Learning to live with questions

One day I had a call from the maternity ward to say a patient wanted to see a chaplain. We do not have many requests from the maternity ward so I was intrigued. I was wondering if I was going to get to bless a living baby for a change.

In fact it turned out to be a very different scenario. The patient’s brother had been murdered. The funeral was going to happen the next day and due to the patient having an emergency caesarean section she was going to miss the service. She felt devastated about her brother’s death, extremely sad at missing the funeral yet she also had the joy of cradling her baby daughter.

The next day, at the time of the funeral, I went and said some prayers with her and a friend who was supporting her. I showed them a picture of a candle I had lit in the chapel with the brother’s name on a card in front of it. They took some comfort from this.

It’s hard to face these awful situations. Sometimes I feel so inadequate and I think who am I to try and make sense of it all? Like the bible says “I am who I am” and in my own limited way I am prepared to keep struggling and to stand alongside those who suffer. I don’t have all the answers but I can enable the questions. Sometimes it's about learning to live with those questions.

rebel rev becomes a travel advisor

As I’ve mused before the role of a chaplain can be extremely varied. One particular patient brought to me some of that variety. She had just arrived in this country from South Africa. She was staying in a hotel near Westminster. This was some distance from my hospital.

On her first day trip out she decided to come to visit some of the historic sites in Greenwich. Unfortunately she fell as she stepped off the bus and badly broke her leg. She was travelling with her sister. Her sister was getting a cab each day from Westminster to the hospital because she was scared of travelling on her own in a foreign country and wouldn't get on a train or a tube. Her money was beginning to run out and they were due to move from the hotel in a few days on to the next leg of their journey (pardon the pun) She did not want to leave her sister, so needed to find out about a local hotel. I became the families travel advisor. I found hotels and then B and B’s for her two daughters when they arrived. I checked tubes and buses and travel routes and supplied them to the family. They were extremely grateful.

As someone who likes to travel and experience other cultures I imagined how awful it would be to be in that situation. I felt it was really important to give this family as much hospitality as possible. Hospitality is actually one of the best tools in the chaplain’s toolkit.

Several years later a member of my own family fell and broke her leg bady while we were holidaying in the Canary Isles. I felt very alone during that time of travelling back and forth to the hospital and having to change hotels and not speak the language. i could've done with a friendly chaplain. Again it reitereated to me the importance of being prepared to be a travelling companion to people who are suffering for as long as they need you.

Is this a change for the better?

As my third year as a hospital chaplain started I realised how comfortable I was in the role. Not only was I comfortable but I was starting to make changes and be involved in some developments.

One of the changes was that I was putting up a very short thought for the week on the notice board outside the chapel. These would be very short quotes and not particularly religious. Things like “Life is not measured by the number of breaths we take but by the moments that take our breath away” I was receiving lots of positive feedback about these quotes and people would sometimes stop me to talk about this weeks quote.

One of the other changes that I was involved with was a more formal structure for staff support in A&E. I always walk through A&E on my way to and from the wards. A&E is a charged environment which has high support needs but it can so easily be neglected and missed out in general chaplaincy visiting. The problem is that the patients don’t get referred to us until they are on the ward. I decided to make a point of not missing out the A&E department and my wanderings were beginning to pay off. Many of the staff talked to me about personal issues they had.

One of the senior nurses asked me if I would take on the clinical supervision of the nursing staff. This would be done once a month and would be carried out in the form of group supervision. Clinical supervision is the wrong name really. It wasn't about supervising their clinical practice but rather enabling their clinical practice by getting anything that was troubling them out of the way.

I was pleased to be asked and jumped at the opportunity to do something on a regular basis. One of the problems of chaplaincy work, is so much of it is fire fighting and dealing with the here and now. It’s good to have things that are more long term to balance this.

When the supervision first started I think the staff were a little suspicious. They were probably wondering what the chaplain was doing in this role. I made it clear to them that I wasn’t doing this as the chaplain but rather as a person who has group work skills. In fact I always started the sessions by removing my clerical collar. I used to finish the sessions with my “Thought for the Week” which I was still doing and putting on the notice board outside the chapel. The staff really appreciated this and it was also leading to more staff coming to talk to me privately.

I wonder if there will be any further new developments as my third year confidence grew?

A hug speaks a 1000 words

The thing that crowned off my second year was the opening of our new hospital block by Archbishop Desmond Tutu. He is one of my hero’s. There was a lot of excitement around the hospital in the build up to that day. I was asked to create a display about the work of the Chaplaincy Department. I was really pleased to do this and the panels I had made up reflected the spiritual as well as the religious aspects of the work of the department. They looked very professional. 

I arrived at work at 7.30 that morning in order to set up my display area. The clouds looked ominous and it was really quite cold. Eventually everyone started to arrive in the big marquis set up in the field at the back of the hospital and we waited eagerly for our guest of honour to arrive who was having a tour around the wards with the Chief Exec.

When the Archbishop arrived he lit the place up with his beaming smile. He went straight passed the “important people” to the school children and was giving them high fives. I was impressed by this. Even though the heavens had opened by now Archbishop Tutu was his own little ray of sunshine.

After all the speeches and presentations had happened the Chief Exec brought him off the stage to meet some of the people. I was really made up when she introduced him to me. I asked him if it was ok if I gave him a hug to say thank you to him for being such a good man and making a difference to the world in his work for peace and justice. His face all crinkled as he smiled at me and said of course you can. That hug was very precious to me and inspired me to continue to work for peace and justice and challenge inequality wherever I encountered it. What a year!

The privilege of collecting tears

One day I was called to the ward where an elderly man made an impact on me. His wife was dying. She was nominally C of E and he nominally RC. They had been married for 72 years. He was very strong while all his family were present. I used to pop in early in the morning when he was there on his own. For those few days that we chatted he would break his heart over the separation that he was about to experience. He told me that they had never been apart. Not even during the war because he had a job that kept him at home. His whole face would crinkle with grief as he spoke of his memories. As official visiting time got near he would blow his nose and become the stoic man that his family knew. I was so pleased he allowed himself to cry with me. The patient died and I watched the family walk away surrounding the surviving spouse. Somewhere deep inside of me I suspected that this man would soon follow his wife.

Around this time the woman that had cancer and believed God would heal her came back into the hospital. She was very poorly and the chemotherapy she had endured for system control was not helping.

When I visited I found she was more receptive to me. We talked about lots and I would pray with her regularly and read to her from the Psalms. She grew frailer with every passing day. On Maundy Thursday I knew she didn’t have much time left. With her families permission I did a liturgy which involved them anointing her and in turn she anointed them. It was very touching. At the end I gave her a hug. I said it was a good time to die as it was Holy Week. I wished her well for her journey and said she would have a few choice questions for God when she met up. I asked her to give God my love. She smiled at me. As I walked out the door she weakly raised her hand and started to sing “I know that my redeemer liveth” I left the room smiling. The reason for the smile was that I had accompanied this woman on her journey and been privileged to see her shift from her fundamental perspective of expecting God to heal her to one where she not only knew she was going to die but she embraced it. Wow. Amen!

Theological and cultural differences lead to a hard time on the children's ward

As I was coming to the end of my second year as a chaplain I was presented with one of my biggest challenges. A toddler had suddenly and unexpectedly died on the children’s ward. I was called by a very distressed member of staff who said they didn’t know what to do, the family were wailing and crying and praying to God to raise their daughter from the dead. I said I’d be there immediately but inside I felt all wobbly. How on earth was I going to make sense of any of this.

When I arrived the staff told me the child had come in with chicken pox and in fact was better so they were making arrangements for her discharge later that day. What had happened was that suddenly the child started bleeding from everywhere and stopped breathing. Resuscitation was immediately attempted but this proved futile and the little girl died.

When I went into the room, much of the equipment was still strewn about amongst bloodstained clothes and blankets. The mum was sobbing uncontrollably and the dad was running out of the room then running back in and saying “In the name of Jesus I command you open your eyes” There was another woman wearing a white bloodstained shirt who was on the phone and alternating between crying and saying prayers. I latter found out she was the toddlers aunt. A senior nurse and the divisional manager were in the room and they were tidying up and getting ready to wash the child. Another nurse was trying to console the family. The non-verbal communication between us as staff spoke volumes about the awfulness of the situation and how helpless we all felt.

I stood in front of the mum and placed my arms on her shoulders and said how sorry I was for her pain. She threw herself on the floor and nearly knocked me over such was the force of her grief. The dad came in and I offered my condolences to him. He was angry and would have none of it. He said we must have faith and pray that God would raise the child from the dead. He also told me this was a test of their faith. I felt awful because I just don’t agree with that kind of theology and I don’t believe in that kind of God. God doesn’t test people’s faith by killing their children. If that was the case I couldn’t be a person of faith. Even though I didn’t agree with their theology I had to let this family express their grief the way they wanted to. They were waiting for their pastor to arrive.

While we were all waiting the nursing staff cleared the room and washed most of the blood away. The parents didn’t want the child formally washed as they were still hoping for a miracle. During this time I held the mums hand, I read them some Psalms, but not any that would enforce their religious view. I prayed, although I found this really difficult and I began to talk to them about the ultimate healing can sometimes be death. I also talked to them about a God who watched helplessly as his own son died but because Jesus died in that way and rose again that is why we can believe in everlasting life. I didn’t know whether any of it was going in.

Eventually their pastor arrived and I gave them some space and myself and the nursing staff left the room. From the nursing station we could hear the shouts and raised voices as they tried to pray their child alive. It was having an awful effect on the ward staff, patients and visitors alike. I gave them about 20 minutes. During this time I encouraged the staff to talk to me about the events that had lead up to this awful situation. That is always the first stage of any debrief. Everyone was traumatised by events.

After 20 minutes I went in and stood quietly at the back of the room. The pastor in a big booming voice would say a prayer and then roughly shake the little toddler. Dad would also do the same. It was heartbreaking to watch. I knew I couldn’t let this go on indefinitely on the ward due to the needs of everybody else, but how was I going to shift them.

I stepped forward and said that I had some oil and would they like me to anoint the child. They wanted this. I said some general prayers about us not knowing or understanding God’s ways and praying for God’s  transforming love to come into this situation. I got them each to anoint her too. They seemed slightly calmer and I said that we were going to need to move the toddler to a quieter place where they could continue to be with her and pray and get any other relatives to come but that we needed to move away from the ward area because of disturbing any of the sick children. I said that the mortuary had a room that was private and any noise they made would not disturb any one. They accepted what I had to say. I quickly went and phoned the mortuary staff and warned them about what was going to happen.

When I got back into the room Dad had picked up the child and wanted to carry her to the mortuary. I wrapped a blanket around her whilst nodding to the nursing staff to let them know this was ok. We went down the back steps and across to the mortuary the whole time I was praying that nobody would stop us to talk because it would have been obvious that Dad was carrying a dead child.

I was so relieved to get then into our visitors room at the mortuary without incident. The mortuary staff and I took turns at being with the family for the next 5 hours until they were all prayed and cried out. It was really important to enable them to express their grief how they wanted to without necessarily reinforcing their beliefs. Because I patiently waited for them to be ready I was eventually able to do a goodbye ritual. Afterwards I reassured them of on-going support and watched them dejectedly walk away. The mortuary worker and I then sat down with each other to try and make sense of all that we had witnessed. This of course was an impossible task.

I then went back to the children's ward to look after the doctors and nurses who were very upset and wondering if they did everything they could. The consultant also needed a few moments with me so great was the impact of this little girls death.

Along with several of the nursing staff I went to the toddlers funeral. The family were grateful for what we had done but most of the hospital staff felt they hadn’t done anything and some were still wondering if they had missed anything that could have prevented the death.

I supported staff through debriefs and regular visits to the ward but it wasn’t till the results of the post mortem came out that staff really stopped giving themselves a hard time.

I have taken to popping into the chapel on my way home and handing all those I carry with me in my heart and mind and the work of the day over to God. I literally leave them on the altar. It was one of those days where only God could make sense of it.

The grim reaper or a midwife to the soul?

At the time of writing this my full time colleague had been off or several weeks and I was feeling the strain of working so much on my own. In my opinion it is not good to work in such a demanding role in isolation. I had built up some good relationships around the hospital and could go to some of my colleagues for support. This is not the same though as working with someone who you share a set of spiritual and religious beliefs with. I was also feeling swamped with work. It’s hard to suddenly go down to one fulltime person when there are usually two.

My usual way of dealing with these things is to put my head down, grit my teeth and get on with it. This however is not good stewardship of myself, so I asked for help from the hospital management and from the Diocese. I also asked for help from the local clergy. I was very fortunate. The Diocese were able to arrange for a local curate to come to the hospital one afternoon a week. The hospital management said I could get someone each week on a locum bank hours contract and I also built up a list of 15 volunteers from local churches to cover the emergency rota. All this made me realise how much work the two of us full timers do. We work a 37.5 hour week and then do another 45 hours on call. This of course is spread out 24/7. There is a retired cleric who always covers a Friday night, otherwise it’s down to just two full timers. If one of us is off for any length of time it puts a severe burden on the other person.

Saying all this, I love a challenge and I rose to it and really enjoyed trying to co-ordinate and develop so many different aspects of the chaplaincy service.

One night I was called out to the Stroke Ward. When I got there I discovered a delightful man who was preparing himself to die. His speech hadn’t been affected so communication was good. He wanted some reassurance about the dying process and what would happen to him. I thought he was talking about heaven so started talking about going into the arms of a loving God. He said he knew that but what would physically happen to him. This was a new one on me and I wasn’t sure. I encouraged him to speak to the nurses. He said many of them didn’t like to talk about death but he thought I’d be ok with it. I told him I was ok with it and I promised him I would get the answers and get back to him on that one. He then talked to me about how he felt to be leaving his wife after their 60 years together. It was all I could do not to weep with him for the sadness he felt at the pain he would cause his family. I reassured him that love always has pain as the flip side because great love involves great risk and that risk is the pain of parting. When you love someone or have been loved by them it always hurts when they are no longer physically there. But we wouldn’t live our lives with out that love. He understood this and knew he had been fortunate to have 60 years of love. I knew he and his wife needed to experience the pain as the working out of that love until they were to meet again.

I went back the next morning with a leaflet I had found from the Macmillan Team about the physical process of death. The patient was quite frail by then and not able to speak as much. I read the leaflet to him and he nodded at times. I slipped out of the room when his wife and daughter arrived to give them space for those last precious few hours. He died peacefully later that day.

Wow what a privilege. I thank that man for sharing his final journey with me. He was so steady and ready to meet his maker. It’s such a shame that so many people are uncomfortable talking about death. We’re all going to go one day. Death needs to be embraced and not feared. If there is no God then it’s just like falling asleep. We don’t know when the defining moment of sleep comes, we just close our eyes and know we’ve been asleep when we wake up. If there is no God then we won’t wake up. If however, there is a God, as I believe, then we will wake up surrounded by love and light and be invited by a loving God to know whether what we have valued in our lives has eternal value. Again this is nothing to fear. I hope that people don’t see me as the “Grim Reaper” but I do hope they know they can always talk to me about death and dying.