustle it. And it says when you. When you get yourself distressing all the problems also pressing Want to change it oh, but don’t know how Praying for the pearly gates Hurry up, don’t be late but there’s a life to live right here, right now.

Alex 33:12

That’s the song.

Betty 33:13

That’s the song. Because you can’t really do anything for others or help yourself if you’re stressing, you know, and we all have stress. We all live under stress, and we learn. I had to learn. I ended up in the hospital under stress. You know, But I don’t think that I. That I try to fix the problems in life. I just tried to fix whatever problem comes in my sphere. Yeah. And so then I can’t worry about what I can’t fix. You know, I can’t stress over how horrible the world is because it does nothing to change it, and it only hurts me.

That’s my philosophy. So I Just try to fix whatever I can fix right here, right now in my space and feel good about it. And so every opportunity to feel good lifts me up and keeps me from being tired of it all. You know, I’ve heard people say, you know, especially African American, I’m tired of teaching. I’m tired of. Well, I’m not tired. There’s an old song that says, I’m not tired yet. You know, well, some people want me to retire. I’m not tired yet.

Jessica 34:39

Your teaching is what brought me to a different place and what allowed this film to happen. If you hadn’t been willing to talk to me, to accept me, to love me, we wouldn’t have a film. We wouldn’t have all the programs that we’re going to create to go with it.

Betty 34:58

Yeah.

Jessica 34:59

So thank you.

Eric 35:01

And can I ask, you know, the sphere of things that we could fix, I wonder? Like, you’ve known each other now for a decade and a half. You’ve been on this palliative care team, Betty, it sounds like, for a long time before that, hospice. Can I hear from you how you think about. What do you think the role of the chaplain is in the hospital and also on a palliative care team? Because I’m hearing it’s teacher, it’s educator, it’s working with patients, it’s an advocate. How do you think about the role of the chaplain?

Betty 35:39

It’s holding the story of those who are suffering and bringing that story to life in those who don’t understand and maybe bias or prejudice. It’s helping both sides, the patient and the caregivers, to work together for the betterment of the patient. And so if I can say to a doctor or social worker or a nurse, this is what’s going on, this is why they’re. They’re here. They’re in grief. They just had five deaths in their family this year. They just, you know, and get them to see them as people who need care and need help and also with the patient, because sometimes the patient will say, are they experimenting on me?

The doctors say they’re going to try this and going to try that. I think they’re experimenting on me or some other thing they might say to me. And I can. I can help them to see from the doctor’s point, then I can let the doctors know, wait a minute. Maybe you need to change your vocabulary. Maybe you need not to say to someone, we’re going to wean you, or we’re going to try this, especially if they’re African American. And those words Sound like they’re being used.

Eric 36:58

Let me ask you this, is that, you know, in most hospitals, I would just gonna throw my observation working a lot of hospitals is that the chaplains are often invisible. They’re seeing to the, to the healthcare providers, not to the patients, but to the healthcare providers. The notes that are left are not telling stories. They’re often like visited patient, like one liners. They’re not integrated with medical teams. So they’re kind of feels like they’re doing their own things. The healthcare providers are the physicians, the nurse practitioners. The nurses are not often interacting with them unless something really bad goes on and we ask for help from our own team’s perspective.

Is Highland uniquely different, do you think? Is just Betty uniquely different?

Betty 37:45

Like what is it, you know, from this movie? I want chaplains to understand their role in a better way. That they are not pastors in the hospital, that they are not pastoral care, which many of them think they are, that they have something valuable to offer and that they are an integral part of a team, whether they’re in palliative care or they’re just walking around. I really would love to see hospitals have a chaplain on every team, the medical team, the surgery team, because that way the care for those patients would be. Should be holistic. But the chaplains have to learn as well what their role should be and what their role could be.

Jessica 38:32

But let’s not forget that that’s swimming a little bit upstream. Because if you, if you have people at the top of this hierarchy who are not interested or not willing to listen, then it’s, it’s, it’s really swimming upstream and it’s hard for.

Betty 38:46

I mean, well, I think it has to, I think it has to be together. I think you have to almost simultaneously at the same time because that’s what we did. Both parties have to grow into a role that is beneficial to the patients, to the hospital, to the teams and to individuals so the team can grow and each person can grow. That’s really what I think the movies should be about.

Alex 39:11

Okay, I’m going to challenge Jessica here. It does seem like, you know, one of the key places where you might want to start. The low hanging fruit, where it makes obvious sense, is the icu. And you were saying earlier, like, you know, in the ICU you’re a different person, you’re a different doctor. There’s such a strong hierarchy there. I mean, could you imagine taking a week and saying we’re going to do it differently, we’re going to round and we’re going to give equal time to the medical team, the chaplain, the bedside nurse, the social worker, and we’re going to hear all sorts of aspects of what’s going on in this patient’s lives.

Betty 39:50

Well, every Tuesday at Highland, the palliative care rounds with the ICU team. And just this week, we have a chaplain who’s a palliative care chaplain in the outpatient clinic, but she also works on certain floors as just a regular chaplain. And I suggested that she round with them, and they took that suggestion. And so now they’re going to have a chaplain rounding with them at least one day a week.

Jessica 40:21

That’s great, and that’s great. But I really think you and I think we both agree that it’s. It’s a special ICU team that will actually, number one, do that. And number two, really listen. I mean, they’re so busy. I’ll tell you, the other day, it was a couple months ago, I was actually in with a patient who was dying in the icu. And there’s, you know, a glass door. It’s an older building, San Leandro. And I was sitting.

Betty 40:50

You were in San Leandro?

Jessica 40:51

San Leandro. And I was facing the patient, and we were just sitting. And outside behind me was the hallway. And I noticed that, you know, we were just sitting there and we were just holding her hand and she was talking. She was talking to us, and we were listening. And behind me, rounds were happening of the ICU team, and they were all standing around, their arms checked. And I realized, first of all, I knew what they thought about what I was doing, which was, oh, my God, come on, do something. This is a waste of time. They wouldn’t even say those words in their head. But I knew that that was how it would have been viewed.

Betty 41:23

So I think that’s pretty. No, no, no.

Jessica 41:28

I’m sorry. I’ve worked in a lot of hospitals, and this is a much more systemic problem. It’s a cultural problem. And I think for us to address it, it’s going to be a whole different. I’ll tell you one thing we are planning to do. We’ve been. We met with the people, the Graduate Theological Seminary, I think it’s called, in New York City. And I have this vision of one of our pilots being watch this film, medical students and chaplaincy students together, and having them be dyads and really start to, at a young stage, stage of their training, start to talk about what does it mean to work together.

Eric 42:00

I love that. And I wonder. Jessica, I’m going to Bring us back because we’re wrapping up at the end of the hour. If I’m interested in bringing this into my own hospital, this film, the lessons learned. Remind me, how do I do that?

Jessica 42:15

Thank you for asking. Please sign up for our newsletter at thechaplainandthedoctor.com Sign up for the newsletter.

Eric 42:22

We’ll have a link to that on our show notes. So just go to GeriPal if you forget what that is. But that’s pretty easy. The chaplain and the doctor.com.

Jessica 42:29

Just follow us on social media because a lot of the stuff comes up and it’s at Jessica Zitter md. We didn’t change it to real medicine media.

Eric 42:34

Are you like on TikTok? Are you like, doing TikTok dances?

Betty 42:37

No, no, no, no.

Jessica 42:38

You know Instagram. I don’t do it on my Instagram.

Eric 42:40

Betty, you’re on TikTok. No?

Betty 42:50

What’s TikTok? [laughter]

Eric 42:53

I want to thank Betty, Jessica for being on this podcast. I learned so much. I have some take homes after watching this movie and really thinking about how I am truly integrating our own chaplains in palliative care on our service and rethinking about that. So I really want to thank you for being on this podcast, for doing the movie, and just for everything that you do.

Eric 43:17

You both are truly an inspiration.

Eric 43:24

You two feel like sisters. Like you’re constantly, like rubbing each other a little bit, hugging each other.

Jessica 43:32

We are. Every time we watch the film at a film festival together, we are holding hands the whole time.

Betty 43:37

Yeah. Crying and laughing.

Eric 43:40

Well, how about a little bit more of the song from the movie?

Alex 43:42

Alex, Betty, do you want to introduce…you requested this verse specifically that starts with I’ve known misery and joy.

Betty 43:50

Yes, it’s. It’s a little bit more about my life and some of the things that I’ve gone through. It doesn’t give you in depth, but it gives you a little, little taste if you.

Alex 44:01

Yeah. Okay, here we go.

Alex 44:09

(singing)

Eric 44:58

Betty, Jessica, thank you for being on this podcast.

Jessica 45:02

Thank you both so much.

Eric 45:05

And to all of our listeners, please join the newsletter at thechaplainandthedoctor.com Again, we’ll have links to that, and thank you for your continued support.

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Disclosures:
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