The face of grace

By David Becker '73 (MDiv '00)

At age 50, I changed careers and returned to Brite Divinity School to become a hospital chaplain.

When I started my clinical training at Children's Medical Center of Dallas, I thought to myself: Hey, I handled complicated and stressful commercial real estate transactions. I am a tough guy! A bunch of little kids are not going to frighten me.

Yet, being a compassionate chaplain is different, and I had little idea that these youngsters would touch me in such profound ways.

A chaplain is one of the few people in the hospital who does not come to do invasive procedures. I do not draw blood, give shots, insert IVs or perform surgery. I offer hopeful conversation, reassurance and, on occasion, a pastoral prayer.

Monday is ear tube and tonsillectomy day. By the time I arrive, the kids have had silly juice, an oral sedative to help them relax. From the distressed expressions on the faces of attending parents, perhaps it would have been better to give the adults some juice, too.

I might use my sense of humor to break the pall that occasionally hangs over the hospital. I take the chaplaincy much more seriously than I take myself. Still, I must be careful not to make light of distressing events. More often than not, I commend each child about how brave she or he is.

If I can get away with it, and the kids know I am being playful, I might ask if they are married to get them laughing. Sometimes if Mom is looking a bit sad, I will suggest to the child that maybe "you could cheer up your sister over here." Of course, then I usually make two friends. I will ask kids to open their mouths wide so I can look down their throats at the tonsil. (I cannot tell a tonsil from a toenail.) Then I wonder out loud if the doctors are having their weekly contest to see which patient has the best looking tonsils. I tell them that doctors mount the best ones in their trophy room.

Recently I came to the bedside of a child anxious about impending surgery. She was crying, so I asked if she was feeling scared. "Yes." "Would it help if I said a little prayer with you?" Her mother, who appeared to need some support, nodded yes. Now both the mom and the little girl both had tears running down their faces. After a little chit chat about her family, I asked the little girl, "Who is the bravest person you know in the world?"

"Annabelle," she answered.

"Oh, okay. Is Annabelle your sister?"

"No," she said. "Annabelle is my Rottweiler. She is not scared of anything."

I feel funny praying for a dog but it does seem vital to make this connection. "If you will start the prayer," I tell her, "I will finish it."

"Do I have to? I don't know what to say."

"Let me suggest that you start with ÔDear God,' or anything else you have to say. I believe that God hears your prayer and wants to take your fears away. May I hold your hand?"

"Okay." (I touch Mary's hand as Mom clamps my other hand like a vise grip.)

The patient begins: "Dear God . . . (heaving cries and sniffles). I'm scared. (More heaving cries and sniffles and then silence.) I continue to pray for her family, doctors, staff members and, of course, that she will be as brave as Annabelle.

Chaplains must have a non-anxious presence in the midst of witnessing some pretty awful stuff. Not only patients and their families, but the hospital staff needs pastoral attention. We talk about spiritual questions and the dialogue is always compelling. Nurses, respiratory therapists, X-ray techs, housekeeping staff and medical records clerks are all heroes and heroines in crisis.

They sometimes appreciate a gentle word and a listening ear. Chaplains minister to staff members who face the stress of caring for the sick and the loss when a patient dies. I meet children in the recovery room after surgery. I want to be there, especially after a kid has dental surgery, a craniotomy (where the skull is cut and re-sectioned to allow the brain to properly form) or a cleft-lip or palate repaired.

I stand with distraught parents as they face the shock of seeing their children, many times babies, temporarily disfigured by the surgical repairs. Recently I located a prayer cloth (it was a warming blanket) so a Muslim could do required prayers in the middle of the surgical recovery room.

I extend hospitality to patients and families, just as a parish minister graciously greets visitors to Sunday morning worship. Learning to be an effective chaplain is part of the discernment process of my seminary experience.

Clinical pastoral education offers hands-on knowledge of spiritual care. Many denominations require CPE as a spiritual boot camp in preparation for ordination. It is a structured program of pastoral formation and theological reflection requiring 300 hours of direct contact with hospital patients and 100 classroom hours reporting the nature of the visits verbatim to other chaplains who review and evaluate my work.

I engage weekly in small support group discussions with a young Southern Baptist individual and a retired geologist studying to be a Catholic deacon. Two nights a month, I am the sole chaplain in the hospital. When the trauma beep goes off, I go to the emergency room quickly.

Many trauma patients are involved in motor vehicle accidents and come from great distances. Parents are not with the kids because they were driving the car and are either injured or killed. Not only is the child's support system absent but it is futile trying to extract personal health information from a child.

One night a 9-year-old boy came in by air transport after a head-on truck collision that killed his father, uncle and two cousins. The hospital did not know the identity of the child. After four hours, the boy's mother heard about the accident on the radio and came to the hospital to find out. She took one look at the tubes and wires attached to her son in the pediatric intensive care unit (PICU) and said, "He is not going to make it."

The young mother summoned her father, two daughters and other relatives to come the hospital. She then asked the nurses to get a representative from Southwest Transplant Alliance to come so she could discuss donating her child's tissue and organs.

When the family finally gathered in a hospital conference room, I could not put off telling them the fate of the other occupants in the accident. I felt compelled to use no euphemisms. I told the young patient's mom that her spouse (and the father of the two teen-age sisters in the room) plus both cousins were dead.

I can still feel the sorrow and anguish that filled that room. I cried. The sadness just overwhelmed me. When the rush of grief passed, we prayed together for a very long time.

The crisis with the young accident patient grew worse and I encouraged each family member to spend some time at his bedside. Only the mother knew that hope for his survival was slim. He was intubated and unresponsive but looked like the happy little boy who had left on his first hunting trip with his dad just 12 hours earlier.

At midnight, a PICU nurse called me to pray with a young couple whose three-week-old girl was admitted for open-heart surgery. The baby was in her pediatrician office for a routine exam when the abnormality became known. This was the couple's first child. They were so afraid that they sat in the waiting room in stunned silence.

I quietly spoke the parents' first names three times. They did not appear to hear me. Then I knelt down beside them and spoke the daughter's name. I said, "I stopped to see your daughter in the pre-surgery area. I feel that she is in very good hands."

When it was time, we lifted everyone in their family and hospital community up in prayer. I spent the rest of that night between these two families. I talked with family members of the motor vehicle accident victim as each arrived at the hospital.

I took them in groups to the chapel. We prayed God would be present with them and that God's will would be done with the patient. I talked with the young parents of the open-heart surgery patient and listened to the stories of their lives. We laughed over the hundreds of baby photos they brought to the hospital. We ate breakfast together in the hospital cafeteria.

Two other children died in the hospital that night. Both had been deteriorating for some time and the families finally gathered and terminated life support. One boy was playing superman and his head hit the corner the television set.

The other, a little girl, was a victim of abuse and had catastrophic injuries to her internal organs. I stood and watched as the nurses disconnected the monitors and put each child into each mother's arms. We prayed as the families said good bye to their children.

I escorted the families to their cars and completed the necessary paperwork for the hospital. Then I wrapped each child in a clean blanket and carried them downstairs to the hospital morgue.

About 4:30am, the three week-old heart surgery patient returned from the operating room. Just four hours before, her color was sallow. Now, she had a wonderful pink tone and a much healthier future. As a Christian, it occurred to me that I had witnessed a resurrection in the hospital.

Not every story that night had a happy ending. But this tiny girl had been raised from near death to new life. Theologian Henri Nouwen calls me a wounded healer. I set aside personal difficulties and uncertainties in my life to assist others in building bridges over the major anxieties.

It is a ministry of presence and listening, often just staying quietly with people in pain. I serve simply by standing beside suffering people in times of their greatest need. Frequently I cry because the sadness overwhelms me. Human suffering is never easy.

Chaplains come so people might not have to face pain alone.

David Becker is a 1973 graduate of TCU and a 2001 graduate of Brite Divinity School. He is a full-time writer and hospital chaplain. He recently published an article on human organ donations in Ministry Magazine and is writing weekly devotions for 2004 The Upper Room Disciplines. He can be reached at evadgorf@aol.com.