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Fall Ministries - Chaplains

Healthcare’s spiritual healers

Special Report Writer
New York

Margot Hover spots her “congregation.” They’re sitting on two long wooden church benches on the 17th floor of Memorial Sloan-Kettering Cancer Center here. A procession of patients files back from their chemotherapy treatments. They occupy the benches in the hospital’s outpatient clinic, waiting with their caregivers before and after their appointments. In their faces, Hover reads apprehension, sickness, frustration -- sometimes anger.

“It’s a good time for a pastoral visit,” the Sloan-Kettering chaplain said. The hospital is a stop of last resort for many patients. Their cancers have progressed, returned or they have come to participate in an experimental treatment. They need an empathetic listener, she said. Frequently dying is on their minds even if they can’t speak the word.

Hover views cancer as a family disease. Often she finds the best way to be the hands of care to a suffering or dying patient is to pose questions that will facilitate conversations among loved ones or lessen their anxiety. She might ask the wife of a dying patient: “What does it mean for him to die?” She may ask her husband: “What meaning do you want the rest of your life to have?”

“Would you like to say something to God?” can open the door to spiritual healing and peace, she said, even after surgical and medical doors have closed. But not every patient is comfortable with a visit from the chaplain. For some religion is an obstacle, a cause for distress, the former nun said. “There’s a difference between people who want a chaplain and those who need us.”

According to Hover, who holds a doctor of ministry degree and has published widely in health care journals, “Assessment is the name of the game.” Chaplains must make “a spiritual diagnosis,” she said and bring care to all who suffer in body, mind and spirit. Often it means extending care to family members and health care personnel.

Now in her fifth year at Sloan-Kettering, Hover also supervises residences in clinical pastoral education. The hospital is among 20 New York area institutions served by the HealthCare Chaplaincy. The 39-year-old agency is a multifaith community of professionals dedicated to the advancement of pastoral care, education and research. From a small Protestant chaplaincy service on the city’s East Side, it has grown into one of the largest and most religiously diverse pastoral care providers in the nation. Most of its chaplains are ordained men and women or religious sisters.

Jesuit Fr. Walter J. Smith serves as its president and CEO. In 1999 the agency’s chaplains made more than a quarter of a million pastoral visits in 28 clinical sites in and around New York City. More than 250 pastoral education students representing 30 faith traditions have trained and practiced spiritual care with the HealthCare Chaplaincy.

For the first time in its history, the chaplaincy opened its doors to specialty residents last year. The four who enrolled came from as far away as California and Nigeria to work at Sloan-Kettering for a year that Hover likened to post-graduate study at a top-notch university. Each had already completed a one-year clinical pastoral education residency -- as do all of the agency’s corps-in-training.

The further year of study allowed the specialists to take part in weekly psychiatric, multidisciplinary, and pain and palliative care rounds. They could offer observations on an equal footing with hospital medical staff, social workers and bereavement specialists. They exchanged case study presentations with psychiatry residents and got the chance to pursue their own fields of interest. One resident chose to examine the research literature on intercessory prayer, comparing those findings with data he collected during his interactions with leukemia and colorectal cancer patients. Another resident focused her pastoral study on feelings of shame among breast cancer patients.

Chaplains are now an integral component of the modern health care team that patients have a right to expect, Smith said. But changes in the economic and legislative climate have put “unprecedented pressures” on them. To survive, they have to justify their services against the bottom line. “Yet we know that what we provide for patients can’t be … captured by cost analysis,” said Smith, who came to the agency five years ago after serving as academic dean and a clinical professor of psychology and pastoral care at Weston School of Theology in Cambridge, Mass.

When the body is sick, emotions are out of control and the intellect is preoccupied with processing new information, “a person’s faith and spirituality may be his or her only available resources,” he said.

“There’s nothing mundane about what we do,” noted the Rev. George Handzo, head of chaplaincy at Sloan-Kettering. “We get to be part of a tremendously intimate experience. We get a chance -- if we’re good -- to make a difference in their lives. It doesn’t depend on if they live or die. It’s a question of how they die.”

Handzo, a Lutheran minister and a specialist in the care of children with cancer and their families, joined the agency in 1978. As for qualifications for the job: “You need to have thought about death and dying and to have your theology on straight.” Those who can’t deal theologically with suffering, “won’t last,” he said. And “control freaks need not apply.”

The HealthCare Chaplaincy serves more than area hospitals. It has also moved into nursing homes and outpatient delivery sites. Last year Hover and Imam Yusuf Hasan, the agency’s only Islamic chaplain, attended to dozens of families at New York’s Kennedy Airport whose loved ones were killed in the crash of Egypt Air.

The multi-faith aspect of the work has allowed the agency to “work effectively without sacrificing any of our religious identities,” Smith said. Besides some 18 denominations of Christians and the single Islamic chaplain, the agency employs a number of Jewish chaplains and a Buddhist chaplain.

“The vision of what we’re about has begun to be recognized,” Smith said of his $5 million agency, which relies on foundations, corporations and individual donors for half of its budget. “There’s a palpable sense that we’re making a difference, that we’re changing the world of health care.”

National Catholic Reporter, September 15, 2000