When Speaking is Not An Option!

Sarah and her family were an intensive and extensive pastoral care situation that taxed every aspect of my ability. My initial experience with this family did not seem very positive. They all stated that they were not Christian/religious at all and were not interested in chaplain visits. However, a few days later I found Sarah's son in the waiting room weeping. He had just heard that his mother was dying and that there was no hope. After talking a while, he asked me to visit his mother again. His mother had a tracheal tube and could not make noise, but could form words. When visiting his mother this time, who was also crying, she grabbed my hand and held on. We sat there for a long time before her mouth formed the words, “I… love… Jesus… but… I… don’t… like… religion….” I affirmed the importance of this statement over her loyalty to any religion.


While limited in our ability to communicate, we spent several hours over the next week sitting together holding hands, crying, reading Scripture, and praying together. Over the next few days, Sarah was able to separate what was important to her spiritually from what was not. Her only prayer requests were answered in the days before her death (to die at home with her family around her, eat macaroni and cheese one more time, and be kissed by her little dogs again). While we prayed together for these things, behind the scenes I was able, with the help of hospice, to make these things happen. She felt them to be a miracle from God, and it was wonderful to be the instrument which God used to make miracles happen. For those that knew Sarah, she died at peace with her family, her life, and her God.

The foremost pastoral skill utilized in this setting was pastoral presence. The ability to sit for long periods of time, occasionally crying, occasionally praying, with few if any words to say, reestablished this woman’s connection to her spiritual roots. While I never learned what those roots were, my presence represented them to her. Further, my being non-judgmental to her previous attitude towards God and her previous disconnection from God, provided the grace needed to embrace the same God she once spurned. A final, valuable pastoral skill in this situation was my confidence that during this time God’s Spirit was working. Sarah and I could not really communicate, and her family was unwilling (while tolerant of their wife’s/mother’s change of heart, they remained unwilling throughout this experience) to discuss her/their spiritual journey. Therefore I determined early on in this experience that God’s Spirit would have to work; I did not know what to say or what to do. Interestingly enough, while in most cases listening is paramount, in this case listening played a very small role.

“The Forgetting: A Portrait of Alzheimer’s!”

“The Forgetting: A Portrait of Alzheimer’s” is a 2003 Public Broadcasting Service Documentary that was patterned after a book by David Shenk by the same title. The made-for-television special portrays the entire spectrum of Alzheimer’s history from the ancient legends of demented folklore to its original diagnosis in 1903 by Dr. Eloise Alzheimer and on to the cutting edge of Alzheimer’s research today.  I highly reccommend this series for all who are interested in Alzheimer and is available on youtube.com. I will focus my reflection upon this relentless disease and how it will impact in the future my work as a hospice and/or hospital chaplain.

Alzheimer’s can be separated into two broad categories: early-onset Alzheimer’s and old-age Alzheimer’s. Behaviorally, early-onset Alzheimer’s can be defined as dementia that begins prior to the seventieth birthday, and conversely, old-age Alzheimer’s is everything else. Clinically, all forms of Alzheimer’s are caused from the interruption of synapse (electrical brain connections) secondary to the accumulation of plaque (starchy deposits). This interruption ultimately results in the death and shrinkage of brain tissue. Of the two, early-onset Alzheimer’s is more aggressive and the progress from diagnosis from onset to death can be very rapid (<5 yrs.), while old-age Alzheimer’s takes much longer (13-20 yrs).

In 1987 Alzheimer’s was already considered epidemic with 500,000 living with the disease in the United States alone. By 2002 the ranks of those diagnosed with Alzheimer’s were well over 5 million people (more than 10 times). While this number is alarming, it should not be construed to be spreading to new populations. Rather consider this: in 1980 there were 2,250 people in the United States that were over 100 years old. In the year 2000 that number had swollen to 250,000 people over 100 years old (also more than 10 times). This fact is solely responsible for the increase in the vast number of those diagnosed with Alzheimer’s, because the increase is in the old-age Alzheimer’s category.

Ten percent of all 75-year-old Americans have Alzheimer’s. The number is a little harder to determine (due to other forms of dementia being present as well) in Americans that reach the age of 85. However, studies show a range between 25 and 47% of all 85-year-old Americans as having Alzheimer’s. Due to advances in other areas of health care, more and more people are living to such a ripe, old age, and therefore the number of Alzheimer’s patients continues to grow. This growth is at an unprecedented cost to Americans with 100 billion dollars being spent in 2002 for the treatment and care of Alzheimer’s patients alone. With baby boomers soon to reach ‘old-age,’ the number of Alzheimer’s patients is expected to multiply by 10 again, reaching 25 million by 2030. By this time the cost of treatment and care for Alzheimer’s will be larger than the United States government’s entire annual budget. It is obvious that something must be done, and research is at a furious pace, with many new breakthroughs in recent years.

While praying for a cure and/or an effective treatment for the disease is prudent, there is little doubt that there is (and will be increasingly so) a great need for chaplains who will be willing, prepared, and qualified to provide spiritual care to those demented patients walking in the shadows of their old age.

The Man Who Plays the Music!

“Even marginal people within the church receive the social benefits of church involvement (Paragament, page 56). By marginal, Pargament meant people that live on the peripherals of the church such as non-attending relatives of members, non-attending maintenance personnel, local business employees or owners, and/or possibly rarely attending visitors. They all receive the social benefit of being loosely associated with the church. For example, the non-attending relative might be able to call on the ministry to pray in times of sickness, preach funerals, enjoy the camaraderie of passing fellowship, or have marriage ceremonies performed. The local business employees or owners benefit from the increase in business, and the morality propagated by the church decreases theft and vandalism. Many non-members, non-attending marginal people, benefit from the community of the church, and often they are unaware of such benefits.


These thoughts and more can be related directly to clinical ministry in either the hospital or hospice setting. Many ‘marginal’ people benefit from the ministry of the chaplain, and often neither the chaplain or the benefited are cognitively aware of the benefit. For example, I was called out to see a client who was actively dying last night. Her granddaughter was all alone with her grandmother as she died, and the hospice nurse was concerned about the unhealthy nature of this aloneness. I, as the on-call chaplain, was called to provide support. The focus of my ministry was the client and her granddaughter. However, while there, I was able to minister to the lady in the next bed who was scared of all the commotion and to the aide who had cared for the client for 4 years and was as emotionally distraught as the granddaughter. Many times my ministry touches medical staff on the peripherals of the situation such as doctors, nurses, aides, and other medical professionals. Even at times this blessing is extended to volunteers such as the cookie ladies or non-medical staff such as maintenance personnel and janitorial staff.

The idea of the mere presence of the chaplain is well established as an effective treatment modality among medical literature. It is true that the wherewithal to why presence is effective remains difficult to explain. Nevertheless, none would deny the value of presence. I had a patient one time that rejected spiritual care outright upon my arrival in the room. As I immediately backed out of the room, the patient called me back to the room. For some reason he felt safe to ask me some questions. He stated, “I believe in God… but really now… what exactly do you think you can do to help me in a few minutes that will change the outcome of my situation?” At this time I had yet to even say anything beyond, “Hi! My name is Joey, and I am the chaplain…” before being thrown out of the room.

I asked him, more from inspiration than planned cognition, “What are you thinking about right now?”

He said, “Well I’m thinking about how I am not sure prayer works… and what motivates you to spend your time coming around to our rooms…”

I replied, “First you say you are thinking about prayer and that you are considering my motivations. Earlier you volunteered quickly, without my saying anything, that you believe in God.” After he affirmed what I said was right, I followed up with a second question, “What were you thinking about before I came in?”

With a chuckle, knowing I had him, he replied, “I was thinking about how mad I was at being sick and how much bad luck I have.”

With a knowing smile, I too joined him in chuckling, “I guess I could leave now and consider that the job I came to do has been done. When I arrived you were mad about your sickness and thinking about your bad luck. Now you are chuckling and thinking about the God you believed in, wondering if prayer might work, and considering one’s motivations. I would say just my presence has done good work here. I really could not have accomplished more if I had preached a sermon!”

When the chaplain walks into the room, the very presence of the church community surrounds him, and even people on the margins benefit. Immediately people’s thoughts, of both the target patient and bystanders, go to more spiritual things, and they began to draw strength from spiritual resources. If an off-color story or joke is being told, it is hushed and apologies are made. If doubt has permeated one’s thoughts, hope is often birthed anew. There is nothing mystical about presence. When one is introduced as a chaplain, the mind gravitates to all of the things you associate with such a word. The word and work of a chaplain evokes a wide array of thoughts in patients, such as: hope, love, gentleness, Christ, church, prayer, strength, healing, scriptures, hymns, and more. If the chaplain is familiar, even an introduction can become unnecessary to blossom thoughts and memories. I can even see this in patients with dementia. They often don’t remember who I am, but one such lady said, “I know you, you are the man who plays the music!” That and more is presence…

A Holy Place for This Battered Band

“Now for a brief time God, our God, has allowed us, this battered band, to get a firm foothold in this holy place so that our God may brighten our eyes and lighten our burdens as we serve out this hard sentence.” (Ezra 9:8, The Message)


This Holy experience I want to share with each of you. For Pentecostals, this was truly a Pentecostal experience. I don’t know what others may say, think, or call it; all I can be certain of is that this experience will sustain me for many years to come.

It was the last patient of the day, and I almost didn’t go and see the man because he was in such agony. They had been unable to contain his pain that was secondary to palative back surgery that was secondary to metastasized cancer. He had been unable to be moved without screaming, due to his pain, and wanted to just be left alone by everyone. His prognosis is extremely poor and death is imminent. I decided to see him, against his spoken request to the nurse to be left alone, in hopes that prayer might work where medication had not.

I entered the room, and he was lying very still and taking very short, gasping-type breaths. His pain was obvious! I introduced myself and acknowledged his pain and sickness. He was obviously not an American, and I asked him his nationality (this is not something I have ever asked before, and I am not sure why I asked it this time). He told me he was from South America. I asked him what brought him to America, and he told me he had worked his whole life as an international salesman for a locally based company, and they had moved him to America to be closer to their corporate headquarters.

I was about to offer prayer when he asked me what faith I was. When I told him I was Pentecostal, he asked me if I was 'what kind of Pentecostal' (my thoughts at this point – this guy must know a bit about Pentecost). He was familiar with my tradition and stated that he had helped start Pentecostal missions for all over his home country.  He began to talk about the wonder of his work and the importance of the changing power of Pentecost in people’s lives. While he did not consider himself a preacher, his money and contacts were able to start countless missions in the jungles. It is his most rewarding legacy. He seemed to light up as he talked about this work.

It is important that you remember that through all of this he is making small, gasping breaths to try and control his pain. Each whispered word jarred his body and heightened his pain. I wanted to stop him, but there was something therapeutic in his talking about his love for the work of God. There was something pure and holy in this dying old man, who had taken over the entire conversation.

At some point in his talk about his love for the work of God, a change began to take place, and if I might be so bold, it seemed as if angels began to lift up this man and gave him strength. His whispered words of pain became stronger, and it was as if he had become free from the bonds of the world. He began to speak as a prophet and began to speak into my life words of life, hope, and strength. He began to speak out about my ministry as a hospital chaplain and to confirm God’s call and anointing in the path that I am walking. He identified my fears, doubts, and obstacles that would have been impossible for him to know. He assured me that God would go with me, provide for me, and that God had a great work for me to do that would include a harvest of many souls.

After about ten minutes of speaking into my life and story, he reached out his thin, frail arms and laid his hands upon me. He spent another five minutes speaking in tongues and praying for me, asking God for His anointing and blessing upon my life and ministry. God’s presence seemed to flood into the place as he prayed. Surely we had found a holy place together in the presence of God. As the patient prayed loudly and boldly, I began to speak quietly in tongues as an almost physical anointing poured over me, warming me from head to toe.

Spent, the old man collapsed back in the bed, once again gasping small breaths of pain. We sat there together silently for a while, and then he said, “Maybe God has let me live to this point that I might do this one thing more before I die!” Tears were rolling down my face, and I did not know what to say. The only thing I could think was that neither my CPE training nor my education had prepared me for this experience. When I finally turned to leave the room, the one-on-one nurse was standing there wide-eyed in the doorway. When she saw my tears, she quickly turned away and made herself appear busy. These words seem inadequate to describe this experience, but if I live another fifty years, I will not forget this experience.

Faith in God Alone

“...therefore choose life, that both thou and thy seed may live.” (Deuteronomy 30:19b)


Sometimes my work has been a constant reminder of the result of the choices we make in life. After three suicide victims and a multitude of other patients that were dying from self-inflicted injuries and/or diseases, it is difficult not to, at least, think about the choices that people are making every day of their lives. In the last few weeks I have seen more arms with needle tracks than I’ve seen in the last 40-plus years of my life. Dr. X told the ICU last week, “We need to get used to the idea that we are no longer a suburban community hospital, but rather the city has overtaken our hospital.” As a consequence of such demographic changes, we are now seeing the drug and alcohol abuse that is characteristic of a city hospital.

Every one of the suicide victims had rough lives of crime, abuse, drugs, and only God knows what else. I stood at the bedside of one such victim who also had brain and lung cancer, that was secondary to liver cancer, that was secondary to Hepatitis C, that was secondary to IV drug abuse. The family hysterically pleaded with me to pray that he be given one more chance to wake up from the overdose and have one more chance to make life right. The basis of their confidence in my prayers stemmed from my praying for the patient’s brother, who underwent brain surgery a few months ago, after leaving our ICU for Big Barnes. The brother recovered; therefore, if you pray for this patient he too will wake up and be able to embrace the family he has rejected. I tried to advise them that God did not always work in such a manner (the doctors said this patient would probably not live to wake up) and that while I would pray to a merciful God, it would be up to that same God to raise him up (or not). It was our job to trust God’s will regardless of the outcome. We prayed, and a few hours later he woke up, was extubated, and was sitting up talking the next morning when I arrived.

Now I said all of that, not to demonstrate the power of God, which is already well established, but rather to illustrate my frustration with the whole situation. I kind of felt like Jonah who preached, had revival with thousands of converts, and then was upset because he got what he preached/prayed for in Nineveh. It certainly seemed to all that God had heard my simple prayer, but within a few hours the patient was wanting (threatening) to leave the hospital so he could get on with making poor choices.

Now I know that God is sovereign, but I had to ask the question, “Why?” Why not the little lady on the other side of the ICU who was sick at no fault of her own? When I prayed for her nothing happened (at least not a physical healing). While thinking on this over the last week, I was finally reminded of my own little sermonette to the family when they asked me to pray. “I would pray to a merciful God, it would be up to that same God to raise him up (or not). It was our job to trust God’s will, regardless of the outcome.” I guess I will never fully understand or comprehend God’s grace and mercy, but I am again assured that Christ will have mercy on whom He will have mercy, and He will have compassion on whom He will have compassion. (Romans 9:15) Further, I may not understand what God does with my efforts, but certainly God knows what is best and what is right in each situation. Ultimately it is my job alone to trust God, to choose life, to encourage my patients to choose life, and that by doing so each of us will live.

Are You Listening?

• “The more you listen in depth, the more you will become aware that most people have relatively little insight into their own lives. Perhaps people’s lives are unexamined because no one is listening to them.” (John S. Savage, Listening and Caring Skills; A Guide for Groups and Leaders, Abingdon Press, 1996, page 33)
• “What you see is often not what is, and what they say is usually not the problem.” (Paraphrase of a quote from Cindy Miller, Counseling Professor at UGST, Couples in Crises Class, 2005)

 The first quote above, read earlier this week, made me remember the second quote that I often heard repeated while attending seminary. The responsibility of such statements sometimes overwhelms me when I think of the implication of missing the many listening cues that the chaplain is inundated with every time he enters a hospital room. Especially when the chaplain is often bombarded with miscues from the nurses, doctors, other staff, family members, bystanders, and even the patient themselves. As well, his own pain, problems, past, family, and more distract the chaplain. With all my being, I desire to be sensitive to what people are trying to, and needing to, say. But honestly, I know my humanity is a problem for the effectiveness of this whole process.

 

While I agree with the words of both quotes, the tenure of responsibility is more than any human can consistently keep up with. While it may seem that I am trying to defend the right or potential inability to not do a “good” job consistently while visiting patients, I assure you that the contrary is true. However, doing the job of listening effectively will take more than education, practice, or instruction. All of these are beneficial and should be taken advantage of, but dependence upon them alone will not produce the results desired. “Have I heard correctly? Am I listening well? Did I hear what was important? Will my response be clearly understandable?” (Emma J. Justes, Hearing Beyond the Words: How to Become a Listening Pastor, Abingdon Press, 2006, page 72.) The more I grapple with being a good listener, the more I realize that it will take an extraterrestrial influence to be able to do what I desire and is needed.

 

As a Christian chaplain, I am daily made aware that “that something needed” is available in the presence of God’s Spirit. Only with God’s Spirit preceding him and abiding with him can the chaplain walk into room after room of devastation, sickness, disease, heartache, and death and be able to repeatedly listen with a depth that will help him to assist the patient in becoming more insightful of their own lives. Such deep listening will enable the chaplain to guide the patient into their own encounter with the Spirit by reexamining their own spiritual journey. I am reminded of the words of the Apostle Paul that, when he was weak, Christ was made strong (2 Corinthians 12:10). My prayer is that in recognizing my weakness and knowing I can never consistently be a 5.0 chaplain, or even a consistent 3.0 chaplain, Christ’s Spirit might be strong in my ministry. That through Christ, which strengthens me, I can do all things (Philippians 4:13), and the more I am dependent upon His assistance, the better the chance of having an empathy score between 3.0 and 5.0. My greatest desire is that His Spirit would go with me while I do my human best and make up the difference. It is only with this faith I can continue to go from room to room…

 

All things to all people, that I might win some!

1 Corinthians 9:19-24 (TMNT) “Even though I am free of the demands and expectations of everyone, I have voluntarily become a servant to any and all in order to reach a wide range of people: religious, nonreligious, meticulous moralists, loose-living immoralists, the defeated, the demoralized—whoever. I didn’t take on their way of life. I kept my bearings in Christ—but I entered their world and tried to experience things from their point of view. I’ve become just about every sort of servant there is in my attempts to lead those I meet into a God-saved life. I did all this because of the Message. I didn’t just want to talk about it; I wanted to be in on it!”

This reflection is the result of a visit that I had with a very confused lady in her mid-sixties, who also happens to be Catholic. They had not yet determined the reason for her confusion, and it was becoming more pronounced by the hour. Over the course of 15-plus minutes, I could not keep her oriented to who I was and where we were (if not so serious, it would have been a very funny experience). However, I have not been able to get this situation off my mind, and therefore I will write the essence of my reflection.

While there, she thought that I was many things: doctor, priest, neighbor, relative, nurse, stranger, chaplain, and more. Because she was so confused, she also did not hesitate to speak her mind, much to the embarrassment of her daughter. She asked me if I was her priest, and when I said no, she asked me what religion I was. When I answered Pentecost, she responded with, “Oh, you’re one of those that speak in tongues.” I then asked her if she felt like she would like a Catholic Sister to visit her. She said, “Yes, I would like communion.” She then became very puzzled that a Catholic Sister and a Pentecostal minister could be chaplains together. I then tried to explain to her that both the Catholic Sister and myself visited with people, regardless of their faith, and if a specific need arose, we would contact each other. To try and explain, I offered the following example, “If a Catholic wants communion, I contact a Sister to fulfill that wish, and I suppose that if Sr. Mary was visiting a Pentecostal [I was fishing for an example she would appreciate] that wanted to speak in tongues, she might ask me to visit them.” There is quite a bit of humor here considering this lady was very confused.

This little interaction has provided me with many chuckles over the last week, but also a whole lot of reflection about who I am to the people I visit, and can I be “…all things to all people that I might [help] some?” Paul’s words, expanded by The Message Bible, expressed his desire to be a wide range of things, “whoever,” with the simple caveat to keep one’s self oriented in Christ. While communion and speaking in tongues are both Biblical experiences, they are not my missions while a chaplain. Yes, both may happen at times, but the important thing is to be a servant that attempts to lead people into a ‘God-oriented’ experience, taking them from wherever and whomever they are and pointing them towards God. I stand at the bedside as neither Catholic nor Pentecostal, but rather as an ambassador of God’s goodwill to all woman/mankind, whoever they may be.

It is not always easy to lay aside who I am and forget my particular brand, title, experiences, and/or traditions. As chaplain I am not there for me, but rather I am there for the patient lying in the bed. My time there must be spent focusing on where the patient is and how they might come closer in both faith and experience to the Christ of the Scriptures. I must draw from the resources of who they are and the traditions that are loved and meaningful to them and point them to a living God who is both present and interested in their situation. They are not forgotten, rejected, or abandoned, but rather sought after, loved, and succored by Christ.

Do this and you’ll live!

The parable of the Good Samaritin (Luke 10:26-37) is my favorite passage from the Bible, about which I have spent a tremendous amount of time reflecting and writing, and the guiding light of both my life and my ministry. Time, energy, and space will limit the points I wish to make, so I will try and limit them to how they impact my ministry as a chaplain. First, consideration will be given to the place of the neighbor in the context of chaplaincy; second, an examination into the preparation of the chaplain as the Good Samaritan; and third, finding life in caring for the dying.

Throughout the New Testament the word ‘neighbor’ is translated from the Greek word pleôsion. Pleôsion, when used as an adverb, is translated ‘near’, and when used as a noun, is translated ‘neighbor’, meaning one who is close by. Considering the commandment to love those who are close by as one’s self, and also the commandment to love even one’s enemies, changes entirely the common thoughts on such relationships. “Your neighbor is not your blood-relation only, not the circle of your acquaintance only, not your countryman or co-religionist only; but he or she whom you can help in any way whatsoever – the wretched tatterdemalion from the slightest contact with whom you shrink; the besotted and degraded; even your enemy, who hates you and despitefully uses you; him, her, mankind, you are to love.” (H.D. M. Spence, ed, The Pulpit Commentary, Vol. 16)  While Spencer was referring to one’s most wretched enemy as the neighbor, for the hospital or hospice chaplain such wretchedness can be allegorically and/or metaphorically conceived to be the most wretched of anguish, pain, confusion, and disease. It is these from which the natural woman/man will shrink, from even the slightest contact, but yet the chaplain chooses each day to walk into the lives of such individuals and their families.

The question, attempting to define one’s neighbor, is not a new question but was the same question asked of Jesus that precipitated the popular story of the Good Samaritan. “Who is my neighbor?” In answering this question today, it is important that we notice the positional references illustrated in the parable. The chaplain could argue that his patients are not his neighbors, but whether by choice, calling, and/or anointing, the chaplain has willingly walked into the proximity of his patients, thus making him/her the neighbor of the sick and dying. This is a good thing for the patient, because there are none who are more often lonely, shunned, or forgotten. My patients are my neighbors.

Another thing that has always fascinated me about this story is the preparation of the Good Samaritan. He came prepared to help someone injured along the road. He carried with him a first aid kit with disinfectant and bandages. He had transportation on which to carry the wounded. He had emergency funds available to pay for the extended care of the sick or injured. Finally, He had some training in the care and transportation of people in need of emergency care. While it may have been happenstance that the Good Samaritan came upon the man who had fallen among thieves, it is clear that he was prepared for such a possibility. None of the others who passed by were prepared to assist, either in what they had brought along or emotionally. None of them had considered the ‘what ifs’ of their journey that day. The Good Samaritan knew what to bring, what to do with what he brought, and where to take the injured he might pass.

The chaplain too should consider his/her preparation for the journey of chaplaincy and make sure she/he knows what to bring, what to do with what he has brought along, and where to take the sick and injured. There are many allegorical conclusions that I can make from this, but for me, my education and experience have taught me what I needed for journey down the chaplaincy road; CPE has taught, and is teaching, me what to do with what I have brought along on this journey; and my faith tradition has taught me where to bring my patients (at least those willing to go along).

Before Jesus began the parable of the Good Samaritan, He asked the question of his listeners, “What is in the Law?” As Jews had already been answering for centuries, the lawyer answered, “Love the Lord your God with all your passion and prayer and muscle and intelligence—and that you love your neighbor as well as you do yourself.” The last point I will make about this parable will consider the reply of our Lord to the above statement, “Do it and you’ll live.” In other words, Love God and love your neighbor and you will have life. This came to my mind this past week as I stood by the bed of a woman who was dying, talking with her husband. The woman was obviously in the final stages of her disease process, and her husband’s grief at losing her was great. Yet, he felt compelled to ask, “How do you do this? How do you go from one dying patient to another without cracking up?”

Standing there, I thought of the words of Christ, “Do this and you’ll live.” That by loving my neighbor, who happened to be like the man the Good Samaritan found by the side of the road dying, I could have life. The Good Samaritan knew the secret that the ‘religious’ leaders of the day did not know: the way to life was not in riches, or stature, or appointments, but rather in stopping to love the unlovable, the unapproachable, the diseased, and the dying. For me, the most important thing Jesus did, besides Calvary, was to touch the leper. That is what I see my job as, one who touches lepers, one who loves them in the same way I long to be loved, one who loves his neighbor as himself. Nothing fancy, just a leper toucher, but with the job comes life in such a way that words cannot explain.

Quote of the week!

"At the moment of death, we will not be judged according to the number of good deeds we have done or by the diplomas we have received. We will be judged according to the love we have put into our work." Mother Teresa

God is Still Speaking…

When I walked into Sally’s room, there was little change. The progression of Alzheimer’s marched on down its deadly path. She was no longer able to walk, take care of herself, or make her needs known. Her words were few and seemed mostly random as she laid back in the broada-chair (a form of modern geri-chair). Breakfast and lunch still stained her blouse as a baby doll, that a kind aide had left, lay cuddled in her old, wrinkled arms.

I knelt beside Sally’s chair and greeted her. Her little-girl giggle seemed so out of place in the frail body that waited on the cusp of death. Her face seemed to shine (probably the active imagination of one who so wanted to change the day for the better) when I suggested that we go outside and sit in the sunshine for our visit.

Once outside there was little to say beyond comments about the weather or how one was feeling. For such situations (when conversations seem to escape the clients’ abilities) I move into a routine, hoping to find something to bring peace, and the clients’ awareness of God’s presence. I played several old, familiar sacred hymns on my MP3 player and read the common verses of the Bible.

As I offered prayer, in preparation to leave, I felt Sally’s hand reach up and touch my cheek. When I opened my eyes, with her hand resting on my cheek, I was looking into her face from a foot away. Sally was trying to talk. This in and of itself was not unusual, for many such patients wish to talk, and sometimes do, in a random, nonsensical manner.

However, Sally’s voice was less than random and it felt directed to me from the heart of God. This is what she said with her hand on my cheek, “Why… (the dots here represent pauses)… you’re troubled… why… you don’t have to be… God knows… God knows… God knows… take care of you… God knows… (long pause)… He knows… You’re a teacher… a teacher… you’ve always been!” She pulled my hand to her mouth, kissed it, and whispered, “I love you!”

By this time, tears were running down my face as I realized, once again, that God had used the voice of the demented to speak to me and remind me of His presence, His love, and His calling. Someone asked me the other day why God does not speak much anymore. I responded that He was speaking just as much today as He always has, the problem is that nobody is listening. God is still speaking to you, and I feel compelled to ask you, “Are you listening?”

Dementia is no respecter of persons...

Dementia walks the sacred halls of the world’s cathedrals, among the vast wealth of Wall Street, and among the hovels of the poorest of our world. Slowly creeping where it is not bidden, getting a grip in the minds of the great, dementia marches relentlessly on and will not be deterred from its aimless end. No weapon has ever been formed against it successfully; there is no slowing its insistence upon devouring the mental faculties of both the very intelligent and the very ignorant. It destroys relationships, careers, educations, families, even the ability to appreciate the very simple pleasures of life (chocolate, grandkids, and flowers). No matter how devastating dementia is to all involved, no matter how degrading it is to each victim, and no matter how sure death is to the one diagnosed, each victim remains the creation of God, the child of its maker, and the love of his/her family.

With 58 % (33 of 57) of my case load involving some form of dementia (Alzheimer’s, CVA, Parkinson’s, non-specific Dementia) as their primary cause of pending death and another 19 % (11 of 57) with non-specific Debility as their primary cause of death who are also suffering from varying levels of dementia, dementia has been on my mind a whole lot this summer. Further, and even more importantly, I must ask the difficult questions. First, how does one effectively minister to people with dementia? Second, how does one draw the family back into the relationship without hurting them or creating a further schism between the demented and the family?

“People rarely lose interest in things they have enjoyed throughout their lives simply because they are experiencing declines in mental function. If their activities can be modified and simplified to meet their changing abilities, they can continue to enjoy things that caused them pleasure in the past and so retain an important aspect of their identities.”

Jennifer Hay, Alzheimer’s and Dementia (People’s Medical Society)

While these words were not written for the clergy, I think they have great wisdom that provides guidelines for those ministering to those with dementia. Further, they demonstrate the need for a good initial assessment of the client and the client’s family. Through a series of informal interviews and research into the client’s life, it is often easy for clergy to determine what was/is important to the client and what has caused them pleasure. Hay also goes on to use the example that clients to whom music was important can continue to find pleasure in music, even though dementia has taken its toll. Many people have found prayer, Scriptures, and sacred hymns to provide immense pleasure, comfort, and peace throughout their lives. The chaplain of the demented can easily provide these simple pleasures/tasks routinely to their clients with little difficulty. It has even been true in many cases, when the source of one’s pleasure is ‘unknown,’ it can be determined even in the non-verbal through experimentation. It amazes and thrills me to pull my phone from my pocket (doubles as an mp3 player), play an old hymn like “Amazing Grace,” and watch the same non-verbal client’s mouth drop open, occasionally see a tear make its way through the wrinkles of his aged face, or the demented Pentecostal raise her hands and shout in a feeble voice, “Hallelujah!”  I have even watched non-verbal, non-responsive clients mouth the 23rd Psalm and/or the “Lord’s Prayer” in the final moments of their lives. All this and more can, and usually does, thrill the families of the demented client.

The next question, “How does one draw the family back into the relationship without hurting them or creating a further schism between the demented and the family?” is not so easily answered, due to the multiplicity of human nature. What will help one family rarely will be the same answer for the next family. I call them the wall huggers, and there are at least a few by every deathbed. In some cases the entire family are wall huggers. I arrive at the room and they are hugging the walls, or maybe propping them up (sometimes it is hard to tell), and nobody is by the bed. Consequently the client dies alone, even though the ones that love them most are only a few feet away. I have found that direct request rarely works (“Why don’t you take the hand of your mother?”). Appealing to the altruistic natures of the family usually only works occasionally, and generally only briefly, by making the family feel guilty. The most successful thing I have done is through example. This, however, takes time, which is a valuable commodity that is often unavailable.

The example that I try to set is as follows. The main thing I try to do when entering the room is to make contact with the client through touch and voice. First, getting close to the client, so they are aware on some level that there is an additional person with them, is important for many because they often cannot see well. Second, I think making physical contact through holding hands or touching the face adds an addition point of contact and closeness. Third, voice contact through often one-sided conversation, provides addition bonding. Types of voice contact can be as simple as a description of how the day is going to devotional or scriptural readings. A fourth type of contact that is difficult for many, but one in which I find great pleasure, is stepping for a while into their alternate reality (chasing butterflies in an imaginary park, catching the ‘biggest’ fish, truck driving cross-country, or watching the bears play on the steps of the church across the street). If time will allow, family will usually follow the example that is set for them by people who, they figure, know how to deal with the demented. I often demonstrate to families the value of sacred hymns and the reading of favorite Bible passages. It is also from the above posture that I can quote/read Scripture, play or sing sacred hymns, and/or offer individualized, personal prayers. Unfortunately time is an enemy, and there have been many times that the most I could accomplish was to briefly provide the above before the client stepped across the divide, with no time for the family to release the wall and join me and the client by the bed.

A God Who Never Changes

Hebrews 13:7-8 (TMNT)  “Appreciate your pastoral leaders who gave you the Word of God. Take a good look at the way they live [and die], and let their faithfulness instruct you, as well as their truthfulness. There should be a consistency that runs through us all. For Jesus doesn’t change—yesterday, today, tomorrow, he’s always totally himself.”

In a world of flux and drastic change, there are few places that change is more obvious than in the Intensive Care Unit (ICU) of most hospitals. Lives, careers, and families are altered forever by death, disease, and disability. I stood by the beds of many such cases in the last few years and was made even more aware of my own impotence and fragility, either to alter my own course or to personally alter the courses of those to whom I minister.

One particular 79-year-old gentleman with an advanced case of gangrene in his right leg was facing immediate amputation of the same. His wife introduced me to him and informed me that he was a retired Baptist preacher and had been a prison chaplain for many years. He and I talked together for 15-plus minutes before we got around to talking about the pending amputation. I asked him how the amputation was going to change his life (I was trying to determine how well he was accepting the inevitable). He thought for several minutes as we sat there in silence. Then he spoke only a few words, but rarely has any man spoken more powerful and profound words. He said in a quiet voice, “Well, God doesn’t change!”

Those words were words I needed to hear to put my ministry in the ICU into its proper perspective. Not that I expected that of myself I could do anything, but it is my nature to want to do something myself to help. But I am only an often-feeble channel through which our Lord can minister to the sick and dying. While the lives of people around me are changing in drastic ways, “God doesn’t change!” I really think that this is one of the significant messages that I could and probably should communicate, both in words and deeds, to our patients. In spite of one’s situation, God does not change. He is still there in every way He has always been. Calvary and the death of Jesus did not change God. Persecution throughout the history of the world has not changed God. God is still God, the same God who is without beginning or ending.

I also found it of special interest that the above gentleman’s life demonstrated the principles of Hebrews 13:7-8. As I took a good look at this “retired” pastoral leader, his faithfulness was instructing those around him. His consistency was not altered by the situation, but rather it was a demonstration of God’s faithfulness and permanence throughout life, even unto death. While I had come to minister, he in turn was looking to minister to me and to shore up the faith of those around him.

I have thought much about this since those few words were spoken into my heart. I don’t think I have walked into a single room that I have not felt the effect of those words ministering strength and comfort to my heart and soul. My prayer is that my life will be lived in such a manner that it will demonstrate the faithfulness and permanence of “Jesus [who] doesn’t change—yesterday, today, tomorrow, [who is] always totally Himself.”

Presence is often more than enough...

Like many, such encounters are neither planned nor predictable, but rather come as a surprise and provide fodder for reflection and intrinsic rewards for a long time. I met Lewis one cold, wintery Saturday morning when the nurse informed me that she had a man who had been given a poor diagnosis of cancer, and he was not dealing with it very well. She wanted to know, since I was there visiting another patient, if I could stop in and visit him. I agreed, and because of the nature of the timing and the quick visit (as you will see), I knew no more about the background of the patient as person and patient than what I have articulated here.


The following is the scenario as I experienced it: When I arrive at the client’s room, Lewis is sitting up with his legs crossed on a flat hospital bed, and the hospital table is across the bed in front of him. On the table are an open briefcase, a cell phone, and miscellaneous papers. Beside Lewis on the bed are several, obviously already read, local and national newspapers, including the Wall Street Journal. Lewis looks young for 52 and relatively healthy and alert. On the end of his nose is perched a pair of reading glasses. He is wearing designer-type sweats that look out of place in the ICU, his hair is well-groomed, he is clean-shaven, and looks like he is waiting to play the part of a businessman in a movie. As a matter of fact, Lewis, in general, looks out of place in the ICU and makes me wonder what he is doing there. Lewis looks like he should be at the gym instead of the ICU.

Lewis looks up as I enter, “Hello, Lewis, my name is Joey, and I am the chaplain this weekend here at…”

“[Profanity], Get the h… out of here!” much to my surprise he again said loudly, “GET OUT!”

This is not what I expected, and the nurse must have had her wires crossed. As I began backing out, “I’m sorry! The nurse thought you might like a visit!”

“JUST GET OUT!” he repeats now, hollering and including a few non-repeatable adjectives.

“Goodbye, and have a nice day!” I walk out the door as I refuse to indulge his narcissistic need to rile me.

When I am about 10 feet from the door and moving fast, another holler is heard from the room, “CHAPLAIN, GET BACK IN HERE!”

As my brain and feet have a tug-of-war about what we are going to do, I turn around and return to the door and just stick my head in. There is no sense in going in too far just to get thrown out again, “Yes!” I replied rather timidly.

Not as loudly, “Get back in here!”

My timidity is showing when I take one step inside the door, “You told me to get out!”

Now talking in an almost normal voice, but as one who is used to giving orders, “I know, but I want to ask you a question!”

As I walk over to the bed, I am thinking fast and trying to get back in control of the situation, “May I take a seat?”

Lewis seems surprised by my remaining ability to ask if I can be seated, but points to the chair by the bed and says, “Help yourself.”

Sitting down slowly and crossing my legs and leaning back in what I call my counselor position, calmly asking, “So what would you like to ask me?”

With an exasperated expression, like one would sometimes address a foolish child, Lewis asks, “Just what did you think you were going to do when you came in here? Just march in here, mumble some holy prayer, and everything would change for the better?”

With a chuckle, “Maybe! Certainly wouldn’t hurt to try prayer, but probably not what I would have done first.” I will choose my battle, and this is not the one I want to fight, especially since I am convinced that this is not the basis of his anger; besides, there is some truth and humor in his question/postulation.

He fails to see the humor, “It’s a good thing you chaplains are not paid! It would be a waste of money!

“I’m sure some would agree with you!” Again, to fight this battle here would not solve anything or benefit Lewis at all, and I am sure it would be a lost cause. It would not help my cause here to let him know that I am paid, and paid rather well, considering.

Continuing his questioning above, “Seriously, what would you have liked to accomplish here when you were going to visit me?” Aha, now we are getting to the question behind the question. His professional curiosity will kill the proverbial cat.

With a little smile on my face, “Oh, I already accomplished what I set out to do!” I say this before I really have time to think about what I am saying. I sense a power greater than myself; God’s Holy Spirit is present and filling my mouth in my hour of need.

Surprise is obvious on his face, “Oh, and what is that?” I too am trying to mask the surprise on my face and figure out what to say next.

“Are you sure you want me to explain this to you? It might be better if we just let it work on you slowly!” God’s Spirit has not left me, and by now I think I know where He is leading this conversation. While this is apropos to what I had been studying, this is the first time it has been quickened to my mind while speaking to a patient.

The proverbial hook is set in Lewis’ psyche, and he is not about to let me go, “No, I want to know what you think you accomplished in those few seconds!”

“Ok, we will start with the most obvious. First, you are no longer sitting here alone fretting over your diagnosis. You have me (foolish, time and money-wasting as I am) to think about and talk to.” I say this light- heartedly with a chuckle (♫ A spoon full of sugar... ♪).

He too chuckles, “I guess you got me there! You might be good for something! What else do you think you accomplished?”

Taking my time, I postulate a second reason, knowing that I am hitting closer to home with each reason, “Another obvious thing is that I am indirectly relieving some of your stress by giving you a place to vent some of your frustration!”

To my surprise, Lewis quickly agrees. This time he is more serious, “Yeah, you’re right again! I felt like my head was going to explode when you came in, and now I am feeling that less. What else?” While before his bitterness and anger made him blind to help, when offered, he now seems almost eager to know what I am going to say next.

“Well, the other is not as easy to see, but I will try to explain. First, your records say that you are Christian. Is that correct?” It is now time to use what I have learned during my recent studies and hope that I am on target.

He nods, “Yes, I have been a member of [some name like Crestfield Community Church] all my life. I usually go every week.”

Here goes my best, “You see, Lewis, there is a thing we chaplains call ‘presence’. As ministers of Christ, we don’t represent the hospital or ourselves, even though what we do reflects on both. No, we represent Christ! Even though you did not want me to visit earlier, just the fact that you realized I was a chaplain triggered memories in your mind. The fact that you go to church weekly tells me there has been lots of meaning attached to church and the things of God throughout your life. I don’t know what those things are exactly, but let me speculate for a moment. For some, the chaplain’s presence might trigger the memory of a godly mother who bandaged their skinned knees and said prayers, that reminds you today that God is here, and He does care about your diagnosis. For others, they memorized the 23rd Psalm, and the chaplain’s presence reminds them that God is their Shepherd and that even though you now walk through the valley of the shadow of death, you don’t have to fear such evil for God is with you…”

By this time a tear rolls down his cheek as Lewis interrupts, “Stop! Stop! You win! I can’t take any more. Please go now! You’re right. Forgive me for earlier. Just go!” He wipes his tear away with a tissue.

With a little smile, “Ok, I will go. I just wanted to answer your question. Don’t worry about earlier. Considering what you’re going through, it’s understandable. Would you like me to say one of those holy prayers before I leave?”

Much subdued, “Yeah, like you said, it couldn’t hurt!”

“Dear Lord, you see the fear and the pain…” I begin a short prayer and then quietly leave the room. My work is done, but the Master’s has only just begun.

A huge blow hit Lewis, when the doctors told him that he had cancer and was facing the possibility of an early death, which left his faith reeling. His misguided anger at me as the chaplain actually gave God the loophole through which to minister and provide salve for his fear and pain. It is always amazing to see God’s Spirit at work in people’s lives and how He uses me to be an instrument of His Spirit, even though I often have no forewarning of the situation.

Perchance God has let me live to do this one thing more!

It was the last patient of the day, and I almost didn’t go and see Ricardo because he was in such agony. They had been unable to contain his pain that was secondary to back surgery, which was palliative for his metastasized cancer. He had been unable to be moved without screaming, due to his pain, and wanted to just be left alone by everyone. Ricardo’s prognosis was extremely poor, and death was imminent. I decided to see him, against his spoken request to the nurse to be left alone, in hope that prayers might work where medication had not.

I entered the room, and Ricardo was lying very still and taking very short, gasping-type breaths. His pain was obvious! I introduced myself and acknowledged his pain and sickness. He was obviously not an American, and I asked him his nationality (this is not something I have ever asked before, and I am not sure why I asked it this time). He told me he was from South America. I asked Ricardo what brought him to America, and he told me he had worked his whole life as an international salesman, and they had moved him to America to be closer to their corporate headquarters.

I was about to offer prayer when Ricardo asked me what faith I was. When I told him I was Pentecostal, he responded that he too was Pentecostal.  He told me that he had bought a lot of books, Bibles and literature to mission works that he had helped start in South America, while traveling there for for his company. Ricardo stated that he had helped start several missions with the literature, books, and materials. He began to talk about the wonder of his work and the importance of the changing power of Pentecost in people’s lives. While he did not consider himself a preacher, his money and contacts were able to start countless missions in the jungles. It was his most rewarding legacy. He seemed to light up as he talked about this work.

It is important that you remember that through all of this Ricardo is making small, gasping breaths to try and control his pain. Each Spanish-accented and whispered word jarred Ricardo’s body and heightened his pain, making him difficult to understand. I wanted to stop him, but there was something therapeutic in his talking about his love for the work of God in South America. There was something pure and holy in this dying, old man, who had taken over the entire conversation while I sat and listened.

At some point in Ricardo’s talk about his love for the work of God, a change began to take place, and if I might be so bold, it seemed as if angels began to lift up this man and gave him strength. Ricardo’s whispered words of pain became stronger, and it was as if he had become free from the bonds of the world. He began to speak as a prophet and began to speak into my life words of life, hope, and strength. He began to speak out about my ministry as a chaplain and to confirm God’s call and anointing in the path that I am walking. Ricardo identified my fears, doubts, and obstacles that would have been impossible for him to know. He assured me that God would go with me, provide for me, and that God had a great work for me to do that would include a harvest of many souls.

After about ten minutes of speaking into my life and story, Ricardo reached out his thin, frail arms and laid his hands upon me. He spent another five minutes praying for me while speaking in tongues, asking God for His anointing and blessing upon my life and ministry. God’s presence seemed to flood into the place as Ricardo prayed. Surely we had found a holy place together in the presence of God. As the patient prayed loudly and boldly, I began to speak quietly in tongues as a physical anointing poured over me, warming me from head to toe. The one ministered to had become the minister for the one who had come to minister.

Spent, Ricardo collapsed back in the bed, once again gasping small breaths of pain. We sat there together silently for a while, and then he said, “Maybe God has let me live to this point that I might do this one thing more before I die!” Ricardo would die feeling that he had lived to accomplish a great task, and indeed he had. His words would impact my ministry for the rest of my life, and therefore many shall be blessed by the words of this dear South American brother. These words seem inadequate to describe this experience, but if I live another fifty years, I will not forget this experience.

A Living Sermon

I paused outside of the room to gather my thoughts and breathe a prayer for the job that was ahead. The nurse had called and informed me of a new patient that had a fast-growing cancer on her face, neck, and head. She was not expected to live very long. A month ago she had been 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 prior). 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…

What do I do for this lady? What can I offer her? What does the ecclesia have to offer her? How can the gospel be presented to her 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 must also be governed by some form of an outline. Therefore, I will now offer a brief sermon outline that I attempted to live for this patient:

Title – 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.”

Point#1

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!).

Point#2

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!)

Point#3

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!

The Lived Sermon...
Kim 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 touching the leper, played some hymns on my iPod, but mostly just held her hand and touched her head and hair. One old hymn written by Charlotte Elliott, in 1835, seemed especially fitting.

Just as I am, without one plea,

But that Thy blood was shed for me,

And that Thou bidst me come to Thee,

O Lamb of God, I come, I come.

"Ah, this famine of love..."

“Ah, this famine of love! How it saddens my soul!” These were words written by Toyohiko Kagawa, a great Japanese Christian, in 1931, shortly before the onset of the Second World War. “…everywhere this dreadful drought of love! Not a drop of love anywhere: the loveless land is dreary… When the last drop of love has dried away, all men will go mad and begin to massacre all who ever thought of love…” This cry for love was a precursor to the Japanese invasion of the world and remains a cry today in a world tormented with war and terrorism. Not only is the world tormented, but the smallest unit of society, the family, is fighting, dysfunctional, and bifurcated. Nothing amazes me more than families tormented and fighting in life and continuing to do so, even in the face of sickness, pain, and death.

The church is daily exposed to the needs of the world around it, and chaplains, filled with the same Spirit as Christ and the Apostles, are given the opportunity to be living demonstrations of God’s love to those they encounter in their journeys of pain, sickness, and death. Only when chaplains love even the sickest of modern society, people who are much like they are, in the same manner in which they love themselves, will they fulfill the commandment to love God with all of their heart, mind, and strength. “The [chaplain as a] Christian… salt for society, becomes a vehicle for God to reach out to a misguided, oblivious world that so desperately needs His touch.” For now, until that completeness, the chaplain has three responsibilities, which will lead us toward that consummation: Trust steadily in God, hope unswervingly, love extravagantly. And the best of the three is love (1 Corinthians 13:13).

I wrote these words last week after I had been called to a series of particularly difficult deathbed scenes. The first one was the most horrible death as can be imagined. The lady had a bedsore so bad that her bowels had come through the sore in her buttocks area and burst. The smells were indescribable and the death was excruciating for the client, the family, and the staff. The second was to a death of the most dysfunctional family one could encounter, with physical fighting, cursing, and blaming going on all around the staff. It is the job of the chaplain, as the emissary of God, filled with God’s Holy Spirit, to walk into these situations and, like Jesus did to the natural elements, speak peace and hope into the lives of the grieving families. For me, it would not be a job I could do unless I was convinced that God goes both with me and before me. Furthermore, it is my sincere hope that when I leave, I leave some of God with those that stay.

Not the Baker, Just The Bread Man!

Luke 11:3 “Give us day by day our daily bread.”

John 6:48 [Jesus said], “I am that bread of life.”

Acts 2:46 “And they, continuing daily with one accord in the temple, and breaking bread from house to house, did eat their meat with gladness and singleness of heart.”


A Parable About the Bread Man
A small lad rolls over from a night of fitfull sleep and melodramaticly streches out his arms and legs as boys are prone to do. His hand knocks over an empty bottle and pushes away yesterday’s newspaper. His leg kicks the dumpster and is pulled back in pain as he sits up and holds his leg. Tears run down his dirty cheeks, and it is then he hears his stomach rumble. Hunger pangs are a familiar feeling. There is no place to wash up, and he had slept in his clothes. He peers around the side of the dumpster and slowly creeps out into the alley. Dirty hands are run through his hair as he walks out onto the street. The sun is shining while business people and store clerks are bustling about preparing for another day.

The lad is mostly ignored as he squints through the morning rays. The grocery is open on the corner, the smell of coffee wafts through the air from the café, and the bank is rolling out the awnings to protect their afluent customers. Ahh… he sighs as someone opens the door of the bakery. Bread… fresh, baked this morning, and still warm. All of this you could tell from just one whiff when the door was opened by the steady line of customers.

The lad makes his way nonchalantly down the busy street until he is just across the street from the bakery. He waits for a time and then… Yes, there she came down the street. Walking with a purpose towards the bakery as if the smell were drawing her like a magnet. As she walked through the door of the bakery, the lad made his dash across the street to lean against the hydrant on the corner. As if orchestrated in a theater, each player knew his role and place. The lad waited, pretending to ignore the drama that was about to play out on this street corner. Without looking he could hear the door creak open several times. He knew the number of customers and he knew which creak was hers. This was not the first time – this was a morning routine.

The lad had his pride, and it forced him to pretend to ignore the approaching steps of the lady as she returned home to prepare breakfast for her family. He heard her pause and ask, “Johnnie, you want a roll this morning?”

As on the previous morning, and for that matter on many previous mornings, the lad turned and was quick to reply as his belly did flip flops at the smell of the bread, “No, thank you, Ma’am. I’m not hungry this morning!”

“Well, Johnnie,” she replied with a knowing smile, “How about your sister? Maybe you could take a few rolls to her for me!”

“I suppose I could do that. She is very hungry and not likely to get much to eat today!” Johnnie reached out his hand and took two rolls from the lady’s basket and moved on down the street. He continued to walk slowly until the lady was out of sight. He ravenously ate the rolls. He has no sister – at least none that he knows of – he just needed bread, but didn’t know how to ask. Bread…

I heard a minister speak at a missionary conference from the title, “The World Needs Bread.” I presume that this is where I first started thinking about being the bread man. My world involves death rooms that stretch across South St. Louis and around Washington, and it includes hospital and emergency rooms in St. Charles. In each of these rooms are hungry people, people that are hungry for the Bread of Life. Many, if not most, don’t realize they are hungry for that Bread, some are too proud to ask for that Bread, and others don’t even know that this Bread exsists. Nevertheless, one thing is certain, they all need the Bread.

That’s where I come in; I’m the Bread man. I’m not the baker, just the delivery boy. Many years ago I met someone who gave me some of that Bread. Almost 40 years have come and gone since that day, and still I am giving away that same Bread. As a child they told me a story about how all this got started. A small child had 5 small loaves of bread and two fishes. A man who called himself the Bread of Life took that bread, blessed it, and began to divide it up among the multitude. Amazingly enough, those 5 small loaves fed 5000 with leftovers, and another time it fed 4000 with leftovers to share.

Throughout the centuries, women and men continue to bless and pass out that Bread of Life. After 2000 years that Bread has not diminished in either size or power. That Bread is just waiting for the Bread man to bless it, break it, and give it out. Again, that is who I am, the Bread man. Each day I step into the lives of sick, afflicted, diseased, and dying. Each without exception need Bread. All are hungry, and some are even starving; each are praying, “Give us this day our daily Bread!” Sometimes I have to explain what this Bread is because they have never seen it before. Other times they know about the Bread, but have never tasted it, and so my job is to entice them by saying, “Taste and see that the Bread is Good.” Some are like the lad above and too proud to admit they need the Bread, and so I have to present the Bread in such a manner that they can save their pride and still eat the Bread.

Finally, there is the good ground; they spent their life eating Bread, and while they may have eaten Bread earlier that same day, there is rejoicing at the arrival of the Bread man. Like little birds, their mouths are open, waiting for more Bread I’ve held their heads and frail bodies in my arms and fed them the Bread, one small broken piece at a time. I held their hands and fed them Bread as I watched their life here on earth slip away and am assured that the Bread of Life takes over on the other side.

Yes, I am the Bread man, breaking Bread from house to house! It’s not uncommon for the phone or pager to ring, and when answered, a nurse that recognizes the need for Bread is calling for the Bread man to come. I have a hungry patient… she is sick… he is dying… a family is greiving… would the Bread man come and feed them Bread? Often the door is shut, and my children are in bed; I don’t want to rise and give them Bread. Not because of friendship do I rise, but because of the importunity of a hungry world crying out for Bread, I rise and give the needed as he needeth. Why, because I am the Bread man.

Joining the Hand of God to the Hand of the Murderer

It was a cool mid-winter afternoon when the pager went off and dispatch let me know that a code was in process on a 6-month-old baby that was coming into the emergency room via ambulance. I responded quickly and beat the ambulance to the hospital. When the ambulance arrived, I was waiting with the code team on the curb. The baby was taken quickly to room 2 in the emergency room, and it was left to me to handle the father of the baby, who also arrived in the ambulance.


The father, Ted, was about 23 years old, was wearing pajamas, his hair uncombed, his face unshaved, and was obviously upset over the situation. I took Ted to the private family room and initially I just sat and held Ted while he cursed and raged, striking the wall, the couch, and his leg. After about 10 minutes, Ted made several phone calls to his ‘girlfriend’ (who was at work) and other relatives. One of the doctors came in then and asked Ted for his story.

Ted explained that he had just fed the baby (a boy) and the baby was sleeping and he noticed that he was not breathing. Ted then called for his girlfriend’s mother, who also lived there, to come and help. The family started CPR, 911 was called, and the ambulance arrived. The story seemed simple enough and plausible to me. The doctor left, and I prayed with Ted for God to guide the hands of the doctors and the recovery of his baby. We then discussed Ted’s spiritual journey. Ted was raised Lutheran, but had not been to a Lutheran church in about a decade. During the years away from the Lutheran church, Ted ran away and lived with friends in Louisiana. There he joined and attended a large Pentecostal church with his friends for several years. After a few years in Louisiana, at about 20 years of age, Ted ‘ran away’ again and moved to a large mid-western city. There he had not attended church, but he had fathered two children by two different women. He had been living with the family of the second woman. Ted works at the same restaurant as his girlfriend, on opposite shifts (this is where he met her).

After Ted shared his story, he went through another raging spell that seemed more like a 2-year-old throwing a fit than an adult grieving. I used the analogy that Ted looked like a deer caught in the headlights of a truck on a dark, Maine night. Ted’s wife’s family began arriving, and they provided support with hugs and prayers. Especially present was his girlfriend's mother, who had been in the house during the situation. About this time (I had been with Ted about 45 minutes) I found it convenient to take a break and go see what was going on with the child.

Immediately I knew something was up; there were two uniformed police officers and a hospital security guard posted outside the family room door, two more uniformed police officers were outside the emergency room, and another two posted by room 2, where they still worked on the baby. At least a ½ dozen hospital (it was obvious they had called in the on-call) security guards were mingling around the emergency room. Two plain-clothes detectives were talking to doctors in the center of the emergency room.

When the detectives saw me, they asked me exactly what was said during my time in the family room. After telling them what little I knew, the doctor filled me in on the condition of the child. The child had bruises on his back and legs, signs of old and new injuries, old fractures on x-ray, and evidence that the baby had been raped. The doctors and detectives then asked me to return to the family and continue to provide spiritual care, but to keep my eyes and ears open.

This was a very difficult situation for me. On one hand I was expected (by hospital staff and by myself) to continue to provide good pastoral care, and on the other hand to keep my eyes open for the perpetrator. It seemed to be obvious that the father was guilty, due to the fact that he was alone with the baby at the time he stopped breathing. However, I knew that to provide good pastoral care I would have to hold my feelings in check, even though I knew one member of the family had brutally injured and raped this six-month-old child. I returned to the family and gave them a brief update on the baby (only that the doctors had resuscitated the baby and that the baby was still in grave danger) and then prayed with the family, which by this time numbered more than a dozen people, including the father, mother, and grandparents of the child. After a short time the detectives came and informed the family that they would be doing some routine questioning of the family. One-by-one the family was questioned by the detectives in a separate room.

About an hour later the doctor informed me I could bring the parents and grandparents in to see the baby. This was very traumatic for the family and myself (I knew by this time that the baby would not likely live). The baby lay there so very quiet (on a respirator and with several IVs), a blanket covered all but his face to cover his injuries. We gathered around the baby, and at the request of the family I laid my hands upon his red hair and prayed for God to provide a miracle of healing for the child. I also prayed for God to bring healing to a family that would be devastated by this situation (thinking that I knew more than most of them). Shortly thereafter life-flight from Children’s Hospital arrived and flew the baby downtown. The family and police officers quickly followed in automobiles.

This was a very traumatic case in which good pastoral care was so desperately needed. After everyone had left, I sat in the chaplain’s office for about an hour and cried for a child whose life had been cut short before it had hardly begun. I went home and debriefed with my wife and cried again. The next morning I went and saw my supervisor to talk through some more of the lingering emotion. I have long since learned the value of talking out the pain and death that is encountered in the life of the chaplain. All of this helped, and I was able to continue with my busy schedule that day. At this point I did not know the status of the baby or the results of their investigation.

I wish that I could say that the situation ended there and the horrible memory faded slowly into the background of my mind. However, later that day I heard the breaking news, first on the radio and then from a phone call, that the baby had died and the father had confessed to the assault and murder of his son. Further, the family had admitted that they had witnessed the ongoing abuse of the little baby from his birth. They claimed to be afraid of the perpetrator, and he had kept promising that it would not happen again.

For some reason (probably because the facts of the case could no longer be denied or explained away and the reality of it being in the headlines) this hit me even harder than being there at the time. I called several of the chaplains that I work with each day and told them I needed them now. We met around 6 PM in the conference room, and they allowed me to debrief and have another good cry. Their support and hugs were very helpful. Each one expressed a willingness to accept a phone call day or night if needed. I have had a few more times of tears and grief for the situation since then, but each time I have sought out help from my fellow chaplains and my wife.

For the family and the father of the child, I was able to provide quality pastoral care, even though it was obvious that a very tragic crime had been committed by one of them and witnessed and tolerated by others. I did not let personal feelings and/or an abhorrence to what they had done prevent me from being present for them. My desire is to always be Godly presence for my patients, extending to them the benefit of God’s grace and the offer of Calvary’s mercy.