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5 things I’ve learned about healthcare chaplaincy

I was very fortunate to have spent a week with the chaplaincy team at Hinchingbrooke Hospital over the summer. I got to spend some time with Scott, the lead chaplain (and cracking good bloke), visiting patients and exploring the nature of chaplaincy in a healthcare setting. Here are some of the things I've learned. They don't all necessarily link into each other and they certainly don't form a coherent theology of healthcare chaplaincy but they are there as food for thought!

(Any names used are made up, but the stories are all real.)

1. Wholeness in healthcare

It's easy to treat illness as a purely physical phenomenon. Disease can be caused by bacteria, or we might break a bone, or have a chemical imbalance somewhere. We can therefore assume that these should all be treated in physical terms and nothing more. Of course the physical aspects of illness must be treated in appropriate medical ways but it is a mistake to suppose that medical treatment is (or should be) the only aspect of treatment. Human beings are complex psycho-physical beings and we inhabit influential social contexts, it is therefore important to consider psychological and social (and yes, perhaps even spiritual) aspects of life when looking for healing in the fullest sense.

Yes, we need our bodies patched up, but it helps when our minds and spirits are patched up too. Chaplaincy has much to offer here as a means of healing the person as a whole.

2. A ministry of presence

Glenda was an elderly lady. She'd been in hospital for some weeks. When I first went to see her she told me not to waste my time on her. Why are the hospital expending so much time, energy and money on looking after her when there were many more worthy patients. She'd had her time - what a waste to treat her at her age! Frankly, she felt like a bed-blocking waste of space. After chatting to her for several minutes it became clear that she was far from being a waste of space; she had a loving family, was good-humoured, had an interesting story to tell and had plenty of life in her yet. It was really difficult for the hard-pressed nurses to give her the time and reassurance that she needed but I, from the chaplaincy context, wasn't there to take her pulse or give her medication. Chaplains are there because they are there, simply to be a presence with people and to hear their voice.

Maud was also elderly and a little confused. When I saw her she was fed up and absolutely determined that she was going home. She was worried about her dogs back at home and swore blind that if her husband and son weren't looking after them then she was going give them an earful. I didn't doubt her for a second! It didn't take long to work out that her family didn't visit her as often as they might and this was clearly a source of great pain for her. A chaplain can be there as a simple presence. I couldn't be her husband but she was heard and valued (and wasn't quite so keen to go home).

3. Back to the roots of religion (aka. healing is more than physical)

I'll never forget the moment of revelation that came when the wonderful Mary Earl told me the etymology of the word "religion": re-ligio. The "re" bit means "again" and "ligio" is the same root as "ligament" (that which holds things together). Thus the word "religion" means something like "that which binds together again". At the heart of Christianity is the recognition that we are all broken and fragmented and we all need to be patched up and bound together again. In a hospital there is often a very obvious physical component to being bound back together and most Christians (rightly) leave this to medical professionals. However, it is often the case that our minds, souls, relationships and attitudes need to be bound back together just as much as our physical selves. Times of physical suffering can, perhaps, be triggers to reconsidering other aspects of our lives and chaplaincy work can be central on looking at this. However, there are also times when the physical is simply beyond binding. Some illnesses cannot be healed. Some wounds cannot be mended. For the bereaved death cannot be undone. At these times (more than ever) re-ligion offers a very different kind of healing and chaplaincy should be there to help that process along. (Michael Arditti's novel Jubilate explores this theme better than I could).

4. Our language can betray us

We (or I do, anyway) often use language carelessly, without really thinking through the implications. The example Scott gave was the use of the term "miscarriage". It's a word in common usage and it's fairly clear to all what it means - what's wrong with it? In most contexts, there's nothing wrong with it at all. However, when used with a woman who has recently lost her child it has the potential to have all sorts of connotations of failure or culpability. In that situation, pastoral sensitivity demands that we are aware of the possible implications of the words we use. It doesn't follow that the term "miscarriage" should be removed from regular usage (can anyone think of a better term?); however, a good pastor needs to be aware that such a word has the potential to bring to the surface those thoughts and feelings that may be underneath.

There are further implications here. I am persuaded that the way in which we use language is shaped by our context and serves to shape our future context. Consider the use of language in ethics: take euthanasia as a starting point. The term "euthanasia" itself means "good death" and the immediate implication is that the alternative is something less than a "good death". We could call it "mercy killing", the implication being that to oppose it would be merciless. We could call it "assisted suicide"; of course the term "suicide" has its own unhelpful baggage. None of these phrases are perfect, and that is precisely the point. Language is rarely value-neutral, particularly when related to sensitive subjects. This is not an excuse for ridiculous political correctness in which "failure" becomes "deferred success", but it is a call to awareness and sensitivity to the implications of the language we choose to use.

5. Being real

One final thing I picked up is the importance of acknowledging reality in the chaplain's role. There are times when it is both important and appropriate to offer hope of physical healing; there are also times when perhaps the chaplain needs to encourage the patient to accept that they are not going to get better. The healing of acceptance can be vital (in every sense), but it cannot necessarily happen unless someone is willing to call out the reality of the situation.

In a similar way, when someone has died there are times at which what has happened needs to be named as death. It's easy to use euphemisms to avoid the reality of death; sometimes these are appropriate and helpful, but at other times a chaplain may need to use the D-word in order to help friends and relatives move forward. There is a finely balanced pastoral challenge here: it is easy to talk of resurrection, but without dwelling in Good Friday for a little while the reality of Easter Sunday is just a white-wash. We can't jump the gun and trivialise death by skipping straight to talk of heaven - a good pastor knows how to be with someone in the darkness of Good Friday, naming it as such and supporting them through it.

To conclude...

One particular privilege of my time at Hinchingbrooke was to join Scott in distributing bedside communion. The gentleman in question was in critical care and he had made the decision to discharge himself so that he could return home to die with his loved ones around him. Before he was discharged he requested bedside communion and it was clear to everyone present that the short service (just 10 minutes) was likely to be the final time this man received communion. Scott didn't explicitly say so, but in his manner and inflection of some of the liturgy made the significance and poignancy of the occasion quite clear. At the end the man's wife was in tears and the man was at peace.

This encapsulated the privilege and importance of hospital chaplaincy for me. There was genuine wholeness and healing in the encounter, even though this wasn't externally visible. The man was bound back together as best as he could be this side of death's curtain; the language used was sensitive but profoundly real; at its root it was a simple act of being present and honest about what was going on. Not as easy as it sounds, and incredibly important.