Tuesday, September 23, 2014

A Day in the Life of a Hospice Chaplain

 By J. R. Peyton, MDiv., June 2010©

I paused outside of the room to gather my thoughts and breathe a prayer for the job that was ahead.  The hospice nurse had called and informed me of a new patient that had a fast-growing cancer (b cell type lymphoma) on her face, neck, and head.  She was not expected to live very long.   A month ago she had been 100% healthy, living independently, and had no visible symptoms.  The nurse had tried to prepare me for a rather unsightly situation and the considerable difficulty in controlling the pain.
            On entering the room, darkened because of the closed drapes and dimmed lights, my eyes slowly adjusted to the darkness.  Withering in pain on the bed was a terribly disfigured woman with multiple, open, weeping tumors on her head, of which some were as large as a football; dozens of other tumors ranged in size from a marble to a golf ball.  Significant amounts of morphine had been administered sublingually, but had little effect on her pain.  Her chart said that she was not a practicing Christian, but had expressed a desire to see the chaplain on admission (some days ago prior to being on hospice).  She is elderly, but her body seems to be rather healthy compared to her head.  She has a decreased level of consciousness (due to medication and disease) and is alert only to herself, her pain, her end-of-life concerns…
Kim[1] was every bit as bad as can be imagined.  She tossed and turned on her bed, her skin was moist and clammy, the sores on her head were… (well, some things can’t be described), and the smell…  I pushed up the chair as close to the bed as it would go and sat down.  When I took her hand, I could feel the grip tighten around mine (somewhere inside she was still reaching out for community).  She whispered a word (one of two words she said while I was there) to me before I could say anything, “Scared!”  I told her who I was and did not receive any response other than her hand gripping mine.  Her collar-length hair was matted, wet, and hanging in her face.  I reached out my other hand and began moving the hair out of her face and running my fingers through her hair and over the tumors that were claiming her life.  Her response was almost immediate as she calmed down and began to more comfortably fall asleep.  The nurse came in and said, “Thank God you’re here.  We haven’t been able to do anything for her.”  Amazing what a hand can do when time is given and the effort is made!  Over the next few hours I said my prayer, even told the story of how Jesus touched the leper, played some hymns on my iPod, but mostly just held her hand and touched her head and hair. 
An hour later, her arm relaxed as her coma deepened, and I was able to go.  The pager on my phone beeped as I walked down the hall, troubled once again over my last visit.  Now the phone was beeping again: a beep that I had learned to associate with crisis.  A beep that pulled me from my troubled reflection, “Was I doing enough?  Were the songs/scriptures/prayers meaningful?  Had I briefly been able to highlight the joined hands of God and man?”
            The text message read, “New pt in Gerald, Mo, may die at any moment.  Can you come today and do intake/assessment?”  A few phone calls later, I had rearranged my schedule, postponed less critical appointments, picked up a lunch for the 160-mile, round-trip journey, and headed down the road in my car to a new unknown crisis.  Would I be able to provide comfort?  Could I extend the hand of Christ to care for the sick, diseased, and/or demented?
            While I drove out to the house, I received a call from the hospice social worker with a briefing on what was known.  She was an 82-year-old woman with an inoperable cranial aneurism that could burst at any time.  As well, she had an implanted pacemaker/defibrillator that kept firing irregularly whenever the heart failed to fire on its own.  She had several children of varying involvement.  Finally, she also had some form of dementia.
            When I arrived at the house, the front door was ajar, so I walked on in (only done in the country) and found the family room crowded with family and hospice workers trying to provide initial services to the family and client.  As is often the case, other than a precursory greeting and/or examination, the demented patient is then ignored and the attention is given to the family.  It is the chaplain’s job to ‘spend time’ with the patient (time I love to spend).  I knelt next to the wheel chair and put my arm on the back of the chair.  The patient immediately gave me a sloppy hug and laid her head on my shoulder.  She welcomed me warmly and denied any pain.  We talked of her family, of whom she could provide little information to the number or names of her children.  She did not know the day, month, or year.  She was unable to tell where she was other than “Home!”
            Finally, I asked the questions I am forced to ask about her faith tradition for her records.  She immediately stated that she was Catholic.  When asked if she had always been Catholic, she stated, “No! I just changed a few weeks ago!”  A family member in the background stated, “More like 50 years ago!”  When asked what she was before she became Catholic (seeing that it felt so fresh and recent to her) she again answered quickly that she grew up Mormon.  When asked if she thought of herself as either Catholic or Mormon, she stated she wasn’t sure.  When asked if I could contact a Catholic Priest or Mormon Elder for her, she said, “No!  The first one didn’t approve of my first marriage, and the second didn’t approve of my divorce and second marriage!  Besides, my husband is United Church of Christ!”  When asked if she ever went to church with her husband, she again informed me, “He doesn’t go to his church either, because they didn’t approve of me!”  She then, without prompting, drops a bomb shell on me, “Besides, we have you now (gives me a little, slobbery hug and kiss on the cheek)!  You will be our pastor now!”  When I asked her husband if I could contact someone for him to act as a spiritual advisor, he too affirmed his wife’s words, “No, we have not attended church in 40 years, and I am sure that you can take care of any religious needs we have!”  It is worth noting here that while she could not remember the names of her children, she could quite accurately relate the painful history of a rather fractured faith background.
It would be easy sometimes to just “walk away” after a week of daily death, heartbreak, and mayhem.  But someone must do this work… I believe Jesus would do this work… and I want so desperately to be Jesus to them.  Sometimes I feel like I am close… but other times I know I am a million miles from the mark.
What do I do for these ladies?  What can I offer them?  What does the ecclesia have to offer them?  How can the gospel be presented to them this late in the situation?  What form would the kerygma take, and what should it look like?  In this context I do not stand at a podium, take a text, and pontificate about some aspect of the scripture, a format that anticipates an allotment of time in which to reflect, incorporate, and by which to become empowered.  On the other hand, my actions become the kerygma for the patient, and therefore this lived sermon[2] must be a major consideration (and the result of) any research that is to be done on ministering to people at the time of death. 

[1] Names of patients and their situation changed enough to protect the privacy and dignity of the patient and their families.
[2] See Attachment One for sample sermon outline that is intended to be lived rather than spoken from a pulpit.

Attachment One
The Hand that Touched

Text - (Mark 1:40-42) (The Message)
            “A leper came to him, begging on his knees, "If you want to, you can cleanse me." Deeply moved, Jesus put out his hand, touched him, and said, "I want to. Be clean." Then and there the leprosy was gone, his skin smooth and healthy.”

            The beggar’s situation seemed hopeless.  Set apart in a dark place, alone, and certainly he was afraid.  His hand reached out…  (This will attempt to meet the patient where she/he is at this time – I see you! I hear you!).

            Jesus recognized that the leper was after more than physical healing.  If that were all there was to this story, then Jesus could have spoken the word from a distance and accomplished the same.  No, Jesus recognized the outreached hand that said, “Can anybody love me just the way I am!  I am so all alone in my pain, my disability, and my hopelessness!”  So Jesus did what was important first – He touched the leper, He accepted the stigma of becoming a leper, and bridged the gap between heaven and hell!  The healing of his body was secondary to the healing of his self image.  (This will attempt to provide the patient with validation of life, faith, and meaning – I feel/touch you!)

            How long had it been since he had been touched by anyone?  Can you imagine with me for a moment how it must feel to not know the touch of man (or God)?  Even a hand of hatred is better than total seclusion (an Eskimo proverb)! The gift of touch, regardless of the physical healing, created a feeling of wellness and wholeness in the man’s life.  (This will hopefully infuse the patient with a sense of worth and accomplishment – I value you!)
Conclusion – The lived moment!
            * (Matthew 28:20b) “And remember, I am with you each and every day until the end of [your life]." (my paraphrase)

            * It is my desire in the lived sermon to join the diseased body of humanity and the divine hand of God together! 

Pastoral Prayer
            Dear God we stand here in our weakness in need of your hand.  We don’t pretend to understand the ‘why’ or any other of the deep questions of life.  We do recognize the need of community… the need for someone to be here.  Let my hands, the hands of the nurses and aides, and the hands of all who visit here be the hands of God.  Let her community bring blessings, peace, and contentment in these hours of pain and passing.  We ask all these things with our faith firmly in the mystery of your Son, Jesus Christ.  As Jesus provided mediation between God and humanity – Let Kim’s community now mediate to her the endless love of the Master’s touch.  Amen!

Thursday, July 10, 2014

Explanation of Clinical Chaplaincy given at the UGST Symposium 2013

Personally, I have completed four units of CPE and, after working for over 5 years full-time as a chaplain, I am now a board certifiable chaplain.  A Board Certified Chaplain (BCC) is very expensive and requires a minimum of four units of CPE (two must be Level Two CPE), 2000 clinical hours of work after completing CPE, a Master’s of Divinity, a lengthy application process, and then sitting for a consultation/review by other BCCs.  After being hired by UGST, I walked them through the year-long process of becoming a Member School of ACPE.  I then was the natural and only potential candidate for the cluster board to appoint to the St. Louis Cluster Board that governs CPE training in the St. Louis, MO, and the Springfield, IL, area.  The St. Louis Cluster is the only remaining Cluster board in the ACPE; at one time such cluster governance dominated the ACPE.  This Cluster has survived because it is dedicated to unity, tolerance, and a commitment to be inclusive to a wide variety of faith backgrounds.  In this Cluster, United Pentecostal Church (UPCI) chaplains have found a warm welcome and mentoring by CPE supervisors who are dedicated to making a place at the table for them.
It would be helpful to start with an overview of clinical chaplaincy and how chaplaincy training takes place.  CPE training is given in a succession of levels, and the level you complete will determine the job opportunities.  It is also worth noting that the requirements for employment are different from state to state, and even from county to county, depending on the strength of enforcement by state and local officials.  For example, Missouri law states that no one can work in any clinical chaplaincy position without at least one unit of CPE.  However, in rural areas state regulators ignore this requirement because there is no CPE training available (although someone with CPE would be preferred in a hiring process).  On the other hand, in population centers like St. Louis and Kansas City you would probably not even be considered for an entry-level position without two units of CPE. 
As a final note on employment, it is the expectation of ACPE, most educators, and even state regulators that the Federal Government will likely establish rules on the education requirement of chaplains, because both Medicaid and Medicare are now billed for and reimburse for chaplains’ visits in a hospice setting.  In 2010 the Medicare Hospice Guidelines made the chaplain and/or a counselor a mandatory part of the Hospice Team. As in the case of other medical providers that are part of the Hospice Team, a minimum standard will probably be set in the near future.  When this happens it is the hope of ACPE that this will be set high (M. Div. and four units of CPE) (which is in keeping with social worker requirements) to improve the quality of care that chaplains are providing.  When this happens present day chaplains will be given a time span to come into compliance before being allowed to work for a company that accepts Medicaid and/or Medicare.
While I have no official data, there are only a handful of licensed or ordained ministers in the UPCI that have any CPE at all.  As far as I know, there are only a couple of people who are board certifiable (I am the only one I know of for certain).  Further, there are no Oneness Pentecostal supervisors or any Oneness Pentecostal students in supervisory training.  Crystal, if she gets a supervisory training slot, will be the very first to have been accepted into such a training program.
After a lengthy application is filled out ($50 fee) and the student is selected, all CPE students start with Level One training at a hospital that is licensed by ACPE to provide the training.  The cost for a unit of CPE varies between locations, but is usually around $600.  ACPE gives priority to people with an M. Div. and students in a similar program.  However, if slots are available, supervisors will fill the slots with anyone interested in chaplaincy.  The clinical method of training in CPE units require between five and eight students to be effective.  Each unit of Level One or Level Two CPE require 300 hours of clinical time, 100 hours of didactic and group supervision, and sometimes a variety of other responsibilities such as on-call work.  Each unit is usually made up of students at a variety of levels, and the cohort supports each other through the process.  Units can be done over different periods of time (10 weeks @ 40 hours a week and often called an ‘Intensive Unit’, 20 weeks @ 20 hours a week and is often referred to as an ‘Extended Unit’, etc).
Anytime after a single unit is completed and either the student or the supervisor feels that the student has completed all of the Level One objectives (objectives are listed in the ACPE Handbook), the student can apply to sit for a Level One Consultation.  A Level One Consultation is a written and verbal examination by supervisors and other important hospital employees or Cluster board members to determine if they are ready to begin working on Level Two objectives.  Many students will work for many units on Level One and never sit for a Level Two Consultation.  One reason for this is that supervisors will rarely tell students what is clearly written in the ACPE Handbook (students are required to sign that they have read the handbook), and I have known students who have completed six units of CPE and, when asked, had never heard of Level Two CPE.
Another opportunity for those seeking training is to be hired by a medical facility as a ‘resident’.  It is required that residents have at least one unit of CPE before becoming a resident.  As a resident they will do four Intensive Units back-to-back over the course of a year.  During that time the resident is expected to devote their entire attention to CPE learning and working at the medical facility that hired them.  While resident students are still required to pay for their CPE units, they are paid a stipend that again varies between location (between $23,000 and $32,000 a year).  Occasionally hospitals will hire a Second-Year Resident that will serve as a resident and mentor to other residents.
The next level of training would be a supervisory candidate training.  Because of the number of clinical hours one accumulates doing CPE, it is not required (as in other programs) that those seeking supervisory training have a clinical period (or become BCC) between finishing Level Two training and starting supervisory candidate training.  Supervisory training is provided by a supervisor who is qualified to do so and a medical center that is licensed to provide the training.  Supervisory training takes between three and five years after completing Levels One and Two CPE.  Therefore it would not be considered unusual if the entire process (Level One to Full Supervisor qualified) took about ten years to complete.  Currently in the United States, chaplain supervisors have been ageing and retiring at a faster rate than new supervisors have been trained.  There is therefore an increasing shortage of supervisors available.  Currently in the St. Louis area there have been two supervisor positions and a supervisor trainee position open for almost a year.  The before-mentioned shortage, coupled with ACPE’s dedication to inclusion of under-represented groups (especially Pentecostals, who now make up 1/12 of the world’s population), opens a space for a golden age of opportunity for Pentecostal chaplains.

My vision when I started out in chaplaincy was to have an influence on chaplaincy education throughout the Oneness movement.  By being appointed to the St. Louis Cluster Board as a representative of UGST (and by extension representing all Pentecostal chaplains), I have in some ways jumped over the need to have supervisory training in order to have this influence. I envisioned that this would only be possible by becoming the first UPCI supervisor and training UPCI’s future chaplains.  However, by sitting on the Cluster Board, I can influence the decisions of the Cluster as it determines who gets the scarce training slots in the St. Louis area.  Further, because of this position, I am sought out to consult on matters that affect or include Pentecostals in general.  I am also asked to sit on Level One Consultation Boards, Supervisory Candidate Mock Boards, meet with and/or interview potential job applicants around the city and give feedback, give presentations at chaplaincy training events and conferences, provide hospital training for chaplains and social workers, and only God knows the influence I can have over CPE and chaplaincy training in the remaining years of my life.  My chaplaincy journey has been one of faith, and God has surely opened the doors so that, as His vessel, I might be used to bring glory to His Kingdom.

Tuesday, September 25, 2012

A definition of beauty...

“…for seven weeks I’ve lived in here,
Penned up inside this ghetto.
But I have found what I love here.
The dandelions call to me
And the white chestnut branches in the court.
Only I never saw another butterfly.”[1]

            If this writer is to answer the primary question driving this research and postulated throughout these pages, ‘What pastoral care method(s) effectively provide a space of beauty at the end of life?’ one must first define beauty and understand its importance in ministry at the end of life, if one is to know for what to look.  This writer accepts that a definitive definition of beauty can never be fully comprehended and that the exploration of beauty is limited and tentative at best[2]; however, the hope in attempting a definition, no matter how fleeting, will provide a mosaic with which to focus this investigation into its existence at the time of death.  To do this, this writer will look to Jonathan Edwards and John O’Donohue for a simple, but poignant, definition of Christian beauty and to the Old Testament for a pre-Christian understanding of God’s beauty. Further, he will identify the need for pursuing God’s beauty, acknowledge the increase of ugliness which is the result of a loss of America’s God consciousness, and send a call to the Christian community to awaken and see His beauty and to the hospice chaplain, who is uniquely seated to facilitate the seeing of God’s beauty at the time of death.
It would be difficult, if not impossible, to attempt to define and understand beauty without considering the work of Jonathan Edwards who was/is the most prolific writer on beauty, with beauty being “…central and more pervasive [in his writings] than in any other text in the history of Christian theology.”[3]  Further, Edwards felt it was not enough just to know the definition of beauty in some logical format; “instead, one had to have a sense of it or, we might say, one had to experience God's beauty for oneself.”[4]  So, it seems to be our duty to both articulate a definition and grapple with a sense of this beauty that exudes from God’s being. It is just such a sense that this writer hopes to extrapolate from the musings of experienced hospice chaplains: chaplains who have seen such beauty when the Lord was/is among them and their patients, as on Sinai, in a holy place[5].  “[One] does not merely rationally believe that God is glorious, but he has a sense of the gloriousness of God in his heart.”[6]
            As simple as it may sound, John O’Donohue, a 20th Century Celtic philosopher, defined beauty this way, “God[7] is Beauty!”[8]  Jonathan Edwards’, an 18th Century theologian and sometimes mystic, believed that the theology of beauty “…begins and ends with God …an extraordinary vision of the divine Beauty replicating itself in all of creation.”[9] Throughout Christian history, theologians have built upon the foundation of biblical revelation for such a definition. They have continually sought to understand beauty as a “…sense of the divine being and character, as well as the works of God, and to define beauty in terms of the excellence and glory of God.”[10]  Therefore, there is one thing that this writer desires; like the Psalmist … one thing will I seek after… to behold the beauty of the Lord![11]  “Edwards argued that God’s ravishing beauty is the first and most important thing to be said of God. ‘God is God, and distinguished from all other beings and exalted above’em, chiefly by his divine beauty.’”[12]
O’Donohue mostly rejects tangible beauty for a mystical/spiritual beauty, embracing the ‘God is beauty’ mantra, and sees items such as art or music only as a possible vehicle to experience real beauty.  O’Donohue identifies beauty more as a state of being or God’s creative work on a journey towards completion/fulfillment.  As an illustration, O’Donohue offers, “You may hear a piece of music which turns your thoughts to one previous moment of love.”[13]  The aura remaining/created from that previous moment of love is the real beauty and not the music.  It therefore becomes the chaplain’s job at the time of death to provide the vehicle, or trigger the aura, that allows/helps the dying to find such a place of beauty.  Joan Chittister writes: “It is beauty that magnetizes the contemplative, and it is the duty of the contemplative to give beauty away so that the rest of the world may, in the midst of squalor, ugliness, and pain, remember that beauty is possible.”[14]
            Even before the Christian era, Old Testament writers related the idea of all beauty with the beauty of God.  Such beauty, grounded in God, fixes “…a degree of permanence and objectivity to the very idea of beauty.”[15]  There are at least three ways in which the Old Testament conceptualizes God’s beauty that has influenced the understanding of beauty into the Christian era and is apropos to this research.  First, “…behold the beauty of the Lord;” the very being of God testifies of His beauty.  Second, God’s beauty is associated with His moral character; God's excellence, honor, and majesty exude His beauty throughout all the creation, created in His image.[16]  “Out of Zion, the perfection of beauty, God hath shined.”[17]  Throughout Scripture there is no greater moral virtue coupled with beauty than God’s holiness. [18]  The psalmist David exhorted God’s creation to worship the Lord in the beauty of holiness,[19] and declared that God would live among those who worshiped Him in such beauty.[20]
God made everything beautiful in His time; from the very first, “Let there be…” to the very least of His creation today, God, with all of His creation looking on, continues to agree about His ongoing creative work, “It is good!”[21] The third idea associating God with beauty is His continued work in creation. “The whole of creation, functioning according to its intended purposes, in harmony and fruitfulness, is said to be beautiful.”[22]  Beautiful, because the beauty of the Lord our God is upon His creation, and has established that His ongoing creative work is now in the hands of His creation.[23]  Forever, oh God, you are beauty, your creation created in your image is beauty, and the beauty of your essence continues in the work of your creation.
While Edwards understood beauty as described above, primarily as a celebration of God’s being, he also understood that contemplating God’s beauty was secondary to the celebration of God’s being.  However, humans, as finite creatures with a finite understanding, must transverse contemplating God’s beauty on the road to celebrating the beauty of His being.  “Thus, while secondary beauty focuses on what immediately delights, primary beauty takes us out of ourselves into a contemplation of God’s own beautifying life and how we contribute to its expansion in the world.”[24]  Conversely, refusing to delight in our immediate surrounding that is endowed with God’s beauty will prohibit the celebration of the beauty of His being and blind us from seeing the ongoing influence of His beauty in the lives of His creation around us.  “The conscious celebration of God’s beauty is the end toward which the whole creation is drawn.”[25]
Edwards felt that creation is drawn to God’s beauty and that we should be concerned with living in the presence of such beauty more than anything else.[26]  Maybe we should not be as concerned with finding beauty as in recognizing His existing beauty and the ongoing work of beauty in His creative work, which surrounds creation every day.  “The natural world … enlarges the human capacity to sense the fullness of God’s beauty, and the appreciation of that beauty subsequently leads to ethical action.  Nature teaches us God’s beauty, and God’s beauty drives us to its continual replication in space and time.”[27]  Edwards loved the outdoors and spent much of his time outside in the woods or fields around his home, because the beauties he found in nature were really  “…emanations, or shadows, of the excellencies of the Son of God.”[28]
            For the sake of this research, it seems important to digress before progressing to a definitive understanding of beauty and how it applies.  The question that must be in the mind of the reader, as it is in the mind of the writer, is, What about the ugliness that seems to permeate the world around us?  If God is beauty, if He exudes beauty in His ongoing creation, and if His creation is participant in this beauty, where is this beauty?  This "…violence, oppression, economic enslavement and social irrationality," this ugliness has "…given despair a new warrant."[29]  George Steiner, along with many others watching our world, feels there is a "…systematic turn-about towards bestialization."[30]  When comparing the suffering in our world up against God’s beauty, it often seems difficult to see… or is it, as will be discussed below, overlooked, ignored, or clouded by the distractions of an increasingly violent world?
            T. M. Moore writes extensively on this point and feels that, “…the demise of beauty in the arts is the result of the loss of regard for God, then the hope for a recovery of beauty is somehow linked with restoration of respect for God.”[31]  While Moore is considering the demise of beauty in aesthetic art, it is still apropos because he also understands beauty as defined by Edwards and O’Donohue.  God is beauty; He exudes beauty through His holy creation, and His creation has (or can) become part of this beauty in the things that he does.  Therefore the artist, as beauty created by a holy God who is radiant beauty, creates beauty in his artistic work when influenced by the God of beauty.  Moore recognizes that, at least statistically, there “…seems to be no shortage of belief in God in contemporary America; yet the decline of beauty and the ascendance of ugliness has become a daily and widespread complaint.”[32] 
Because of a decline in contemplation of God’s beauty, it is possible that the celebration of God’s being is ignored and His beauty is hidden.  Christianity has dumbed down everything associated with God, His work, and His church.  “Much of the stress and emptiness that haunts us can be traced back to our lack of attention to beauty.”[33]  One has only to attend the postmodern worship service at the church on the corner to realize the theological shallowness of the songs, the art, and the d├ęcor; nothing seems to matter.  Modern Christian theology has become a mile wide (reflecting its modern resurgence), but only an inch deep.  Moore insisted “…that the hope for recovering beauty in an age of ugliness and death rests with those who embrace this biblical and theological perspective and heritage and who undertake the responsibility of cultivating a theologically informed taste for beauty.”[34]  Gerald Hopkins believed that God was/is trying to make His being “…known through the things of this world, and he lamented the fact that people seem so dull of hearing and blind to the beauty and glory that God is revealing all around them.”[35]
This demise of beauty in the arts and/or in the recognizing of God’s beauty in both His being and His creation, “…is the result of the loss of regard for God, then the hope for a recovery of beauty is somehow linked with restoration of respect for God.”[36]  If there is to be a restoration of respect for God, it will take Christian leaders (theologians, pastors, and Christian educators) accepting their God-ordained responsibility to nurture a theological taste for beauty in the hearts and minds of the ecclesia. “For, if cultivating taste as a spiritual gift and discipline does not begin with these, the teachers of the Christian community, it will never be established among the hosts of the community at large.”[37]
A “…persistent longing for beauty can serve as a starting-point…” or a place of awakening “…a true sense of beauty in this age of ugliness and death.”[38]   The call to awaken is a call to take one’s rightful place in God’s creative beauty, and when one does, one becomes more aware of the beauty in the world.[39]  “When we waken to beauty, we keep desire alive in its freshness, passion, and creativity.  Beauty is not a deadener but a quickener!”[40]  As one awakens in her approach to God, she “enters the presence of One who is the embodiment of all things beautiful.  Being in God's presence is supremely pleasant, filled with delights, majestic and excellent beyond description, and leads the faithful to exclaim, ‘how great is His goodness, and how great His beauty!’[41][42]
This research project is a starting point motivated by a persistent longing for seeing God’s beauty at work in the efforts of the hospice chaplain, especially at the time of death.  This project is a call for chaplains to awaken to the beauty in God’s creation and to the beauty in the lives (work) of His creation.  The beauty that is already there, but often missed in the business of paperwork, travel, and scheduling.  The mentally and physically exhausting work of the chaplain is especially suited for seeing God’s beauty; “Edwards found the reality of God’s beauty was most obvious during a time of ‘sensory overload’.”[43]  No one recognizes the decline of, and the recognition of, God’s beauty more than chaplains who live in the daily ugliness of death.  Patients, as most people today, rarely, if ever, understand God in the beauty of His being, His character, or His work; therefore “…it makes sense for us to believe that, if there is to be any recovery of beauty in this age of ugliness and death, it must arise from within the community of those who know God today.”[44]  The chaplain must become the mirror in which both patients and family can see God’s beauty in their lives and their own creative work.
Surrounded by pain and suffering each and every day, it would seem difficult, for most uninitiated, to discern beauty; however, it is “…the ‘new sense’ imparted by God’s spirit that makes this discernment possible.  The new capacity for perceiving God’s beauty makes one simultaneously more sensitive to deformity, more attentive to the distortion of God’s mirrored loveliness.”[45] Only those who have been there understand the ability for something strange and beautiful to happen when a patient is at the end of life.  The face relaxes as all fear, horror, pain, and suffering seem to fade away and disappear.  “‘I have often watched a look of happy wonder dawn in his eyes when he realized what was happening,’ writes a veteran [caregiver].  ‘He seemed to come alive in a new form.’”[46]
No symbol greater epitomizes suffering than the Gospel’s rendition of Christ’s suffering on the cross, and yet, no greater picture of beauty has ever been recorded.  There was never another time when God’s “…divine glory and majesty covered with so thick and dark a veil …yet never was His divine glory so manifested by any act of His, as in yielding Himself up to these sufferings.”[47]  Edwards’ love for beauty caused him to look for God’s beauty in places that astonished some; he “…knew that God’s most astonishing beauty lies hidden in the earth’s suffering, because the anguish of nature points to the agony of the cross.”[48]  There was/is no limit to which God would go to right the full brokenness of creation that it might be in harmony with His beauty; the ugliness of the cross was that symbol to all of this ongoing creative work.[49]  “The experience of finite beauty is …grounded in the transcendent beauty that belongs to all being [and] …persists regardless of the destructive forces of ugliness or evil.”[50]
            So the job of the chaplain could/would basically be one of holding up a mirror so the world can see its own inherent beauty as one created by God.  When one sees this beauty, there is a sense of homecoming, a sense of belonging to something greater than this temporary life.[51]  Not everyone hears/sees [G]god the same way as everyone else,[52] yet however one sees God, there is beauty in the seeing!  This becomes especially poignant for the chaplain, because when one loses “…sight of beauty [the] struggle becomes tired and functional.”[53]  Therefore, the joint search for beauty, the dance between patient and chaplain, seems to obligate them in two directions: “First, to seek this gift, and to desire it earnestly; and, second, to practice this gift as part of one's everyday spiritual discipline.”[54]
            Throughout this section one can seen how beauty and God are inseparable ideologues; God is beauty and/or beauty is God.  This is supported by both the pre and post New Testament writers, calling communities everywhere, in spite of the increase in ugliness, to awaken, pursue, and see God’s beauty.  Finally, hospice chaplains are uniquely situated to holding up a mirror so the world can see its own inherent beauty as one created by God.  When communities look for beauty and “…respond with joy to the call of beauty …in an instant it can awaken under the layers of the heart a forgotten brightness.”[55]  God’s beauty will not lay dormant, but is sure to spread when lifted up in joy, for “God’s beauty within the world is infectious.”[56]

[1] Pavel Friedmann in I Never Saw Another Butterfly: Children’s Drawings and Poems from Terezin Concentration Camp, 1942-1944 (New York: Schocken Books, 1993), 38.
[2] John O’Donohue, The Invisible Embrace of Beauty: Rediscovering the True Sources of Compassion, Serenity, and Hope (New York: Harper Perennial Publishers, 2003), 9.
[3] Belden C. Lane, Ravished by Beauty: The Surprising Legacy of Reformed Spirituality (New York: Oxford University Press, 2011), 171.
[4] Edward Hickman, "A Divine and Supernatural Light," in The Works of Jonathan Edwards, vol. 2, ed. (Edinburgh: Banner of Truth, 1995), 14, quoted by T. M. Moore, “The Hope of Beauty in an Age of Ugliness and Death” Theology Today 61 no 2 (2004), 161.
[5] Psalms 68:17.
[6] Jonathan Edwards, as quoted by Lane, Ravished by Beauty, 184.
[7] While this writer makes no excuse for his open belief in God, however, he also recognizes that some who read this research may be of the non-theist belief.  Two of the eleven chaplains interviewed for this research were non-theist. This author believe that this research is valuable regardless of one’s understanding of God and that most chaplains, theist or non-theist, recognize a part of G(g)od in the lives of all people.  Regardless of how one understands or explains G(g)od, a piece of the Holy is there in each human life.
[8] O’Donohue, The Invisible Embrace of Beauty, 217-247.
[9] Lane, Ravished by Beauty, 172.
[10] Moore, “The Hope of Beauty in an Age of Ugliness and Death,” 162.
[11] Psalms 27:4.
[12] Edwards quoted by Belden C. Lane, Ravished by Beauty, 173.
[13] Ibid, 194.
[14] O’Donohue, The Invisible Embrace of Beauty, 215.
[15] Moore, “The Hope of Beauty in an Age of Ugliness and Death,” 159
[16] Genesis 1:26.
[17] Psalms 50:2.
[18] Moore, “The Hope of Beauty in an Age of Ugliness and Death,” 158-160
[19] Psalms 29:2.
[20] Psalms 22:3.
[21] Genesis 1.
[22] Moore, “The Hope of Beauty in an Age of Ugliness and Death,” 160
[23] Psalms 90:17.
[24] Edwards, quoted by Lane, Ravished by Beauty, 196.
[25] Lane, Ravished by Beauty, 171.
[26] Edwards, quoted by Lane, Ravished by Beauty, 174.
[27] Ibid, 172.
[28] Ibid, 177.
[29] George Steiner, Grammars of Creation (New Haven: Yale University Press, 2001), 5-16.
[30] Ibid.
[31] Moore, “The Hope of Beauty in an Age of Ugliness and Death,” 156.
[32] Ibid, 157.
[33] O’Donohue, The Invisible Embrace of Beauty, 4.
[34] Moore, “The Hope of Beauty in an Age of Ugliness and Death,” 157.
[35] Gerard Manley Hopkins, "On the Origin of Beauty: A Platonic Dialogue," in Gerard Manley Hopkins: Poems and Prose, ed. W. H. Gardner, (London: Penguin, 1963), 166.
[36] Moore, “The Hope of Beauty in an Age of Ugliness and Death,” 156.
[37] Ibid, 172.
[38] Ibid, 158.
[39] O’Donohue, The Invisible Embrace of Beauty, 7.
[40] Ibid, 4.
[41] Zechariah 9:17.
[42] Moore, “The Hope of Beauty in an Age of Ugliness and Death,” 159.
[43] Lane, Ravished by Beauty, 188.
[44] Moore, “The Hope of Beauty in an Age of Ugliness and Death,” 169.
[45] Lane, Ravished by Beauty, 192.
[46] Glen Davidson, Living With Dying (Minneapolis: Augsburg Publishing House, 1975), 95.
[47] Edwards, quoted by Lane, Ravished by Beauty, 192.
[48] Lane, Ravished by Beauty, 191.
[49] Ibid, 192.
[50] Deal W. Hudson, An American Conversion: One Man’s Discovery of Beauty and Truth in Times of Crisis (New York: Crossroad Publishing Company, 2003), 125.
[51] O’Donohue, The Invisible Embrace of Beauty, 2.
[52] Diana Bass, Christianity for the Rest of Us (San Francisco: HarperSanFrancisco Publishers, 2006), 205
[53] O’Donohue, The Invisible Embrace of Beauty, 6.
[54] Moore, “The Hope of Beauty in an Age of Ugliness and Death,” 172.
[55] O’Donohue, The Invisible Embrace of Beauty, 13.
[56] Lane, Ravished by Beauty, 175.