Well, I survived my first verbatim…


Last week, I had to give my first verbatim.

For the uninitiated, a verbatim is one of the major teaching tools in the CPE process.  It starts by the chaplain intern recalling as best as (s)he can the dialogue of a patient encounter, particularly one where the intern realized some things went well and other things being uncomfortable or difficult or unsure.  As well as documenting the conversation as closely to the actual one as possible, there is also a great deal of self-reflection at the spiritual, psychological, social, and cultural level.

This work is then read to the other interns and the supervisor, and they all comment, using constructive criticism as much as possible.  The idea is that the intern gains self-knowledge/understanding as well as possibilities for how to make the next encounter of a similar type more fruitful.

For some time now, people who know the process have been bugging me, “Have you done a verbatim yet?”  Sometimes this was said with a giggle or in the tone of voice that hints, “You’re gonna hate it!” or that I’ll be put through the wringer.  This, of course, was little to no help as to what the experience really was going to be like.

But…you know…really…it’s a lot of work…but it wasn’t all that bad.

First of all, it really IS constructive criticism.  Even that was a self-learning lesson.  The reality is that the medical school experience taught me “there’s really no such thing as constructive criticism.”  When one is on the bottom of the medical training food chain, one expects the criticism to be sharp, searing, and designed to make one feel like a pile of crap at the end.  Now, that’s not to say some people don’t give true constructive criticism, but it’s not the norm in med school and residency–and in all fairness, there are also times in medicine when someone’s life is on the line and there’s no time for niceties.  That said, the dressing downs were so painful and malignant, it hypersensitized me to simply expect criticism will be bad.  It’s probably colored my general view of criticism and added to that delusional feeling of “I must be perfect.”

Another awkward truth is, in medicine, I’ve handed out the malignant kind, too (just not as much as some people; however I do know I can be a bit on the volcanic side when it happens), and when I look back, it was almost always because I feared repercussions that I would be left holding the bag on a mess, or a situation where I ended up doing three times as much work because of the student/resident than if I could have simply done it myself.  What CPE, and its real emphasis on true constructive criticism has done, is make me realize that when I blew a gasket on something in medicine, it really wasn’t about that poor student or resident.  It was about me and my fear or irritation.

A big maturation factor in the switch from medicine to pastoral ministry for me has been the recognition that ministry is so NOT about me…and I discover that so many times, that realization makes it much more possible to hold my temper.  When it’s not about me, the fear and irritation lessen.

I’m also learning these realizations change how I handle situations as a medical director.  I had one this week where, in the old days, I would have called the offending doctor up and read the riot act to that doctor.  Instead, I shrugged and said, “We need to put the risk manager in the loop.  All was well that ended well, by the grace of God, but we can’t be having this happen again.”  I’ve learned to be quicker on the apology when I’m wrong, and I’ve learned not everything is worth dying in the ditch simply to win the battle.

In my verbatim, because I was willing to suspend my historical disbelief regarding constructive criticism, I was able to hear good advice about cues and body language that I can take to future chaplain-patient encounters.

Hmmm.  “I believe.  Help my unbelief!”  I think I’ve heard that one before!


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