For hospital chaplains, who minister to patients and families of many faiths or even none at all, the motivation is simple — to help people endure illness and even death. But the work is extraordinarily difficult. Today, meet the people who walk life’s most difficult paths with people of all kinds.
By Cindy Miller and Edward Miller | Photographs by John Glenn
At the end of the day, Becky Shoaf hangs up her white lab coat, and whispers a short prayer she borrowed from a Pope: “Take them, Lord. I’ve done all I can do.”
In a South deeply rooted in religion, medical care extends beyond the bricks and mortar and high-tech medicine of a modern healthcare system. It embraces a spirituality that some people can’t get comfortable with, and others can’t live without.
This is Becky’s world.
As a chaplain in the Piedmont Healthcare system, she tends the fires of spirituality. She ministers to one of the most diverse congregations around, one where denominational distinctions fade as prayers go up in a variety of languages and faiths.
Becky’s hospital ministry is neither preaching nor persuading. It’s healing. It’s a point she emphasizes without hesitation: “I don’t care what they believe. I care about what they are experiencing.” It’s also a point firmly echoed by a patient who was touched by her spirituality: “I came here for a heart transplant, but found so much more.”
For Becky, it’s also a calling. Her first career was working in a state outreach program serving pregnant women and children through Medicaid. She worked there for 16 years, convinced all along she would retire in that job.
“Then I felt called away, a call that pulled me toward seminary training at Mercer University,” she said. “I abandoned my life plan because I realized I wanted to be a hospital chaplain more than anything else.”
Jobs for chaplains were hard to come by in 2002, but she found a part-time position at Piedmont Atlanta, the same hospital where she gave birth to her daughter. Her introduction to the heartbreak of her calling came quickly. When Becky was summoned to the Critical Care Unit one evening, the patient asked his family to leave the room once she arrived.
“He told me he wanted to get things right, pointing up to the heavens as he said it,” Becky recalls. “We talked and prayed. What he wanted was help in saying goodbye to his family.
“I left the hospital late that night, and learned the next day that he had died before daybreak. Prior to that, I had never imagined that I might be comforting a patient a few hours before he died.”
Heartbreak is part of the job, but despite the pain, there comes a time when someone knows — and understands deeply — that she was meant to do this work. For Becky, that time came during the early days of her work as a chaplain, when she was called in on a pregnancy loss.
“It’s a sad but frequent occurrence,” she says, “and I wasn’t sure how I would do holding those babies. When I held my first baby, I knew. This was my calling.”
Becky is one of 19 chaplains who serve the Piedmont system, which reaches into Atlanta’s exurbs of Coweta, Fayette, Henry, Pickens and Newton counties, and whose patients come from across Georgia and neighboring states. For Becky and her colleagues, spiritual moments often happen by simply being there, triaging the clinical areas like cardiac intensive care and oncology, blending in with the nurses and physicians to sense where they are needed most.
“We go from person to person, giving a light touch,” says Liz Harris-Lamkin, a chaplain at Piedmont Atlanta. “We know when we have to stop and stay.”
Staying is another way of describing the chaplains’ currency of care –– the gift of time. A quiet hug. An explanation of a doctor’s orders. The heart-wrenching act of rocking a dying baby. These are the gifts of the chaplains that seem to come naturally, yet have been perfected through continuous training and practice.
Chaplains hover near the most acute cases –– advanced heart failures, transplant patients and those with medical devices driving hearts that can’t function without help. Chaplains offer the gift of time to those who need them most. Physicians and the nursing staff know how valuable those gifts can be, and chaplains rely on staff to help them know where the needs are greatest.
“If somebody is crying, deciding or dying, it’s a good time to call the chaplain,” says Mark Riley, the chaplain at Piedmont Newnan.
That call often comes from the staff itself, a coordination of care that some call the dance of the professionals. Physicians and nurses are trained to oversee the clinical needs of patients. But that approach alone may not treat the needs of the whole person. Medical professionals have come to realize the importance of the spiritual and emotional component. And that’s where the chaplains help teach them about care as opposed to treatment.
Patients sustained by faith often tell chaplains about their personal relationship with Jesus Christ. Chaplains respect that, and then ask, “But how do you feel?”
“People want someone to ask them how they are,” says Liz, explaining what patients want from chaplains. “They want someone to walk with them.”
This walk often tests the tough love of confronting difficult questions with answers that land gently, that respect the feelings, intelligence and dignity of each patient and family. Walking with them usually follows the narrow path between encouragement and false hope. Chaplains don’t cure, but can sustain the will to go on in the face of pain and fear. Some patients turn to their religion to sustain that perseverance.
“Our job is to be with them where they are,” says Liz. “You don’t dismantle structures that have propped them up for a long time. We meet people with very rigid belief systems, as well as those with no beliefs at all. Regardless, we have to protect their stories, values and beliefs, their definitions of what quality of life is.”
Commitment to a mission doesn’t make the work any less painful, a reality evident in Becky’s story of a man in his 20s who had received a new heart:
“He was loved by the hospital staff, and dozens of people from the small community where he lived made the journey to Atlanta to encourage his recovery. He was working toward his license as a funeral director and had everything to live for, but died two months after the transplant. There were a lot of broken hearts here for a long time.”
Among those broken hearts were the five constituencies chaplains care for: patients, their families, the staff, other chaplains and, of course, themselves.
Not surprisingly, the medical and nursing staffs often need special support from the chaplains. Acute cases like transplants can ratchet up their tension nearly to the breaking point. Terminal cases require brave faces to mask the ache of helplessness. Burnout is a common side effect for caregivers.
In one case, a baby was dying, and the family said its goodbyes. Then the staff stepped in and took turns rocking the baby in its final hours of a short life. A chaplain was there, sharing in the holding of the baby while consoling the nurses in their own sense of loss. The comfort came, in a large part, from just being there.
“We find ourselves supporting people all along the way from stoic to emotional,” says Mark, the Piedmont Newnan chaplain. “We find families immersed in their own drama, simply inconsolable at the moment. We are constantly reminded that people grieve in their own way — and there’s no judgment in that.”
It’s no coincidence that in the hospital chapel in Newnan there is a rack for prayer mats to serve Muslim patients and families. In many places in what Flannery O’Connor dubbed “the Christ-Haunted South,” theology still divides. Piedmont’s chaplains — supported by dozens of volunteer worship leaders representing just about every religion — make sure spirituality unites and comforts.
There’s pain, though, in seeing others suffer.
“It’s tough work, and you have to be prepared,” says Becky. “When I enter a patient’s life I have to leave myself somewhere else, because it’s for them, not me. My lab coat helps gather up the tears.
“It’s an honor to stand in the sacred space of family. It takes energy to support the staff in the intensity of their work. But I love it.“
In conversations with some of Becky’s patients, they express a gratitude bordering on awe. They describe her with many words, but they use one repeatedly: “calm.” She is calm in the midst of their stress, and that helps patients endure.
When Becky heard that, she lowered her gaze, blinked a few times, smiled, and said softly, “That’s sweet.” Yes, it is.