Embodying Love and Hope – The Chaplain’s Calling

Today is the last day of eight and a half years working as an NHS chaplain. I began what you might call my career at the age of twenty-five when I was ordained deacon in the Church of England’s Durham diocese, and, with short breaks for study or illness, I have been doing a variety of jobs as a priest since then. Much of that was as a parish priest in a variety of settings, but I have also had a number of roles which have involved being an educator, a community activist, a development worker, a chaplain, and a manager. This last period has been an intense exposure to people at some of the most vulnerable times of their lives. Indeed, a good deal of it has been about accompanying people who are saying goodbye to life, or are watching someone they love die, or supporting people who are just coping with the immediate aftermath of a loved one’s death.

The unique aspect of a chaplain’s role is that they are called and paid to be present for people, in whatever way those people find most helpful, as they process whatever it is they are living through now. Unlike clergy in other contexts, NHS chaplains, whatever their faith background, take a self-denying ordinance of non-proselytisation. We never seek to convert or convince or even influence others into seeing the world the way we do. We try to stand alongside the person we are with and let them disclose to us what it feels like to be where they are. We support them as they articulate the questions that their present condition raises for them. What we offer them is unconditional loving human regard and attention, what some might call compassionate concern.

In its best form, this is a regard that helps others open up about what is happening to them, or to the person they are concerned for. It can help bring into the light of day questions that may seem to hard to name, or long-buried regrets or anxieties. Those explorations are often accompanied by tears – of regret, of relief, of sorrow, and sometimes of joy and acceptance too. It may, in the form in which NHS chaplains exercise it, be an encounter that happens just once, or it may be part of a series of visits over the course of a period of treatment. Shorter hospital stays and fewer inpatient visits mean that chaplaincy is challenged to think creatively about how this care can continue to be available in an ever-changing health service.  The future is going to be configured very differently to the service that is there today, let alone that of yesteryear’s models.

In a changed society chaplaincy is also there for people whatever their background of affiliation, belief or non-belief. Amongst all the fluctuations of our world, the fluctuations in religious or spiritual commitment are enormous, and hard to quantify. Some have never found any need for or attraction in religion. Some have left religion for atheism, as a conscious ideological choice, but many more have left religion for other less clearly defined reasons. For some people their spiritual assumptions form part of a background to their lives that is rarely used and never tested until a crisis strikes. Other people experiment with an eclectic mix of beliefs and practices that focus around a this life spirituality. Faiths and philosophies are present through migration on our doorsteps as they never were a generation ago, with their adherents across generations finding that their relationship with their faith background are as complex as that of the formerly Christian population. Chaplains never know what they may find when asked to see someone – we wait for them to tell us what are their concerns, and how they are thinking about them.

Nevertheless, one of the things that forms part of the code of practice of the profession is that chaplains should attend to their own spiritual life and health, from whatever tradition and faith they come. There is something that chaplains carry, and it is understood to be something they gain from their participation in whatever faith they profess, that gives them the strength to do what is not easy work. It is not at all unusual to be told by people you meet, when you have explained something of what you do, that they think they could never do that. I know that it does sometimes require considerable courage to stay in the presence of suffering; it is not at all easy to watch and wait with people who are nearing the end of their lives. The clinicians have the task of doing things to try and make the situation easier; but when the medicine has been administered, the dressings changed, the patient turned and all is done – then the chaplain’s work begins.

I believe that what we bring, though it may never be named, is love and hope. Our humanity is stripped bare by our mortality. Who we were, good or bad, lies in the past. We are now just ourselves, facing our end. Who will love us? All of us, I guess, hope that when our end comes there will be people from our past, our relations, children, friends, who will love us through to the end. But what if there aren’t? I have sat by the bed of those who apparently have no one in the world to love them as they come to their end. I know that my muddled life is no justification for love – I have my regrets and missteps and follies. It is not about what people deserve. But I know I will always need love, and sat by someone else’s death bed, I know they do too. So that is what I try and do as I look at their face and give them my attention.

I also carry with me hope. Whatever faith I represent, I suspect that chaplains may be more important for this quality than almost any other. It may not be vocalised at all . But I know I believe that all will be well, and all will be well, and all manner of thing shall be well. I know why I believe that too. I don’t have to explain it, or defend it, or promote it. I just have to embody it for the people I am with when I act as a chaplain. I hold it for myself and for them when the hand I am holding lets go its hold on this life.

Now I am going to stop doing this in the form I have been doing it. I am stopping because I don’t have the strength to continue to do it. I look forward to going to say farewell to some of my esteemed colleagues who will carry on the work. I don’t think I will stop doing the things that chaplains and priests do, though I am stepping out into a future where I have no official role in that sense. I will continue to stir up the gift that is in me as far as I am able, and we will see what opens up.

Managing Pain

This is not about the usual subject. It is about real pain. I have had trouble with my spine since I was a teenager. Since the age of twenty or so, I have self-managed, with GP support, what I suppose is best described as moderate to severe chronic lower back pain. This was joined by neck pain, mild at first, then much more serious after an accident on holiday in 2011. Most of the time I just get on with life. I know what I can do, and what I can not do. When things are bad I have a raft of medications at my disposal, most of which would reduce people who were not used to them to sedated stupefaction. But as I am getting older and things are getting noticeably worse, I thought I needed to know what was the state of play. In other words, I was starting to feel that this was all getting beyond my own capacity to manage by myself. I needed some help.
So this morning I went to a local clinic for an appointment with a Pain Management specialist. It was, without question, the best NHS referral consultation I can ever remember. I saw Dr Thomas Keane, a Pain Specialist from Sherwood Forest Hospitals. Remember that name. Dr Keane was brilliant.
He couldn’t have been better. I was treated with dignity, like an intelligent human being. He understood my history (long and boring except to me) and seemed to appreciate what the things I cope with do to me. He checked me over, and talked about a management plan. I nearly swooned – no one has EVER talked like that to me. He was cheerful and clear and pleasant, and did not sugarcoat the reality that some treatments may have considerable risk factors Now I will go for an MRI scan for the lower back (the neck had one not that long ago) and then we will see where we go next.
It wasn’t wizzy new medicine that made it so good. Apart from his eyes and hands and one of those mallet thingys that test your reflexes, Dr Keane used no equipment. He had summaries of previous investigations to go on – but not the full reports. He is now sending for those. With his history-taking and his observations and the relatively modest proposals for the way forward, he gave me new hope that I can find some support in managing this side of my life.
The things that made this such a first-class experience were things that cost nothing. It was his demeanour. It was the fact that he seemed to be on my wavelength as far as what this does to me. It was that he indicated that there were things that can be done to try and help. No guarantees, of course, but I understand that. It was that I left his consulting room feeling supported, heard, encouraged, and knowing that this person was going to work with me in the future. It was that I didn’t leave feeling like a case, but like a person.
You can’t ask for more. And because it was in a local clinic it was nearer to home, the wait was shorter, and the follow up and first-line treatments can also be done in similar clinic settings. Not one hospital appointment, except for the scan. This is the way of the future. Thank you, Sherwood Forest Hospitals and thank you, Dr Keane.