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Healing, Not Curing: A hospital chaplain's job is more — much more — than comforting the dying
Rejoice with those who rejoice and weep with those who weep.
In a darkened hospital room, Katharine Howe Toledano sits in a chair next to the bed. She reaches out and gently cradles the hand of Gloria Robinson.
"Just to see her face, her smile. She cares," Robinson says. "She lifts you up; she's there. If it wasn't for her "
Tears well up in her eyes and she wipes them away with her fingertips.
"Ah, that's sweet. Thank you. Thank you," Toledano says, a slight knot in her voice and tears glistening in her eyes, too.
Robinson is on Erlanger Medical Center's oncology floor, suffering from ovarian cancer, a battle she's been fighting for five years. As they talk about Robinson's "grandbabies" (ages 25, 23 and 17), Toledano softly pats Robinson on the shoulder. Then she spontaneously stands up, leans down and tenderly hugs her.
"We're going to make it through this. We are. Yeah," she tells Robinson.
She sits back down and, a moment later, launches into a conversation about the multi-colored knit cap on Robinson's head.
"I'm also responsible for putting this hat on her. I don't think she's seen herself in the mirror," Toledano says, punctuating the statement with her immense laugh.
Shifting seamlessly from sadness to humor is a necessary talent that helps Toledano in her job as a chaplain at Erlanger. She works mainly on the oncology floor, where many of the people she comforts never go home or, if they do, must suffer first through the debilitating side effects of radiation treatment or chemotherapy or surgery or all of the above. Toledano leans on her faith to get her through days that threaten to overwhelm her, days when she needs comfort herself.
"My personal philosophy is that every person's journey is part of God's bigger story," she says, sitting in her office after leaving Robinson's room. "There's no one in this life that doesn't go through some pain or suffering, that doesn't have some loss or grief, and so that's part of the story, and we hold each other up through that and become part of a wider circle."
She mentions Romans 12:15, calling it her "mantra": "Rejoice with those who rejoice and weep with those who weep."
Perception vs. Reality
To most people, a hospital chaplain's job seems like a never-ending walk of woe. Trying to comfort those who are going to die. Holding up spouses who are constantly in danger of emotional collapse. Consoling distraught family members who can't save or who have just lost someone they love.
But chaplains at Chattanooga's three largest hospitals - Erlanger, Parkridge Medical Center and CHI Memorial - insist their job is not constant horror. Even when dealing with patients in the middle of the worst illnesses or the most agonizing treatments, they find uplifting moments, encounters that feed their soul and offset the ones that drain it.
Mark Davis, chaplain at Parkridge, certainly understands why people might look at him and think, "Oh my, how horrible his day-to-day life must be." But that's not the case at all, he says, calling it "joyful."
"They think that my job is hard, but my job is no harder for me than their job is for them," he says. "I'm made for this, so this doesn't stress me I'm lifting people up every day. That's pretty happy."
Betsy Kammerdiener, lead chaplain at Memorial, says she thrives on helping those who come to the hospital, even if they never leave.
"I love being with patients at the end of life, when I can help midwife that," she says. "I'm sitting with a patient, if they can talk, or with family, getting them to talk about stories. What was a loved one like? How did y'all meet? What did she like to do? Was she a little stubborn?
"We're working on the healing. I love that process."
In an emotional dichotomy, chaplains say that, even when times are at their worst, they may also contains moment of the best.
"You're there for people, but you're THERE for people. You know what I mean?" Greg Daniel, one of three on-staff chaplains at Erlanger, says while sitting in the hospital chapel, a virtual rainbow of mosaic tiles deftly hiding doves, nests and other figures in their patterns.
Daniel was immersed in one of those yin-yang moments a little more than two months ago - the November crash of the Woodmore Elementary School bus that killed six children. Hearing about the accident, all of Erlanger's chaplains came running, knowing that injured children were headed for the emergency room. In such circumstances, "you can't come to pieces," he explains.
"You've got to hold back. But after that storm subsides, you've got to deal with your own heart, those visual traumas you're seeing, a 6-year-old little girl laying in a bed and it's so easy to remember and think: My granddaughter is 6 years old and what would it be like to lose her?"
But while dealing with the horrific, he also found moments of transcendence.
"The best part is that it's a very sacred place to be with someone who is going through such trauma and loss and uncertainty and be able to bring some modicum of a nonanxious presence to their lives when the storm is just swirling about them," Daniel says.
"The worst part is we're in a time of crisis with the people and you know they're hurting and you hurt for them and with them, and there's not anything you can do. You can't fix it. You're really basically to be there with them. You experience part of that trauma yourself, and you grieve alongside of them."
BRINGING COMFORT
Mark Davis strolls through the busy waiting room at Parkridge, stopping to shake hands, chat, listen, laugh. One family has folks who've come from Florida and North Carolina to be there for a relative; another woman came down from Cleveland, Ohio. At one point, Davis and a family of four link hands in a circle and pray.
"I come in and look for people who have worried looks on their faces," he says. "Family members a lot of times feel pretty helpless; they want a solution. There is so much unknown about the future when a medical problem comes up. Are they going to make it? Are they not? Is this going to change my life? Is a patient in the ICU going to wake up from his coma or not?
"At times like these, people are very open to someone who's got some encouragement and answers. And the answer is: This is life. You don't know what's next."
Chaplains stress that, even at their best, they're healing, not curing. They can ease a patient's or a family member's fears, soothe their soul, help them deal. Heal their spirit, in other words. But curing is the territory of the medical team looking after the patient - and even they cannot always cure. And sometimes, the chaplains can't heal.
"The toughest times are when there seems to be no hope in the face of despair," Kammerdiener says. "If people can't connect with their pain, with something bigger, with some hope, with some transcendence, it's hard."
Early in his career, Olen Grubbs, pastoral care and education director at Erlanger, was chaplain at the state of Georgia's mental hospital- now known as Central State Hospital - in Milledgeville, Ga. He learned quickly that, even though he thought he could, curing was outside his abilities.
"I had the idea that I was going to learn to be a minister who was also an expert in psychology and personality, and I was going to be a counselor and help all these people with an illness get well," he recalls. "And my discovery was that, actually, the healing that took place was in the relationship of care that happened between me and those folks, because most of those folks were not going to quit being crazy or mentally ill. They were going to bear that and suffer with that for the rest of their lives. And how do you find healing for their suffering and how do you find hope in that process?"
But when you truly reach someone, truly help, the feeling doesn't go away for the chaplain or the patient.
"You get feedback," Daniel says. "People tell you, 'Chaplain, I'm so glad you're here. Thank you for being here.' They may never remember your face or your name but they do remember that someone was there."
He recalls a particular instance when there was a patient in the Trauma Intensive Care Unit who "wasn't going to make it."
"I worked with the family over three to four weeks and, after that, they wrote me every Christmas, saying 'Glad you were there,'" he says.
And, while chaplains at Chattanooga's major hospitals are Christians, they'll help any patient of any denomination. When the final hours are in sight, all say they've brought in rabbis for Jewish patients, priests for Catholics, imams for Muslims.
"I even brought in a Wiccan priest one time," Kammerdiener says.
And for atheists? Just being there and talking and offering sympathy can be enough.
"In some ways, atheists are the easiest because they don't ask: 'Why is God doing this to me?'" Kammerdiener says.
Above and beyond
Monica Chambers sits alone in an Erlanger hospital room, waiting for her husband, Jerry, to come back from surgery. He's suffering from Stage 4 liver cancer and there's no hope of getting better, she says. But he also has a bowel blockage that must be removed or the end will come in hours, not days or weeks.
Toledano squats down, talking with her eye-to-eye, placing her hand on Chambers' arm. They talk about her adult son who has ADHD and was drifting aimlessly until he recently found a direction in life as a drummer in a rock band. She points to a small piece of art on the wall, something obviously made by a small child. It's from her 4-year-old autistic granddaughter, Haley. Jerry calls it "his angel" that was made by "his angel," she says.
Stuck in the hospital for more than two weeks, she and her husband were worried about bills that would be left behind after he died - day-to-day ones such as car payments and utilities. "They're all in his name," Chambers says.
But Toledano "called in a favor," and had a notary public come to the hospital and witness her husband signing the paperwork to give her the ability to keep the lights on and the car in the driveway.
"He was so much at peace after," Chambers says. "He said, 'I know that financially you're going to be able to do what you need to do.'
"You've helped me so much in the last 48 hours," she tells Toledano. "I don't know what I would've done without you."
"Well, if we get it done, that's all that matters. Get it done," the chaplain says.
A few minutes later, walking down the hallway from the Chambers' hospital room, she notes that, even though she managed to get a notary public to Erlanger for the couple, "most of what I do is listen."
"People having their opportunity to tell their story is very healing. I think there's always something to celebrate in someone's journey."
All the chaplains say listening is a major part of what they do. People in hospitals, whether they're the patient or the family, often have a desperate need to talk. But the listening they do requires a special type of attention.
"The assumption is that we're listening and moving on," Kammerdiener says. "Yes, we do a lot of listening, but it's an active listening, for the story and the pain and the joy and the support. It's being present to the person."
"There's a lot of suffering that goes on here," says Grubbs. "The root word of 'suffering' means 'to bear' or 'bear with,' so what the chaplain does is bear with folks, and I think what you learn is the power of the listening ear, for folks to give voice to their questions and their pain and their suffering, if they can. They do that in a lot of ways, not just words."
But being quiet and simply being there may be the best medicines.
"The quietness of presence and care when you stay there with folks, it just makes a difference," says Grubbs. "Usually a shut mouth works better than an open mouth. A chaplain once told me she learned to do three things. She called them the '3 H's.' Hush, hug, hang around."
Beyond just lending an attentive ear, chaplains often must juggle multiple balls, taking on the roles of psychologist, mediator and even detective.
"It may appear that the adult son or daughter is having a very difficult time transitioning from the aggressive, curative care to the end of life," Kammerdiener says. "They may be belligerent. I can come along and say, in my mind, 'Why? What's the hurt there?' And you may find out that Dad just died two months and the thought of losing Mom is more more than the person can manage."
But belligerence can sometimes turn ugly, and chaplains may be called on to calm a situation that's close to blowing up. Under stress and filled with fear, some people react with anger or get disruptive if they're told they can't see the patient or a doctor is unavailable to talk to them at that moment. In some cases, the person's behavior reaches the point where it's interfering with the medical staff, making it hard for them to do their job.
"There was a guy here who was creating a huge problem," Davis recalls. "I had to interject myself and tell him, 'Look you don't want to get arrested. Our security guard is standing right there and the Chattanooga Police Department is on campus and, if you keep this up, this is going to be a way worse day than it is right now. Let's go into the waiting room and sit and talk, or you're going out of here in handcuffs.'"
In a similar situation, chaplains also must step between feuding families and turn down the heat.
"Sometimes, I end up being in a family conflict," Davis says. "You've got one family member who wants to pull the plug because there's no hope and another one says, 'Let's wait two days.' Or there's a dispute about who's in control of the decisions. One family member says 'I am' and another says 'I am.'"
Despite the unanimous belief that the job has more positives than negatives, the local chaplains admit that there are those days when the load seems heavier than normal. But they try to shrug off those days and focus on the better ones.
"I've got emotions and, as a matter of fact, I've cried with families myself because I've gotten close to families over a few days and I see the sadness," Davis says. "But you know, if I can help people accept something that is inevitable and kind of get a bigger picture of this life-and-death thing, then I've done something."
Toledano says, "I definitely have my own spiritual resources and places that I go to get renewed and refreshed. There are days when it's very draining and there's days when I feel very uplifted."
"There's good news, too. There's people finishing their treatments and getting better and going on their way. That's a great story, and you want to be there."
And even when the end comes, there's something special about that moment, too, Grubbs contends.
"When you are in a room where someone takes their last breath, it's such a holy, sacred moment," he says. "It's such a mystery to go from breath to no breath anymore. To see that happen with young and old and to be with folks that love them to say goodbye, that's a place in our heart that holds both joy and sorrow."
Contact Shawn Ryan at sryan@timesfreepress.com or 423-757-6327.