Learning resilience from hospital chaplaincy

Feb. 10, 2021, 8:12 p.m.

Training to be a hospital chaplain for a year changed the way I see suffering. Life and death in the hospital were tenuous and terrifying. Nothing was impossible and nothing was guaranteed. Sometimes patients died, while other times they received a life-changing diagnosis. In the face of that uncertainty and fear, a chaplain needed to be a loving and understanding presence. As the current pandemic wreaks havoc on families stretching to make ends meet and further isolates many already lonely people, I have been thinking more and more about the lessons in resilience I encountered at the hospital. 

Prior to starting my doctoral program at Stanford, I spent a year at a hospital in San Francisco where I completed a Clinical Pastoral Education program, a type of interfaith professional training for hospice and hospital chaplains. During that time, I visited patients on my assigned units and learned spiritual caregiving skills through didactics and group work. I observed medical teams with patients and their families. If a patient wanted a visit from a chaplain, whether for a personal conversation, prayer, meditation, blessing or sacrament, I needed to be there. Every other week I spent the night at the hospital on-call, during which time I responded to all emergency calls and trauma cases to offer spiritual care. Sometimes this involved prayers for the dead.

As a chaplain resident, I often met with patients who were struggling with pain, both physical and emotional. This taught me to take pain seriously as a problem — to see how difficult chronic and acute pain were to bear, the need for sense-making and solace in the face of inevitable suffering and the limits, sometimes, of medicine to help those in the deepest pain. At those times, religion and spirituality were often, though not always, important sources of comfort for many patients.

The program I was in served two main hospitals, Parnassus and Mission Bay, where chaplain residents like me sometimes spent the night on-call, waiting for the pager to ring to announce the next emergency. For Code Blues, meaning cardiac arrest, we knew to go to the Emergency Department or the patient’s unit. Parnassus was the difficult one, the one where you often didn’t get very much sleep, and there were numerous calls to the ED at night. None of us were eager to do overnight on-calls at Parnassus. It was a full hospital, and the ED was almost always busy. Mission Bay, the newer hospital, was not at capacity yet, and often the calls there were for pregnant women, children and babies. Some of those were serious, but they were usually less frequent. Though the on-call chaplain couldn’t always sleep through the night, they could often get several uninterrupted hours.

One night, as I was on-call at Parnassus, an older man was dying. His heart was stopping and he kept being brought back to life by the medical team. Shortly after, his heart would start to fail again and there would be another Code Blue, and the medical team would rush to his bed and work frantically, a dozen people bending over his body — doctors, nurses and other staff. They went through this with him several times. It was one of the least peaceful deaths, short of being violently killed, that I could imagine in a hospital. His extended family was there as well. His wife of 40 years or so was terrified. They kept being called back in when the medical team thought he was past hope, then asked to go out when the team once again tried to keep him alive. I could see their agony, especially his wife’s.

Eventually he died, but it wasn’t a peaceful death. It wasn’t how he was supposed to go. It was shocking and stressful. Like him, his family suffered a lot as a result. I was there in the waiting room with them. I brought water but there was little else I could do. I liked them a lot and felt terrible. Eventually, when the medical team finally determined that he was truly gone and that there was nothing more they could do, they let them go in to see his body. I went along.

Seeing that woman bent over her husband’s corpse was one of the greatest moments of anguish I had ever seen. She wasn’t loud or keening, but I could sense her loss. It was like she was losing part of her own soul. Her sister or sister-in-law was next to her. I couldn’t go into the room. I was actually terrified that I couldn’t handle it, that it would traumatize me. I somehow managed to finish my shift, but the memory of her in that room stayed in my mind, and I felt haunted. I didn’t ever see her again. I didn’t really do my job. I was supposed to go and comfort her, instead I froze. I think I saw her at her most private moment of grief, and it felt too much.

I was 29 then, the youngest in the chaplain cohort (we ranged from 29-70). I felt insufficient to the task and overwhelmed, and unprepared to offer a compassionate presence and prayer for the great suffering I knew was in that room. I had seen death in other contexts and kept my presence of mind. But this one hit me hard, and I felt it. I went home and crawled into bed and wept. The next day, I woke up sick and had to call my supervisor. There were a few such events like that for most people during our time that left you shaken and changed. This was one of them. 

What I learned that day is that there is no keeping sorrow at a safe distance, because loss touches loss. Resilience is choosing to participate in heartbreak rather than closing yourself off. Naomi Shihab Nye writes, “Before you know kindness as the deepest thing inside, you must know sorrow as the other deepest thing.” A year into the pandemic, with hundreds of thousands dead and millions of jobs lost, letting ourselves know each other’s sorrow is exactly what we need to do to begin healing from the deep losses that have touched us all.

Contact erstwhile hospital chaplain Nancy Chu at nancychu ‘at’ stanford.edu.

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