CPE - Sermon 2

TO BE OF SERVICE

A Sermon by Paul Kent Oakley

Carbondale (IL) Unitarian Fellowship

10:30 AM, October 2, 2011

WHAT IS A CHAPLAIN?
How many of you have ever received a chaplain visit in the hospital? Either when you were a patient or a family member of a patient? For how many of you was that a positive, helpful experience? How many of you had an unsatisfying or negative experience?

What does the phrase “hospital chaplain” suggest to you? What is a chaplain supposed to do?

Before I started seminary at Meadville Lombard I really didn’t have any idea what a chaplain did. I knew Father Francis Mulcahy from a decade of watching M*A*S*H. Father Mulcahy was a usually good-natured priest who could be called on to do a Methodist service or even officiate at a bris in the absence of both rabbi and mohel. But aside from television, I thought more about the US Air Force Academy, where Evangelical Christian fervor has been known to browbeat non-Christians and the uninterested into attending Christian services and being subjected to proselytization offensives. In hospitals, though, I think I just thought of an ingratiating Evangelical minister going around from room to room trying to save souls before they slipped on to the next world. The only time I had been a patient in a hospital, almost a quarter century ago, it was in Germany. In my month-long hospital stay, no chaplain visited me. It wasn’t part of how things were done there. So I was totally in the dark until I had a class in pastoral ministry in my first year of seminary.

What I learned before heading to St. Louis was that one of the biggest no-no’s for a real chaplain is attempting to provide answers to a patient from the chaplain’s own philosophy or theology. The essential job of the chaplain is to assess the spiritual needs and spiritual resources that the patient (or the patient’s family) has come with and help them access their own source of strength. No preaching allowed. Praying, however is frequently requested by patients and families, though that, too can be problematic. Petitionary prayer is not part of my spiritual practice, but patients often expect it.

HOW A CHAPLAIN IS TRAINED
I was enrolled this summer in a two-and-one-half-month unit of Clinical Pastoral Education (or CPE), a chaplaincy training, at Barnes-Jewish Hospital. CPE is a clinical training method. That means that the biggest text book is the doing of chaplaincy work. The intern chaplain is thrown in the deep end and told to swim. At least that is what it felt like at first. Through practice and reflection, a group of five of us chaplain interns of different faiths and different ages, with different life experiences, came together to learn from the patients and staff, our mentors and supervisor, and from each other how we can address the spiritual needs of patients and families who often do not share our faith identity or other demographic factors. In addition to me, the middle-aged gay white male Unitarian Univeralist, my colleagues were a middle-aged married conservative non-denominational Christian African American woman, a middle-aged married white male liberal Catholic, a young-adult single white female United Methodist, and a young-adult single white female Reform Jew.

To do this work we had to start from a place of authenticity, each being true to our own faith. We five chaplain interns supported each other, helping each other see the meaning or not become overwhelmed in what could be emotionally difficult encounters. Many were the times when as chaplain I sat with a couple as they face pain and uncertainty and even death, and my job was to help them grieve or reconnect with some sense of meaning, some sense of the Holy? And some patients had no one. The chaplain sits with them in their room, together seeking to find hope and comfort. Sometimes, hope and comfort are so far away, that the chaplain has to bear the burden of hope and faith alone until the patient is able to take it up again.

We each took the sense of the divine or what gives meaning from within our traditions as our grounding. But then we had to communicate coherently with patients and families whose cultural language was significantly different from our own. And we heard from them in their many cultural languages, messages that we needed to translate into our own idioms so that we could show back to them the resources and commitments that they had lost touch with in their pain, fear, and uncertainty.

To prepare to do that, we five interns and our supervisor spent eight hours of each week together for class, sacred text, sharing a patient encounter for reflection and feedback, and interpersonal group, where we supported each other and learned from each other. Each of us interns had an hour in individual session with our supervisor each week, during which he helped us to focus on what we are doing and to see ourselves and our chaplaincy with greater accuracy. We interns saw each other at the beginning and end of every day. And many days we also managed to eat lunch together. Supported in this way, I believe, we saw ourselves as facilitators, helping our patients and their families touch the spiritual resources they had within themselves.

But part of that learning process required each intern to arrive at a set of learning goals. Three of us in the group had goals that directly related to how we would relate to patients whose theology was significant different from our own. I cannot share the specific goals of my colleagues, but think about what it might mean to the faith and conscience of a conservative non-denominational Christian or a liberal Jew or a flaming Unitarian Universalist to be asked to pray with a patient whose belief structure and language of prayer were totally foreign – perhaps even offensive to the personal sensibilities of the chaplain. Each one of us had to negotiate a tenable position over the course of the summer, each deciding where the individual’s boundaries were. What will I do for a patient as their chaplain? And what goes too far for me to do in good conscience? What would the patient accept as help from the chaplain? What were the possibilities to navigate between?

I’m going to share a few experiences with you. I’ve made a few alterations that remove all identifying features because each patient has the right to privacy. Here is some of what I learned from this summer:

EMERGENCY DEPARTMENT EXPERIENCE
Now remember I said that clinical education tosses you off the deep end? Imagine this experience. The very first time I was called to the Emergency Department, I entered a room where the body of a young man killed in a motorcycle accident was laid out for his family to spend some time with before they signed papers and went out into what was now a cruel world, alone. I stepped into the room and found family members there, as I had been told. But I was totally unprepared for what I found beyond their presence. While the women comforted each other, the men stood on either side of the broken body of the son who had been pronounced dead on arrival. And as they stood there, they prayed in vigorous Pentecostal manner for a miracle. They proclaimed their faith in a God who raised the dead. The asked for, they claimed, they demanded the miracle that they believed God was capable of and performs. I sat with the women. Held their hands. Got them tissues. Fetched them glasses of ice water. Listened to their groans of horrible pain. I sat with them in their pain. And then, allowing the family some privacy, I left the room to come back later.

When I returned in 15 minutes, the prayers still continued. For two full hours the men prayed for the miracle. And then, as if they had reached their limit, passed beyond denial through exhaustion into acceptance. The tone of their prayers changed. The demands for the miracle were done, and in their place a softer, pained, resigned acceptance of God’s will, a prayer for the young’ man’s soul and thanksgiving for his life. One man told the women to do their crying in that room because when they walked out they were going out victorious in the grace of God.

It wasn’t until later in my time at Barnes-Jewish that I found viable techniques for being authentic yet still of service to patients or families who specifically asked me to pray for a miracle. But that day, I learned that even when I could not in good conscience join in the prayers for the young man to be raised from the dead, I could still be there for the family. Sitting in silence, holding a hand, listening to the mother express her grief, seeing to physical needs… Even when I was completely theologically incompatible with a patient or family, I still had something to offer that no one else in the Emergency Department had the time to offer.

THE PATIENT’S SONS
As well as encounters with true believers, there were probably as many encounters where religious belief and practice were not what a patient wanted. I remember one patient, a middle aged man who’d had spinal surgery. When I introduced myself as a chaplain, he sort of tensed up, but he didn’t tell me to leave, so I stayed and just talked with him for a while, seeing whether something might come up that he needed my ears or shoulder for. And sure enough, as soon as he saw I wasn’t peddling anything, he started talking about what was on his mind. He wasn’t worried about his surgery and recovery. He had faith in his surgeon and the hospital concerning that. But he had a heavy, heavy weight on his heart.

He started talking about his sons for whom he gave up advances in his career in order to raise them alone. In tears he told me how they had not been at the hospital for his surgery. He detailed several ways in which they hadn’t shown they cared about him when he needed them the most. Just for moral support. This was a strong man who had the appearance of someone who didn’t usually cry. Indeed, he told me he hadn’t cried once in the several years since their mother had left. But he cried in my presence as I allowed him to talk about what was important to him rather than coming with an agenda.

His problems could not be fixed in our encounter, but the simple fact of my being present to him, without any agenda, not trying to fix him, allowed this patient the space he needed to unburden his soul of his great disappointment in his sons. I learned again from this patient that it is more important to listen than to think it is possible to fix another’s problems.

EVERYTHING ALL AT ONCE
And then there was the patient who, in the middle of a longish encounter, suddenly reminded me of my ex-wife at her most vulnerable. So there I was, forced to separate out in the moment my personal stuff that I had to deal with later and the needs of the patient. What surprised me as I was putting that personal stuff to the side is that this difficult encounter showed me what I least of all expected: that buried deep there was within me still a well of tenderness toward my ex. Even after decades having only the most minimal contact after some emotional extremes after our divorce. In just a few minutes, this patient forced me to think about things long buried. Talk about a shock! But I put it aside in the moment in order to be present for the patient.

She had a degenerative disease, could barely move in her hospital bed, and you would think that that would be enough. Right? But the universe doesn’t work on the fairness principle but on some other complex calculus of cause and effect. So this woman, a mother of several children, was divorced by her husband when she got the diagnosis of this disease. And because she was debilitated with her disease, he got custody of her children and then remarried. And one of her children committed suicide. And another blamed herself for her sibling’s suicide and couldn’t bring herself to do anything positive and constructive with her life because of the guilt. And that would certainly be enough, no? But there is more. Her house and all her belongings were destroyed in a tornado. If she had lived a few millennia earlier, they might have written a book of the Bible about her story.

Every sentence was physically difficult for her to express. And I was fighting back tears as she was telling it. And finally she asks a wrenching question: does God forgive her? Now here was the big chaplain’s no-no, right? I’m not supposed to tell her what I think. I’m supposed to draw out and help her strengthen her own belief. I tried. Believe me I tried. But she kept coming back to the question. She wanted an answer not a process, and I didn't know how to move forward. So I reassured her that certainly God forgave her. We  cried together. She asked for a prayer.

I left her room knowing two things: I had technically broken the rules of engagement, and I had done the right thing - a right thing for my patient, at least given my level of skill at that moment. From her I learned that rules, though important, have to be weighed against an individual’s carefully discerned need.

FINAL ENCOUNTER
And finally I must tell you that the very last patient I visited this summer threw me out of her room. It is good to laugh now when I word it that way. But there was nothing funny at the time. The nurses had asked me to see her because she had just received a new and devastating diagnosis. So in I went. Somewhat confident in my abilities by that time. I introduced myself as the chaplain. The patient glared at me then turned and stared out the window. I attempted to engage her, using techniques that I’d learned over the summer. And she spoke to me briefly. She told me that all she wanted to do was look out the window and not think about her diagnosis. I tried again because you never know. Sometimes people need someone to let them know that they’re not going away. But she was not ready. She told me loudly that she didn’t want to think about it and used a few colorful phrases to tell me to leave. And I left, telling her that if she would like to see a chaplain later she could ask her nurse to page me.

The final reinforcement of a lesson that I got from her was a crucial lesson. From her I learned again that it’s not about me. My function of trying to help her find a way to deal with what she is going through is supremely unimportant compared to her confirmed judgment that she wants none of it and wants to stare out the window. Looking back on the summer, I am so happy she was my last patient because that is such an important yet difficult lesson to assimilate. It’s not about me.

SEGUE TO CHOIR
I could burden you further with my summer experiences, but I’ve already run past the limits of your patience. So I ask that you pause for a deep breath. …In… Out… In… Out… In… Out…

…Silence is important. Only when we stop our own voices can we hear the voice of those who need our presence…

Before the finest symphony can swell with notes profound

The silence must resound, the silence must resound.

And so we listen in moments clear and calm

To hear, with wonder the quiet strains prolong.

~~~~~

ORDER OF SERVICE
Sunday, October 2, 2011

Mr. Paul Kent Oakley, Presiding and Speaking
Ms. Shaina Graff, Violinist
Mr. Alan Christensen, Pianist
The Carbondale Unitarian Fellowship Choir
       directed by Ms. Geri McKee

Welcome and Introduction
Kindling the Chalice Flame: Nicholas Therrell
Announcements
Prelude: Shaina Graff
Opening Hymn #359 “When We Are Gathered”
Opening Reading #567 “To Be of Use”
Sharing of Joys and Sorrows
A Moment of Silence
Metta Prayer
Unison Offering Reading
Offering Music: Shaina Graff
Message: “To Be of Service”
Musical Interlude: “The Silence and the Song” by Mark Patterson - Carbondale Unitarian Fellowship Choir
Closing Words
Closing Hymn #18 “What Wondrous Love”
Benediction