TalkBack Response to John Less (PlainViews, 6/16/2004, Vol. 1, No. 10)

I can understand that your present circumstances seem bleak and that your response to them is also bleak. But I challenge you to answer these questions about misfortune:
1) Why not you?
2) Are you privy to G-D’s plan?
3) Is there a plan?
4) ) In your opinion, does G-D only exist if G-D manipulates your life in a way that you find agreeable?
5) If you already see the future as hopeless, where is your faith that you have power to be the captain of your ship in the choices you make?
6) Then again, is G-D the sole manipulator of your life or do you have any choice in the decisions you make?
7) If during a flood you choose to ignore a log floating by, preferring to wait for the hand of G-D to lift you out from the waters…and you drown – did you drown because you made a poor choice, because there was a flood or because you are waiting for G-D to personally come down and give you a helping hand?
8) To quote you, “People are used and once their use is exhausted, thrown away like Kleenex”…Thrown away by “whom” - People or G-D? Who is responsible: Those in management who have the power to hire and fire, using their free choice? Is this attitude of being dispensible not part and parcel of a free enterprise, a money driven economy? What would make one think that they are not as susceptible to the “cuts” as anyone else?
9) Might one grow stale, lacking former luster, grow older, slower, less creative, less flexible?
10) It is of course much easier for us to need and want concrete reasons beyond the obvious as to why “things” happen. Things happen every day. Some of the things that happen we can control and others we cannot. But, I think our need to hold G-D responsible for every missed opportunity, for every disappointment, for all our unhappiness – detracts from the gift G-D did give us – that of free choice, of taking responsibilities for our own actions, having the ability to make decisions and to deal with the realities of life. If G-D is merely pulling our strings and we are merely puppets – why should we bother holding G-D to task for being a puppeteer?

Laurie Dinerstein-Kurs
Chaplain, Jewish Federation

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Responses to Chaplain Geralyn Abbott, Spiritual Dimension of Psychiatric Treatment (PlainViews, 6/16/2004, Vol. 1, No. 10)

I am the lead chaplain at the University of Texas-Harris County Psychiatric Center in Houston. We are a short term psychiatric teaching hospital with about 70% of our patients being indigent. The role of chaplain here is totally intergrated into the treatment of the patients. We offer spirituality groups for all levels of our population including adult, adolescent, children and Spanish-speaking patients. We offer a more generic group for the lower functioning patients whereas for the higher functioning patients we offer groups based on principles of pastoral counseling. What we offer as chaplains is recognized as a health care discipline intergral to the treatment of our clients. We are not consultants but a member of the treatment team with a specific role and function. This is happening at other facilities across the nation and is becoming the norm.

Chaplain Alvin Hodges
Houston, TX

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I am writing in response to Chaplain Geralyn Abbott on the Spiritual Dimension of Psychiatric Treatment. I am a chaplain and an ACPE Supervisor in Training (SIT) resident at Banner Thunderbird Medical Center, a 385-bed hospital in the Phoenix area.

Thank you for writing of the importance of the spiritual dimension in healthcare and recovery. I put this definition on my office door. It’s a good reminder to all who enter that I’m not someone who just deals with religion or the common elements of religion. As chaplains we deal with all of that and the deeper, soul issues of ultimate meaning and hope. Science and medicine are very much like religion and spirituality; they don’t cure; they supplement or sometimes fool the body’s natural processes. If that’s not possible, they attempt to remove the disease or destroy it. I’ve read articles in medical/psychological journals where religion and placebos are mentioned in the same line. Both are effective in providing hope. And hope is an effective treatment for illness of both body and soul. It takes surgery to remove physical disease, but it takes ritual or therapy to remove spiritual/emotional disease.

For the past two years I have lead a team of hospital professionals called Spiritual Care At Life’s End (SCALE). We intervene when circumstances threaten to deny a terminal patient “A Good Death.” Part of my work as a chaplain is promotion and education. Without getting into details, we have tried to educate physicians and staff on what indicates a spiritual need. The obvious method has been to provide questions to ask.

Here’s my experience with questions: “Would you like to speak with our chaplain?” or “Would it be helpful to you to talk with your clergy person?” elicit a “no” much of the time. First, an acute-care facility like a hospital is a symbol of hope, compassion and care but also carries the issues of mortality, pain, and death. For the unchurched, suggesting that a chaplain come only confirms or invites the specter of bad luck into the room. How many people refuse to talk about something for fear that simply mentioning the subject will cause it to happen? I once visited a patient in the middle of the night who had coded on the medical floor and was taken to critical care after being revived. When I asked him for permission to come in his room, he said, “Oh my God! Do you know something I don’t?!” We were both relieved to know I was there just because I cared about him. The mythologies and superstitions of the media invade our lives more efficiently than does the church. A simple question like: “Do you want to see our chaplain?” often invokes the former first.

Second, and perhaps more importantly, once a “no” is received as an answer to a proposed chaplain visit, a physician or nurse who witnesses spiritual pain, anticipatory grief or existential angst in that same patient will continue to operate with the last directive, “no chaplain,” until withdrawn by the patient. And if the “no” is documented, our chaplains will respect the patient’s right to privacy. All of this from an innocent question that denies the patient necessary care and rates a “poor” on our service excellence scale.

I remember a critical care nurse who told me of a patient’s husband who was suffering over his wife’s impending death. The nurse asked: “Do you want to see our chaplain? He’s very good!” (Honestly, she said that!) The man refused because he had turned from religion long ago, he was angry and his wife was not religious either. The nurse honored his refusal for some time. When she saw me on this particular visit, this nurse was in a great deal of sympathetic pain over this man’s grief. She didn’t seek help for him but for herself. I ministered to her guilt and pain. Then I visited the man who didn’t want to see the chaplain.

He told me what he told the nurse. I said, “I’m not here because you need religion. I’m here because you’re hurting. When you hurt, I hurt. Perhaps we can help each other through this?” The man talked over an hour of his pain — the pain of impending loss; and, the pain of some older, deeper losses. The most significant of those was the loss of faith in religion. I visited this man daily until his wife died. He asked a lot of questions: “Why?” seemed to start many of them. We don’t have the answer to why we die. We do know loss is painful and we’re willing to enter into someone’s pain with them. But we can’t do that if in the chart it says: “Does not want to see chaplain.”

You said, “Most, if not all, patients have a set of beliefs that inform their attitudes and behaviors.” And, that “belief system … may be influencing their illness or recovery.” I take a stronger position because it informs my initiative in providing spiritual/emotional care. For me, knowing that some system exists for the patient means that I can’t ask a simple faith question and walk away when faith is denied. But for those without training, the simple questions seem to fit – on the surface.

You said, “Faith … can foster hope, acceptance, serenity and peace. However, the lack of a healthy spirituality, belief system or worldview can lead to hopelessness, despair, suicide, fear, and abuse.” What if religion, or a religious figure, or what religion represents to a patient, are part of their basis for hopelessness, lack of self-worth, lack of self-esteem, etc.? Asking a simple question: “Do you have a faith tradition?” can bring up issues of judgment, criticism, and deep angst. If a patient was once part of a tradition that equates sin with non-practice, the question “Are you active in the practice of your faith (Do you attend church/temple/ashram)?” will put them off immediately.

Then there’s the issue of the physician, staff or patient who are atheists. Our facility in Colorado tried questions similar to yours to gather data on the spiritual and emotional needs of their patients. The questions passed the review of the Department of Spiritual Care, various other committees and administration. Within weeks of starting the survey, staff who felt uncomfortable and staff who ran into vocal patients who were uncomfortable with these questions caused enough commotion to result in a suspension of the survey. Certain patients, staff, and physicians who were not practicing any religious tradition felt criticized or put upon by such questions. True, they were in a very small minority, but they must be valued as well as the majority.

In the current atmosphere of political correctness, we can either be frustrated at the hurdles we must jump to help others or we can look at why we are asking the question and formulate a better one. The rule of thumb for physicians is “First, do no harm.” If we are looking to relieve pain, we cannot accept even minor instances of causing pain.
I try to teach our staff to observe and, if they are willing, state the obvious and ask about it. For example, “You look anxious. What’s that about?” If staff members are not willing to ask, they are to call the chaplain. So many things are important in identifying our emotional state of mind. Reading and using the body can go a long way toward dealing with illness. There is more, but I’m over my time limit now.

The professional chaplain is a key part to any healthcare team. I applaud your efforts at making clinicians aware of the spiritual aspect of physical healing. Much success to you and your efforts.
Sincerely,
Rev. James D. Ek
Chaplain and SIT Resident
Banner Thunderbird Medical Center

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Responses to Dr. Diane Bridges Creating Multifaith Resources article (PlainViews, 6/16/2004, Vol. 1, No. 10)

Thank you so much to all those who requested Trillium's multi faith manual.It was an overwhelming response and we thoroughly enjoyed the correspondence and the learning. I am hoping to engage further with you in terms of ideas or suggestions for improvement. Has the manual proved to be helpful? Have you suggestions that we could share re more cultural content? I would be happy to add extra information if it is substantial as I am in the process of going to print again. It is probably too early to evaluate the usefullness but i hope to keep in touch via e-mail. I am most heartened
by requests from the east to the west coast as well as Australia. Thanks also to Martha Jacobs and Nicole La Rosa for all their help. God bless.

Diane Bridges
Trillium Health Centre
Mississauga
Ontario, Canada

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Responses to Chaplain David Plummer’s Evangelical Chaplain article (PlainViews, 5/19/2004, Vol. 1, No. 8)
A comment on Dave Plummer's recent article It seems to me that evangelical ministers and Chaplains dificulty with the ministry in the hosptial, do not grasp a simple contextual issue. Hospitals are not churches. Chaplains do ministry in the hosptial as part of the treatment team; not to get new members to their church . We have many Chaplains that still try to bring a community church identity context function to the modern hospital chaplaincy. As long as we professional chaplains and professional chaplaincy orgasnizations refuse to recognize and speak out for clinically trained chaplaincy being a different contextual function we will continue to be plagued with role and identity confusion.

Larry Austin
Greenville, NC

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I can’t thank you enough for allowing me to have had a voice in this forum. I thoroughly appreciated being able to say “publicly” that which has been troublesome to me for so long. While I have enjoyed receiving PlainViews, I always read it to just keep abreast of what is out there. I, being Jewish, never felt that I would ever have reason to join in on your site.

However, this topic was written for me and I thank you for printing Dr. Plummer’s article and accepting my response. Having said my piece, a great weight has been lifted from me. Thank you.

Most sincerely,
B’shalom,
Laurie Dinerstein-Kurs
Chaplain, Jewish Federation

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I have not read Chaplain David Plummer's Evangelical Chaplains article although seeing some of the responses in the 6/16/2004 issue of PlainViews, I am inspired to. I take note of Chaplain Laurie Dinerstein's concerns about "intolerance" with evangelical students. I can well imagine what some of these expressions of 'intolerance' might be, and how they could be experienced as judgemental, presumtive or worse. However, I also have a concern about "the other side of the fence." My own experience in Clinical Pastoral Education, (14 plus units and working in a hospital with a large CPE training program,) is that, coming out of the more liberal religious tradition as it has, there is in CPE also a signficant danger of "intolerance" towards evangelicals, not to mention those considered 'fundementalists" in different faith traditions. If there is to be any kind of dialogue at all, people have to be accepted where they are, or else we must simply give up any hope of exchange or dialogue or mutual appreciation. I can think of no better place to even begin enabling such "dialogueing" than in a CPE program. The very focus on process, relationships, and healthy and respectful ground rules for communication makes it a potentially optimal environment for people of different traditions and even strongly held beliefs to begin to listen to eachother. It does concern me that if people are put in the evangelical or fundementalist "camp" they are "ruled out" as people we can relate to. Can't this be a reverse kind of intolerance? Do people have to agree or approve of us, our beliefs or our behavior for us to be open to dialoguing with them? I am in the process of thinking through these things myself so I am raising the questions.

Chaplain Donald E. Moore

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Responses to Rabbi Shira Stern and Dr. Tamar Earnest, Why G-d? (PlainViews, 4/7/2004, Vol. 1, No. 5)

I am having a lot of trouble with your editorial policy of referring to God as "G-d." Every time I see it, I hear a blasphemous expletive that, of course, I can't write in this posting and hardly want to say. Inclusiveness aside, it does not honor the Creator to have me think of this every time I read it. Maybe I ought to just get over it, but maybe others make this unfortunate association also. I'm asking you to restore God to our discussions.

Steve Norcross
Director of Pastoral Services
William Temple House
Portland, Oregon

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Chaplain Wannabee Seeks Healing
After walking away from 16 successful years in the public sector, after the investment of time, effort and resources in an
M. Div. and five units of Clinical Pastoral Education, I find myself unable after 5 months of searching to even get a single interview for a chaplain position. With only 2 months of unemployment remaining I am facing a hopeless future of multiple minimum wage paying jobs at fast food and mass merchandisers. In classic CPE tradition I have to reflect and ask: What the heck happened? The best that I’ve been able to come up with are the following answers:

G-d does not exist. Waiting patiently for G-d to act is on par with Linus waiting for the Great Pumpkin to appear.

The notion of G-d “calling” a person to ministry is misguided, i.e. the Deists are right after all.

G-d does indeed act and call people to ministry, however, the will of G-d may be thwarted by human conditions and actions. G-d wants, but G-d can’t necessarily get (or if you prefer, G-d chooses to not get.)

G-d does indeed act and call people to ministry, and provides the means for this ministry to be exercised. This may mean that service to G-d is limited to a particular place and time (think Jonah here). People are used and once their use is exhausted, thrown away like Kleenex.

G-d does indeed act and call people to ministry, and provides the means for this ministry to be exercised. People may make the mistake of believing that they are being called. Maybe I was never meant to be a chaplain. Maybe I failed to discern along with all of my seminary professors, peers, colleagues, and supervisors.

G-d does indeed act and call people to ministry, and provides the means for this ministry to be exercised. G-d may though, have some people endure a dark night of the soul as some kind of cruel test. This to me is terrifying for what hope is there for anyone if G-d routinely acts in the manner of a schoolyard bully?

I hope that these words will make some readers think about what they believe. I also hope that through reader response/feedback, I will be able to formulate some understanding and acceptance of what I’ve gone through, i.e. that I will benefit from the healing ministry that chaplains offer to the wounded.

John Less

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Responses to Chaplain Dick Millspaugh (PlainViews, 6/2/2004, Vol. 1, No. 9)

That was an interesting article that Chaplain Dick Millspaugh wrote on his experience of the initial verbal communication with his patients. One thing I notice about chaplains is our own individual style that works for us when dealing with patients.

The style that I use is a little different. I minister in Jamaica Hospital, Queens, New York in the intensive care unit. Sometimes the patient is aware of what is going on, but most of the time I am talking to the family members. When I walk into the room I use to say, "Hello, my name is Deborah Heard, the chaplain for the hospital." In many cases, the next response was, "What is a chaplain." Then I found myself explaining what a chaplain was. I decided to change that approach. I now use "Hello, my name is Deborah Heard, chaplain for the hospital, and I came by to see how you were feeling." Using this approach (1) connects the term "chaplain" with concern for the person; and (2) I immediately see the change in facial expression, one of relief, after the introduction. It immediately opens up the communication between the patient and/or family and me. So there are many interesting, inventive ways to have that initial verbal contact.

Chaplain Deborah Heard
Jamaica Hospital,
Queens, NY

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In response to Chaplain Dick Millspaugh's "Communication--A First Impression," it is often the simple things that can make the greatest difference. Since reading Chaplain Millspaugh's suggestion to identify yourself when entering a patient's room with the second person possessive form, as in "Hello, I'm your chaplain ...," I have noticed a few significant changes in my pastoral encounters. Not only does it provide a fuller and deeper sense of my own pastoral identity, but it also invites the patient or family member into both a more personal and professional relationship right from the start. Also, by noting the reaction of the patient, both verbally and non-verbally, a door is opened for beginning the spiritual assessment. Thanks Chaplain Millspaugh for this very simple, helpful and direct way to begin a pastoral exchange.

Mark LaRocca-Pitts, MDiv, PhD
Staff Chaplain Athens Regional Medical Center
Georgia

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Responses to Chaplain Lerrill White’s Defining Advocacy (PlainViews, 6/2/2004, Vol. 1, No. 9)

Dear PlainViews- Another great advocacy article. Thanks. Below is a letter to the editor of a local newspaper from one of our APC Advocacy Chairs. Not only does advocacy address public issues, but it also speaks to clarity of chaplaincy and for a healthy understanding of chaplaincy.
Dick Cathell
Chair for the Commission on Advocacy, APC.

Dick,
I thought you might like to see the "letter to the editor" I submitted to the Charleston (SC) Post and Courier last week in response to an AP story about a hospice chaplain in Colorado. The story gave the impression that all chaplains do is give care to the dying, perpetuating the myth that the only time you need a chaplain is when someone is at death's door. My letter was published on May 26.

Best regards,
Chaplain Bruce Jayne, BCC
State Advocacy Chair, SC

Editor
The Post and Courier

The article “Chaplains Prepare Dying for Final Journey” in Sunday’s paper perpetuates a misperception about the kind of care chaplains provide. Many people think that the only time a chaplain is needed is when a patient is near death. Although the focus of a hospice chaplain’s ministry may be related to the dying process, the chaplain is also working with the patient and family to help them find meaning for their lives in their relationships with each other and with their G-d. And in the case of chaplains in hospitals, nursing homes and other institutions their professional and theological training has equipped them to guide people through a search for meaning in the crisis points of their lives, brought on by illness, relationship difficulties, grief, guilt and a host of other factors, which may or may not include end of life issues. They do this by empathetic listening, encouraging people to tell their stories, to reflect on and learn from their own experiences, and by helping them to access their own spiritual resources for support. In short, professional chaplaincy offers a wide-ranging array of spiritual care tailored to the needs of people who are struggling with a variety of issues. The role of the chaplain includes, but is definitely not limited to, giving comfort to the dying.

Rev. Bruce Jayne, BCC
Director of Pastoral Care
Roper St. Francis HealthCare
State Advocacy Chair
Association of Professional Chaplains

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Responses to Chaplain David Plummer’s Evangelical Chaplain article (PlainViews, 5/19/2004, Vol. 1, No. 8)

I hesitated to respond to this site last time, but the topic presented was too close to me to allow me to ignore it. I also thought that once I hit the “send” key, the whole issue would be behind me. OOPS! Not so. Not after I have had the opportunity to read some of the replies to Dr. Plummer’s words.

There is no room here to explore every issue, so let me be succinct and merely respond to one letter, written by Mr. Emanuel Williams. I also went through CPE…and CPE for me was a hell on earth. I had to endure such intolerance that I often wondered to myself, if these seminary students are the chaplains of tomorrow – G-D help us all. If the supervisor’s can be so insensitive to what is going on, how can I hold the student’s accountable?

Recently, an article in the Journal of Pastoral Care and Counseling spoke to just one of the many issues that are touched by evangelicalism. LANGUAGE. I could have been sitting in a class of Russian students and understood as much (I don’t speak Russian).

So ingrained in “their” life are their ideals, philosophies, enthusiasm and language, that it didn’t leave much room for those of us (me) who were not familiar with their expressions, ideas or beliefs.

The tendency to be less than tolerant and open was, in my CPE experience, tolerated from day one. So while I totally and wholeheartedly agree with Dr, Plummer that working chaplains should not be missionaries on a mission when they are acting as chaplains, I am also a bit dismayed by the words of Mr. Emanuel Williams, (amongst others) who, because of his personal ethics and views almost discounted that there are MANY out there who are not being ethical and tolerant. And “new” ones are being turned out every day.

My reason for mentioning this is that the problem has to be fixed at its source – CPE.
Either we train through special sensitivity courses to CPE students to overcome their OWN needs to evangelize and to better meet the needs of the patient, or we will just be cranking out many more (hopefully not many - but, how many more would be acceptable?)

Laurie Dinerstein-Kurs
Chaplain, Jewish Federation

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In regard to June 2, 2004 Issue of Plain Views on questions of Evangelization:
I can feel the perplexity and pain Rev. Steven Heintz and also the pain and anger of Chaplain Laurie Dinerstein-Kurs regarding their experiences. I think the problem is not really spiritual or even religious, but rather intellectual. There was a quote from
Ladislaus Boros, SJ that I once read and it went something like this, "It is rather strange and presumptive and elitist that we can feel assured of our salvation and not assured of our neighbor's salvation!" I also want to add that the question goes both ways;
that is, I once had a patient jump out of bed and then pray over me that the Holy Spirit might come upon me!

John P. Stangle
Certified Chaplain Emeritus, NACC

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TalkBack response to John Stangle
In response to John Stangle's question about the prophetic role (my term) of chaplains in institutional work, the short answer is that chaplains do not often "bite the hand that feeds them." I first became aware of this as a new chaplain when I read a study Edward Thornton did in the 60's out of Crozier/Colgate/Rochester Seminary with institutional chaplains, raising this very issue. The chaplains Thornton worked with were very reluctant to engage in ethical/moral issues which might threaten their jobs. Similar to pastors in the 60's who were threatened over their openness to integration. In my own situation, I have been a part of three chaplaincy staffs at two state hospitals and a VA medial center. When issues come up, it is a difficult choice to make. We saw ourselves as pastors, not prophets, but some situations called for a prophetic intervention, such as Nathan & David. Chaplains have endangered their positions by taking stands on issues as advocates for ethical behavior. Wish it were not so. I had one superintendent who told me he wanted me to be the conscience of the institution and to be free to challenge any behavior I deemed unethical or immoral. This was in the early 70's, and I moved to another state, another position, and have never been asked to function in that way again.

Vance Davis

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I have some questions that I'd like to hear responses to and to learn how others have approached these questions. How do Chaplains deal with the conflict (if any) between having, keeping, and doing a job in an institutional setting and "prophetic voice" type issues? Do most Chaplains feel free to voice their opinions and make suggestions about both local and international issues that seem important? Do Chaplains even have time and energy to deal with other than the most immediate concerns?

Chaplain John Stangle
Certified Chaplain Emeritus, NACC